How to get reimbursement for dad's care without running afoul of Medicaid?

Imho, some caregivers do not ask for nor receive monetary reimbursement for their services. In my case, my late mother was on a poverty wage of $1,223/month. I performed pro bono care from out of state (had to leave my home and state). There was no money to be had as my mother still owned a home (think real estate taxes, utilities, et al).

I consulted an Elder Care Attorney. The consultation was for an hour or so. Cost $250. I prepared a lot of financial data before the meeting but it was worth the effort. Told me what I could do and not do in the state of Florida. A good investment.

You can't for the most part. It is commonly referred to as 'what your family does to help you'. If you have receipts for the medical supplies - then keep the receipts with the checking account info and write a check to each person who paid for those things. Highly unlikely that would be questioned with receipts provided. No receipts? Any payment to you will be questionable and more than likely considered as penalty amount.

As far as travel to visit or help him, that's on you. The average person does not charge their parent to visit.

If dad has money to question reimbursement, why didn't you use his money to pay for the medical supplies? Nursing home, down the road, will look at money he pays/gives to people for the past 5 years.

Keep receipts and use his checks or debit/credit card to pay for things he needs to avoid penalty days that Medicaid will not pay for. In Texas, it's a little over 300 per day considered as cost of NH. They total up what dad gave away and divide by that number to determine how many days of penalty. So if you take money from him now, you'll end up paying penalty days out of your pocket to keep him in the NH should his health require that kind of care.

I think it would be best to determine what state your Father is going to live in long term and then get in touch with a certified eldercare attorney who is well versed in the Medicaid rules in that state. Their initial consultation should not be too expensive as you are really just looking for information to get yo on the correct track.

We had an initial consultation with an elder law attorney. She informed us her fee for Medicaid paperwork would be $9,000. There is a very limited estate. My husband did it all for his aunt & since this situation is in the same state (Wyoming), we are trying to make sure we don’t make a costly mistake while receiving advice from an experienced nursing home social worker & an alliance for aging.

BestLife, the reinbursement is just a small part on your situation and I’m sure seeing hundreds of $ get spent in short order has you horrified, BUT I’d suggest you try to look at the bigger picture which will hinge on where dad is to live out the rest of his life. Ohio? or Florida?

Each state administers it’s Medicaid program uniquely but with oversite by the federal government via CMS (Centers for MediCARE and MedicAID). It’s not a nationwide eligibility like Medicare is. Ohio may not allow certain things that a FL Medicaid caseworker doesn’t even bother with. When your looking at elder law atty’s to represent your dad, please pls let them know that there will likely be paperwork out of his old State. Should he have any real FL assets, like home, land, autos, that will make a huge difference as to his being eligible for LTC Medicaid in Ohio.

As far as reimbursement for your travel, personally I do not see any reimbursements by dad to you or your bro for the costs being easily allowed. That was your choice to do and done out of a sense of familial responsibility. Your not under a court order to accompany him as you might be if you were a guardian or he was your ward. Dad could have paid for his own airline tickets, his Depends, clothing, a medical transport service, a CNA or wound care specialist to accompany him.

The Depends & wound care items, those you likely can be reimbursed for as long as you have an match up receipt. For the wound care stuff, find the discharge orders as they should indicate what type of wound care he needs and it’s frequency so you can show it was medically necessary and not just done for aesthetics, should you be asked. My Hubs got lymph infection post melanoma surgery so yes I know how pricey aerosol saline, Tegaderm patches etc are. The one positive is usually wound care is time limited as they do heal and your DIY’ing it so not driving to & spending hr + at a care center every day or so.

Medicaid expects dad to have living & health care costs. He should be paying for these things out of this monthly income / his assets. It’s important to do as he needs to get his assets down to get him impoverished to be “at need” financially for LTC Medicaid. Whomever is his old DPOA can help him to go online and buy things for his direct needs and gets paid by Dads CC or his debit card. His new atty needs to be one that is familiar with Medicaid compliance in his state. Often estate oriented elder law atty are not, so clearly ask.

Medicaid is very complex and varies in each state--see an eldercare attorney and set up a caregiver's contract. The travel expenses are not refundable. They may see it as vacation money. All insurances only cover ambulance or helicopter under life-threatening situations. Medicaid may cover some non-emergent transport, but he's not on that--but definitely not those kinds of distances.

If your dad pays for the trips they probably will see that as gifting.

Travel expenses are not reimbursed that I know of, if you mean your visits from out of state. Someone needs to be made financial POA so they can pay for supplies from Dad's accounts as his name, signed by POA as POA. Then these are costs that are paid by your father from your father's accounts for your father's needs. See an Elder Law Attorney with your father to do the POA (assuming your father is capable and mentally competent). Often a Lawyer will come to your Father's homes. Do not pay any medical bills out of your own money, and that way they will not be reimbursed to you. When he was in rehab the social workers could have assisted with your getting POA often enough, but for ow, if a family member is capable of doing this, then they should. Otherwise a Fiduciary should be hired to do this work, his bill paying, his cost of living and etc to assist him. Do know careful record keeping, receipts, folders need to be kept as POA. Your father can, of course, withdraw money from his bank ATM to reimburse small things, they simply cannot be in the thousands. People are expected to have costs of living. Your father will then have his own checkbook and his own checkkeeping records to explain what he spent money on. (One of those things cannot be your trips to see him).

Written, signed agreement of care specifying what services will be provided and the amount of pay for those services, usually an hourly rate. Supplies should come from any income your father has. Travel expenses for you are probably not allowed. As mentioned by other posters, keep a detailed paper trail. An elder care attorney or your local Area Agency on Aging can help.

Why are you paying for these things? Does he not get SS? A pension? I always reimbursed myself. Mom had Dads pension which she received in a check ea month of $200. As POA I was able to cash this check. I used this for her personal things. If I ran out of money and needed to use my credit card, I wrote myself a check out of her bank account once a month. I kept an envelope for her 200 and put the receipts in there. For the check, another envelope with the receipts and a number of the check used.

When Medicaid goes thru the 5 years of statements, they are looking for any large amounts being withdrawn and will ask what they were for. They never questioned the $100 or so check I wrote occasionally to myself for her supplies.

Now your travel expenses? That may be questioned. I really don't think your entitled to reimbursement. That is a choice on your part.

Thanks, I am looking for an elder care lawyer, I have a lot of the expenses on credit card so can easily track

Make sure you have a "paper trail" for every expenditure and it's corresponding reimbursement. What I did with my MIL's finances is that I kept the receipts related to her care and reimbursed myself for all supplies, item by item so that each check could easily be matched to each receipt. Travel expenses should be no different but I agree with 97ryoldmom that a consult with an elder law attorney is very advisable and money well spent (and should also be reimbursable). Medicaid differs by state so that's why it's important to consult an attorney that practices in the state where your LO currently lives.

It may be difficult. See a certified elder attorney who is well versed in Medicaid for Ohio if that is where you dad will live.
Use dads funds to pay for the attorney.
You don’t mention dementia so dad can still legally assign a DPOA if he hasn’t already done so. Discuss a care contract for brother or whoever will provide care. The attorney can advise you regarding the expenditures you have made.