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My Mother is confused. She has no assets. The option of picking on Dr.? What are advantages .

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As far as I know they will take all the income that she gets to pay for long term nursing care. My mother is in the process of switching to Medicaid and she has to give her monthly income to the nursing faciility and is allowed to keep 72.00 a month for personal needs. She is only allowed to have 2000.00 in her checking account at all times . We had to spend down her money which included per paid funeral, 1500.00 burial account and turn over her life insurance policy's to the funeral home. It is a long process and very detailed. I had alot of help with the application through a agency that specializes in helping clients with the application . Good luck!!!
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She's in Ohio, and the articles here aging-care.com,are very different than what you went through. Gees ole petey. Pretty Typical, isn't it. I guess this is why we're suppose to to deal with these issues in our 60's. So the stress of all these decisions don't fall on our children's shoulders, while we drift in and out of LaLa Land!
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Consider speaking with an accountant or attorney about the use of trusts to harbor some of her assets. The example above turning life insurance policy over to funeral home is not a fit solution for everyone and I would question this or any guidance that recommends a solution allowing a vendor to benefit from the savings/investments/estate assets rather than a trust keeping the assets within the executor's reach that would mitigate the estate settlements post-departure.
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She doesn't actually lose SS but Medicaid will use it for her care, so amounts to the same thing. In most states, people are allowed to keep a small amount monthly for haircuts, clothing, etc. but that's about all.

Medicaid is there for the poor. Frustrating as it is to lose all parents' assets (as was the case in my family) to care, we also understood that their money was intended for their care. Just about two months after all of my parents' assets were spent down, my mother died. My dad had died a few months earlier. It was difficult for my mother to not be able to leave anything to the family, but I kept explaining that the money was there for her care. Medicaid took over for those last couple of months and we were grateful to have it.

This is a difficult process for those of us who have parents without a lot of assets, but it's real life for many. Experts in the finance field seem to have methods that can work for some to protect assets, but the reality for most of us is that there's not enough money to make this work. There's also the moral ground - as I said, Medicaid is for the poor.
Take care,
Carol
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We seem to be assuming that mom is going into a nursing home and the answers are relevant to that. But, if mom isn't going into a nursing home that makes a difference. Please let us know what the situation is. You don't really change from one to the other. Medicare is primary and you don't give it up if you also qualify for Medicaid. Medicaid is basically medical welfare and kicks in after Medicare. Medicaid has many aspects and in some cases can pick up paying the Medicare premium.
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In NYS you have Medicare as your primary insursnce and Medicaid is your secondary. Medicare only pays for the first 20 days in the nursing home, with Medicaid picking up the sizeable remainder. If mom is already in the nursing home they have a medicaid specialist on staff. They should help walk you through the process sinve you both are looking for the same thing , to get the nursing home paid. If mom doesn't have a lot of assers it's pretty straight forward, but s great deal of paperwork. On the other hsnd if there are assets involved please see an Elder Care Attorney. There is a site online called AVVO. You can ask specific legal questions and lawyers in your area will give you short answers. It also gives reviews on lawyers who practice in your area. I found it extremely helpful. Before I found the site I set up a consultation which I was charged $250 for the hour and she made me feel rushed and worse when I left than when I got there.I hired a lawyer that had wonderful recommendations, no charge for the consultation. Young and eager. If he didn't know something he said so and went and foundd out the answer.Always answered my calls promptly. Something to be said about the more mature attorneys who act as if they are doing you a favor. The one thing I hope you get from my scenerio is to get legal advice. Medicaid has a 5 year look back window. This means they look at evsrything and I mean everything that mom has done with her assets in that time frame and demand explanations. Good luck!
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Good points from everyone here as always!
Carol
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My Mother is 90 and now lives in Ohio.She lives in her home and can stay there as long as she's able to maintain home. the home was put in a trust for my brother and myself when our parents divorced long ago. It's to much for her now,and I'm concerned about safety, wiring 70 years old. She has no assets. No insurance. She has a crept paid for next to our Dear Step-Dad. I want her to move to Califonia,so we can be together. How do I find out policy that's (in stone) on her issues in both states, without attorneys. Were on SS and my Brother, doesn't show his hand in finances. I really am so thankful for imput and direction.
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Unfortunately as a society we have determined to impoverish the elderly for them to receive care (NH care normally). So if the senior has their wits about them they are aware they will spend their last days in a nursing home with Medicaid paying the bill and all of their earned and saved income taken or "spent down". Working all your life and ending up in such a situation isn't what most Americans expected in their "Golden Years".

