My mom and dad live at home in Algonac MI. My dad just got out of rehab after receiving a pacemaker and my mother has Alzheimers. They do not qualify for Medicaid since their income is about $6000 over the amount Medicaid says is the limit for a couple. So how do we pay for home care with no assets to sell? House is in reverse mortgage. The car still has payments but could sell it. My parents just do not have the money to pay for care and expenses and neither do us three kids.
MY Question: Can a lawyer overturn the Medicaid decision in this situation? And where do we get funds from organizations etc. to cover their costs? Area on Aging did not have an answer for us either, so please tell me there is something out there for my parents to live.
Thank you
Susan
9 Answers
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There must be equity in the home. That equity when sold can be used for their care in a facility, less the balance of the reverse mortgage, of course.
Michigan law on Medicaid is very different from other states, see an elder law attorney on how best to proceed in folks best interest.
Facility living is much less expensive than home care. It may be necessary to explore facility living for them both.
A lawyer can appeal a Medicaid decision which will be reconsidered but not necessarily overturned.
RM take 2 paths for distribution:
- line of credit which the property owner can draw from at will. LOC usually have lower RM interest rates but fees tacked on each time you move any $. Whether or not LOC is an asset depends on the RM contact & 2 paths for this seem to be:
..... If it’s not considered “drawn” till actually done from according to contract, then it’s not an asset. So in theory you could have a RM with 100k that you just leave sitting there till it’s an emergency. If they die, & no $ drawn, the RM is just whatever fees & interest on the loan. Some old old before meltdown were this style. Rare.
..... But if it’s a totally in favor of RM type of contract then it is considered an asset in full from day 1 for the LOC RM. whether you take 10k now & leave 90 in the LOC, doesnt matter. It’s all an asset, it’s your debt in full & however RM contract is done.
There was a poster couple of years back who’s mom had like 150k LOC left & she had to draw all of it and use for spend down by Medicaid rules but the RM required $ used first & foremost on property stuff (in arrears taxes & repairs) the dPOA daughter was so over dealing with NH mom & contractors and all on a time bomb to mesh & synch.
- annuity style RM, so get a set amount of $ for a set max period of time based on $ amount RM is. Higher interest rate. For these as it’s monthly distribution (like an annuity but for RM it’s tied to securitized property as collateral not pension $ or insurance $ like other annuities can be) it’s monthly income.
That’s my understanding, devil is quite in the details! 👿
RM are so 1 sided. Between loan amount, interest and whatever fees the RM can tack on, there's not gonna be any equity when house finally gets sold.
Why not give the home to the RM, sell the rest of their assets and go to AL or MC? They are not going to be able to stay in their home much longer as it sounds like they have progressive diseases which will not improve & will need more care and supervision.
Otherwise as someone said, $6000 a month can pay for SOME in home care. They are not paying a mortgage. Sounds like they don’t need a car. What are they doing with that money?
They should use their assets to pay for their own care.
If it’s community based Medicaid (they both continue to live at home) that has more wiggle room for financials, both income AND assets.
OR
did they apply for LTC Medicaid for living in a facility? Either dad in a facility & mom at home as community spouse, or both in a facility.
LTC Medicaid is way more narrow for eligibility for income & assets.
Both types of Medicaid delineates between income (monthly $) & assets (savings, investments, home, car, anything that in theory can be cashed out). But community based Medicaid doesn’t use assets as a determinator for eligibility.
Income is SS$, a dividend or annuity paid, RM$, retirement paid.
For LTC Medicaid, income has to be under whatever MI has the maximum amount. Most states have this at $2150. But your state exact amount important.
For community based Medicaid, need to within lower income zone.
Assets like home or a (1) car is by&large exempt asset for lifetime for either type of Medicaid.
Assets max is 2k for individual LTC Medicaid & 3k for couples.
Don’t confuse income & assets, very different creatures.
community different than LTC, even tho’ both “MedicAID”. Applications probably look similar but huge eligibility differences.
if application was done when he was still post hospitalization & in rehab (which was paid by Medicare as a benefit for like first 20/21 days at 100%), it well could be that the LTC Medicaid program was applied for, but he’s ineligible as he’s now home
OR
it was community Medicaid applied for but application shows him being in a facility so ineligible.
Wrong box checked snafu. I’d look into this as a first as this should be simple fix with fresh correct application filed if so.
if that’s not it post what you find out might be the issue, ok. Good Luck!
If they have to much money saved, I would think that this falls under spend down. If it is money coming in monthly why don't they have enough to hire help?
Can you please clarify the information so that you can get better information. You can see from above how different the situation is depending on the facts.
A certified elder law attorney can be found at www.nelf.org and they can guide you on the rules for Michigan, which are completely different than any other state.
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