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I have been caring for my 91-year-old mother for nearly a decade. She suffers from dementia and is now bed/home-bound. As her condition deteriorates, I may need to apply for Medicaid on her behalf in order to cover the cost of home healthcare aides. I understand there is a waiver available that allows certain Medicaid recipients to remain at home. In addition to SS, she also receives a pension. Will Medicaid take all of her income or just a part of it? Currently, I utilize some of her money to pay for shared household expenses - food, utility bills, etc.

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This post hits home for me, I also live in Virginia and 2 years ago I had to take an unpaid leave of absence to be my mom's full-time caregiver until she passed away from stage 4 metastatic breast cancer September 2021. during that time I was way too overwhelmed to find the support we desperately needed and that experience motivated me to want to help others in similar situations. I now work as a care coordinator for Medicaid recipients at at Aetna Better Health of VA and still trying to figure out how to navigate the system with the Members on my caseload. I wish you the best of luck! Just remember to take care of yourself too! <3
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Call your county office of aged and disabilities.. they can guide you and a caseworker will help you apply for Medicaid.
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Hjcsrrillo, I wish you best of luck. My cituacion so Identical with yours I am caring for my 95 yrs old husband with dementia I do too live in VA. It's is so overwhelming and scare at the same time. I don't even know where to begin.😞
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hjcarrillo Apr 2023
Initially, things can feel overwhelming but there are resources that are available. I live in Loudoun County and they have been an invaluable resource for me. Contact your local Agency for the Aging if you haven't already and ask to speak to a social worker. They can help guide you through the process. Caring for a loved one with dementia has been the hardest thing that I have ever had to do. Even though you do it out of love, it still is very mentally and emotionally exhausting. I wish you and your husband all the best. He is lucky to have you by his side.
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hjcarrillo: Perhaps you need to retain an elder law attorney.
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it turns into a form of Medicaid. they will assist at home and even as need be ,help with placement in a facility.
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hjcarrillo Apr 2023
Hi there. That's exactly what I am hoping for - help at home, but I don't wish to see her placed in a facility. Thank you so much for your response.
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its free in my area you have to apply and get on a wait list
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they will help , just let them know how hard and bad it is
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ley them know how bad it is and you need help
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check in to long term care in your area
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Hi my siblings and I have been caring for our mother who has severe dementia for nearly 7 years now. It’s more than we can do because her dementia is getting much worse, and we have our own medical issues we’re trying to deal with now. She only has SS. We found a decent memory care center that takes her Social Security and Medicaid with just a small stipend from the family each month. We are so grateful. If you have started the Medicaid application, and the circumstances have changed without being approved yet, make sure you update them if you decide to transfer your mother to a facility. That will probably push her into the higher priority category. The last thing we wanted to do is put mom in a home but at 94 she is now mostly unaware of her surroundings (and us). They have stressed to us that they are not a nursing home so if she ever has medical issues they can’t handle she will be transferred to a nursing home. We are still not Medicaid approved yet. We are hoping soon. Private pay will drain us. This process began in early February.
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Dconrad Apr 2023
my brother has is on the waiver program, it took us about 5 months to get approved. Hope it goes faster for you.
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Call the soc security office. Call Medicaid and all agencies involved with payments.

Keep accurate notes of communications / phone calls:
date / time / who you spoke to (or their ID name/number ... the communication. Call back phone # if you need to call back.

Everyone here has their own experience.
You need to get the information from the agencies that may / will provide financial or otherwise, support. Call them directly. All else is somewhat heresy.

Gena / Touch Matters
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apply for community medicade now. it takes 3/4 months. you have to see if she qualifies first. they ADD ALL INCOME UP FIRST/ YOUR LOCAL COUNTY DEPT. OF AGING WILL HELP.
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I am in the middle of this process right now. I hired a (very pricey) eldercare lawyer to manage my mom's application for a Medicaid homecare waiver. Every state is different but I can tell you what my experience has been in Connecticut. The homecare waiver program is not an entitlement program (as "regular" Medicaid is) so the application process is very different.

