How do I get started with finding out how my parents qualify for Medicaid?

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How do I get started to find out what my parents qualify for as far as Medicaid is concerned?
What agency helps to pay for part time home care?

Answers 1 to 10 of 21
how much income is a senior allowed to have from social security and pension in order to be eligible for medicaid to pay for nursing home care
NH (aka skilled nursing facility/SNF or long term care/LTC) is paid for 3 ways: 1) private pay by either the elder or their family; 2) from LTC insurance; or 3) by qualifying for Medicaid.

Medicaid rules determined by each state & are state specific even though it is a federal & state program. Medicaid is needs-based. You are expected to spend your assets first and foremost before the state will pay. There are things you can do to reduce assets but these need to be done by someone qualified to do this that will pass your state's review. An certified elder law attorney is best.

For NH Medicaid eligibility, an individual must show that:
1) are 65+ (can be younger if qualified disability),
2) medical condition requires skilled level of nursing care,
3) monthly income at or below their states max (about 2K),
This is the “income test”– how much $ do you make. TX is $2,094.
4) all countable assets are at or below 2K
This is the “asset test” – how much $ do you own.
5) not gifted away anything of value during 5yr look-back period.
If you do, could be a “transfer penalty” when items are gifted. Penalty different for each state as it’s based on each state’s NH reimbursement rate. For Texas, it is $ 142.92 a day rate (2011).

Look-back is 5 yrs. Most states require 3 – 6 mo. of financials with initial Medicaid application. Can require more financials if something pique’s interest. Financials are bank statements, social security and retirement statements, insurance policies, etc. Your assets are subject to MERP (estate recovery) after death.

ASSETS: All assets are counted, unless the assets fall within the short list of "noncountable" assets:
- personal possessions,
- a vehicle (some states have a limit on the value)
- their principal residence, provided it is in the same state in which the individual is applying for coverage & the house may be kept with no equity limit if the "community spouse" lives there; otherwise the equity limit is 500K (750K in some states)
- prepaid funeral (irrevocable, NCV, usually 10K max)
- small amount of life insurance (usually $1,500 & NCV)
All other assets (savings, stocks, whole life, rental property) are counted.Must “spend down” to get below their states maximum to qualify.

The financials are what most folks focus on. But remember that they also need to medically qualify for needing skilled care for Medicaid.
Top Answer
what service should i contact for my dad to get home care. i would be the provider. he is 85 yrs old retired vet
My mother was just granted a permanent residence card or green card. She is 75 years old now. Never worked here. She will be staying with me and my family here in Florida. She has no social security pension or no source of income. Would she qualify for a medicaid or medicare benefits?
Pri - At 75 your mom is still young and I'd look into getting her naturalized so that she can become a citizen. Not being a citizen is kinda a sticky situation to be in and get federal or state supported care or programs. There are lots of community based organizations who do citizenship classes in other languages too.

Until recently this hasn't been a issue but is so now. At my mom's NH, there actually have been issues with ladies who were war brides and never became citizens and so get ineligible for state Medicaid but can get VA aid & attendance. In speaking with one of their kids, it has been a real nightmare of paperwork as they have dementia too far gone to go and do the citizenship classe & test to be naturalized. My mom lives in a big city with a huge military presence so this situation is not unique and the NH knows how to deal with this issue. But I doubt that other places would be able to work through it. Good luck.
how do we get Mom on Medicaid? How do we get help paying for 24 hour care in home for her as well? We have 24 hour care now and trying to spend down her $$, she doesn't own a home and does not have a car , gets Social security. All annuities cashed in already and all life ins. policies to help pay for homecare. Do we apply now for Medicaid?? Where do we go?
CHristie - I think the issue you are going to have is keeping mom @ home. Most states (who administer Medicaid - which is a joint federal and state program) have Medicaid designed to be for elders who are at a NH rather than for paying for at home care. The concept behind this is that a NH as a facility will have the range of equipment & skilled (& vetted) professionals - social workers, rehab, PT, OT, etc - that someone "working" or helping mom with ADL's in your home could not. Medicaid requires the medical need for skilled nursing, if they are living at home (or in IL) it's kinda hard to validate and document the medical need for skilled care.

The NH or facility is usually the one who submits the Medicaid application on your elders behalf along with their NH bill to the state. BUT the family or responsible party fills out and submits the elders individual Medicaid application to the NH along with the financial documentation required. The NH will give you a 1 or 2 page list of the documents needed - my mom's list was 1 page and her documents ended up being over 100 pages, while my MIL NH list was 2 pages but her documents were maybe 40 pages. Both NH were in TX but each approached it differently. The NH usually does an initial look over of what your submit and I think bases whether or not they accept your elder as "Medicaid Pending" for payment by looking at their financials. NH has an assigned state caseworker for that facility and you do not deal with them unless there is a specific issue with your elders application. My mom was in IL for a couple of years before NH, so her banking showed a clear & consistent pattern via automated payment of how the vast majority of her monthly income was spent. The caseworker may ask to see documentation or receipts on checks if they were not written to a business.

For at home care paid for by Medicaid, you would need to see if your state even does this via a waiver and how the waiver for this is structured. My mom is in TX in a NH and on Medicaid - her state has a very small and limited elder waiver program for nonNH situations and the waiting list is long. In TX it's much easier to get them into a NH than getting a waiver.Waivers tend to be called "community based services" and I'd suggest you contact your local Area on Aging to see what your state & your community provides. This site has a drop down list for AoA by state. Good luck and keep a sense of humor, you'll need it.
My dad sold his home and lived with my brother. The money from the home was put into savings in my brothers name. My brother got sick and used some of the money for medical bills. My dad now needs assisted living. Will my brother have to pay back the money before my dad can get medicaid?
@generous: how long ago did your dad sell the house? In NY state, the typical look-back period for applying for long term care Medicaid is five years; meaning that financial transactions your dad made (including the sale of the house) over the last five years will be looked at. This may vary depending on the state he lives in. Per chance, was the house ever put into a life estate?

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