Would like to move parents on Medicaid from one state to another. Any suggestions?

I recently wrote an article on this topic for AgingCare.com:
https://www.agingcare.com/articles/Moving-to-A-New-State-Can-Affect-Medicaid-Eligibility-174671.htm

joannes I personally have not had good luck with BECU. if there accounts are there and it is working to pay for their care I wouldn't move it. But if they are going on to Medicaid they cannot have more than $2000.00 in the account. BECU use to charge for accounts that went below a certain amount so that is another reason I choose to go to a local bank instead that did not charge for a minimum amount in the account. I don't see why you would need to have a WA Elder attorney if you have one on retainer already. My only other comment is it is useless to try to argue with a dementia or Alzheimer's patient and if they won't accept the help. Then let the chips fall where they may. And maybe and outside agency needs to help mom instead.

Rovana: the history between us has been historically, that I am the cooperative, compliant 'child' who does her bidding or the whole world hears how terrible she gets treated. Narcissistic. And I have trouble being firm and setting boundaries due to the childhood history. But I am reading and learning and my daughter with the masters in counseling is role modeling for me. SHE doesn't get exactly the same treatment. I am learning to say, " Mom....this is where we are....there are these choices, and you can pick one of those, but we have to know what's it's gonna be by (date). The lawyer is close to sitting with her now and telling her it's time to get the two letters from the two doctors re: assessing competence to be making any decisions....and for her to get another neuro psych eval to see if her Alzheimers' has progressed, and to take a driving eval because of the last ticket...and new problem with her car that I've been working on all day today. And tell her that if she won't go along with the outcomes of all those, we'll have to spend her money to go to court and get guardianship. He's told her clearly that she's at the point where the house sale will have to happen in the next approx. 6 months because of the cost of caregivers. And I am not backing down on the need for the caregivers, now that I got them started!! She's working hard at trying to do it all by herself to prove she doesn't need them, and my answer, every time I hear it, is The professionals who have been coming since you left the hospital say that you have balance problems, are a fall risk and your memory is not leaving you the ability to remember when to take all your meds properly, so you need caregivers or AL. Then she argues and rants and raves and says no one has ever told her this or that to her own face, so she doesn't believe it....and the docs never told her she had dementia etc. So now, caregiver takes her to the doc...when doc comes in the room, she calls me on the cell and puts it on speaker and I take notes on the visit. The doc talks to Mom and then summarizes with me. And both caregiver and I know what the doctor told her. Then I can say, "Well, sorry Mom, I guess you just can't remember, but we all three heard the doctor say....blah, blah" so I am going with that!

guesswho4you: can you explain WHY you wouldn't use the CU or WF? The CU is already set up to receive all the SS checks, retirement check and dividends that come in, as my Dad worked for Boeing. Also his medicare supplement is paid from that account. Right now, it's the sep. account that I use for all HIS bills and I transfer extra out of that which is needed for Mom's bills. I don't care about the WF, but right now that is the account in AZ that is for the POA/paying all her bills. I know its a BIG headache to change around SS especially...but also with those others. It's havoc having to send all these places new copies of the POA and set up accounts and all that. At least for me. And the kids that would be taking the parents in already have a Boeing CU account for themselves, so they are familiar with their branch and people. Seemed a convenient idea to just keep that going and get the kids a debit card to access Dad's account. And we will have a WA eldercare attorney to help with all this....because our Tucson eldercare attorney is on a lifetime contract to provide care for the two parents until death....and his office has been ever so helpful. I wouldn't know how to do Medicaid apps and what was needed and how it had to be presented or what the forms were all about, as his office did all that for my dad. I just had to send them what they needed to put into the packet. You are suggesting the exact conversation that my daughter and I have been discussing having with her. We then have to deal with hysteria and tears and statements about people stealing her money and how family is 'supposed' to do this or that for their parents. Last time she laid that on me, I asked her why she didn't go running to my grandpa's in Indiana when he fell and broke his hip and was going downhill? She never went except to the funeral. Her answer: she had a husband, kids and a house to take care of!! And grandpa had a wife and a son in town there to take care of him. Well...she, as the wife, was not able to step up and care for him...which is how I got this whole job to start with, so, as I see it, SHE is the problem child who is unable to do so much except tell everyone trying to help her how they are 'supposed' to do it. My daughter says its time for 'tough love' with her.

