My mom is in a nursing home and her money will run out soon. I want to know when we should start the application process for Medicaid. I have gotten 2 different responses when I pose the question to admins at the Nursing Home. On told me to apply when she has 3-6 months of funds left while the other told me to wait to the funds are down to the last month then apply.
i really want to do this the right way and am afraid that I'm going to do something wrong and be liable for money I don't have. Does anyone have any experience or expertise in this?
2. If any gifts have been made within the last 5 years, the penalty period will not even start to run until you apply for Medicaid. That starts the clock running.
3. If you apply and Mom still has a little bit too much cash, you can certainly come back again when that money is gone.
4. Assuming Mom is in a facility that accepts Medicaid, the facility cannot evict Mom for non-payment of the nursing home bills during the period the state is making up its mind whether Mom qualifies or not.
5. Be aware that some states have a rule that a Medicaid applicant is not eligible for coverage in any month that the nursing home has been paid in full. Perhaps the state’s rationale is that there was no need for Medicaid, since the bill was fully paid, so they will not extend eligibility for any such month. Ac-cordingly, in such states, it is important that the nursing home be paid some-what less than the amount it bills the client, to avoid this problem.
These two strategies will work in most states:
1. Supplemental Needs Trust. Established by a 501(c)3 non-profit organization the potential Medicaid applicant joins this existing trust and transfers (grants) assets to it. A lawyer is not needed to do this. Once transferred, the funds can be used for virtually anything pertaining to the Medicaid beneficiary’s health, maintenance, and welfare. The applicant is immediately eligible for Medicaid provided other requirements have been met. Caveats: 1. at the demise of the beneficiary any remaining funds must first be used to “pay back” the state for Medicaid funds expended before any residual goes to heirs. 2. cost of administration.
2. Personal Services Contract. A contract between the parent and an adult child whereby the adult child is now deemed an “employee” of the parent to provide care giving and advocacy services. The contract establishes an hourly rate of pay, the number of service hours per week, and the statutory remaining life expectancy of the care receiver expressed in months. The sum of these is the lump sum amount that may be legally transferred from the parent to the adult child in full advance satisfaction of the contract. Caveat: This is a taxable event with employment and/or income tax implications to both the parent and adult child.
If you are not interested in the above, or in addition to the above, consider the following before spending down to $2,000:
1. Irrevocable Funeral Trust if pre-needs have yet to be made. Most states permit up to $12,000 to be set aside in such a trust.
2. In addition to, or in lieu of, #1 above states permit between $1,500 and $2,500 to be set aside in cash assets as a “burial fund” in addition to the $2,000 asset limit.
Good luck and God bless.
I used to work with people that did this and they said they always stamp the first application "denied" to discourage people from applying. I know it doesn't make sense, but some people do give up.
At any rate, do it while they are still in the nursing home, because it's even harder to get it if they get out!
Never give up!
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Having had my father in two different facilities in one year, the thing you need to do now is start looking at various homes in your area, find out how many are "medicaid" beds. Medicare has an NH comparison chart of homes that you can use, and they have the questions that you DEFINITELY want to ask! Don't just compare the numbers, DO visit the homes. There were some rated as high as the ones that father was placed in (top of the chart) and I wouldn't place my dog in one of them!
Go during different times of day and different days of the week. Visit the cafeteria, ask for a copy of the activities and menu. See how many people work the day shift compared to the evening and weekend shifts. How often do they bathe them if they can't bathe themselves? My father's skin tears very easily and I had to request that use only a certain type of tape and he wore extra sleeves that covered his hands down to his fingers. Find out what other services they offer, how often they are visited by a doctor, what things aren't covered by medicare of medicaid, like phones, cable, hair cuts, etc.
I know it sounds like a lot, but you will thank yourself later. The last time to do this is when there is a crisis.
Suzanne
Thank you very much for your reply. I will review all that you have written and confirm my decisions with the Nursing Home to see if Ohio has any restrictions that I need to know about. Your response was most informative. I really do appreciate your help.
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