Medicaid related question with someone's estate

[Mom3girls]

Hello! Hoping someone has been in this situation before can help me out. My mother in law has alzheimers and has been living with us for the last two years. She had a minor stroke and heart attack almost a month ago. She has been in the hospital and then rehab center. Developed UTI and pnuemonia and had to go back to hospital. Now has c-diff and mentally no where near what she was before. We have been looking into alzheimers care assisted living but she doesnt have the wealth to support $8,000 a month for two years before medicaid will kick in. okay, background info done...

We have decided that we need to place her into a nursing home after her rehab. I'm not sure if medicaid is the same everywhere or if it's a state program. We have to pay down her debts and get her bank acct down to under $2,000. Are there any loopholes such as small gifts she can give her grandchildren to use up some of the money? She doesn't have much but I hate to have her denied medicaid again next month on Dec. 1st. Everything has to be documented as to how the money she has now is being spent out...If you have been down this road and have any suggestions, PLEASE pass them along. We have an appt with an elder care lawyer later in the week, but I'm in major panic mode NOW.

 

[daughtersrus]

Hello! Hoping someone has been in this situation before can help me out. My mother in law has alzheimers and has been living with us for the last two years. She had a minor stroke and heart attack almost a month ago. She has been in the hospital and then rehab center. Developed UTI and pnuemonia and had to go back to hospital. Now has c-diff and mentally no where near what she was before. We have been looking into alzheimers care assisted living but she doesnt have the wealth to support $8,000 a month for two years before medicaid will kick in. okay, background info done...

We have decided that we need to place her into a nursing home after her rehab. I'm not sure if medicaid is the same everywhere or if it's a state program. We have to pay down her debts and get her bank acct down to under $2,000. Are there any loopholes such as small gifts she can give her grandchildren to use up some of the money? She doesn't have much but I hate to have her denied medicaid again next month on Dec. 1st. Everything has to be documented as to how the money she has now is being spent out...If you have been down this road and have any suggestions, PLEASE pass them along. We have an appt with an elder care lawyer later in the week, but I'm in major panic mode NOW.

We started this with my dad a few years ago but sadly he passed away a few weeks later.

I think that you're doing the right thing by contacting a lawyer specializing in this area. I wish that we had done that much earlier than we did. Who knows, maybe Dad would still be here with us if we had.

 

[golfgal]

If she has enough in assets to pay for 2 years of care, where is all this money? Where is the 2 years coming from?

There is a look back period in every state-most are in the 5 year range-meaning anything given away during that time can and will be used for her care, so no, there are no loopholes to speak of.

You need to move her directly from the hospital to the nursing home, Medicare will pay for the first 100 days, after that she will either need to self-fund or go on Medicaid (that 100 days gives you processing time, she should apply now). Yes, you will have to impoverish her but she needs the care. You CAN pre-pay her funeral expenses so you can use some money to do that. If she still owns a home, you will have to sell that and use the proceeds to pay for care too.

 

[C.Ann]

Brace yourself - and put on your flame suit.. You just opened a horrible can of worms by asking that here..

I'm very sorry to hear you and your family have to go through this.. My mom had to go into a nursing home for severe Alzhiemers (for her own safety) a number of years ago.. My dad left her very well off - so we used all of that (minus what my former SIL scammed out of her) to pay her way until there was nothing left.. At that point she had to be moved to another facility that accepted Medicaid.. She had no problem qualifying, because every penny of her money (including the sale of her home - minus the stolen portion) was spent to pay for the first nursing home she was in..

Try not to let the flame throwers interfere and muddle up your mind.. It's good that you're going to see an elder attorney so everything can be done legally..

Best of luck to you..

 

[Mom3girls]

She DOESN"T have the wealth to support the $8,00 a month. All she has is what was left from her husband's life insurance and that wouldn't even cover one of those months!!! She does have a life insurance policy (enough to cover her own funeral) and we were told we could have the funeral home be the assignee for the policy. The funeral home directors are family friends of ours...we have had three family funerals through them and they are totally trustworthy.

No home to sell.

 

[golfgal]

She DOESN"T have the wealth to support the $8,00 a month. All she has is what was left from her husband's life insurance and that wouldn't even cover one of those months!!! She does have a life insurance policy (enough to cover her own funeral) and we were told we could have the funeral home be the assignee for the policy. The funeral home directors are family friends of ours...we have had three family funerals through them and they are totally trustworthy.

No home to sell.

If she only has $8000 left to her name, where are you getting the 2 year wait from?? Her insurance policy has no bearing on her 'wealth' unless it has a cash value. If she doesn't have any money there is no reason she won't be accepted for Medicaid.

 

[jodifla]

Hello! Hoping someone has been in this situation before can help me out. My mother in law has alzheimers and has been living with us for the last two years. She had a minor stroke and heart attack almost a month ago. She has been in the hospital and then rehab center. Developed UTI and pnuemonia and had to go back to hospital. Now has c-diff and mentally no where near what she was before. We have been looking into alzheimers care assisted living but she doesnt have the wealth to support $8,000 a month for two years before medicaid will kick in. okay, background info done...

