I have been caring for my 91-year-old mother for nearly a decade. She suffers from dementia and is now bed/home-bound. As her condition deteriorates, I may need to apply for Medicaid on her behalf in order to cover the cost of home healthcare aides. I understand there is a waiver available that allows certain Medicaid recipients to remain at home. In addition to SS, she also receives a pension. Will Medicaid take all of her income or just a part of it? Currently, I utilize some of her money to pay for shared household expenses - food, utility bills, etc.
Keep accurate notes of communications / phone calls:
date / time / who you spoke to (or their ID name/number ... the communication. Call back phone # if you need to call back.
Everyone here has their own experience.
You need to get the information from the agencies that may / will provide financial or otherwise, support. Call them directly. All else is somewhat heresy.
Gena / Touch Matters
In CT the asset limit is $1,600. My mom's only asset was cash (her house has been in trust for 15 years since my dad fell ill). I had to spend down all of that and also account for all of her expenditures over the past 5 years (the "lookback" period) to prove she wasn't trying to "hide" money in order to become eligible. Any expenditures that the State deems unallowable will be added up and applied as a penalty, calculated as months of coverage that they will not pay for; in CT the "divisor" is ~$14K, meaning for every ~$14K they determine was questionably spent or transferred, they won't cover one month of care. So if the State claims my mom transferred $28K to me (for example), when she becomes eligible we will have to wait 2 months before the State funding will kick in.
The income limit in CT is $2,265/month, but any overage can be put into what's called a "pooled trust," then disbursed back to her on a monthly basis for use in covering her non-care expenses (e.g., groceries, utilities, etc.). My dad was a veteran and I also had to prove I had applied for benefits from the VA (basically that we had exhausted all other means of support).
The State is coming out this week for a home visit during which they will assess her needs and the level of care she is entitled to (how many hours/day, etc.). Medicaid will only pay for care from agencies that accept Medicaid clients. Her current agency (with caregivers who have been with her for years) does not accept new Medicaid clients, but I'm hoping they will "grandfather" her in as an existing client since we've been with them for so long). The State pays the agency directly for however many hours they've approved.
The application process itself is very time-consuming, both in the amount of time I've had to put into gathering all the documents/preparing paperwork/researching her bank history/etc. and also in the overall timeline. I first contacted the lawyer in December, and we still haven't even put in the official application yet. Then the State can take months to make the eligibility determination. All in all I wish I'd started the process much sooner, because I'm pretty sure she's going to run out of money before the whole thing is done, or possibly even die (sometimes I wonder if that's the whole point, i.e., to make it such an onerous process that the person passes before the State has to shell out a penny).
Again, every state is different, but I hope this info is helpful in some way! Best of luck to you and your mom.
Here is a link to the program in South Carolina.... NOTE... this ONLY applies to SC. Here they call it Community Long Term Care (CLTC). This MAY give insights to questions to consider when you contact the office where you need to apply in Virginia because each state has their own programs.
https://www.scdhhs.gov/historic/insideDHHS/Bureaus/BureauofLongTermCareServices/CLTCOverview.html
Like each of us, Medicaid does not like to spend money that is unnecessary. So, they know that assisting you to care for her in your home longer may cost less than paying for a facility and many folks do not need a skilled level of care but still need help. I suggest that if at all possible, go to the office in person to apply. First check to see what documents they need and it may help avoid a second trip. We found when applying for disability SS for my husband that a lot of the questions did not have black and white answers. By going in person, I was able to explain our situation up front and the rep completed the application for us and he was approved the first time with no appeal. The same happened when we applied for his VA benefits. For example, you have to list her expenses and you may not realize some of the expenses she can count as hers.
If your father was a veteran, be sure to check on any spousal veteran benefits she may be eligible for too. The same suggestion applies... go in person if at all possible, and go soon because benefits are often backdated to the date of the application!
Too many folks rely on what others say and miss out by not getting the facts from the agency who provides the services. When you rely on what others say and never apply, you have just turned yourself down.... when the agency may have approved your application. As laws change, often the facts can change too. This website is great for gaining "insights" from others experiences but never consider them as "answers" for your situation. Reminding myself as well on this one!
As I mentioned, you have made several good points for me to consider. Much appreciated.
Of course you are entitled to charge her for things like rent, food, utilities. That's reasonable.
Here is what's going to happen though. If your mother has any assets (real estate, vehicles, insurance policies, bank accounts, stocks and bonds, etc...) and she gets homecare covered by Medicaid, when she passes they will come for those assets because they recap wherever they can.
If your mother gets a pension and SS, her income may be too high to qualify for Medicaid unless it's for placement in a care facility.
I am not looking for 24-hour care. She is not a difficult person and being bedridden really restricts what she is able to do anyway. I do all the housekeeping stuff and cooking, but I cannot take care of her personal hygiene. This is really what I pay caregivers to address right now. Fortunately, I only need them to come for a couple of hours in the morning and again in the evening. She has no assets to speak of, just a pension and social security. Nearly all of that is used to pay for her care. I worry, however, that if she gets worse and does need more hours of care - given how expensive that is in VA - her income would be insufficient to cover the additional costs. I pay all home expenses, food, bills, etc. Yes, in fact, she was denied Medicaid several years ago due to savings exceeding the threshold. Since then, we have spent that down. So I believe she would be approved for Medicaid in VA the second time around. But there is no way that I wish to see her placed in a facility. I do know that in VA there is a Medicaid waiver that would permit a ward to remain in the home but I don't know to apply/qualify for that specifically. But some of the posts here have given me some leads to pursue.
Have you tried Hospice? Normally its a Nurse who comes in once or twice a week. An aide 2 to 3x a week to bathe the person. A poster had said in her State she was able to get a hospice aide for 4 or 5 hrs. Hospice is paid by Medicare. So no cost to u or Mom. But when done in the home, family still does most of the work.