Question about long term care and medicaid

[rcrush]

My dad is living in a nursing home and it costs about 3200 a month. His retirement benefits and SS comes to around 2400-2600 someting like that. Everytime else has been used to pay for the nursing home cost he lost the house his car and everything. Credit card bills are mounting up and I think they are going to try and sue.


We've been using everything to pay the monthly nursing home cost. Pretty soon the insurance check from when my mom died will run out from paying nursing home and other bills.

I keep reading that medicaid will only cover him if he makes something like less than $2000 a month with retirement benefits and SS. Is there any way that medicaid will cover the difference? I dont know what else we can do because it seems like you have to be penny-less to have medicaid cover you but my dad seems to receive just a little too much in benefits but not enough to cover a nursing home.

[imdjh]

1. That's sad. Nothing to add here.

[timeforpeace]

2. "He lost his house car and everything". You mean he sold them. That's the way it works to qualify

for welfare which medicaid is.

[sandnsea]

3. Is he in Texas?

The first thing you want to do is move him out of that state if he is, because they really do have "death panels".

Each state is different on Medicaid requirements so unless someone tells you they are familiar with Texas specific laws, continue to check.

A friend of mine went to a lawyer to protect his assets because his wife has Alzheimer's and is in long term care. That was in California though. You might want to consider a lawyer if you can get a recommendation. Not all of them will help.

[Warpy]

4. Your best bet is to talk to them directly

and see what can be done for him.

Unfortunately, nobody seems to give much of a damn about the most vulnerable people, the frail elderly.

[rcrush]

6. Talk to who?

Nursing home?

Whomever the hell is trying to sue him?

[Warpy]

16. Large nursing homes have social workers.

If the place is smaller, then contact Medicaid directly.

I understand putting medical bills on a credit card, but it's not the wisest thing to do. I can't help him there. If they sue, he should prepare for bankruptcy.

The only alternative is to take the patient into the home with services to help with bathing once or twice a week. It's backbreaking labor and extremely hard on the whole family, so I don't suggest it lightly.

There are no good solutions here.

[rcrush]

18. Didnt put any medical expenses on a credit card

Was just debt he ran up over the years. All his money goes to the nursing home. Just wasnt able to pay it if I wanted to keep paying the nursing home.

[Warpy]

24. My advice still stands.

I would imagine a credit card judgment against him would take some of his income and put him under the limit for Medicaid. Do have him talk to either the nursing home social worker or to the state Medicaid office, though.

[jwirr]

19. County Social Services Department is usually in control of the Medicaid

program and if I were you I would simply put an application in for assistance and see what they say. Even if you are over the limit there is a spend down program that is meant to help when it can. You are right Medicaid was designed to help the poor and you often have to become poor before it kicks in. All they can do to you is say "no".

[JeanGrey]

5. I believe he can qualify. Of course they will take everything he

draws but medicaid will cover the rest, since he will effectively have no assets left.

[rcrush]

7. Thats what I need to know

We've pretty much accepted the fact that he's going to have no assets left. He's in his 80's with dementia and cant take care of himself. He doesnt even recognize me. But his military benefits are like 2k a month and a little SS. From the rules I've read it seems like he's in this little bracket where he's too rich to qualify but too poor for a hospice care.

[JeanGrey]

9. Hospice isn't based on your income.

But I do think he will qualify once he is broke. My mother drew about 2000 a month, she was a nursing home for about four years and she was medicaid. They let her keep 30 bucks a month(!) but of course the three daughters we made sure she was never without anything.

[rcrush]

10. Yeah I read about the $30 a month allowance

My dads in a nursing home atm and we got a $30,000 check when my mom died but the nursing home just about ate all that up. I was worried that since he draws more than $2000 a month from retirement that medicaid wouldnt help him.

[JeanGrey]

29. I think he could still qualify but they will take it all

[DURHAM D]

13. His monthly income is not the issue.

His assets are. If I understand it correctly if he is worth less than $2,000 he can receive medicaid. You need to apply immediately. I think they will then take his monthly income to offset the expenses of the health care facility except for about $50 a month.

Something to remember - they can take a look back at the past 5 years to see if his assets were given to (taken by) his family. If he "over gifted" during that period they will not be happy.

[WillYourVoteBCounted]

31. rcrush, see this link for ideas and help

I know this may not be in your state, but take a look at this website
and you will get an idea of the type of help that may be out there.

For a few hundred bucks you can get decent sharp advice that will protect your
father's interests and see to it that he gets the care he needs and deserves.

I do not work for these folks, I have sought their advice.

www.ElderlawFirm.com

[Gormy Cuss]

8. Medicaid is for the indigent, and that's why all major assets must be exhausted before it pays

You say that you keep reading about Medicaid -- what you need to do is find out from an expert.
Look for an elder care advocate in your area. It may cost a few hundred dollars for a private consultation but it sounds like you need good information now.

Good luck. I've gone through the elder care scenario with a penniless relative and the Medicaid process was still a nightmare, but eventually it worked out.


eta: if you can't afford an elder care consult, start the Medicaid application process.