We need to provide needed care, with a sliding scale and not try to impoverish people who entered old age with income. Again most would prefer to stay in their home with care but the legislation for long term care in the home does not exist so --into the nursing home system they go. Never mind that it costs the taxpayers more than keeping the elder in their home with help.

We need a big rethink on how to fund long term care. Perhaps the pressure of 79 million aging baby boomers in 10-20 yrs will force change. Clearly there are not enough Medicaid paid beds for 79 million elderly.
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You can contact your county agency in aging for some advice. I would also recommend contacting an elder care attorney for a free half hour consultation, usually over the phone. Do this with several attorneys. It sounds like you expect mom to live with you. Do you think you will be able to care for her at home in her final days, whenever that may occur? If yes, Medicaid may be of no concern to you. What happens to the house if mom leaves it? What are the terms of the trust? Can you sell it and use the proceeds now for mom? Will you need brother's ok? Or is mom still in charge of the trust and you and brother are just successor trustees after she passes? Put your facts down on paper and list your questions to get the most out of your free legal consultation. Also, look for free senior services that may help address the issues here.
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My 90 year old mother in law is in a memory care unit in state of North Carolina. She owns absolutely nothing, no house , no assets of any kind whatsoever. She is on Medicaid and they take the entire SS. check , less $60.00, which are for personal needs, plus a very tiny pension she earned while working. This is what happens to people who never save or plan for retirement . Believe me, we are very thankful for the care she is getting now as we don't have the money to afford her care. When you apply for Medicaid, they scrutinize every means of income a person may have that they can get their hands on. It's basically there for the indigent and yes, taxpayers foot the bill.
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I have found enormous assistance through the Department of Aging, which I was directed to by my Congressman's Office. Don't overlook your local government officials for assistance, they have all the resources and can assist you at "no charge".
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You don't lose Medicare if you are of Medicare age, if you go on Medicaid. Medicare is usually primary and Medicaid secondary. In Indiana (don't know if it's the same in all states, but assume so) - Medicare will pay first for doctor's appointments, hospital, labs, etc. Also, if someone gets home health visits after a hospital or nursing home stay, whatever benefits Medicare will pay for has to be used before going to Medicaid. But, the only time they (Medicare) pay anything for care in a nursing home is for 1-3 months after being in the hospital. If they need to be permanently in a nursing home, that goes under Medicaid. Like they have said above, Soc. Sec. is her income for life so they can't take it away, but when they go into a nursing home, she has to give it all to them (minus that small amount for personal items) to help pay for the care there and Medicaid pays for whatever's left. Medicaid is usually regulated by each state, so that state's rules apply, but Medicare is a national program and usually the same everywhere (regular Medicare that is - some are using the HMO Medicare under an insurance company - in that case, the basic Medicare rules apply, but the insurance co. may have additional rules it works under).
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Lizann, I heartily agree. We need to push for legislation for the elderly with few or no assets to be able to stay in their home with care and not be forced into NH. My 93 yr old father is on the cusp of this and will be forced to go to a NH. He has all his wits about him and a NH will do him in, but, his assets have run out and I can't afford to support him/caregivers in home. It is heartbreaking. He and Mom did the best they could and lived a good life, raised me well, but their minimum wage jobs didn't leave much to save. I've filed Aid and Attendance but it has been months now and even a Congressional Inquiry is not moving it along fast enough for my Dad to avoid going on Medicaid. I have spent months filing with the VA/following up/worrying and stressing and still now movement. He served in WWII and earned that benefit and we foolishly were counting on it to help.
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The best insurance we have as baby boomer is to stay healthy. Fortunately my mother (103 yo) was always meticulous about her health and diet. She exercised regularly and ate mostly healthy food, but the problem is with our food supply. That must change before anything changes. My mother developed hyperthyroid, this went undetected by her "doctor" (I use this term for him loosely) and it turned into atrial fibulation then congestive heart failure and a stroke. She cut her own grass and worked as a hairdresser until the stroke at 97. Yes, she does have good genes, but that alone is not enough to ensure health. The GMO (genetically modified "foods") The unhealthy additives and the worst is the changing iodine in bread making and using bromine, numerous endocrine disruptors and hormone disruptors has produced a generation of overweight diabetics with thyroid problems, brittle bones and dementia.If we are to change things, this is where we must start. Nursing homes would be a thing for the very few who are involved in accidents or who have genetic disabilities. Start by watching what you eat, reading the ingredients and understanding the effect that each ingredient has on your body. I wish I had started this sooner. Become an activist on the computer. Take a few minutes a day to look at healthy web sites. Write to your congressman-woman and insist that we have strict labeling laws. Eat lots of raw foods organically grown and the outcome in later years will be much better. Mother is with me now and we eat mostly healthy and a lot of raw. She still wants bread so I try to make homemade with organic ingredients, but it's hard. I work at least 50 hours per week, most of it here at home from my computer (I publish a magazine) I also run a store and human potential center with my husband and work there 2 days a week. I'm 67 and hope that I never need a nursing home.
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IF the elder lives on their own, they MIGHT be able to have a tiny stipend left over to buy a few things--but it will more likely be from STATE DSHS/welfare/Medicaid.
The State captures Medicare first, to pay medical bills.
The Social Security check remains in the elder's pocket/bank account, as long as it does not exceed the limit allowed for a welfare recipient to have.
IF they are in a facility, the facility takes the SSI check, and captures all the Medicare to pay for the care facility costs, first, THEN bills Medicaid.
In that case, of being in a facility, the elder no longer has pocket-money.
Assets, such as a house, car, savings, etc. must be spent down, to allow access to Medicaid.
The ranking order for use as paying for care systems and debts, goes kinda like this:
1. Retirement funds and Social Security monthly check
2. Medicare
3. Other assets
4. Medicaid
IF someone has a Reverse Mortgage [RM], OTHER rules might apply.
The RM is a loan an elder can take out on their real property.
It can pay them a lump-sum, or monthly payments.
It puts a lien on the property owed to the lender.
Over time, the property MIGHT accrue greater value, which MIGHT be able to be lined by other creditors, such as the State.
Heirs can sell the property to recover some assets and/or pay off that RM--
BUT-- they must do that BEFORE the elder has been Out of that property for a year--after that one-year date of non-occupancy, they forfeit the property, the lender then sells it to recover the loan--and the Lender MIGHT not sell it at full value--which means other lien-holders, or the heirs, take a loss on the value of the property not recovered in a fair value sale.

