During Medicaid spenddown, how should I purchase items for Mom? I need to buy her a new mattress and bedding, clothing, adult diapers, new walker, etc. Can I use her debit card and order them from her Amazon account and have it mailed to her? Is that sufficient?
Do NOT transfer money to yourself and then pay for items.
Using a debit card is fine, just make sure you save receipts.
May I ask if you are taking any steps to avoid spend down of all of your mother's funds?
I suggest that you investigate methods of transferring assets away from her prior to Medicaid application so funds will be available for her use while receiving Medicaid benefits.
As you are discovering, care is expensive and I can promise you Medicaid will not adequately cover all needs.
I'm new to this situation with caregiving mom. You mentioned that we should be taking steps to avoid spending down all of mom's funds, prior to applying for medicaid. Please refer me to a good source of information on exactly what to do and how to do it please. Or, maybe you could advise me here on this forum? Thank you for your time.
You mention a new mattress...... so what is the future placement for mom? If she’s going into a NH, usually they will not allow outside mattresses to come in. It’s a health & safety issue required under state laws. So find that out before you buy a mattre$$, ok!
Now ALs sometimes do as it’s not skilled nursing care so different rules. But most AL isn’t covered by LTC Medicaid unless she’s in the handful of states that have AL waivers & lots of ALS who happily participate in them.
Regarding other spend down ideas:
- multiple pair of eyeglasses
- new hearing aid & multiple packs of batteries
- extra shoes
all of these seem to flat go MIA in a NH. My mom loved those hideous SAS shoes & inevitably just 1 of a pair went mia every 3 mos or so. On retrospect could have bought & stored several pairs & she’d used all.
how are you planning on storing stuff?
If it’s in your home, Id suggest you do a Target run and buy a storage “closet” or shelving unit if you have an empty closet to use exclusively. Whichever is ONLY for mom & you take a foto before & after. Buy boxes of Ziplock freezer grade 2 gallon bags & Sharpie & put her whatever’s in them & marker as to contents. Freezer grade important as impermeable to outside dampness, dust, etc. Target & BedBathB have coordinating “dorm” items (shelving, crates, open bins) & on sale now as it’s past college move in time. If she could use a mini frig & the place allows it, she might buy one. & yeah these too available in dorm decor. & buy a plastic shoe box to throw every receipt in every time. Really stuff adds up, from replacement light bulb to shampoo to thermal pjs.
Id suggest you look at her wardrobe to see if what she has will actually stand up to the serious high heat big machine laundry systems facilities use. These are brutal on clothing & elastic. If not buy new everything and in multiples of 2. Ditto for her bedding.
Other stuff: clock (biggest you can find), reading lamp &/or torch lamp, large print magazine subscriptions.
Electronics kinda depends on what she truly can manage on her own. But all this stuff “walks”, so keep that in mind
If she needs dental work, that might be a way to spend down a HUGE amount of $. Few implants, crowns, etc easily be 20k++. My mom did $$$$ in dental & well worth it. Dental care is imo pretty nonexistent once in a facility & not covered to any real extent by Medicare or Medicaid. It’s those pink nibbled sponge sticks flouride wipes across teeth unless they can on their own actually brush & floss.
buy door hanger & floral wreath for her. Helps her find her room!
also decide what path she & you as DPOA will take for how her required by Medicaid copay or SOC (share of cost) will be done. NH tend to heavily imply that they need to become financial rep & so her SS goes direct to them with her PNA (personal needs allowance) going into an Trust account at the NH. So if you want to buy stuff you have to go to biz office and fill out a withdrawal request...... BUT it does not have to run this way. She can continue to have $ going direct deposit into checking acct & you as dpoa write out a ck to the NH for copay each mo. This way the PNA stays in her account & there for you to use as needed to replace clothing, toiletries, etc. You do need to make sure that never ever a mo ends at over 2k tho, as 2k is usually max assets LTC Medicaid allows. You can open an Trust account at the NH with like $200 for the on site beauty shop to auto draw from for her weekly or bimonthly visits & she uses for buying snacks or outing $.
Best of luck to you . It’s nerve wrecking!!
Do you have an Elder Care attorney? At the least you could get an initial consult and pose your questions with them. If documents are not already in place (DPOA, MPOA, will, etc) they can assist with that. They can also provide advice for Medicaid, spending down (legal and prepaid burial expenses I do believe are allowable expenses.)
Since you were talked out of taking care of this before, understand that now you will have that 5 year look back, where anything and everything spent or taken from mom's account will need to be 'justified' (needs documentation so they can determine if it is allowable expense.) Any cash withdrawals could be a problem, as they could be viewed as "gifting", even if it was spent on necessities (unless there are receipts that could back up the money spent.)
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