My mom has been in liver failure for the past 2 years and recently diagnosed with bipolar. Her medications have not helped her and she is still manic and gets upset very easily. None of my siblings can take her in because her behavior (we have little kids) and she needs someone with her to make sure she takes her medications throughout the day (3 times a day). She will be 64 in a month and retires from work. She gets my dad’s social security (he passed away) which is $2,560 a month and she pays Cobra $707 a month until she goes on Medicare. She went into a ton of debt in the last 2 months due to her mood disorder. She has no assets except a car that is worth around $6,000, however when I called Medicaid they said individuals are allowed a car and they don’t consider that an asset. We applied for Medicaid help but I’m not sure if she will qualify due to the amount of social security she gets. She has been getting social security for 4 months. We could back pay the social security so she gets off it but again will have to find the money for that. Basic care will cost $3,500 dollars a month at the lowest and I’m in graduate school and don’t have that. Not sure what other options there are.
Is she a candidate for LTC? In most states Medicaid only pays for LTC, which is medically assessed as necessary by a doctor, and sometimes allowed by a facility. This means they require 24/7 medical oversight, are bedridden and cannot take help themselves at all.
Look into faith-based, non-profit facilities. They often provide very good care at a more reasonable price (my MIL is in such a place).
The last option (which may be the "best") is to allow the court to assign a 3rd party legal guardian to her. Then the state will take over managing her affairs and making decisions for her. In my family's experience, this was a Godsend of a solution for my SFIL when he refused to assign a PoA. And even if you are your Mom's PoA, resigning it may be something to consider so that the state can take over.
Contact your local Area Agency on Aging and see if you can get hospice help.
Private pay hospice can be done but $$$. Fwiw Medicare pays most hospice providers a flat capitation rate of $4,800 a month. So an agency would likely want that type of fee paid to accept a p.p. client.
Medicaid is huge # of different programs, which one did you apply for?
-Medicaid as health insurance so mom can stop Cobra?
-Medicaid for community program, like IHHS in home health?
-Medicaid for her going onto PACE?
-Medicaid 2 b a custodial care resident living in a LTC facility?
This is beyond important as specific program will have its own eligibility requirements. Eligibility is BOTH medical AND Financial but depth varies by program. I’m not criticizing you but am trying to point out that it’s really really super important that you look at the requirements for the program you think mom may be eligible for.
Medicaid that pays for custodial care costs in a facility is LTC Medicaid and for the vast majority of States is limited to care in a skilled nursing facility/ SNF (so no AL or MC run by an AL) and has income max @ $2829 and a nonexempt asset max @ 2K (like $ in savings); but allows to retain a (1) car & home if it was her primary residence with value max placed on both those exempt assets to be ok. Has a 3-5 yr review of financials. As its usually placement in a SNF, mom would have to show via her health charts / assessment that she absolutely needs skilled nursing care. If this is the one you filed for her, as she is living on her own AND working, she - in my experience- will be ineligible.
That your mom is still living on her own and well enough to still be going and working, she doesn’t seem to be “at need” medically to be in a NH. Her big issue will be viewed - I bet - as medication management issue… and if she is on is meds that one can in theory self administer…. just isn’t enough. She / you as her POA imo have to get her renal disease to be the big reason why she requires skilled nursing and needs the 24/7 oversight that a NH provides. I’d suggest that you get an assessment done to see how she “assesses”. If her health chart is thin, it has to be beefed up.
That your mom is still working - to me - is the 1st hurdle in her clearing financially for any type of “at need” program as she has multiple sources of income (her job plus that SSA$) so she’s viewed as over resourced; although she may be able to get on ACA health insurance and drop Cobra. That’s a running the #s comparison. Then to me her 2nd hurdle for placement in a facility is she is not yet on Medicare. Why? Well those in a NH are usually over 65 so there with 3 different payors: Medicare as health insurance, Medicaid as nonACA health insurance (the 2 often combined for coverage under a Managed Care health insurance system) AND if low income & assets enough LTC Medicaid which will pay custodial care room&board costs. Some facilities do have custodial residents who are strictly on the Medicaids but the payment structure is cumbersome so if a facility can fill a bed with 65+ on Medicare & Medicaid as their health insurers and LTC Medicaid for room&board it’s easier.
You all use the hospital and rehab time to clear mom’s home and apt out. Find what is needed paperwork wise to get her eligibility done.
Regarding the house and car allowed to be an exempt asset…. Well although this is true, it is a sticky to carry out in reality. Why? It’s bc once they file for LTC Medicaid they are required to do a Share of Cost of their income to the facility. The only way around not having to do a SOC would be IF there is a spouse living in the home or IF they actually had a legal dependent (like the grandma was the legal guardian of a grandkid, so grandkid needs grandmas income). The SOC is almost all the $ they get each month less a State determined Personal Needs Allowance. PNA averages $50-$75 a month. So there’s no $ to upkeep house and car. If family want to pay all costs till beyond death and has the likelihood of exemptions / exclusions to Estate Recovery or other reasons that makes sense, it could be what’s done. Most of the time, house & car get sold and the $ used for spend down to get impoverished enough for LTC Medicaid.
hopefully your mom doesn’t have a house to be sold. The 6K value car, that may be worthwhile to hang on to if it’s in better running condition and you could use a second car, have garage, etc. You do need to be named as a driver on its insurance which you will be paying for. The issue imho with cars is that Medicaid wants them sold at Blue Book Value. And that tends not to be quite so simple when it’s an older car with issues. If the lot offers mom $3700, but BBV is $6200, Medicaid will want to know why it wasn’t FMV and it’s a butt rash of paperwork.
You can also find pro bono in your state. There are attorneys that will volunteer time to help for free if you have limited funds. Best of luck!