We have decided that we need to place her into a nursing home after her rehab. I'm not sure if medicaid is the same everywhere or if it's a state program. We have to pay down her debts and get her bank acct down to under $2,000. Are there any loopholes such as small gifts she can give her grandchildren to use up some of the money? She doesn't have much but I hate to have her denied medicaid again next month on Dec. 1st. Everything has to be documented as to how the money she has now is being spent out...If you have been down this road and have any suggestions, PLEASE pass them along. We have an appt with an elder care lawyer later in the week, but I'm in major panic mode NOW.

Get a lawyer who SPECIALIZES in this type of elder care law. That's very important.

Medicaid rules are state to state. Certain costs, like a prepaid funeral plan, don't count as part of the $2,000.

 

[Mom3girls]

If she only has $8000 left to her name, where are you getting the 2 year wait from?? Her insurance policy has no bearing on her 'wealth' unless it has a cash value. If she doesn't have any money there is no reason she won't be accepted for Medicaid.

I didn't say there was a two year wait for medicaid. I said that at many assisted living facilities it is private pay for the first two years then they accept medicaid as payment. I would have to pay roughly $192,000 out of pocket for the first two years and then medicaid would be accepted there. That is why we have to have her placed in a nursing home where medicaid will cover her care from the month she has her assets under $2000.

 

[J/T Gramdma]

With my Dad, he went to the nursing home straight from the hospital so medicare paid for his care. Yes he had an estate, but medicare paid as the doctor requested the nursing home. My Mom went to the nursing home after being home several days and we had to private pay for the same nursing home. This was our experience in Maryland. It was a sad day when it happened but it was in the best interests of my parents. Take care of yourself so you can take care of yor parents.

 

[RitaE]

So is she currently hospitalized and is she covered under Medicare?
If so my guess is the best option currently is to do as Golfgal suggests and have her moved to skilled Nursing for rehab therapy (covered under Medicare). That buys you the time to work out the best plan of action for extended care.

My best thoughts for you - we've been through this with a couple of relatives and it is exhausting. The hospitals usually have Social Workers to help explain options. Has anybody offered you such services?

 

[golfgal]

I didn't say there was a two year wait for medicaid. I said that at many assisted living facilities it is private pay for the first two years then they accept medicaid as payment. I would have to pay roughly $192,000 out of pocket for the first two years and then medicaid would be accepted there. That is why we have to have her placed in a nursing home where medicaid will cover her care from the month she has her assets under $2000.

You were not clear about that. Most private pay places won't take ANY medicaid. That is the problem with medicaid, it isn't accepted everywhere. If she doesn't have money, start applying for medicaid now, get the hospital social workers to get going on finding a placement for her. You pretty much have to take what you can find and won't have a whole lot of say in the matter. If she has more then $2000 in assets, she will have to pay for her stay until that money runs out then medicaid will kick in. If she DOES have money, prepay her funeral. How old is she and are you SURE her life insurance is still in force-many run out after age 65 or 70. Even if she still has life insurance you can still prepay her funeral and then when she dies the beneficiaries of the policy get the money-the really only legal way to pass things on in a case like this.

For my mom, her care was covered mostly by her social security check and a little bit from medicaid but she didn't have any assets to worry about.

In the mean time-go get Long Term Care Insurance for you and your DH so your kids won't have to worry about this.

 

[PatsMom]

Not sure if this is the case everywhere, but here in New Hampshire if someone gets Medicaid and has a life insurance policy, any proceeds are claimable by the state. I think you can pay for the funeral and anything above that goes to them. The object is that the taxpayers should not be paying for medical care to allow for an inheritance to someone's children.

Good luck to you. Finding an elder care attorney may be a waste of money. If your Mom has so few assets, it should be relatively easy to spend them by reducing debt, Gifts cannot be made without having an impact on eligibility.

Also, if she has any income (pension, social security) it is considered to be assigned to the nursing home. I believe that the patient may be allowed a small amount for personal items but I would be prepared to pay for some things if it were my mother.

 

[jodifla]

Not sure if this is the case everywhere, but here in New Hampshire if someone gets Medicaid and has a life insurance policy, any proceeds are claimable by the state. I think you can pay for the funeral and anything above that goes to them. The object is that the taxpayers should not be paying for medical care to allow for an inheritance to someone's children.

Good luck to you. Finding an elder care attorney may be a waste of money. If your Mom has so few assets, it should be relatively easy to spend them by reducing debt, Gifts cannot be made without having an impact on eligibility.

Also, if she has any income (pension, social security) it is considered to be assigned to the nursing home. I believe that the patient may be allowed a small amount for personal items but I would be prepared to pay for some things if it were my mother.

In Florida, they don't take all the proceeds. Only what the state paid out.