I would not use Boeing Credit union but go to a smaller bank that is local. Nor would I transfer any money from a Wells Fargo bank in one state to another. And only if is a small amount of money if it is over $20,000 get a eldercare attorney to help you out. And I'd say "Sorry, Mom but there ain't nothing in this life that is free and taking care of you is definitely not going to be free. You cost a lot." The end of the game is here you are at the 10 yard line. You no longer need a house to live in if you cannot keep it up. You need to pay for your care and be it with your children (they deserve to be paid to take care of you for how ever long that may be) or at a assisted living center or NH you will need to pay your fare share you don't get to take it with you when you leave. Either give it to your kids now before you go and before you need Medicaid. Or make it h*ll for them after you go. Be kind to your kids as they say they will be taking care of you at some point in your life. Quit holding out mom. God doesn't want your money.

Joannes, how does it work when you "push back"? Like, Mom you are refusing to do this and that, so I'M refusing to do my this and that? In other words, call her bluff, refuse to cooperate with her behavior, call her fraud what it is? I learned to be respectful but firm, like immovable on my side.

NO don't do it. TX has LONG waiting lists for Medicaid help. As soon as you leave IL, the Medicaid stops cold. You'll be in no man's land for a long time. I'm sure IL pays a lot more than TX will.

Thanks for that info, guesswho. So if Mom's house were sold and all the proceeds were put into their Boeing Credit Union account which is based in WA state, or if we transferred the POA account from an AZ Wells Fargo to a WA Wells Fargo, that would satisfy things with Medicaid? And then we could create another 'caretaker account' at the same credit union and move or set it up with money from the house? If we did this, there would be a contract signed called a Life Estate Contract, which stipulates that the family up there agrees to allow the parents to live in the family's house for the rest of their lives (my parents lives that is....) I suppose that would be akin to a written caretaker agreement?

I just do not think my mother is going to agree to anything where her home has to be sold or where any money, at any time, goes to family! She expects family to do everything for free just because they are family! And she is VERY paranoid of any possibility that anyone could be 'stealing' her money. I get by with paying her bills because she doesn't know how to do that....but she's at that bank seeking print outs all the time of the POA checking account so she can 'check up' on me!! So even her own daughter is totally suspect in her mind and this is not dementia, as she's been this way all her life. ANY transaction....even at the grocery, she goes into it assuming that someone is going to try to cheat her out of something. And when I watch the games she plays with stores etc, I think she fears this, because she is so darned guilty of it herself! Always trying to buy something on sale and then return it and get the orig price refunded to her, and things like that! Will buy meat, and eat part of it, and then go back to the store and complain it wasn't good, so she can get more for free. I do not know what happened in her childhood....but it certainly ruined her for being any kind of normal!

Putting in any money into a caretaker account with a written caretaker agreement of what the money is for, and not in the patients name it also a way to go in WA. It takes about 3 months to get all the paperwork through in WA. But you also will need to have a assessment done with the individuals to have the state decide how much they will pay because they have a test they apply after an in person interview included with all the paperwork. And everything has to be asset wise in WA accounts will not take out of state asset as they would be used as a spend down. Maximum allowed limit of assets is $2000.00, no car is allowed. Most all the housing is at least $2000.00 so they have to have some money from SS to pay for it Medicaid will not pay the full amount.

If they have assets you have to sell, look into putting them into a disability trust. Medicaid can't touch that money.

We are considering this type of move for my parents, from AZ to WA state. My Dad is on AZ's version of Medicaid and his case manager has told me that, YES, he will go off AZ Medicaid and then once he is situated in WA, if we do this, then there will have to be an application to get on WA's version of Medicaid. Since each state does their own version, as long as they meet the minimum federal requirements, his benefits could be better or worse. And no one has explained whether it will be a fast process or not, since all the required paperwork was turned in once and there WAS an approval in place with care provided. I do not know how that will work. My parents would be moving in with family and we would NOT move them until everything was set up and ready. We would fly my dad with two family members, and drive Mom up there first with the required furniture and belongings. Mom is still home with early Alzheimer's but Dad is in a facility. I know there will be an adjustment period for both, but would hope that with them being in their own little apt, within the family's home, with 5 teen to adult family members to help provide care until they were lined up for some in home help from Medicaid, that it would work out. Only reason we are looking at this way is because Mom refuses to go to AL, and is now with caregivers at home, and is depressed as all get out that at the end of her life, she and Dad are separated from each other. There is no family with her in her town, and the family that IS more local (me and our other daughter) both have serious reasons why we could not take the two of them in with us. If anyone has better ideas of how to solve our dilemma, let me know.... as we are already running into financial issues just re: the need to sell one home and find another that family in WA can afford, with a MIL type apt as part of the home. Things just get more complicated by the day....for me and after ready the comments in this post, I will be second guessing if this idea can work out!!

