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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.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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Doing anything to determine CSRA or it’s sister acronym MMNA monthly maintenance needs assessment/ allowance is not IMO ever a DIY. You needs an experienced Medicaid atty & likely one that is CELA.
The spousal $$$ stuff really gets tied into debt and having debt can actually work in your favor as you’ll need more of the NH spouse mo income diverted or “waived” to you as the still living in the community spouse rather than becoming the NH spouse copay. Like having a hefty mortgage is good rather than paying it off. Having documentation that you as the CS have higher than average prescription drug or utilities or insurance costs, all can work in your favor to get NH spouse income waived to you.
& in looking at CS issues, it’s not just the CSRA or MMNA stuff that matters but the CS income matters too. For the NH spouse thier income is central to getting LTC Medicaid… it has to be within Medicaid limits for your state (most have it abt $2100 mo). But the CS income, should not be a factor for their NH needing spouse to get on Medicaid. The CS income, well that they can be creative with and this is what a savvy CELA type of attorney should be able to give you options to do. Like if you can do a SPIA, single premium immediate annuity.
Personally I hate HATE annuities but a SPIA is a very special creature. The CS is allowed to have thier own exempt assets, tends to be $128k for most states. Over that you go into spend down in order for NH spouse to be Medicaid eligible. But if CS can get a SPIA, they can use the overage to buy a SPIA that pays them a low enough amount. It’s the CS income and not be be an issue for the NH spouse mo income and should not an issue for Medicaid (if your state allows SPIA). So when the likelihood happens that NH spouse dies, the CS still has that nice SPIA out there paying a bit each mo and nothing Medicaid can do about it. SPIA are speciality underwriting and a better elder law atty should know if it makes sense for the CS situation and also have a relationship with underwriter to get one done. You do need to be on the somewhat younger side to make SPIA work best.
Also if it’s NH / CS situation, if your like a lot of married couples you have each other as the beneficiary. Bad idea. So you’ll need to change your beneficiary on life insurance policies before ever doing a Medicaid application. For example, should CS get hit by a bus & die and has the NH spouse as their 50k life insurance beneficiary, it will clusterF the NH spouses Medicaid as the NH spouse now has $ 50k so no longer eligible for Medicaid. Or even a little policy of 10k. Plus The CS spouse is dead, so who is going to do what’s needed for dealing w NH spouse Medicaid paperwork?
It’s stuff like this that makes the NH / CS situation way way more complicated & why you need a good atty to work with ahead of ever doing a Medicaid application. Doing a individual widow or widower Medicaid application is easy compared to CS / NH one IMO.
This is from a site called "Payingforseniorcare.com"
"As mentioned above, Arizona follows a special set of rules to protect the financial security of a non-applicant spouse, when his/her spouse requires long-term care. This means that the state will permit a much higher level of resources to be held by the non-applicant when only one spouse is applying for Medicaid. As of January 2021, this amount may be as much as $130,380. In most states, this is called the Community Spouse Resource Allowance (CSRA), but in Arizona it is called the Community Spouse Resource Deduction (CSRD). Please note that the applicant spouse is still able to keep up to $2,000 in assets. Should one have more assets than the allowable limit, it is possible to convert countable assets into exempt ones, such as using funds to modify one’s home to be wheelchair accessible. By doing so, a person can lower their countable assets, and hence, meet Medicaid’s asset limit. This option is most likely to help those who are close to the limits and still cannot afford their cost of care. To consider how to restructure your financial assets, one should consult with a Medicaid planner. Simple errors can delay benefits and may disqualify an applicant from Medicaid."
With regard to income, the site states:
"Arizona follows a special set of rules to protect the financial security of a healthy spouse, also called the community spouse, well spouse, or non-applicant spouse, when his or her spouse needs long-term care. This means that the state will permit an applicant spouse to transfer income to a non-applicant spouse. This is commonly called a monthly maintenance needs allowance, but in Arizona, it is called a community spouse monthly income allowance (CSMIA). This spousal allowance protects the non-applicant spouse from having too little income from which to live. As of 2021, an applicant spouse may transfer up to $3,259.50 / month in income to his/her non-applicant spouse in order to bring his/her monthly income to this level. It is still possible to qualify for ALTCS with income over the limit should the excess income be allocated to an income only trust, also called a Miller Trust. In Arizona, this type of trust is often called a Special Treatment Trust (STT). To learn more about Medicaid qualifying income trusts, one should contact a planning professional familiar with Arizona Medicaid."