In CT the asset limit is $1,600. My mom's only asset was cash (her house has been in trust for 15 years since my dad fell ill). I had to spend down all of that and also account for all of her expenditures over the past 5 years (the "lookback" period) to prove she wasn't trying to "hide" money in order to become eligible. Any expenditures that the State deems unallowable will be added up and applied as a penalty, calculated as months of coverage that they will not pay for; in CT the "divisor" is ~$14K, meaning for every ~$14K they determine was questionably spent or transferred, they won't cover one month of care. So if the State claims my mom transferred $28K to me (for example), when she becomes eligible we will have to wait 2 months before the State funding will kick in.

The income limit in CT is $2,265/month, but any overage can be put into what's called a "pooled trust," then disbursed back to her on a monthly basis for use in covering her non-care expenses (e.g., groceries, utilities, etc.). My dad was a veteran and I also had to prove I had applied for benefits from the VA (basically that we had exhausted all other means of support).

The State is coming out this week for a home visit during which they will assess her needs and the level of care she is entitled to (how many hours/day, etc.). Medicaid will only pay for care from agencies that accept Medicaid clients. Her current agency (with caregivers who have been with her for years) does not accept new Medicaid clients, but I'm hoping they will "grandfather" her in as an existing client since we've been with them for so long). The State pays the agency directly for however many hours they've approved.

The application process itself is very time-consuming, both in the amount of time I've had to put into gathering all the documents/preparing paperwork/researching her bank history/etc. and also in the overall timeline. I first contacted the lawyer in December, and we still haven't even put in the official application yet. Then the State can take months to make the eligibility determination. All in all I wish I'd started the process much sooner, because I'm pretty sure she's going to run out of money before the whole thing is done, or possibly even die (sometimes I wonder if that's the whole point, i.e., to make it such an onerous process that the person passes before the State has to shell out a penny).

Again, every state is different, but I hope this info is helpful in some way! Best of luck to you and your mom.
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hjcarrillo Apr 2023
Thank you so much for taking the time to reply to my post. There is a lot to digest, and I confess, some of the terms are new to me. I do get the gist of your comments though. As my mother's legal guardian and conservator (since 2020), I have become well-acquainted with all the administrative oversight that is imposed on the caregiver. In fact, just recently I submitted a nearly 200-page document providing details on how I spent my mother's pension and social security monies. I have become quite the Excel and Word expert! I sincerely hope that your assessor (and "the system") realizes that it would be in your mother's best interests to retain her current caregivers, especially if they are good with her. All the best.
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Your mom is very blessed to have you doing what you can to keep her at home. Do not wait for her condition to deteriorate any more before contacting your local Medicaid agency as she may already be eligible which can help your 401 (k) savings last longer. If she is not eligible yet, you would have correct information to know when and how to apply later. If your mother was not living with you, she would obviously be paying a lot more for her living expenses. Your mother will be evaluated on her own without taking in consideration your assets.

Here is a link to the program in South Carolina.... NOTE... this ONLY applies to SC. Here they call it Community Long Term Care (CLTC). This MAY give insights to questions to consider when you contact the office where you need to apply in Virginia because each state has their own programs.

https://www.scdhhs.gov/historic/insideDHHS/Bureaus/BureauofLongTermCareServices/CLTCOverview.html

Like each of us, Medicaid does not like to spend money that is unnecessary. So, they know that assisting you to care for her in your home longer may cost less than paying for a facility and many folks do not need a skilled level of care but still need help. I suggest that if at all possible, go to the office in person to apply. First check to see what documents they need and it may help avoid a second trip. We found when applying for disability SS for my husband that a lot of the questions did not have black and white answers. By going in person, I was able to explain our situation up front and the rep completed the application for us and he was approved the first time with no appeal. The same happened when we applied for his VA benefits. For example, you have to list her expenses and you may not realize some of the expenses she can count as hers.

If your father was a veteran, be sure to check on any spousal veteran benefits she may be eligible for too. The same suggestion applies... go in person if at all possible, and go soon because benefits are often backdated to the date of the application!

