aannie Asked August 2020

My mother is in assisted living. Her Alzheimer’s is getting worse and she's out of money. She doesn’t qualify for Medicaid. What do I do?

My mother has no assets, nothing left but her social security and VA payments she gets. She’s just short of qualifying for Medicaid. The qualification limit is $2,349 and her income is $2,457! Her monthly expenses come to $4,823 each month.

Her Alzheimer's is at the stage where she is paranoid, aggressive and aggravated most of the time.

My mother is 96 and physically healthy.

Part of her problem is she’s been spitting out her pills because she thinks they are trying to poison her!

Of course, most of those pills are to calm her emotional state, so they brought in Hospice Palliative Care to be a part of her care now. The goal is to find a way to administer her meds to make sure she’s getting them in her. Temporarily they are using injections and creams to try to get her back to the point she was just two months ago when she was mostly calm and happy. Recently she’s been going into rages and she slapped two nurses! That is not my mom. She wouldn’t do that in her right mind.

Anyway, she needs much more additional care and at the same time she’s out of money. The last of our resources was cashing in her life insurance policies.

So now she can only afford half of the cost to stay there. I’ve exhausted my research resources trying to find financial help. Up until just a few weeks ago Medicaid allowed subtracting a quarter of the VA money as “non-income“ which would have let her qualify. The government just took that option away. This has been their policy for at least a few years if not more, because I checked on all this a year ago so I wasn’t worried about her qualifying.

The Medicaid person I spoke with said they were all shocked when this order came through a few weeks ago. They have many people on Medicaid who use that system. So....I’m stressed to the hilt...she only has one more month she can pay and I don’t know what to do.

My mother must be in a facility with 24 hour care. Living with me would not be possible.

She lived with me for 7 years before Assisted Living.

Have any of you gone through not qualifying and desperately needing financial help? If so, what did you do?

I appreciate any comments and info.

thank you.

43 Answers

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You have been missinformed. You need to contact the Medicaid office regarding getting your mother into a skilled nursing facility and applying for Medicaid. Most facilities will be able to help you with the application. Eventhough your mother's income may be over the income "limit", that doesn't mean she doesn't qualify. Medicaid will require you to do an Income Trust/Miller Trust document and there is a process involved with maintaining the account. You also need more information regarding how VA is treated when applying for Medicaid. The VA benefit usually consists of VA Pension and Aid & Attendance. When applying for Medicaid, the A&A portion of the monthly benefit is not considered "income" by Medicaid - but the pension portion is and will need to be paid to the facility while waiting for the Medicaid application to be approved. Once approved, you are required to notify the VA and eventually the entire benefit will be reduced to $90 - which your mother will be able to keep each month, in addition to her monthly allowance ($30 in SC). Again, I would recommend that you seek help in this matter and be careful not to take advice from people who don't know what they are talking about - when it comes to getting your mother the care she needs.

Helpful Answer (23)

I just spoke with my elder care attorney about this same situation yesterday and he confirmed what was stated above.

(5)

I just wanted to say that I'm disgusted, living in the richest country in the world, that we have beg, borrow and steal to take care of our elders. Shameful.

Helpful Answer (14)

Also feels like we have to do that for ourselves because if you’re a primary caretaker of both parents and your in your 40-50’s you can’t get health insurance at a decent
rate. Health care shouldn’t financially cripple us or make us choose worse conditions for our aging parents.

(4)

The first thing to keep in mind is you do not have to take her home. In other words do not let the facility discharge her to you. They cannot do it. It is unsafe and unethical. They must find an appropriate facility if they choose not to care for her anymore. Now, on to qualifying for Medicaid. What you need to do is set up a Miller Trust where the excess money over the state limit is deposited. I would see an attorney to do it. Some choose to do it themselves, but I would have an attorney set it up. She can qualify for LTC Medicaid. Then, if the facility she's in now doesn't have a bed, she'd have to transfer to a SNF that does. But you do not take her home, the facility she is in should help you find another location for Mom.

Helpful Answer (9)

I don't think ALs are under the same laws as a LTC facility. You lease your room. You pay rent. Even my daughter, who works in a hospital, says hospitals can do an unsafe discharge. LTC facilities cannot do an unsafe discharge.

I don't think an AL is obliged to help you find another place. Moms had no SW. These places are businesses. Our local one lost their accreditation with Medicaid and the families of those residents receiving it had to scurry to find other facilities.

(1)

Find the best elder care lawyer. Use her money to pay the lawyer...never pay out of your pocket....... she'll have to spend down her money to qualify for medicaid. You can just refuse to take her home....very hard to care for someone with dementia....I've done it.... horrible disease to see a loved one suffer like that...

Helpful Answer (8)

Her monthly income is too high to qualify, not how much she has in the bank! Big difference.

(6)

She can have a high share of cost and be on medicaid. The V.A. resourses may be there. If a medicaid elgability is a issue...always have in the plan to "return home" even if will never happen (if there is a house involved). Hospice is involved and they deal with behavior. Be sure you are not trying to "hang on to" her resourses.
Medicare pays for hospice.

Helpful Answer (7)

Have you reached out to an eldercare attorney? Dont go by what your state Medicaid offices tell you, a good eldercare attorney can find a way most of the time

Helpful Answer (7)

Aanie; where is mom living right now? Is she in her own home or in a facility?

If this is a sudden change of mental status, has she been tested for a UTI, which can cause psychiatric symptoms?

yes, you need an eldercare attorney who understands Medicaid in her state.

Helpful Answer (6)

Sounds like you have not been talking to the right people.
See an Elder Care Attorney and he will stear you in the right
direction. Their are all kinds of legal ways your mother can
qualify for assistance even though it may appear she does
not qualify. Take someone you trust when you visit the lawyer.

Pay the attorney, Believe me you will get back more than you
pay him. He knows the legal ways to get people qualified. Their
are always exceptions to the general rules.

Helpful Answer (6)

I am so sorry that you are going through this stress! We found a solution to my mom spitting out her pills - we grind them up twice a day (pill grinder from CVS or Walgreens) and mix them with a tiny bit of CBD honey and put them in a croissant or cookie. She sees what we are doing, and still willingly takes the "treat". We have 1 pill that was recently added at night that can not be crushed, so we have to talke her into swallowing it first before getting her "treat". So far it is working.

Helpful Answer (5)

My mother's income was just a bit to high for her to qualify for community Medicaid. I set her up with a Medicaid spend down. I just had to produce expenses each month that brought her income down to the Medicaid level. I could use the cost of her health insurance supplement, medical bills and any Part D copays and her depends and pads, kleenex and over the counter vitamins and even her tylenol. Once she qualified she was eligible for lower copays for her medications and even to have her Part D insurance paid for. The assisted living that she was living in even charged a lower amount based on her income. Once she qualified for a Nursing Home the application for Chronic care was easy since I had everything together from applying for community care. Just know you need 5 years of back bank statements for Chronic care. Your local Office of Aging can help you with the application.

Helpful Answer (5)

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My mother is in assisted living. Her Alzheimer’s is getting worse and she's out of money. She doesn’t qualify for Medicaid. What do I do?

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