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Concern about medicaid "lookback" and her spending $300 on gambling a month might make her ineligible!?

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Spend down $ needs to be spent by her on herself or her needs.
If she wants to do $35,000 for dental work or $35,000 for a face lift, doesn’t matter it’s $ spent by her on herself.
Decisions aren’t what we might think is the best use of funds, but as long as they are competent & cognitive, it’s their choice.
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Regrading the 5 year look-back, I'm under the impression that applicants are not penalized for spending their money on themselves during that time frame. Can you verify with a state Medicaid/social worker if a Medicaid applicant is penalized for spending her money on any activities she enjoys. It's her money. Any gifting would count against her.

If she didn't give her casino monies to her kids or anyone else I think she would not be penalized for exercising her right to use her resources for herself as she sees fit. That said, I would try to gather any artifacts in her possession that would help confirm she did in fact spend time at the casinos and used the monies as stated.
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I’m gonna reply to my reply replies here as I think it might get lost otherwise...

TXGirl - Worried has it right. I don’t think the OP has an issue with the casino - its some of the replies that appear to.

As Worried states - there are all
sorts of habits, hobbies and other forms of entertainment - even eating at restaurants - that can easily get to $300 a month in the blink of an eye.

While some may frown at my trips to a casino - I, in turn have to shake my head at “scrap-booking” and the zillion dollar industry that has become. Of course, one does have a stash of hand-stamped, ribboned homemade greeting cards to show for it. But personally... I’d rather watch paint dry.

Anyhoo... just saying in approaching an answer to this particular post and question - rather than thinking of an answer as it relates to casinos and gambling - perhaps just generalizing it as “entertainment” dollars spent may provide better answers.

But, whatever... I try not to judge.
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Moreso, therein lies the question what if she wins a jackpot at the casino? Then Medicaid is no doubt going to disqualify.
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Houseplant102 Sep 2019
In my state there was a list that illustrated various examples of monies acquired after eligibility that must be paid the state. I've not referenced the list since, but 3 things I recall that would temporarily disqualify the nursing home resident.
Monies won in a lawsuit, won by gambling, or inherited would each be owed to the state. The state was pretty clear on this issue.
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When will people understand that Medicaid is not an entitlement? It is government assistance for people who are indigent. That means they have LITTLE TO NO MONEY to spend on their care and expenses.

A person on Medicare is required to have less than $2313 a month in income, anything over that is expected to go to pay for your care. Any asserts they own are expected to be sold and/or used to pay for nursing home or at home care. If there is a spouse living in the family home it is exempted plus about $23,000 in assets to support that spouse.

So if you can figure out how an elderly person can live on $2013 a month to allow for $300 to waste at a casino go for it.
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worriedinCali Sep 2019
Actually the amount of assets the spouse can have is not $23000. The amount depends on the state you live in. If one spouse is applying, in the OPs state they can keep half the assets up to a maximum of $126,000. Some states such as NY allow a single person to have $15k cash in the bank.

Let us not forget those who fund government assistance are the tax payers. If they fund it, they should get to use it. Just my opinion though.
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First, forget anyone who knocks you about trips to a casino. It’s one of the few things left my mom enjoys, and we take her. If she enjoyed movies, we would take her there. If she enjoyed water skiing, we would take her to do that. Life is too short, especially for them, so why not enjoy as much as possible!

Since it sounds like your mom is not on Medicaid yet, I strongly urge you to go see an elder attorney. They can walk you through setting up a trust for your mom, which is so eye opening to what you can and can’t do ... and how to move funds so that there is money for her to have for spending, and money to reimburse you as needed ... and you can make requests for the funds for large ticket items, such as a wheelchair or whatever from the trust as needed.

Good luck!
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Shane1124 Sep 2019
I so agree NekkidFish. If that’s what makes mom happy then let her do it. Just because she gambles doesn’t make her a bad person. Geez.
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Although this doesn't quite address the question, I am going through the process of watching Mum's money and my inheritance dissapper at an alarming rate. She is too far gone to come here if i spent 50k to create an apartment. And, the 5 year lookback is going to wreak havoc as it approaches in a couple of years. I did speak with the State Attorney general's office here in MA about another matter. The woman I spoke with was as outraged as I was about how we treat our elderly in this state/country. They save all their money to a comfort level, and once in assisted living, it is stripped away very quickly. As one of my favorite client's said yesterday, one of the biggest rip-off's going!!!
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TXGirl82 Sep 2019
It doesn't address the question at all.

Your situation sounds stressful, but not unusual.

With respect, why not take the idea of receiving an inheritance off the table? It is reasonable, in my view, to require people to pay for the extra help needed if they are "gone too far" (as you describe your mother). It's expensive, yes. The ALs around me are pretty posh and they do have to pay their people (with benefits, I hope).

