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markevans999 Asked August 2023

When to apply for medicaid?

FIL is in rehab now. insurance runs out on Sept. 19th. Will be transferring to SNH on that date. Has about $14,000 in the bank which will last about 3 months. Nursing home costs about $9,500/month. When should I apply for medicaid, when he's down to $2,000 or sooner? He lives in South Carolina.

JoAnn29 Aug 2023
If your talking Medicare, those 100 days are not guaranteed. If Medicare feels he has hit a plateau, they will have him realeased. If he has been there longer than 20days, he now is paying 50% of the daily cost. If he has a really good suppliment they maybe paying that if not, he will be. That 14k only pays about a month of a NH. You need to start that application now. Do not use the NH to do it. Go directly to Medicaid and see what you need to have. I like being on top of things and don't trust a NH to do that job in the timely manner Medicaid requires. If after talking to Medicaid, u feel u need help get an Elder lawyer.

My Moms application was pretty cut and dry. She only had about 20k, two months in LTC. Once she paid that, she was under the asset cap and her SS and pension were under the income cap, Her house was an exempt asset and up for sale. I started the application in April, she paid May and June, I confirmed Medicaid had everything they needed in June and Medicaid started July 1st.

newbiewife Aug 2023
If he only has $14,000 total assets, I'd apply for Medicaid now (or Sept 19 when he enters the skilled nursing section). That money will be spent down within a couple months, depending on what his monthly income is from social security and pension, if any. Once his application is processed, they will likely ask for an updated accounting and bank statements since the time of the application which can show that he is down to the asset limit. And double check your state's asset limit. Our state (Maine) has a $10,000 limit, not including the person's primary residence.

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Geaton777 Aug 2023
Since each states' Medicaid programs may pay for different levels of care, you need to find out what SC Medicaid pays for. My state, MN, pays only for LTC, which is assessed as medically necessary by a doctor.

Your FIL can go into a facility on private pay but make sure this facility accepts Medicaid recipients and has open beds. Current residents of facilities get "first dibs" on Medicaid beds. Then any openings are offered to non-residents on waiting lists. Once he becomes a resident of a facility, the admins there can give guidance as to when to apply. It usually takes 3 months to know if one has qualified (after submitting an application). FYI many states have a 5-year "look-back" period on the financial part of the app.

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