My mother (widowed) has nothing in trust. And has no long term care insurance.
If she ends up in assisted living…
(I don’t know exact numbers)
She gets $3,000 a month from social security and retirement
Assisted living is around $6,000.
She has two cars. One is around $20K, the other is maybe worth $3,000 on a good day.
She has a condo - primary residence
She has some investments
She has some money in checking and savings
As I understand it, she would have to pay for her care out of pocket until her investments, checking and savings are gone, then have to sell her car(s)?
After everything but her residence is gone, Medicaid will take over? She can have $2,000 worth of assets and will get $50 a month allowance?
Once she passes away, then her house is sold and Medicaid is reimbursed or takes what is owed first?
Is this universal or can it be different state to state?
Here’s my worry….
Her cell phone bill is $60 a month.
Unless she is seriously incapacitated, she’s going to want cable TV, Wi-Fi, a haircut every six weeks and a pedicure monthly.
That’s just stuff off the top of my head.
A bigger concern is if her TV and iPad go kaput in the same month.
Also, how do utilities get paid for the condo?
In most states, Medicaid only pays for LTC, which means qualifying financially AND medically as needing that level of care as assessed by a doctor. Most states have a 5-year financial look-back for the financial application, so your mother or her FPoA needs to be informed about what types of money management and transactions would endanger her ability to qualify.
Since this is a global forum, I recommend you make an appointment to talk to a Medicaid Planner for her state.
Does she have her POA's, will, DNR, all the necessary documents drafted and in place? If not, she needs to see an elder law attorney to set these things up.
I’m not sure why I thought her residence was protected. It seems if she has some cognizance left, it would be very heartbreaking to not have the hope of a home to go to.
I predict she will end up in care in the next year. While there is some slipping of the mind, most is as expected for her age. I think. On my best day, I’m a pessimist, but I think mentally she is okay mentally. Any pain pill stronger than Tylenol and things get iffy. But it’s been like that since she was in her early 60s. Pain pills make her very noncompliant and have her send someone (me) to buy 1500 tablets of Vitamin C.
It will be mobility and ability to do daily living skills that will make her unable to stay in her own home.
Are you her POA/HCPOA? Although you don't have contact with your 2 abusive siblings, your mother does. Do they do anything for her? You moved farther away from her (yay!). How close are they?
I would have applied for Medicaid for my mother had she run out of money and needed it, but it didn't work out that way. She wound up having enough money to private pay her way thru AL and Memory Care AL until she died at 95 with advanced dementia. And at that stage of the game, she couldn't use a cell phone, TV or iPad.
Don't borrow trouble, that's my suggestion.
Your mother has a decent monthly income to begin with, owns cars and a condo, so she may have many YEARS of AL life ahead of her before she needs to apply for Medicaid and worry about iPads and TVs.
What I did is what I suggest you do: Go sit down with a Certified Elder Care Attorney and get ALL the details about how to get mom taken care of for life, in the most prudent way possible. S/he will also guide you about Medicaid and the 5 year look back, etc. It's very good information and worth its weight in gold.
We start off dependant on our family, grow up & become independent adults.
Then old age arrives...
Once we are semi-dependant on others for everyday help, assistance is required. Either in home (eg aides, cleaning, meals, other home services) or in a residentail care facility.
If we live long enough to become fully dependant, 24/7 care is required - either at home or NH/MC.
I have no idea where I will "end up" but I intend to keep changing & adapt where & how I live to keep up! I only need one home, so if I need AL, I won't need a condo anymore.
It is a big life adjustment, but a normal thing, to downsize.
You have the basics correct for most state. I believe in California we have only a two year look back, a car can be kept (but, why?) and we can keep 130,000. That is a brand new law, as we used to be able to keep only the usual 2,000 of so most states allow before medicaid kicks in. Everywhere, what medicaid DOES kick in they will attempt to claw back upon sale of that condo. If Mom isn't returning to it you may as well sell it now and that's off your back.