I guess I don't understand what you and the lady at the state AGs office want. Free AL so the money can pass on to the kids? You would just be taxed at a higher rate even (maybe especially) on income you didn't earn. Someone has to pay for eldercare.
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They are just never going to ask about a withdrawal for recreational thing. You could be on a cruise, and overnight somewhere would cost you more. I often don't withdraw for weeks and then withdraw 2,000.00 for groceries, other things. It is those withdrawals check written to daughter for 10,000 which is contributed to Grandson's College fund. Those are the things they look to. That is gifting to a child. If those are there in the look back period (2 1/2 years in California) then they are going to get dinged. But not that 1,000 here and there for groceries, trip to walmart, clothes shopping or CASINO, hee hee.
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I’m not sure that this is going to come out right but here goes...

In answering this question I think the fact that the money is being spent gambling at a casino is clouding and coloring the answers. Not all, of course- but definitely more than a few. This is just what she enjoys doing, evidently, for fun.

What if it had been $300 a month spent going to the movies? There is still nothing tangible to show for the money spent - just the fact that time was spent doing something she enjoys. But to make my point - what if they were “X Rated” movies? That’s bad but would “PG” be okay?

What if she spent $300 a month eating at the Ben & Jerry’s Icecream shop? Not okay? But if she spent the same money at Whole Foods on fancy, organic, imported fruit juices - would that be okay?

Some people enjoy going to the Casinos. And yes, I’m probably writing this because my hubby and I are two such people. Sometimes we make a long weekend of it and go to the casino located in a small town at the beach. Sometimes we just make a day of it and drive to the fancy, new casino about 30 minutes away - and eat lunch at the obnoxiously expensive Michael Jordan’s restaurant located in the casino... before we hit the slots.

Point being - we enjoy it and have a lot of fun. More fun when we win but still fun even when we loose. And contrary to a previous post - no, we don’t go “hoping to strike it rich”
although if that should happen - that would probably be the most fun ever!

So, please try to put stereotypes and person bias aside. Us “gamblers” aren’t all frittering away the kiddies college funds and dodging the guy who’s trying to repossess our car.
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pamzimmrrt Sep 2019
Wow thank you !My mom and Aunt love to go the casino.. and hubs and I enjoy taking them. That the and dang hairdresser are about all Mom enjoys anymore, and the two of them can afford a few hours every so often. We also don't ever expect to get rich,, just to have a good time out and about. I think some people are a bit preachy about things they don't approve of.. and fine for them. I don't go to church 5 times a week, but I don't judge those who do.
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Does her assisted living facility accept Medicaid? If so, you’re in luck. But she will only have a small monthly allowance (Moms was $60) so unless you subsidize her trips, she will be out of luck.
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No, she will not be able to go to the Casino on Medicaid. As posted, she will only get a small amount a month from her SS. In NJ its $50. Not even sure if u could give her the $300 to spend.

You need to talk to the Administrator at the AL. In my state you must private pay for at least 2 yrs before Medicaid will pay for your care. Then, it depends on if the AL has hit the % of Medicaid residents they allow. You can have no assets. NJ allows 2k in a bank acct that can only be used for Mom personally. Casinos don't count.
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A few years ago, when my mom was on Medicaid, she was only allowed to keep $35 per month for her personal use. The rest of her income went to the facility. Medicaid covered the rest. I tell you that $35 didn't cover diddly for her. I used it to have her get her monthly hair dresser appointment, and I paid for the remainder of even that appointment. Any thing else she needed , like better quality lotions, soap and shampoo, a new items of clothing occasionally, replacing the things that went missing, all came out of my pocket. I think you can forget about gambling while on Medicaid.
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From what I can tell, she is not on Medicaid yet because she is in AL facility and is still 'spending down' her savings until she reaches a point of becoming eligible for Medicaid. You actually need to talk with a Medicaid worker in your state who can tell you how the withdrawals for these outings will be handled - or talk to an atty. If she is just drawing cash out of bank to spend on 'whatever', it is very possible the money could be looked at as gifting if there are no receipts to show she used the money for herself.

There are a lot of families who write checks to themselves and note it as being paid for caregiving services, etc, to move money back to family pockets and get mom eligible for medicaid bed quicker -and it can be disallowed...creating penalty period where you have to pay for the Medicaid bed for the number of months equal to what was taken out.

