"Spending down" to Medicaid good or bad?

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"Spending down" to Medicaid good or bad?

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I've been looking into assisted living options for my mother and wow are they expensive! There's no way she could pay for such a place, but people have told me about that sometimes it makes sense to go ahead and let the assisted living costs eat up the savings until qualifying for Medicaid. Has anyone on this site done this? What are the pros and cons? I long ago accepted that I'll never receive any inheritance from her and I'd be glad to see her money to go to her support. Right now she lives independently but has fallen many times and is having more and more trouble planning healthy meals and truly needs help - so far she refuses to allow in home help. Odds are she'd refuse to go to assisted living too. GAH! Anyway, my main question is about the spend down....what do you guys think?

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I've heard horror stories about "Medicaid" living, and just wanted to vent that with so many people living so much longer, that there is absolutely no relief or any kind of insurance for caregiving, not even a partial help, nada, zip, nothing. And yet we have money to send to other countries for so-called aid when we don't aid the people that need it here.

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Can she move in with you? You can use her assets for her food, care, etc and it would be nice for her to be loved at home by family just as she once loved and cared for you when you were small and helpless. If she needs a nursing home in the future and Medicaid, you will have already spent the money down.

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After living alone for many years and a 2 1/2 hour drive from me, my mother's last fall made her situation untenable. The "swing bed" facility she was in was also a nursing home and after "spending down" her limited assets she qualified for Medicaid. The nursing home coordinator and local Medicaid representative were both very helpful in getting this to happen. If the estate is small these contacts may be all you require (otherwise add a skilled attorney to the mix). At the time this happened to her, asset transfers had to occur 5 years prior to Medicaid application. Many seniors will resist losing that much control!

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It's Heiser not Houser! Good lord I think my brain is becoming pickled by all this. The book looks very useful thanks for writing it.

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Signmeister, great suggestions definitely the direction I'm thinking in - I'll tell you though what my mother "has to accept" and refuses to would amaze you and most rational people. Still I will keep at it!

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Thank you all! Gabriel Houser I'll sure take a look at your book it would be wonderful to be able to save some of her assets.

Igloo, yes my mother is still living in her home in her seventies. She is doing her ADL's, but with difficulty - she can walk with a walker but often uses just her cane instead but it's really not enough IMO anymore. She's deeply antisocial so I suspect the wonderful activities that AL offers would not interest her, but regular help with meds, cleaning, laundry keeping her place safe to navigate is much needed.

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Whirlpool, It would probably be a good idea to read Gabriel Heiser's book, "How to Protect Your Assets From Devastating Nursing Home Costs: Secrets of Medicaid", as mentioned here on this site. Then, talk to others who have "spent down" their assets in order to qualify for Medicaid.

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My grandfather was able to 'pay his own way' due to very astute money management by my dad (his son in law). At 96 (!) he finally ran out of money, but at that time he needed more than assisted living. The really nicer ones (NH's) that do allow/qualify for Medicaid often have waiting lists. It is much better to be proactive and find out approximately what the waiting time is as well as how far his money will probably last in AL so that you don't have to 'take what you can get' if a nursing home is the only option. He lived to be 99. The last 3-4 years he was unable to get out of his wheelchair and was severely diabetic. His only thrill in life by then was eating, so his diabetes was very bad and he was very heavy. But hey! He was married three times (outlived them all, including his first wife, my grandmother) and practically made it to 100. In the end he didn't know who anybody was, either. Life should be enjoyed and can be with some proper planning.

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Whirlpool - so mom is mom still living in her home? or is she in an IL community? and you are looking at AL, correct? How old is she and what would you realistically say is her ability to do her ADL's? like can she on her own get up, get dressed and then walk (or with a walker) go to a central area for meals and activities?

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Hi: The entire point of my book "How to Protect Your Family's Assets from Devastating Nursing Home Costs: Medicaid Secrets" is to help people in your mother's situation from needlessly "spending down" their assets. There are many ways to conserve that money so that it would be available to benefit your mother in future years, but the sooner you act the more of her money you can protect. Because there are many options to consider, I recommend you review the book. I am sure you will find many practical and helpful suggestions there. Best of luck with everything!

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My mother-in-law is 92 and is blind from macular degeneration. She also suffers from the early stages of dementia. Otherwise, she is healthy and will likely live to be 100. We moved her from an assisted living facility in Florida (expensive) to a facility here in Vermont (very, very expensive) to be closer to us. We are her only family. She has income and savings enough to pay for the assisted living facility for about three more years. At that time, we will have to apply to Medicaid to cover her living expenses.
When looking at assisted living facilities, be sure to question whether or not they will accept Medicaid. Many will simply not accept it, and some will require that she pay her own way for a specified amount of time before accepting Medicaid. The facility where my mother-in-law lives has a specified number of rooms that are eligible for Medicaid recipients, and one of those rooms must be available in order for her to remain there under Medicaid. She is currently in a private room, and Medicaid will require that she share a room with someone, so she will have to move to another room.
While your mom may not like the idea of assisted living, I think that she will have to accept the fact that she can no longer care for herself, and that she may be endangering her health and well-being by living alone. A little nudging may be in order from you and any other family members that can provide some moral support for you. Take her to visit a few different facilities and let her be a part of the decision making. Again, be sure to ask if they will accept Medicaid before making any commitments.

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About the Veterans Administration program mentioned by Gayle189, I put in an application for Mom a year ago this past April and still don't have a decision. Asked for help from one of our U.S. Senators and heard back that his office had sent a query on our behalf and they might get a response in 45 to 60 days. Seems like the VA needs a caregiver.

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if your mother is a veteran or spouse of a veteran she would be eligible for aid and attendance which would supplement her income....if that isn't an option I would suggest having a caregiver come in and help her until she is down $2000 savings then apply for Medicaid waivers until she qualifies for a NH ...if her income is under $2000 a month she can qualify for the waivers...if her savings is under $2000 she qualifies for Medicaid

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A little more information that might matter - if she continues at her current rate of decline it may not be long till she qualifies for the nursing home part of an AL community which Medicaid would definitely pay for. I hate to say it but I don't even know if she has a year to stay at the AL level and she would have money for that. It all feels like some horrible nightmare, I always thought she'd have so much more time than this - both of her parents declined at far greater ages than she is now.

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"Spending down" to Medicaid good or bad?

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