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karenrosendall Asked February 2011

Do you have to wait for Medicaid to start before entering a nursing home if you have no other way to pay for it? I feel like im drowning.

igloo572 Feb 2011
It can seem overwhelming. Here's my take on all this based on dealing with it.........

Many LTC or SNF (long term care or skilled nursing facilities - which is what nursing homes are called now) will take a resident "Medicaid Pending". If you or your parent aren't already on Medicaid and now are at the point to need that level of care (you have to NEED that level of care and ordered by your doctor with medical reports to back this all up). And you have to qualify for Medicaid in order to have Medicaid pay. Every state does it differently but overall it seems that you cannot have more than $ 2,000 income per month. SOme states are $ 2,022.00 and some are $2,100. Now they can own a home (individual residence not an income producing property) and a single car (the value cannot exceed a certain amount depending on the state) but overall other than that the total on other assets have to be no more than 2K monthly.

How Medicaid beds are handled really depends on the facility. Even though they have Medicaid beds they don't have to take you "medicaid pending" - they can require you pay their daily rate for LTC or SNF for every day until you qualify. If they take "pending" the rate is usually based on what you would pay to them based on your income level at Medicaid rate. So if your income $ 1,200 per month, your daily rate would be $ 42.86 per day for February. Which is huge amount less than a $ 200.00 a day rate. Most LTC/SNF is $ 3,000 - $ 6,000 mo private pay.

WIth "pending" you still would have to pay entire $ 1,200 you get for Feb. to the facility until you qualify.

Medicaid is supposed to turn applications around within 30 - 45 days. Alot depends on how organized you are with the documents required in order to qualify and if the facility is submitting the paperwork on your behalf. This is really important as they will have a set caseworker that reviews the application and only does LTC & SNF applications.

If you go to apply on your own, you end up in the same line as those going in for food stamps, ADC, WIC and whatever else poverty programs are out there. This is kinda a cluster.
So try to find a place that does medicaid pending and works with you on the paperwork.

The facilities can ask you to show them 6 mos to 3 years of
assets before they will take you "pending" as they don't want to get a resident that might be rejected from Medicaid for too much income, or transferring $$ or property within the 3 to 5 year look back. So you have to have your financial documents organized in advance. You are going to have to give this to the Medicaid caseworker anyways, so you might as well. If you are over the monthly maximum, you should think about meeting with an elder care attorney to get up a legitimate trust so you can qualify for Medicaid and have the attorney do it so that they will accept it. I don't think this is something you can do on your own as this is just too important.
Good luck.

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