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(A) My grandma takes in about 23,117 every year from pension and social security. We make $899 too much every month so we put the excess into a pool trust. Any MLTC plans in NEW YORK that allow you do CDPAP (a family member would be paid for caregiving) WITHOUT Medicaid? Considering her income. Do MLTC plans count expenses? I know Medicaid doesn’t.


(B) can we get a Medicare advantage plan that covers the cost specifically for Eliquis? On united healthcare plan right now that will not cover meds as much if you don’t meet a certain deductible. You may meet this threshold one year and not meet it another. We would love more consistent prescription coverage. Any good experiences?

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I found ur post a little confusing. For who are you putting $899 in a pool trust for? In my State the Medicaid cap (for LTC) is a little more than $2300 a month. That would be 27,600 a year. Your grandmother is well under that. Yes, each state is different. Is she receiving in home medicaid? Your profile says she is living with you.

You said "we make". When getting resources for Grandma, your income should not count. Only hers. Medicaid only looks at her income. If not on Medicaid, why are you pooling money now? $899 a month is a lot of money when in the end Medicaid may get it if Grandmom ever needs Medicaid for her care.

When it comes to insurance the best place to go is Office of Aging. States only allow certain insurance companies to write policies. I would make sure you understand what a Medicare Advantage is before you consider it. Even though Medicare is in the name, what Medicare has done is contract out to an insurance Co. Yes, a Dr. may be a Medicare Doctor but not be in the MA network. O of A can take you thru what is available. And answer any questions you have.

Three years ago my Mom brought in 20,600. She was able to get her prescription plan thru the State. It was called PADD. It was run by Silverscript. May want to check that out.
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Thank you both so much. Very helpful.
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Eliquis does not have a low cost on any type of plan. Advantage plans generally do not have good drug plans in many states. Contact the drug manufacturer to see if qualify for their discount. Try did have some discount coupons available.
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Your grandparent would have to pay the family member. If they aren’t eligible for Medicaid then there are no state programs that would pay a family member. If the grandparent is a war time veteran then may be qualify for aid & attendance which can be used to pay a family caregiver. But other than that, grandparent would have to use their income to pay for a caregiver.
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