He has Medicare and Medicaid. I called the Social Security office today to ask for an increase and was denied. The new administrator at the AL is new and so far has been of no help. The lady said either family has to pay the rest or find a new home somewhere else, like my home! Um, no to my home!
Now what? I need to know what kind of questions to ask and  to whom...any kind of advice that's out there please direct me!

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If his needs are being met, he is safe, well, warm and cared for......Pay the $10 difference and be happy that is the only gap in funds...the rest of us are selling everything to pay $6500 a month or more out of pocket!
Helpful Answer (30)

Bella, let me first say our "system" for paying for care for the disabled and elderly in this country sucks. Your frustration is totally justified. That won't pay the ALF, but take some comfort in company.

Apparently this facility took Medicaid in payment in the past. Apparently they still accept Medicaid payments.

Medicaid has a schedule of what they pay for what level of service. It is pretty much never the full asking price of the facility. That is why not all facilities accept Medicaid -- if they do, they also have to accept what Medicaid is willing to pay. Let's say this ALF charges $3,800 per month for the level of care your father is getting. Medicaid says, yes, we'll pay for this eligible person, but our schedule caps out at $3,000 for this level of care. [I'm making these numbers up.] This person must pay you $650/month, and we will pay $2,350. The facility cannot make someone else pay the $800 they come up short (compared to self-pay). They either accept the Medicaid number or they can't receive any Medicaid (for any residents).

The facility could raise the fee to $4,000. Private pay residents will have to pay the increase, but Medicaid will still be paying $2350, and Dad will still be paying $650, per law and legal contract. These amounts would change if 1) Dad's SS goes up or 2) Medicaid adjusts their fee schedule.

BTW, did Dad's SS amount go up a little for 2018?

Keep in mind that when Dad gets the proceeds from the sale of his house, he will not be eligible for Medicaid until that money is gone. For that period he will be paying the private-pay rate, which is higher than Medicaid has been paying. And it is higher than it would otherwise have to be, because the private pay fees are in effect subsidizing the Medicaid rates.

With funds so tight, I hate to suggest this, but it could save you money and hassle in the long run. Consult an attorney who specializes in Elder Law. The house sale should be handled correctly and also in the best interests of your Dad.

Try calling your Area Agency on Aging to see if there may be some legal assistance available.

By the way, did I mention that the way we pay for medical care in this country sucks?
Helpful Answer (17)

For anyone reading this, if you think it’s difficult now.....just wait. The tax deal signed in Dec will not be able to meet projections. States need to do balanced budgets and the only way will be to get close to budget will be to reduce the states share of cost of any “at need” programs. The requirements of work for Medicaid done this week is just the tip of what’s coming.

LTC is a huge part of Medicaid, somewhere like 35-60% of costs. Feds require skilled nursing care to be a benefit. What I think will happen is that the medical “at need” aspect of Medicaid will be drastically narrowed.... that to enter SNF you will need 2 step MD certification (like what Hospice does, so there’s a system already used like this) to show medical “need” and they must be coming from a multi day hospitalization (so first 20/21 days paid by MediCARE, so less paid by state & they have a medical chart that is easily accessed) and medical recertification every 90 days and a part of the existing every 90 day care plan meeting required by MediCARE. No more moving into a NH from living at home, IL or AL. It’ll reduce NH admits 30-40% I’d bet. Just too bad for families if elder has to move in with them cause their still good on ADLs....

You know all of us who post on this site are experts on Aging & LTC.
Share your knowledge.
Folks just have no idea what AL, NH costs or how tight Medicaid eligibility is. 
Or that MediCARE does not pay for LTC.
Or that Medicaid requires a share of cost of their income.
Work in detail info you know & experiences you’ve had into every day conversations. I’ve stopped being surprised that folks have no idea that NH cost 7K to 15K a month but it’s still good to enlighten folks with that dire info!
Helpful Answer (14)

10 bucks is nothing and that is not the problem here. For the past two years my husband and I have forked out thousands of dollars for his care and yes they have sucked all his assets out of him to get to the point where he's at now. Which I agree that's how it should be!! NOT Looking for a free ride for him!! Husband and I are trying to plan for our damn future too.

 By the way we are purchasing his property at fair market value at the amount of $100,000 which will go straight back into Medicaid.   We have done everything by the books!   I'm NOT Complaining about the 10 bucks, what do people do when they don't have family to help them out continuously?!?

 What if he didn't have us who would come up with the 10 bucks?! because he has nothing!
They're telling my dad he'll only get 30 bucks a month to spend

"only gap in funds" I WISH!
Helpful Answer (13)

My SS payment went up $46 this year! If I were in a facility on Medicaid, all of that extra $46 would go to the facility. I would still keep my personal allowance. (In my state it is $90.)

The deal is, I turn over all of my SS money except the personal allowance, and Medicaid pays the rest up to their limit, and the facility simply has to accept that.

So ... if Dad got a small increase this year in his SS, then the AL is justified in expecting him to turn that increase over to them. That's the deal. They are still losing money compared to their private-pay rates.

Do get some legal assistance with the property purchase. This stuff gets complicated.
Helpful Answer (10)

Just have to say...SS was not meant to completely take care of you in your old age. It was felt by 65 you may have a pension, savings and own your own home mortgage free. Now I realize that for a lot of people they lived from pay to pay and couldn't save or own a home but that was the mindset. Social security just had a pay raise. It's done once a year. Mine...was taken up with the increase of part B. I do feel, with the amount of elderly living till 90s, that our government needs to help out with these high costs of Las. Not everyone is ready for a NH. Families are having enough problems living on one salary without having to quit a job to take care of a LO.
Helpful Answer (9)

Dads SS increase this year was "$5".
Has lived at AL a total of about 16 months...(moved back home for 3 months last Spring) then back to AL.
Not once has he received any allowance. It's been a constant battle with the "officials" in charge of the finances there at AL. No one can give an answer's always "we'll check on that " or "we need to contact such and such "etc. etc...
Anything my dad needs he gets from my husband and I, we pay his pharmacy bill that Medicare or Medicaid doesn't cover, we buy his toilet paper, clothes, rolaids, milk/food for his fridge, you name it!  It's endless!!

Am I complaining? Yes! Because this father of mine was not there for me growing up when I needed things. Not material things, just the basic stuff it takes to raise a kid! My mom did it all. Dad had a girlfriend and took care of her two kids, he never came around or tried to call me or visit me or ask me how I was doing.
Skipped out on child support too and was forced to pay or face jail time. When I was born he told my mom that I was now her entertainment!
In my opinion this man I call dad is very lucky to have me for a daughter but most of all he's lucky that I married a man that has made me to do the right thing and that was to step up and take care of my damn father.

So yeah we will keep paying his way...who cares about the 10 bucks
Helpful Answer (9)

Is Medicaid paying towards his rent? I can't believe you got an AL for only $650 a month. If Medicaid is paying most of it then u need to call them to see if they will meet the increase.
Helpful Answer (8)

Not to add to your frustration, but I too would just pay the $10. And I get it about trying to prepare for your future; sometimes it's just one more thing to add to the frustrations we have in trying to care for parents. I say count your blessings on this one.
Helpful Answer (8)

The truth really is that the people ruling this country hate poor people. The more they suffer the better. We could have decent systems but that would be socialism, ok for the rich and for big business, but not for anyone else. As long as voters fall for the "socialism" nonsense, things will only get worse. If you think the "good old days" were good, then know that until Social Security began, it was commonplace for old people to kill themselves once they could not longer work. Fact.
Helpful Answer (8)

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