I'm sure there are also other qualifiers.
Best keep on your toes!
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Just a few clarifications for Chimonger. The Social Security check is not SSI. Either way the vast majority of the money goes to pay the expenses of the person in the nursing home. The patients DO get to keep a small amount for personal expenses, which various by state. The statements about spending down all assets like a car, savings are way too generalized here to be correct.
Each state is different but as far as I know every state allows SOME assets to be retained.
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Why would you think that your mother or anyone else would get free 24 hour care and also get to keep her SS? Are you aware what 24 hour a day care costs? Way more then what SS is paying for your mother. Be grateful that your mother has the option the get the 24 hour a day care and that she is well cared for . That is what you should be thinking about.
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Lizann...You madea great point. it's more econimical for the govt to let an elderly person remain in their home but send cate there. Govt can cut overhead and provide better, one on one care for less money. more bang for the buck. But when does govt do anything sensible?
My mom needs care but won't leave her home. i am spending down her very hatd earned savings for in home care plus maintaining her household. the pool of funds will run out. if a caretaker was provide for, even some of the cost, i could stretch home maintenance longer.
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forgive typos...using cell phone to type.
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Much has been said and you will surely utilize many of these suggestions. My experiences led me to the Aging and disability resource center (very helpful). No attorney was needed. Dad still living and receiving Moms Soc.Sec. Spend down included a burial trust up to 12,000.00,(burial included both parents each at that rate), Bought plot and stone, bought Mom all new clothes, put $2000. in bank for her, but have to keep it at that level at all times. Note (money cannot be given away within less than 5 years or they will make you wait to receive Medicaid/even after the spend down). Property as in land/rentals etc… (not your home or personal possessions/but the value of such must be disclosed) have to go on the market/for sale(also note here, that I believe she can title land or property with another family member, therefore Medicaid will only take a % of its value/this you would need a lawyer for). If it sells Medicaid gets the $$. You must show receipts for all expenses. Secret- take some extra cash and put it back for her in the event she needs something more, or lives to 90+ years and needs a new wardrobe, find a way to show expense, or do it before you apply and contribute it to living costs. If she can drive, buy a new car, furniture for home or nursing home use. She can pay you a wage within reason, for POA or services as well. Give receipts. We 4 siblings, moved my parent here from Arkansas in 2010. Dad paid us each $1000.00, Medicaid found this reasonable. My Dad loaned my brother 3000.00 prior to the spend down. Dad had to pay out of pocket for nursing home until that $3000. was spent down. If there is no surviving spouse to receive Soc.Sec. Medicaid will take all but an allowance as mentioned earlier by princess7. So let say your Mom has $100,000. She has to be at poverty level to receive complete Medicaid. She will probably have to spend down to $20,000. or less, with minimal insurance. If she has life insurance, it will be considered cash. As vegaslady says take notes and document everything. Lots of paper work coming up. I put together a binder with multiple folders to track of it all. Best to you & yours.
Suegirl- Aging and Disability resources will have contact info for both states.
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We had to apply for Medicaid for our mom, because we felt (a) there's a history of longevity in her family & who are we to think that Mom won't live at least 5-8 more years, if not more; (b) dad, 94 and mom's husband, has terrible dementia but can still ambulate and we take care of him in his own home, and hope to do so for as long as he lives.

