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How can elderly couple afford assisted living with less than $2000 monthly income?

Just about every senior information office will have a subsidiary that you can make an appointment with to check into things like Medicare/Medicaid qualifying. They can inform you about things like how to spend down income legally in order to qualify by purchasing a small vision or hearing health plan. These are not things most Medicaid offices will tell you. Being over by a small amount of income (like $14) should not keep a person from qualifying if you spend it down in that way. Having more than $2000 in savings or investments will disqualify a person though. I believe that if you gift your money the wait time is three years before you could qualify for Medicaid but check with your local office. Once a person qualifies for Medical or Medicaid, if your state has an Assisted Living Waiver Program you can begin the process of seeing if the person qualifies for the program. It’s a great program that is meant to keep folks out of nursing homes if they do not require skilled nursing but need assistance with every day living. There is a waitlist in many states that have the program and Assisted Living Facilities have to opt in to the program so not all ALFs are involved in it. I recently placed my nearly penniless uncle in a beautiful one in our area through the program in Calif. It took time and lots of patience but was well worth the effort. I found out that I could get around the long waitlist in the program by calling Adult Protective Services to get them to open a case for my uncle, saying that he was a danger to himself (which he was because he was running out of steam to care for himself at 89). Once a case was opened by APS they put him at the top of the list and within 2 months we moved him!
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Chittman Oct 15, 2019
Good suggestions! We are trying to work through mom's “wall of denial” to get the approval process going. She was already evaluated and determined to need 8/7 care for ADLs in Texas almost three years ago. Since she thinks her, “brain is better now”, she is refusing to prepare for the future. I’ve been told that we can start the approval process in AZ without her. We may report to that soon.
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I found a small board and care for my dad. He was over the limit for Medicaid by $14.00, so finding a facility that he could afford and age in place was important. They are referred to as care homes.

He had a roommate and they would go get into mischief together and take walks. All of his needs were met, they just don't have the organized activities. Part of why it didn't cost 3k monthly.

Where are they located? Not every town has this type of option, but the kind posters here can help you figure out what you choices are based on location.
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Reply to Isthisrealyreal
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Chittman, the couple could consider starting with in-home care provided by a reputable company. In FL, my LOs pay $22 p/hr, per person for minimal care that includes light housekeeping, cooking, running errands, driving, entertainment, bathroom + dressing help. As the elderly needs increase the company needs to provide a different skill level caregiver with a higher hourly rate. The couple can stay in their home until the cost of this type of care starts to exceed what AL (or another living arrangement) would cost. It buys some time and allows them to age in place a little longer. Good luck!
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Chittman Oct 12, 2019
Thanks for your reply! They are aging in place in our home at this point. They are doing well, besides cyclical behavior disturbances from dementia for mom. We want to plan for care for them here for as long as possible, but state eligibility states, “ eligible recipient must meet need for care in skilled nursing facility”, before receiving benefits. They are not willing to move forward with becoming eligible yet, so we wait...
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I live in Maine and help my friend who will soon be 82. Recently she was hospitalized for a serious illness and upon her release needed to go to an ALF at least to recuperate. I was able to find one room in our entire county, that room is $5,000.00 per month with the highest level of assistance. There are lower levels of assistance that start around $3,500.00. This is for a private pay room.
I also looked into home assistance for her at her apartment. For 8 hours a day, 7 days a week, that also cost $5,000.00 per month but would leave her alone at night. That figure would include meal preparation, light housekeeping and personal care.
While I realize that your wife’s parents do not wish to apply for benefits at this time, now is the time to help them apply. The process takes time and with an income of around $2,000.00 per month, they should be eligible for assistance. Finding a facility also takes time and if they were already approved for assistance, the transition to an ALF would be faster.
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Reply to Stilltired
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Chittman, the prices can be a huge sticker shock. Once I saw how much it cost, I decided to hold my retirement fund hostage. My bucket list is now a thimble.
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Chittman Oct 12, 2019
My wife and I plan to not leverage our retirement in the care of her parents. Our priorities and assets are well protected and separate from our commitment to their care when they need it.
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In some states, Medicaid will pay for Assisted Living through a waiver program.
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Judy79 Oct 12, 2019
Wish my mom could qualify for Medicaid but she has too much income. Plus she has investments. Would they take that from too? How would I find out about that?
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I don't know of anything in my area, I'm surprised to see some responses here that say there are assisted living situations available for less than $2k a month. I'd be suspicious of the level of supervision and comfort of the facility at such a low cost.

To the OP, you'll know when the time is right, via your stress level, to place Mom in a nursing facility. I would suggest you start now getting them approved for LTC Medicaid. It will be easy based on their income. You likely can do it online at your state's social services website. Then start looking at nursing homes in your area. If there is a waiting list for one that you desire, put them (or him or her) on it. Also look into in home care covered by LTC Medicaid. It may be available (in my case it wasn't, but I've heard in other states it is more readily available). The state doesn't look at your assets, only theirs. Hope this helps.
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Chittman Oct 15, 2019
Thank you for sound advice!
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I have been dealing this for two years for my parents and I have researched everything. The best way I have found are Personal Care Homes. In researching you will likely find many in your area. They run from $1500 a month to $2800 per month. My grandma spent her last 3 years in one. Many are monitored by the state. But you must do your research. Look for reviews and talk to families. There are good ones out there and good people who run then!
The research takes time, now is the time to start it...not when they need it!
Dimentia is an approved hospice reason. You may not need that now but in the future, they are a great resource!
good luck and God bless!
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Reply to Vorwald
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I am in SC. All AL facilities are different. There was 1 place I talked to here who accepted self Pay for a given period but then would accept Medicaid once all the asserts were spent down. My Mom was in a shared AL room in PA until I moved her down here in with me. It was a very nice award winning facility. It was $1,700 a month. Investments will be used for the spend down. Whole life insurance policies will need to be cashed in. Term life insurance policies will be safe. Not sure about annuities since they are all so different. I saw an elder lawyer and will go back for 1 more visit.
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Chittman Oct 15, 2019
Reading your reply made me feel that there is a light at the end of this tunnel. My wife and I don’t want to get caught in the “despair trap” that I read so many caregivers are coming from. Thank you for being compassionate and real!
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Another possibility: Sometimes , if an AL is affiliated with a religious organization the price is much less. Here in OH, for example there is a nice Christian AL for just over 2000 mo.....
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jmacleve Oct 16, 2019
May I ask where in Ohio?
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