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jolobo Asked January 2021

How do people live on the Medicaid allowance?

Since the Medicaid allowance is only $875 a month, how do people pay all their bills and buy food?

NYCmama Jan 2021
JLoBx you are correct that is the allowable income to qualify for Medicaid home care in NY. Any excess income must be put in a Pooled Income trust account (such as NYSARC) and it can be used to legitimately pay bills. Then you have to enroll in a MLTC agency which will access your loved ones needs and establish how many hours of home care are allowed. The MLTC can get you a Lifeline alert, and all supplies needed. However you will deal directly with the agency assigned or chosen by you (not the MLTC) for home care aides. I’m one month into this process and it’s NOT a cakewalk.
if you haven’t already started this process I strongly suggest you contact a good elder care attorney who can help you through it while legally protecting any assets your LO may have.

JustDaughter Jan 2021
And Covidfornow, you might be interested to know that $20/hr goes to the agency. The aide generally gets less than half that...
Stacy0122 Jan 2021
Covidfornow is describing what is called self determination. There is no agency involved but a fiscal fiduciary.

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covidfornow Jan 2021
Was there an assessment done to find out the number of hours per week are allowed? We did the in home Medicaid application for our mother and they said 55 hours per week is was they'd reimburse for for in home care. They don't pay more than $20/hr,  I've heard. We'll find out. Other than that, its social security to pay bills, food, rent etc. This is in Maine.

BarbBrooklyn Jan 2021
JLo, please let us know what you find out.

We learn from each other!

JoAnn29 Jan 2021
For Medicaid cap that seems very low. What State do u live in?
worriedinCali Jan 2021
She’s in NY I believe and she’s not talking about Medicaid health insurance. She’s talking about home & community based services (which is the program that pays for home care, adult day care etc). The eligibility criteria is a bit different and she is understandably not quite understanding what she is reading about the income limits.
Stacy0122 Jan 2021
You are looking at non-MAGI numbers (Modified Adjusted Gross Income). Look at the MAGI charts and adjust income based on allowances.

BarbBrooklyn Jan 2021
Jlo, have ypu talked to Medicaid?

Have you shown them housing and heating costs?
jolobo Jan 2021
No, I will speak to them today.
mstrbill Jan 2021
JoLo,

That amount is not what Medicaid gives you to live on, it is the income level needed to qualify for Long Term Care Medicaid (Nursing Home Medicaid). Please note that if your income is over that, you still can qualify for LTC Medicaid be setting up a Miller Trust.
jolobo Jan 2021
Thanks, I will look at that trust. This isn't for NH, it's for home based services
BarbBrooklyn Jan 2021
JLO, you need to talk to a Medicaid employee (most likely on the phone with COVID).

You need to explain the situation and the person's ongoing medical and housing costs.

And again, are we talking about Medicaid as health care insurance or NH medicaid? Two very different animals.

If this is someone who is staying in the community, they may well qualify for Medicaid-expansion program insurance, which may have a small copay amount.

NYS is actually quite generous when it comes to these programs.
jolobo Jan 2021
It's the cap on what a person is allowed to live on in order to get Medicaid for home and community services - for aides in the home.
JoAnn29 Jan 2021
Do you mean Social Security? Maybe SSI which is a supplemental insurance? Medicaid does not give monetary support. Medicaid is for Medical, in home care or care in a Nursing home.

Social Security was not set up to be the main support for people. Just a supplimental. By 65 it was figured your home would be paid off. You would have saved for retirement and/or had a pension. The Country has changed. For a lot of people its hard to stay above water let alone save. Homes have been lost.

For someone only bringing in $895 a month they have to seek out resources. Have to give up extras. There are food stamps. Vouchers to help pay rent. Some people have to continue to work. Food closets. Low income apts subsidized by HUD.

Social Security is based on the years worked. They take in consideration the last 35. That means that if u wait till 66/some people 67 to retire with 100% you need to work continuously from age 31 and make decent money. If there are gaps in your earnings, that will reflect on what u receive. For me, I only receive 700+ so I rely on my husbands SS and pension to live. And will if he goes before me. I couldn't do it on my earnings alone.
Frebrowser Jan 2021
Actually Social Security is based on the highest indexed (for inflation) 35 years of earnings.

https://www.ssa.gov/pubs/EN-05-10070.pdf.
BarbBrooklyn Jan 2021
Medicaid calculations are complicated. Is there a community spouse involved?

Basically, if your housing costs (rent/mortgage, insurance, heating and cooling) are over the allowance amount, you will receive monies to cover those expenses.
jolobo Jan 2021
No community spouse. That is not what I have been reading. There is something about a pooled trust in NYS, but when I looked up those, they did not make sense for this situation.
mstrbill Jan 2021
I'm confused, what Medicaid allowance is this? Is this what Medicaid pays in your State for an in home caregiver?
jolobo Jan 2021
It is the amount of money that Medicaid allows you to live on. https://www.medicaidplanningassistance.org/medicaid-eligibility-new-york/

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