Medicaid for TX is done by TxDHHS and within it's TXDADS sector. You can google the details - state has a pretty good website for overall info.

I have dealt with moving MIL from LA to TX and the nuances of TX rules. & I have gone through Medicaid application in 2011 for my late mom who was a TX resident. For MIL, her application was first after Hurricane Katrina in 2005 and TX was very forgiving on folks having documents and basically if you were ok for LA Medicaid, it carried over. Then 6 months later in 2006 everybody had to apply to TX program. If they had not gotten a TX ID or TX drivers license or changed their SS and other monthly income to be sent to a TX address then they had to do so or be ruled ineligible for TX Medicaid to pay although they qualified for Medicaid.

For those who still had a home or a car in Louisiana, those assets would now be considered NON-EXEMPT assets. So all that still had their old home or old car back in LA were now over the 2k asset limit and therefore ineligible for Medicaid. The ones I knew this happened to either had to private pay for NH or moved back to a NH somewhere in Shreveport area as that was the only area that had Medicaid beds - it was a pretty chaotic period of time. Under Medicaid rules, you are allowed a home & a car but as far as TX was concerned they had to be in the state to be an exempt asset. I would assume this hasn't changed since then. So Annie if your folks still have a home or car in IL, they are going to need to sell the house in IL asap and use the proceeds as a spend down; the car they can bring with them but have to register it with TxDot within 30 days of the move and get TX auto insurance (TxDot has no sense of humor).

You are going to have to get their ID changed to TX, that too is done @ TXDot - so google to see what is needed to do this. TxDot locations always seem to be very crowded & humorless if you do not bring all the required documents with you.

On banking, if there is any way that there is a banking group that is in IL and in TX and close enough to you to get to, I'd suggest you get all their SS, retirement and all other income moved to that banking group & asap. It will just make is easier for when you need to change addresses. You basically are going to need to do a change of address to all & any items for them that is a document needed to accompany their TX Medicaid application.

Your DPOA on them needs to be done by a TX attorney with TX notary seal. There are many many NAELA certified elder law attorneys throughout the state of Tx too which is fortunate. You will find that anything with out of state notary will not fly. UPS stores in better locations often have notaries in TX.

For TX Medicaid, my experience is that is is easier to get them into a NH than onto a Medicaid waiver program for AL. TX Medicaid reimbursement rate to the NH is pretty low - about $ 155 a day in 2015. So most Medicaid taking NH are pretty basic in what is provided as the $ is just not there for the NH to spend. Very tight profit margin. The better Medicaid NH stay pretty full with 90% occupancy rate. You may find that you have to get them into a less than desirable NH first and then once they clear Medicaid, move them to another nicer NH. Once they are approved for Medicaid, moving them from one NH to another is simple and without any penalty from the old NH as they are paid on a day rate by the state - I did it for my mom at about month 10 of her first NH, and other than the floor nurse being a butt rash on getting all of mom's medications, it was simple.

Good luck if you do decide on the move.

The main issue is that you're moving her from a liberal state to a conservative. She is eligible for more things with less restrictions in Illinois than Texas. Texas is rated 47 out of 50 states in benefits. I would look into Texas medicaid eligibility before making a decision. The more republican your state is, the more obstacles. Good luck

I have seen this happen. Children moving parents from what they know. Its hard for the elderly to adjust. Best thing, children move to where the parent is but...thats not always possible.

The move itself bothers me. We moved grandma from IL. to AZ. and it was very detrimental to her. The change was too much. She lost her mind. My father in law had to fly her, 1st class back to IL. to a NH. She did improve, once she got home.

There is no residency requirement for applying for Medicaid in a new state, but as others pointed out below, there are differences in the rules that may or may not affect your parent's eligibility. It is best to find out whether or not they would qualify now, BEFORE you move! A visit to an elder law attorney in the new state for a one-hour consultation may be well worth the expense.

