For optimum financial assistance in GA, which is best, Medicare or Medicaid?

Yes, what isthisreal said. I haven't worked at this particular place for 17 yrs but there was a woman who had to retire because her Mom needed care. She went to SS and asked how much she would get, $600. When she came back to work I felt something was wrong. I asked had she been married, she said yes over 20yrs and widowed. Married over 10 ten years and divorced. She was never asked these questions. So she went back and told SS what she told me and she got $200 more.

With her low income and assets she is probably eligible for SSI, Supplemental Security Income, which you apply for thru the Social Security Administration. It could supplement her low SS to bring her total gross income to $783 (the 2020 limit). Figure out if she already has Medicare. ( Many low income don't because they think they can't afford the premium. They turn it down.) Then with either your state or local welfare agency (it varies state to state) apply for the Medicare Savings Program (MSP). The state then pays the Medicare premium and the late signup penalties, and her deductible and co-pays (except for meds). There are different levels of MSP depending on income, but her income would qualify her for the most benefits. At the same time with the state or local agency apply for Medicaid. Then find out what Medicaid programs are available in the state for the kind of care necessary for her anticipated future needs. Medicaid pays for those specialized care needs, not Medicare. The hardest part of all this is dealing with Social Security on behalf of someone else. They won't talk to anyone else except the recipient. Try doing it online.

Steeley, if she can give social security consent to speak with you they should be able to tell you what she is signed up for as far as Medicare is concerned.

You can also look at the annual 1099 and notice of benefits. They both show if Medicare is being withheld from her check.

She should also be eligible to get part or all (questionable how that works) her deceased spouses SS. If she was married more than once, ask social security to check which spouse's account would provide the most money. Make sure that getting an increase of her social security doesn't disqualify her from getting Medicaid.

Medicare and Medicaid are not a one or the other, 2 entirely different programs. They work completely different and pay for different services.

My 1st phone calls would be to Social Security Administration to find out what is happening with Medicare and HHSD Health and Human Services Department of her county to find out what the Medicaid maximum monthly income is to qualify for services. You want to know this so you don't inadvertently do anything to disqualify her. At 500.00 monthly she will qualify for assistance, each state is different, so you will have to find out how to get her the care she needs in her local.

Best of luck finding her the best care possible. Be patient with these phone calls, dealing with the bureaucracy of government programs is trying, but you can get lots of help by being kind and patient even when you want to cry because of the rude assistant, they make notes about the phone calls.

Georgia has multiple Medicaid waiver programs that will pay for assisted living. They also have a community care services program that will provide services to those who want to remain at home.

Steeley,

How does she pay for her Dr. visits and medications? Or is she on no medications and never sees a Dr?

Barb, not sure about automatically signed up. It was automatic for DH and I because we drew our SS at 62. If you aren't on SS at 65, then I think you have to apply for Medicare.

Steeley, there are penalties for not taking Medicare at 65. I think allowances are made for people who have continued to work and employers are paying for health insurance. Medicare does not pay for ALs , MCs or NHs. Its a health insurance.

As said, Medicaid does provide health insurance and Long term care in NH. Rarely does it pay for MC or an AL. In my state you have to privately pay for at least 2 yrs to maybe get Medicaid to pay for an AL or MC.

If MIL is not on Medicare, how does her doctor, prescriptions and hospital bills get paid? Did she work, did her husband work and if so, for how long? When husband passed, did she see SS concerning an adjustment in her payment? She should have received his portion and hers would have dropped. (This is what I was told and have seen but there are people on the forum that disagree with that)

To answer your question, since MIL has no money, Medicaid would be your option but they basically only cover NHs. You will need to see if wavers are given in ur State for ALs and MCs.

I suggest you talk to someone at your County Office of Aging. They maybe able to help u.

Are you sure she doesn't have Medicare?

Most people are automatically enrolled in Medicare part A at age 65. You have to sign up for Part B and a deduction is taken from your Social Security payment each month.

Medicare is a federal program that provides health coverage if you are 65+ or under 65 and have a disability, no matter your income. 

Medicaid is a state and federal program that provides health coverage if you have a very low income.

Medicaid doesn't always pay for AL but in some states it does, she'd need to check with social services for her county. Based on the info provided, she would very likely qualify for Medicaid for at least LTC or MC. Make sure what ever facility she chooses actually accepts Medicaid recipients and that there's no long waiting list for rooms. Medicaid means she will be in a shared room.