If she is using debit card to gamble with, that will also be seen on bank statements. I would ask the pros in your state. The Medicaid workers or atty.
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I don’t mean to be mean but if she has $300 to spend gambling a month, honestly she should not be eligible for Medicaid. It is for people who do not have money. If she is eligible more than likely that amount of money will be counted as income. Not sure because it’s been years since I’ve had anything to do with figuring out anything about Medicaid. I worked in the field of Social Work for over 25 years and the people I saw on Medicaid were very broke and were lucky to have enough food much less money to gamble.
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worriedinCali Sep 2019
Let’s not forget though that those who do have money help fund Medicaid and other entitlement programs while those without money, do not. So is it really necessary to judge those who pay for it when they want to use it?
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I would question these outings myself. Assisted living deals with people who need help with things, and in the case of my mother with her diagnoses, along with her mental problems, I certainly wouldn't allow her to go with them to gambling casino! I am her POA and Guardian, and I don't even allow her to have more than about $2.00 on her at any time. Putting valuables out there for anyone to see or find out about or know about leads to problems...and not only with Medicaid!
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Lookback has more to do with gifting to other relatives to the exception between spouses. "Finally, there is never any penalty imposed on gifts between spouses. Since the total assets of both spouses are counted when one spouse applies for Medicaid, there is no reason to impose a penalty on such transfers, and indeed that is exactly how the law reads." https://www.agingcare.com/articles/medicaid-lookback-and-penalty-period-166116.htm
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I am going to question the benefit of an assisted living facility taking residents to a casino in the first place. Yes, I know that is not what the poster asked. But there is generally no good news that happens at a casino. People enjoy going, I guess, but it is always in the hope of striking it rich. My mother is in a supportive living facility and I would really object to that kind of an outing. Yes, of course, people have a right to do what they want but for the facility to enable that seems ill-advised. If she has so little money that she will be needed to go to Medicaid in the future, seems like $3600 a year could be better spent.
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cetude Sep 2019
why not spend it on a good time while one can
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No need to worry, Medicaid case workers generally are only concerned with large asset transfers that appear to be attempts to hide assets or gift money to relatives.
At least from my research. If someone has a story that shows something different I'd be interested to hear it.
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Although, I don’t know this for a fact but I agree with the other replies.

$300 a month breaks down to $75 a week and one could easily spend that having breakfast out at a diner every morning - which a lot of older folks do. And - it is not expected that receipts are kept when an older person is just living their life, perhaps meeting their group of regular buddies every morning for breakfast. Know what I mean?

If you were talking $3,000 a month whether it be at a casino or a restaurant- then you might have cause to worry. But $300 a month on entertainment? I sincerely doubt it. Shoot, not when a movie for two and a bucket of popcorn with sodas can run you $30?!!
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If someone going on Medicaid is very poor, how do they spend $300.00 a month on gambling.
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mstrbill Sep 2019
Usedup, the person is not poor yet nor on Medicaid yet. The question was if in the future should she need to be on Medicaid would spending $300 a month on gambling disqualify her because of the 5 year look back rule.
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She can have $2000 when she goes on Medicaid, and assisted living will let her keep $90 a month, at least in IL. Frittering the money away will not disqualify her.
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She won’t be able to afford $300 gambling trips once she is on Medicaid in an assisted living. Yes Medicaid may question all the $300 withdrawls but you might want to run the question by an eligibility worker at the Medicaid office. She can live her life And spend her money before going in Medicaid. Medicaid likely won’t frown upon the $300 transactions because she wasn’t just gifting her money away. I mean she was gifting it to the casino LOL (unless she was winning more than she put in). But I mean she’s allowed to spend her money on entertainment and gambling and travel, she just can’t go giving away large amounts. If she wins money, she’ll have to report the income to Medicaid. She won’t have to turn it over to them, she will just lose her eligibility until the money has been spent down on her care. And it doesn’t take winning much to get kicked off Medicaid. Some states will kick you off if you win $1,000.
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I guess she isn't winning, ha ha. I never do either. I think also that there is an amount of spending money you have a month, recreation, clothing, extras, some seniors like home shopping network, or have expensive packages for computer and movies. Don't know how often she goes, but I think her expenditures are not going to be questioned in this amount. CALI, where are you. I think she often has great answers to these questions. You might want to run it past medicare and medicaid offices, as well. IE "How much recreation, spending money can a senior spend per month without being questioned about these expenditures".
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I could be way off, and we do have people here very well versed in Medicaid do’s and don’ts, but I believe you are allowed to have a certain amount in assets to your name and what you do with it is up to you. However, if Mom should hit on a machine or at a table, she will have to turn over the money to Medicaid, I think.
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JoAnn29 Sep 2019
It depends on the Medicaid. Insurance verses care. I was assuming OP meant her Mom would need Medicaid in future to help pay for the AL. In that instance, Mom is only allowed 2k (in my state) in assets. Those can only be used toward things she needs. Once a year u have to send in bank acct records. They will question an amt of 300 going out monthly. Really, why would someone feel they can still gamble when the state is paying for their care.
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