[rcrush]

11. Would that be a Long Term Care Ombudsman?

I came across that earlier googling but no one was in the office. Is that who I want to speak to?

[Gormy Cuss]

22. I don't know the term but I'd pursue someone with that title as part of the process.

Elder care advocates (mostly social workers by training) tend to be cheaper than attorneys but would cost more than someone in a public job performing a similar role. If the ombudsman is a public resource it would be worth at least touching base with that person.

[Traveling_Home]

12. Medicaid is typically .......

a benefit of people on SSI. For people needing LTC services the Feds allow them to receive of to 300% of the current SSI rate (FBR) and still qualify for medicaid. The 2009 FBR (Federal Benefit rate) for SSI is $674/mo. He can have a total income of up to 300% of FBR or $2022 a month.

[rcrush]

15. What happends if he exceeds that

His retirement and SS seem to be around 2500-2700 a month. Still not enough to pay a nursing home every month. And we've almost eaten up the savings.

[Traveling_Home]

20. Contact a Lawyer specializing in Elderlaw/Elder benefits

Ask if it might be possible to divert any of his income into a medicaid exempt trust.

That's where I would start.

Good Luck

[salvorhardin]

21. Expenses are taken into account

So he may well qualify for Medicaid, but it all depends on exactly what type of social security he's receiving. Is it regular social security or supplemental social security income? Or both? Also, under certain special circumstances, Medicare will pay for long term care.

One thing is for certain, it's very complex and I can understand why you're confused. You need to talk to somebody knowledgeable in this area. A Long Term Care Ombudsman may well be able to help you sort it out. You can find a LTC Ombudsman in your area here: http://www.ltcombudsman.org/static_pages/help.cfm

[jwirr]

23. Does that include a spend down? Because if it does not then it is even

more. I also suggest that you go straight to the horses mouth. The Social Services Department administers Medicaid for people who are poor, disabled or elderly. They are supposed to take the application and determine if the person is eligible for MA and explain why or why not. They do as someone else stated check back 5 years to make sure the persons assets were not transferred into someone Else's name. This is the normal procedure for elderly who run out of money in a nursing home. I used to work as a service worker for the elderly. Also since this money comes from federal sources each state has to follow relatively similar rules in administering it. Not exactly but similar. Go to them and find out.

[DesertFlower]

14. i'm in arizona.

last year my mom who had dementia went into a group home. her private room was $3,000 a month. her social security was about $1,000 a month. she had about $40,000 in savings from which i drew to pay for the room. the group home did have a contract with AHCCCS (our medicaid). the deal was when her money ran out, she would have to move into a semi private room for which medicaid would pay around $2,000 a month (actually about $1,000 after her social security). she passed away after 3 months in the group home.

good luck to you.

[rcrush]

26. Did you work that out with the nursing home or medicaid?

[DesertFlower]

28. medicaid has a set rate that

they pay. i make sure that when i chose the group home that they had a contract with the state. if not i would have had to move her to a place that did when her money ran out.

[newfie11]

17. Have you talked to the social worker at his nursing home?

I would start there. I know an elderly woman that is in a nursing home here in Nebraska. Her entire SS check is taken by the nursing home but she gets $50 a month spending money. She was allowed to keep a little over 3 thousand for burial.Of course I don't know how much her ss check is or her retirement money but the social worker at the nursing home is the one who set everything up. If these are his credit cards I would bring that up to the social worker. If they are yours I think you are going to need to talk to them.
Good luck.

[rcrush]

25. I guess my biggest fear is

When he runs out of his money to pay for nursing home care and its not sure if I can get him on medicaid yet will he be in danger of being evicted from the nursing home? He has no where to go and I dont have the means to take care of him. My older brother wants nothing to do with the family so he wont even answer the phone.


From what I can tell he may be able to qualify for the income requirement and since he doesnt have a house anymore that shouldnt be an issue.

But can that happen? Will the nursing home most likely work with us?

[DURHAM D]

27. Nursing homes will evict occupants because their family will not file for medicaid.

The facility should help you with the process of applying. They don't want to evict your dad - they will just want to get paid. You can't blame them. And, they don't care about the source of the funds.

My mother was moved into an Alzheimers unit in December of 2006 and died in late 2008. My father is currently in that same Alzheimers unit. I have spent a lot of time in nursing homes the past few years and although in our case we were not receiving assistance, it does seem that most of the occupant's care is being paid for by medicaid. We know this because we battle the facility constantly over double billing on medication and unnecessary procedures. They used to say to us "why do you care, you are not paying for it"? When we repeatedly told them that indeed my parents were paying their own way and also we don't like the idea that regular medicare was over-billed for unnecessary items like speech therapy for my 93 year old father they looked at us like we were freaks. Apparently it is not the norm. Now they get it - wasted money is wasted money no matter the payer.

Good luck. I don't think it will be as difficult as you think.

[WillYourVoteBCounted]

30. could you meet with an atty who specializes in this

there are some attorneys who even have a social worker or former medicaid worker on staff,
and they know all of the rules and regulations.

It wouldn't hurt to get a few names recommendations and get an appointment
for advice.

Now is exactly when you need good legal advice.