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My grandfather is going to require long term/nursing care. He is currently in a rehabilitation facility and I understand he basically has 20 days paid in full by Medicare and the next 80 would be covered between Medicare and his supplemental insurance as long as he is showing improvement under Medicares standards. He had pneumonia, a UTI, had fallen and has dementia. He is showing some improvement with PT at the rehab center but they aren't sure its enough for Medicare to keep him there. We've been encouraged to look into long term care and have looked at a few facilities and is on a waiting list at the place he's currently at as I think the transition would be smoother for him. My concern of course is financial. The rehab facility in Norther Illinois is lovely but very costly. He does have some assets that He would go thru very quickly. the staff there assured us they would assist him once his money ran out they would assist him in applying for Medicaid but I've reviewed Medicaids policies and from what I can tell he doesn't qualify for even when his assets run out due to the amount he makes per month between social security and pension. They've told me on more than one occasion not to worry. I don't want him to be in a situation where he runs out of money and cant pay for the care he has and needs to move. Also, he has a majority of his money in a trust. does that change anything ? I know this Is very specific so even if yu hae a suggestion on who I could speak with it would be great. eldercare lawyer?

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New - I'd suggest you contact the atty that did the trust to see if they are a NAELA or CELA level elder law atty or if not can refer you to one. The trust is going to be sticky to deal with and just what needs to be done will be interdependent on your states laws and how Medicaid is administrated in your state. Trust takes things beyond it ever being a DIY. Realize that dad may just have too much $ to qualify for Medicaid till he private pays for quite a while.

In addition to what Pam wrote on dealing with above income situations, often for those that make too much monthly income to be eligible as per Medicaid they can do a Miller Trust to deal with the overage.

Miller is pretty simple IF the income sources qualify as "guaranteed" (dads trust is going to make this complicated is my guess). Basically how Miller works is this: dad gets 1k SS plus a retirement of$ 1,500 a mo. $ 2,500 mo income. Dads state has the maximum monthly income at $ 2,100. So dad make $ 400 too much a mo to qualify for Medicaid. The Miller becomes the payee of the income (or the overage) and Voila! Dad becomes eligible. Some states have miller so that all income goes towards the required monthly co-pay or SOC (share of cost) to NH; other states have the overage go into a trust account which has the state as the beneficiary & upon death escheats to the state. Miller is not a DIY.

It's good you are looking into all this now. Good luck!
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Some states allow you to deduct the cost of the nursing home as part of the qualification process. For example, a widow in NY gets $1600 a month, technically over the Medicaid limit. But if the nursing home is $14,000 a month, she more than qualifies. Medicaid requires all facilities to assist with the application process.
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