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Mom is 92, in Skilled Nursing at $14,000/mth and has about 10 months worth of money. She's bedridden, has to be fed pureed foods, and stares blankly at the ceiling. I fear I will file and she will pass weeks later.
Sorry you are dealing with this, as it is not simple.
The first thing is confirming that your mother's SNF (skilled nursing facility) is "Medicare and Medicaid" qualified. I assume so/hope so.
If YES, the business office folks there at the facility can be VERY helpful regarding what you need to do, but as others have noted, working with a licensed elder care attorney in the state where she resides is key, as there are multiple steps and lots of paperwork to gather BEFORE applying. And mistakes could disqualify her.
Medicaid has a "look back" provision, which means they look back over five full years to see what, if any, expenditures your mom has had as they are looking for "large sums" that may have been gifted, hidden, etc. That "look back" requirement means you need to pull 5 years of bank statements, credit cards, SSA, tax filings, on and on. HOPE you have electronic access to all of this, as pulling this info online is so much easier. An attorney can help you with this. AND YES, the lawyer's fee should be paid from her resources (you do NOT pay this). Yes, could be a significant sum ($3 - 5K), but again, mistakes could disqualify her.
ALSO (hard to say), but if NOT yet done, you should pay from her resources ALL funeral expenses! Prepaid funeral expenses within reason (a $50K built moselum would NOT be reasonable) are allowable expenditures under Medicaid LTC. W/my mom mom, even when a family member gifted us the burial plot, the cost of just the burial (no service or anything) was $14K. The plot would have been another $12K where we live - OMG VERY Expensive for just the basics. Pay it out of her funds BEFORE she totally spends down, so this is taken care of if NOT already paid.
Assuming no gifting of large sums over the past 5 years, no sale of a home for which the funds are NOT part of her account, THEN she has to meet 2 thresholds: 1) she has to meet her State's income threshold (something such as NO more thant $2K in total assets and 2) the SNF has to qualify her as "in need of SNF level of care".
Generally, an attorney and the business folks at the SNF can work out a spend-down plan for you in the months before she has totally spent down. Hopefully, all assets are depleted, (no IRA funds sitting around), and the month when she is at the NOT able to pay the SNF monthly fee, at midnight, that is when you need to take screenshots of her account showing insufficient funds AND you file the next day. This again is so much easier if you have set up online access to her bank account (all funds should be in one account, condense all into one).
Hopefully, you have a POA to handle all of this!
Once she is qualified, you have to keep her under the State's income threshold. So if she gets an SSA check and maybe something else, YOU CANNOT let her bank account accumulate more than that monthly threshold amount. You'll need to pay the SNF the amount Medicaid requires from her SSA payment and another other incoming funds (pension?). She is allowed to only keep like $80, but over time that $80 cannot exceed the total income threshold; so you'll need to spend some of those frunds from time to time (buy candy or something form her account even if it is just to give to the SNF staff) so she NEVER goes of the State's income threshold as if she does she is thereby disqualifed and that is a hot mess....
Does not really matter if you file, and then she passes. This happens all the time. You just need to work with the SNF business folks and an elder care attorney to follow all the legal steps (not knowing is no excuse, and there is no do-over) and create a spenddown plan now.
I filed two years ago. I was told at first mom was not eligible, but every year mom gets two Medicaid cards in the mail. She has not run out of money yet, but when she does we can just update that information with the county.
I agree with AMZebbC. This is the type of situation in which consulting an attorney with knowledge of and experience with Medicaid LTC can be very helpful. The attorney can help you decide whether it makes sense to apply for Medicaid at this juncture of your parent's life.
My State you can't do much more than before 90 days. In that time you must spend down the money and get them info needed. Call your County Social Service Office and talk to a Medicaid caseworker and ask this question.
You’re not out anything but the effort of doing the application if you file and mom dies. We did the application when my mom was within six months of running out of funds. Ask the business manager of the nursing home if they have any advice. The nursing home my mother was in had an excellent one who walked us through the process at no charge, not everywhere has this, but it can’t hurt to ask. I’m sorry you’re in this sad place with your mother
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
The first thing is confirming that your mother's SNF (skilled nursing facility) is "Medicare and Medicaid" qualified. I assume so/hope so.
If YES, the business office folks there at the facility can be VERY helpful regarding what you need to do, but as others have noted, working with a licensed elder care attorney in the state where she resides is key, as there are multiple steps and lots of paperwork to gather BEFORE applying. And mistakes could disqualify her.
Medicaid has a "look back" provision, which means they look back over five full years to see what, if any, expenditures your mom has had as they are looking for "large sums" that may have been gifted, hidden, etc. That "look back" requirement means you need to pull 5 years of bank statements, credit cards, SSA, tax filings, on and on. HOPE you have electronic access to all of this, as pulling this info online is so much easier. An attorney can help you with this. AND YES, the lawyer's fee should be paid from her resources (you do NOT pay this). Yes, could be a significant sum ($3 - 5K), but again, mistakes could disqualify her.
ALSO (hard to say), but if NOT yet done, you should pay from her resources ALL funeral expenses! Prepaid funeral expenses within reason (a $50K built moselum would NOT be reasonable) are allowable expenditures under Medicaid LTC. W/my mom mom, even when a family member gifted us the burial plot, the cost of just the burial (no service or anything) was $14K. The plot would have been another $12K where we live - OMG VERY Expensive for just the basics. Pay it out of her funds BEFORE she totally spends down, so this is taken care of if NOT already paid.
Assuming no gifting of large sums over the past 5 years, no sale of a home for which the funds are NOT part of her account, THEN she has to meet 2 thresholds: 1) she has to meet her State's income threshold (something such as NO more thant $2K in total assets and 2) the SNF has to qualify her as "in need of SNF level of care".
Generally, an attorney and the business folks at the SNF can work out a spend-down plan for you in the months before she has totally spent down. Hopefully, all assets are depleted, (no IRA funds sitting around), and the month when she is at the NOT able to pay the SNF monthly fee, at midnight, that is when you need to take screenshots of her account showing insufficient funds AND you file the next day. This again is so much easier if you have set up online access to her bank account (all funds should be in one account, condense all into one).
Hopefully, you have a POA to handle all of this!
Once she is qualified, you have to keep her under the State's income threshold. So if she gets an SSA check and maybe something else, YOU CANNOT let her bank account accumulate more than that monthly threshold amount. You'll need to pay the SNF the amount Medicaid requires from her SSA payment and another other incoming funds (pension?). She is allowed to only keep like $80, but over time that $80 cannot exceed the total income threshold; so you'll need to spend some of those frunds from time to time (buy candy or something form her account even if it is just to give to the SNF staff) so she NEVER goes of the State's income threshold as if she does she is thereby disqualifed and that is a hot mess....
Does not really matter if you file, and then she passes. This happens all the time. You just need to work with the SNF business folks and an elder care attorney to follow all the legal steps (not knowing is no excuse, and there is no do-over) and create a spenddown plan now.
Good luck with this.
Anyone can file online anytime, no lawyer needed.
It is wise to consult with and eldercare attorney that has knowledge of the Medicaid LTC application process.