This all has to do with the combined monthly income you have for one thing. Your assets over and above that income. Basically assets get split with your husbands going towards his care. When spent down then Medicaid is applied for. The Community Spouse remains in the home with one car. You will get enough money to live on. There is more to this. Each state has its own criteria. I suggest consulting with a lawyer well versed in Medicaid.
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 spousal $$$ stuff really gets tied into debt and having debt can actually work in your favor as you’ll need more of the NH spouse mo income diverted or “waived” to you as the still living in the community spouse rather than becoming the NH spouse copay. Like having a hefty mortgage is good rather than paying it off. Having documentation that you as the CS have higher than average prescription drug or utilities or insurance costs, all can work in your favor to get NH spouse income waived to you.
& in looking at CS issues, it’s not just the CSRA or MMNA stuff that matters but the CS income matters too. For the NH spouse thier income is central to getting LTC Medicaid… it has to be within Medicaid limits for your state (most have it abt $2100 mo). But the CS income, should not be a factor for their NH needing spouse to get on Medicaid. The CS income, well that they can be creative with and this is what a savvy CELA type of attorney should be able to give you options to do. Like if you can do a SPIA, single premium immediate annuity.
Personally I hate HATE annuities but a SPIA is a very special creature. The CS is allowed to have thier own exempt assets, tends to be $128k for most states. Over that you go into spend down in order for NH spouse to be Medicaid eligible. But if CS can get a SPIA, they can use the overage to buy a SPIA that pays them a low enough amount. It’s the CS income and not be be an issue for the NH spouse mo income and should not an issue for Medicaid (if your state allows SPIA). So when the likelihood happens that NH spouse dies, the CS still has that nice SPIA out there paying a bit each mo and nothing Medicaid can do about it. SPIA are speciality underwriting and a better elder law atty should know if it makes sense for the CS situation and also have a relationship with underwriter to get one done. You do need to be on the somewhat younger side to make SPIA work best.
Also if it’s NH / CS situation, if your like a lot of married couples you have each other as the beneficiary. Bad idea. So you’ll need to change your beneficiary on life insurance policies before ever doing a Medicaid application. For example, should CS get hit by a bus & die and has the NH spouse as their 50k life insurance beneficiary, it will clusterF the NH spouses Medicaid as the NH spouse now has $ 50k so no longer eligible for Medicaid. Or even a little policy of 10k. Plus The CS spouse is dead, so who is going to do what’s needed for dealing w NH spouse Medicaid paperwork?
It’s stuff like this that makes the NH / CS situation way way more complicated & why you need a good atty to work with ahead of ever doing a Medicaid application. Doing a individual widow or widower Medicaid application is easy compared to CS / NH one IMO.
"As mentioned above, Arizona follows a special set of rules to protect the financial security of a non-applicant spouse, when his/her spouse requires long-term care. This means that the state will permit a much higher level of resources to be held by the non-applicant when only one spouse is applying for Medicaid. As of January 2021, this amount may be as much as $130,380. In most states, this is called the Community Spouse Resource Allowance (CSRA), but in Arizona it is called the Community Spouse Resource Deduction (CSRD). Please note that the applicant spouse is still able to keep up to $2,000 in assets.
Should one have more assets than the allowable limit, it is possible to convert countable assets into exempt ones, such as using funds to modify one’s home to be wheelchair accessible. By doing so, a person can lower their countable assets, and hence, meet Medicaid’s asset limit. This option is most likely to help those who are close to the limits and still cannot afford their cost of care. To consider how to restructure your financial assets, one should consult with a Medicaid planner. Simple errors can delay benefits and may disqualify an applicant from Medicaid."
With regard to income, the site states:
"Arizona follows a special set of rules to protect the financial security of a healthy spouse, also called the community spouse, well spouse, or non-applicant spouse, when his or her spouse needs long-term care. This means that the state will permit an applicant spouse to transfer income to a non-applicant spouse. This is commonly called a monthly maintenance needs allowance, but in Arizona, it is called a community spouse monthly income allowance (CSMIA). This spousal allowance protects the non-applicant spouse from having too little income from which to live. As of 2021, an applicant spouse may transfer up to $3,259.50 / month in income to his/her non-applicant spouse in order to bring his/her monthly income to this level.
It is still possible to qualify for ALTCS with income over the limit should the excess income be allocated to an income only trust, also called a Miller Trust. In Arizona, this type of trust is often called a Special Treatment Trust (STT). To learn more about Medicaid qualifying income trusts, one should contact a planning professional familiar with Arizona Medicaid."
Here is a link to another useful site:
https://www.medicaidplanningassistance.org/medicaid-eligibility-arizona/