 

[j's m]

If she has enough in assets to pay for 2 years of care, where is all this money? Where is the 2 years coming from?

There is a look back period in every state-most are in the 5 year range-meaning anything given away during that time can and will be used for her care, so no, there are no loopholes to speak of.

You need to move her directly from the hospital to the nursing home, Medicare will pay for the first 100 days, after that she will either need to self-fund or go on Medicaid (that 100 days gives you processing time, she should apply now). Yes, you will have to impoverish her but she needs the care. You CAN pre-pay her funeral expenses so you can use some money to do that. If she still owns a home, you will have to sell that and use the proceeds to pay for care too.

Medicare pays in full for only the first 20 days after a hospital stay of at least 3 qualified days.

At day 21, you are required to have a daily co-pay of $ 137.50 until you hit day 100.

 

[DMRick]

...If you have been down this road and have any suggestions, PLEASE pass them along. We have an appt with an elder care lawyer later in the week, but I'm in major panic mode NOW.

I think that's the smartest thing you can do. We've been there and the lawyer was wonderful. They'll let you know percent wise how much she can gift and still get medicade once the money is gone.

It does help to hear other's opinion, of course, but in the end a lawyer from your state, and knowing your circumstances will help you the most. If we didn't get a lawyer we would not have know about the gifting.

Edited to add that I didn't see she only had less than $8000. I think the hospital social workers will be more helpful to you in this case (I assume no house, etc). . Once they get her transferred, the nursing homes will take over her SS and pension if applicable(once she has spent down) and usually they give about $50 (in NYS) for monthly spending to the patient. She can (in NYS at least) pay for her funeral with either her cash, or assign her life insurance. Medicaid then covers the rest. If she doesn't assign her life insurance it usually gets turned in so be sure you check that. One thing that is really difficult, is that if you are on medicaid and go into the hospital for over a week, the nursing home can give away your bed if they so choose, (if you are not completely self paying) and the patient may not go back to that nursing home, if they have no room (again, only speaking for NYS). That is a real pain, because you need to pack them up, and store their stuff, until they get assigned a new home.

 

[manning]

If she has enough in assets to pay for 2 years of care, where is all this money? Where is the 2 years coming from?

There is a look back period in every state-most are in the 5 year range-meaning anything given away during that time can and will be used for her care, so no, there are no loopholes to speak of.

You need to move her directly from the hospital to the nursing home, Medicare will pay for the first 100 days, after that she will either need to self-fund or go on Medicaid (that 100 days gives you processing time, she should apply now). Yes, you will have to impoverish her but she needs the care. You CAN pre-pay her funeral expenses so you can use some money to do that. If she still owns a home, you will have to sell that and use the proceeds to pay for care too

You need to move her directly from the hospital to the nursing home, Medicare will pay for the first 100 days.

There is a caveat her. She will have to participate in her rehab. In other words if she refuses to do the rehab Medicare will kick her out.

 

[Mimi1965]

So is she currently hospitalized and is she covered under Medicare?
If so my guess is the best option currently is to do as Golfgal suggests and have her moved to skilled Nursing for rehab therapy (covered under Medicare). That buys you the time to work out the best plan of action for extended care.

My best thoughts for you - we've been through this with a couple of relatives and it is exhausting. The hospitals usually have Social Workers to help explain options. Has anybody offered you such services?

Do this-SNIF -skilled nursing Facility-Medicare pays 100 days-then use her $$ to buy a pre-paid funeral -that will eat up all of it

 

[TiggerStac]

Medicare pays in full for only the first 20 days after a hospital stay of at least 3 qualified days.

At day 21, you are required to have a daily co-pay of $ 137.50 until you hit day 100.

Do this-SNIF -skilled nursing Facility-Medicare pays 100 days-then use her $$ to buy a pre-paid funeral -that will eat up all of it

medicare doesnt' always pay the full 100 days, its up to 100 days w/the 20 days at full payment and 21-100 w/coinsurance. The resident has to be receiving a "skilled level of care" which means actively participating in therapy a certain amount of time a week, certain types of wound care, feeding tube. Just because they are discharged from hospital doesnt mean that they automatically get 100 days. If I had .05 for every time I had a family member say that to me in the 8 years that I worked as office mgr/billing in SNF, i'd be able to fund an extra disney trip

Medicaid guidelines vary from state to state, most of what people have said on here are similar ot MA. You are heading in the right direction contacting an elder law atty. But beware, any I have dealt with are $$$$$. In MA that $$ spent is allowed to spend down to the 2k.

 

[Mimi1965]

You are correct Tigger-I'm dealing with this now=-moving my Mom from Rehab floor of hospital to a SNIF-and she has a co-insurance who will pick up the remaining$$ if she stays days 21-100-but she has to be progressing with rehab and not "Plateau"ing

 

[fkj2]

If the pneumonia and C diff aren't fully resolved, then she may qualify from the skilled nursing aspect.