Too many folks rely on what others say and miss out by not getting the facts from the agency who provides the services. When you rely on what others say and never apply, you have just turned yourself down.... when the agency may have approved your application. As laws change, often the facts can change too. This website is great for gaining "insights" from others experiences but never consider them as "answers" for your situation. Reminding myself as well on this one!
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hjcarrillo Apr 2023
Thank you so much for taking the time to reply to my post and giving me such insightful advice. I will definitely take your recommendations to heart and check out the link above. On a side note: I have semi-seriously thought about moving out of VA, and among a group of alternate locations, have looked at properties in the Summerville area. Of course, it would be most challenging to make such a move with my mother in her condition, so I suppose I am simply daydreaming. Looks like a very nice area in any event.

As I mentioned, you have made several good points for me to consider. Much appreciated.
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Medicaid will not pay for her to have 24-hour care at home. They will pay for her to be in a nursing home or memory care. It will not pay for round-the-clock care or for live-in caregivers.
Of course you are entitled to charge her for things like rent, food, utilities. That's reasonable.
Here is what's going to happen though. If your mother has any assets (real estate, vehicles, insurance policies, bank accounts, stocks and bonds, etc...) and she gets homecare covered by Medicaid, when she passes they will come for those assets because they recap wherever they can.
If your mother gets a pension and SS, her income may be too high to qualify for Medicaid unless it's for placement in a care facility.
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hjcarrillo Apr 2023
Thank you for your reply.

I am not looking for 24-hour care. She is not a difficult person and being bedridden really restricts what she is able to do anyway. I do all the housekeeping stuff and cooking, but I cannot take care of her personal hygiene. This is really what I pay caregivers to address right now. Fortunately, I only need them to come for a couple of hours in the morning and again in the evening. She has no assets to speak of, just a pension and social security. Nearly all of that is used to pay for her care. I worry, however, that if she gets worse and does need more hours of care - given how expensive that is in VA - her income would be insufficient to cover the additional costs. I pay all home expenses, food, bills, etc. Yes, in fact, she was denied Medicaid several years ago due to savings exceeding the threshold. Since then, we have spent that down. So I believe she would be approved for Medicaid in VA the second time around. But there is no way that I wish to see her placed in a facility. I do know that in VA there is a Medicaid waiver that would permit a ward to remain in the home but I don't know to apply/qualify for that specifically. But some of the posts here have given me some leads to pursue.
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Medicaid in home care has different criteria than Long-term care. I think the asset cap and income cap are the same but not sure about how SS is handled when she is living in your home. If she was in her own home, then her expenses would be considered. Sounds like Mom needs 24/7 care and Medicaid may not have that many hours available. It may be better to place her in a facility with Medicaid paying. Yes, her SS and pension will go to offset the cost of her care. But what are you going to do if she passes. Her SS and pension stop then too. Call your Social Service office and talk to a caseworker.

Have you tried Hospice? Normally its a Nurse who comes in once or twice a week. An aide 2 to 3x a week to bathe the person. A poster had said in her State she was able to get a hospice aide for 4 or 5 hrs. Hospice is paid by Medicare. So no cost to u or Mom. But when done in the home, family still does most of the work.
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hjcarrillo Mar 2023
Thank you for your response. I use almost all of my mother's income to pay for home healthcare aides. They come twice a day in two-hour shifts to address the personal care that I cannot provide - for example, diaper changing, bathing, and the like. In VA where we live they charge between $20-$30 an hour. I worry that she will need increasing care as her dementia progresses. I do everything else for her on a 24/7 basis. I've been doing this every day for a decade without a single day off. I have been living off of my 401(k) savings, which I have just about exhausted (thankfully I will start collecting SS later this year). So, I should be fine after my mother passes - just need to downsize. My mother has been receiving home hospice care sans caregivers for almost four years now. But she needs someone to visit AM and PM every day including on the weekends (not just twice a week in the AM); also, the hospice aides are very rushed and consequently not gentle enough for my mother. I am not keen on placing in a facility. I believe she has surpassed all expectations because she is well taken care of at home.
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