I moved my 82 year old dad (on Medicaid) from central IL to the western part of VA about 2 years ago. The Medicaid programs of states are generally similar, but they are not identical nor reciprocal. I would suggest contacting the state of TX well in advance of the move (I don't know the specific agency though - Social Services?, Dept. on Aging?, Ombudsman?, etc.) regarding its Medicaid program and its requirements. One key issue may be eligibility based on a residency (or physical presence in the state) requirement. An application in another state is basically like applying for Medicaid for the first time, so be prepared with all of the necessary supporting documentation and paperwork. If possible, get as much paperwork done (or better yet, completed and submitted) prior to the move; again check with TX about if this could/ can be an option.

Also, if you are the P.O. A. for your parents, check with TX to make sure that the ones (legal and medical) you have are acceptable there. And if so, be sure to have an ample supply of them. If not, make sure to have ones drawn up that the state does/will accept. The state of VA recognized mine from IL.

If you have not yet selected a facility for your parents, I would start screening and "interviewing" them now, and select one. There are multiple websites that have reviews/ ratings of facilities, and some of them have state inspection reports online, along with specific user comments. That helps, but nothing beats an actual site visit, and your 'gut feeling' after the 'interview' with the staff and touring the whole facility (including 'back of house' areas). Some of the issues I covered in my search included the following: acceptance of Medicaid, room availability/ setup for double occupancy, OT & PT therapy functions for residents (on or off site?) activity functions for residents (both on & off 'campus'), food service, facility condition/ cleanliness/ maintenance, resident-staffing ratios (RN and CNA's), 'memory care' capabilities for residents (on site?), local transportation for residence, and physician/ specialists arrangements and extent of coverage allowed by the state and how that is implemented at the facility.

If you already have a care facility arranged in TX, make sure to get the application there done as "Medicaid Pending" so it doesn't default to private pay (big $) during the application/ review/ approval period of the state agency. And, generally there is a (probably state specific) limited ("retroactive coverage') time frame for Medicaid. Be certain that the application to the state is accurate, complete, compliant, and fully documented, so that it can & will be reviewed and approved on the first submission. As you probably already know, the wheels of the bureaucracy can, and often do rotate in slow motion. In VA, when dad's first application was denied, I had to resubmit a totally new form, complete with all new (updated) documentation, and the whole cycle started anew. As you probably know, the wheels of the bureaucracy can (and often do) rotate in slow motion.

As for the actual 'move', I would suggest a couple of things. If possible, get a second person to go along to help with your parents (and driving!), make sure any overnight accommodations are accessible, and depending on your situation, check into a rental van, that may make the wheelchair issue easier. Bear in mind that all of the moving expenses are most likely out of pocket, and I could not find any information that these expenses are allowable, covered, or reimbursable by Medicaid.

My (overweight, but not obese) dad had hearing and vision issues, slight (early) dementia, and moderate mobility impairment, but was still cognitive and ambulatory enough to handle a road trip. I was fortunate that he was still able to travel with me (in a crew cab pickup), and I planned an overnight trip, to keep the drive times reasonably comfortable for him (two days with 7 hours of road time day). It was challenging, but feasible, and I had allowed for schedule flexibility and additional "contingency" time if needed for any possible medical or basic fatigue issues. I tried to keep the route through as many major metro areas as possible in case an emergency developed (fortunately, none did). The care facility in IL was able to provide an ample supply of his prescriptions to cover the trip and about a week's reserve, just in case of any delays during the relocation to VA.

Basically, I tried to do the best 'due diligence' possible in order to get the optimal results for my dad. I found that the old adage of "plan for the worst, and hope for the best" was certainly pertinent for this type of event! I hope that at least some of this helps, and I wish you the best of luck.

moved my mother to live with us in Texas after my dad died, Shes from Michigan. Its been a nightmare and now we are trying to move her back. If you don't have support from siblings in Texas, I would urge you to think twice. If Texas is a new state to them you will be responsible for everything.... including how un happy they will be in a new state away from everything they have known.

I'd contact the Medicaid people in the county where you live and ask them what steps you need to take. Every state has differing policies with Medicaid so it's best to start early since a switch will need to be made.

Good luck with this. Please keep us updated on how you are doing.
Carol