Mom and sister have just moved into an ALF together. Sister is on SSDI because of deformed feet but she can walk some, just not well, and not long distances. She will be helping mom with the simpler ADLs, keeping mom’s level of care cost down, and enabling mild/moderate dementia mom (for now) to stay in AL and not MC. The lower LOC cost balances the additional cost of the larger apartment for two.
My question: almost ALL of sister’s monthly SSDI check will go towards paying the “extra person fee” at the ALF. She will have less than $200 a month left for any of her own expenses.
I am having mom pay for things sister paid for while living with mom before, like cable, storage unit (mom will now share it since moving to the ALF) and particular snacks.
What small things can mom pay for for my sister that will not cause a problem during the Medicaid look-back period? I am not talking big expenses... Mom would always pay, for instance, when they went out for lunch or ice cream together. And mom insists that sister get her hair or nails done too when they go to the salon. Because that makes it fun! Again, not big expenses—the weekly shampoo and style is just $15 each.
Are reasonable birthday gifts ok? Christmas? How about small gifts like “I found a shirt you would love!” for no reason at all? I know some of this is ok, of course, but I cannot find any defined guidelines about how much is ok, and how much is too much. The articles hit the big stuff, like large monetary gifts, cars, and houses, but no real discussion about what might be problematic with small expenditures, when you aren’t actively trying to spend down.
Their spending overall is just so minimal.
Sister will need to carry her own car insurance, though she will be driving mom’s car (no car of her own) and using it almost exclusively for doctor appointments and necessary outings that serve both sister’s and mom’s needs. Sister can only drive short distances, and only drives when she has to. (Sister is happy to have her world be the ALF.) Can mom pay sister’s insurance, perhaps by adding sister to her own car insurance plan?
Because she is on SSDI, she is not allowed to “work”, so she cannot formally be paid as mom’s caregiver. She MAY be able to receive some gifted money from my mom monthly, but again, that might cause look-back issues later for mom.
Dad died a year ago, and tracking what was spent is tricky. I am trying to have my ducks in a row for the coming years just in case.
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Personally I think the caseworkers look for a pattern of spending in evaluating the lookback. Most elders are kinda still doing old school checks so looking at bank statements is done. It’s something that deviates from the pattern that gets “red flagged” to be inquired about from the caseworker to the applicant or their POA and a response in detail is needed in short order back to the caseworker. For example, my mom wrote checks out for car repair, BUT she did not write it out to XYZ Auto Repair but to the mechanic who owned the shop in his name, Joe Smith. Fortunately mom kept oodles of paperwork so I had the invoices from the mechanic and they were not small as time plus parts. Sent invoices over to the caseworker & all ok. But ya gotta have all this kind of stuff readily available and know where it is. The application cannot sit in limbo for weeks. It’s on a timeline…. a very narrow timeframe. Otherwise the application times out and deemed ineligible due to incomplete documentation. The threshold seems to be $500 for checks written out to an entity that seems questionable. It’s always best to write out checks to a business name rather than the individuals name if Medicaid is ever anticipated.
What they are looking for is something like my helping with Grandson's college expenses. Writing out a check for 5,000 several times during the year isn't OK with them. They don't want me paying his college, buying him a car, and then coming to the taxpayers with "I need help".
So you might want to consider a call to Medicare at 1-800-medicare and ask them what expenses are not OK for medicaid lookback, and what are. You will be on the phone waiting a long time, but they are ordinarily very kind when you get them.
Good luck. And just tell Mom not to be writing out checks in the 1,000s without checking first.
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