But I understand the distress when one sees all of your parents' assets slowly drained away. This is happening right now to mom & dad. Dad has been able to hold on to what was left for his care, but once he is gone...ALL of it is gone.

Our worst fears now are that dad will continue to live past his assets and we will have to apply for Medicaid for him too.

It is horrid to have dementia in America!
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It is horrible how the elderly are treated. Most of them worked and saved their whole lives to have some money saved to pass on to their children, if they only had a crystal ball and gifted it out before the state took it!!:( but the money means nothing at all to me anymore, I just want the best care for my mom at this time!! Sleep well!!!
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When my our Mother moves out of the house either one of us can force the sell. Yes I want my Mother here with me. And if comes to that point where t can't take care of her. I don't see that happening. But if she were hospitalized,I would be there also. I love and enjoy her company. I learn from her each day.
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That is so nice to hear!!! I know how you feel, unfortunately it got way too hard for me to care for my mother. We lived together for 7 years and then after her stroke it just became too difficult. I enjoyed her company as well and we did everything together. I have my daily visits with her but miss my old mom alot. It has been quite the adjustment for both of us but we are doing her best and she is being well taken care of. Thank god for that. Best of luck to you !!! You sound like an amazing caregiver!!! Too bad that there are not more people in the world like you!
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Using assets for elders' care should come before inheritance and just be glad that Medicaid (and the taxpayers) are there.
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This may be off the subject but what is really needed is better treatments for Alzheimer's disease. No one should have to live 10 years in a wheelchair or bed, unable to communicate, wearing diapers and having to be fed. And a person like that (who needs a hoist and 2 men to transfer them) can't live at home. Most people can't or don't want to envision themselves like that for that long so they don't give money away 5 years ahead. Unfortunately in my case my Dad is one of the minority whose mind is long gone but body is extremely healthy.
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How long before a nursing home takes your social security check because the nursing home didn't take my mom's money so I played her bills she had now there saying there taking me to court she gets Medicaid and Medicare can they do this to me please help me
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Buster - your mom as a individual with no spouse NH resident is require to do a copay or SOC (share of cost) of her monthly income (like her SS) from her first day at the NH. Once on Medicaid all they have each month is whatever amount your state has as the personal needs allowance. PNA varies by state. Most have it at $60 a mo. And that’s it for $ for them once on Medicaid.
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