Basically you have it right, and your own state, YES, has its own rules, benefits and drawbacks, so check those out for yourself.
Best out to you.
When choosing a ALF or NH you need to be discussing with them if they accept medicaid after the person has no longer any private pay funds. The fact that there is SS AND a pension will make your Mother more "wanted". But some ALF are private pay only, and the resident must seek other places that accept medicaid if they need to go on medicaid.
Do know also that that condo you are hoping to keep for her to "return to" is a pipe dream, and speaking of pipes, they leak, burst and do all that good thing. If you are POA and wish to manage it as an asset for her, renting it out and etc then that is good income for her, but it is also a pain in the neck for you or any other Fiduciary.
You are correct in that now is the time to be deciding on all this, getting papers in order so a POA is yours and is strong enough you CAN sell the condo should you need to for her care. Exempt is one thing for a car and condo, but they require keeping and care. As I said, insurance goes way up on an empty condo; it is a sitting duck for problems.
Best of luck again, and congrats on trying to think all this out.
These are issues that MOM, with her umimpaired mental acuity, needs to start thinking about. You can raise them, gently, and say that you are happy to do research with her and discuss her choices, but don't think that in any way these are your problems to solve.
Think about why you think it's your job to keep mom happy, figure out how to pay for what HER resources won't support and keep peace among the siblings.
"She will want cable TV, Wi-Fi, a haircut every six weeks and a pedicure monthly." In my Moms AL cable was not included, that was a separate expense for the resident. Not sure about WiFi since Mom did not use it. There is usually a hairdresser at an AL. But a pedicure she would need to be taken to someone who does it. In my state, Medicaid can be filed for once you have paid privately for two years at least. This depends on if the AL excepts Medicaid and if they do, if they have reached the number of Medicaid recipients they allow.
Now Medicaid. In my State $3000 in monthly income is over the approximately $2300 cap that is allowed. So a Miller/Qualifying Income Trust has to be set up. Not all States allow this. The 700 overage goes into the trust to help qualify the person. Upon their death, the trust reverts to Medicaid. As you said, they are allowed 2k in assets and a small amt of their SS goes into a personal needs acct for their personal use. Cable TV where I live is included in the cost of the NH but very limited. Not sure about WiFI. You will need to pay for her phone or find a cheaper plan that her PNA would cover. I use Tracfone. She can still have her hair done but then again, pedicures will have to be done outside the facility. Once on Medicaid Mom should have Dental, Vision, prescriptions plus health insurance. Check this out with your state. A podiatrist will come in every 10 to 12 weeks to cut toenails only. Medicare pays for this. Nurses and aides are not allowed to cut fingernails or toes. Moms Condo is exempt as is one car. But, there will be no money for the upkeep of either. If you have never lived with Mom as her Caregiver, then yes upon her death the Condo will need to be sold by you so Medicaid can recover what they have put out on Mom. If you were her live in Caregiver, thats a different thing. You may be able to continue to live in the house.
Hope this helps.
Also, Medicaid does not pay for assisted living in some states. Some states require that a person be private cash-pay for AL for a certain period of time before they will accept Medicaid and let them remain in AL.
I'll tell you now, if her income is $3,000 a month she will probably not qualify for Medicaid to pay for services in her home.
I'm in Connecticut and this is a very expensive state. A person with that much income does not qualify for Medicaid unless they are in a facility. The care facility takes their entire income and Medicaid will pay the rest of their care bill. In a facility. Not at home.
Mom may have to tighten her belt a bit and do without some luxuries like pedicures and getting her hair done every six weeks. She may have to have a cheaper cellphone. Doing without these luxuries really isn't hardship. Many people are doing without their medications or are getting evicted because they can't pay their rents. So if the tv and the iPad go kaput in the same month, mom replaces one or the other and should be grateful she has one.
The utilities in her condo get paid for out of her income. Even if she is in a facility. Whoever is her POA has to pay these bills until the property gets sold.
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