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I was recently told that an adult child's funeral arrangements can be pre-paid as part of the Medicaid spend down. Check it out with your local funeral home or elder lawyer.
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Pre pay funeral. There are other spend down items that you could find on Medicaid.gov. Make sure to keep all receipts.
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You are allowed to purchase items needed for her care and comfort. Remember to keep all receipts. A nice television, recliner (perhaps with a lift assist), comfortable bed, nice warm bedding- these are some of the things that come to mind. Does she have her funeral pre-arranged and paid for?
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If her room has enough space a nice recliner would be good. Something that doesn't rock and can be wiped down if there is a spill. Check with the facility first about what works best if it requires electricity.
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My Mom had about 20k I needed to spend down. I first went to Medicaid and started the application. I was given a list of what I needed to do. One was cashing in Moms insurance. That gave me about 10k to set up a trust with the funeral home. According to them, Medicaid allows for the cost of the funeral services, flowers, stone/plaque, luncheon, ect. Monies left over revert back to Medicaid. I placed Mom in LTC May 1st. She paid $18,600 for 2 months private care. This took her under the cap. Medicaid started July 1.

Buy her new clothes. If she wears socks, lots of them. Like said extra pair of glasses. A comforter for her bed. You don't want to put too much in her PNA because this is figured in with the cap money. So, if u have 1000k left in her acct and the cap is 2k, her PNA can't be more than 1k. Moms caseworker said "get creative". As long as its for her, they won't question.

Here is what I found:

In order to be eligible for Medicaid, applicants must have no more than $2,000 in "countable" assets (the dollar figure may be slightly more, depending on the state). In addition, Medicaid also has strict asset transfer rules. If an applicant transfers assets for less than market value, the applicant will be ineligible for Medicaid for a period of time. Applicants for Medicaid and their spouses may protect savings by spending them on non-countable assets.
A Medicaid applicant can spend down money on anything that would benefit the applicant. Following are examples of what a Medicaid applicant may be able to spend money on:
Prepay funeral expenses. A prepaid or pre-need funeral contract allows you to purchase funeral goods and services before you die.

Pay off a mortgage, car loan, or credit card debts. You can pay off the debt fully or make partial payment.

Make repairs to a home. Fix the roof, make the house handicapped accessible, buy new carpet, etc.

Replace an old automobile. This can be useful for the healthy spouse.

Update your personal effects. Buy household goods or personal comfort objects. Buy a new wardrobe, electronics, or furniture.

Medical care and equipment. Purchase items that aren't covered by Medicare or Medicaid. See a dentist or get your eyes checked if those items aren't covered by your insurance.

Pay for more care at home. Make sure you get any caregiving agreements in writing, especially if family members are providing the care.

Buy a new home. A home can be an exempt asset, so it may be possible to purchase a new home.

In the case of married couples, it is often important that any spend-down steps be taken only after the unhealthy spouse moves to a nursing home if this would affect the amount of money the community spouse would get to keep, called the community spouse's resource allowance.
Each state has different requirements for spend down. Before making any spend down plans, consult with your elder law attorney. 
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Ohiogranddaught Jan 2020
You are a true godsend! I shared with my Mom & she has some peace. We are also retaining an elder attorney who is helping. Thank you for your kindness!!!
God bless! ❤️
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How much money do you have to work your way through?
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Ohiogranddaught Jan 2020
Not sure. Have to check with my Mom. Things are heading in a more calm direction as we have retained an elder attorney. Thank you!
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LO's car is exempt. Buy a Ferrari. LO can literally spend the money any way they see fit as long as they don't give it away. If LO has a house, they can spend money to remodel the house. These are legit was to shield assets from MERP if they don't through probate due to a trust or other mechanism.

But why not just spend it down by paying the NH?
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Ohiogranddaught Jan 2020
Can my Mom buy a car? She’s her poa. My Grandpa is deceased. Thank you! We’ve retained an elder attorney so things are looking up. Thank you!
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I agree with all of the suggestions. I also took my mother to a foot doctor to have her toenails and bunions taken care of and a specialized dentist to look at a lump she had inside her mouth. I bought new eye glasses, bedding, toiletries, and clothing for her, as well. To buy extra time for Medicaid to kick in, I prepaid two months of her fees for the memory care facility which allowed the State to complete the paperwork in 2 months. This was helpful as I have found things take so much more time than anticipated and after Mom's funds were depleted, I knew she needed Medicaid so the prepaying of the 2 months of care was ideal. Good luck!
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Ohiogranddaught Jan 2020
Thank you so much! I know the facility has allowed my Mom to pay one month ahead. Great ideas!!!
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Think long term. She may have all she needs for now but if she has a facility in her future realize that things get lost. Consider Extra Dentures if she wears them, extra eyeglasses, extra clothing, hearing aids, a prepaid funeral, a nice rollator. If she doesn’t wear dentures make sure she gets to a good dentist for seniors. If she has a car that is being used for her transportation then new tires and other maintenance items. Anything that can be prepaid that Medicaid doesn’t cover and is for her personal use. Hope this helps.
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Ohiogranddaught Jan 2020
Thank you so much!!! I appreciate your answers.
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Does she have a pre-paid funeral trust set up? This should happen before Medicaid approval because they allow far more before approval than after. Also put the maximum into the Resident's Trust at her AL.
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Ohiogranddaught Jan 2020
I don’t know what a resident’s trust us but I’ll check it out, Thank you so much!!!
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