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SouthernSun Asked June 2021

Medicaid eligibility. Will a life insurance policy prevent my getting him approved at home?

My brother is in a nursing/rehab facility following nearly 4 months of hospitalization from bladder infection that went sepsis with lung failure. He is on a vent with trach likely for the rest of his life. He is severely affected by childhood polio/iron lung and now has progressive post polio syndrome and has been in chair for many years. I can accept that his only asset of checking/savings will be wiped out. His only income is my late dad's social security of less than $1000. He will need hands on assistance for all personal functions and cleanliness, prep of foods he can swallow, monitor of vent machine and clean trach. A $15,000 life insurance policy intended for his final expenses kept him from Medicaid approval in rehab center. Will it also prevent my getting him approved at home? Of course it may end up cashed for rehab care if he does not progress fast enough.

JoAnn29 Jun 2021
Just reread your post. I hope you do not plan to bring brother home. The care he needs needs to be done in a Skilled Nursing facility. Trachs are not easy to care for and there are some facilities where I live that won't take a person on a trach. In home thru Medicaid I doubt will give you an RN. CNAs (aides) are not medically trained. They are only trained to feed, bath, change beds, change depends, dress, do laundry, some housekeeping, etc. CNAs do not clean trachs. And, Medicaid may not give you 24/7 aides. Itscbeen discussed on the board that 4 hrs a day is about normal. And that may not be every day. You would need to take up the slack. Don't think brother can afford round the clock aides. Thats about 10k a month and all the problems that go with it.

Really sorry what brother is going thru with no fault of his own. But you both need to be looking at skilled nursing facilities that take Medicaid. Trying to care for him at home is just not plausible.

JoAnn29 Jun 2021
https://www.agingcare.com/questions/my-brother-is-in-acute-care-hospital-with-trach-and-ventilator-he-wants-to-go-home-they-want-rehab-467848.htm

There are responses to your above question. I did say then that if the policy is keeping him from getting Medicaid and it has "cash in" value than cash it in, and buy a prepaid funeral with it. If there are any final expenses, they don't get paid. You are not responsible for his debts.

Please, don't take what a Social Worker or finance person tells you in rehab. They have no idea all the rules concerning Medicaid. If they did know the rules they would have known the policy needs to be cashed in towards his care. But he may also not have qualified if he had more than 2k in his savings and checking. You really need to talk to a Medicaid representative. You need to know brothers finances so have his bank statements available. These will show what he receives in SS and what his totals are. If there are bills pending you need to know how much more will be coming out of his acct. For a 15,000 policy you will not get 15k. Maybe a few thousand.

So, you need to see what assets he has. If more than 2k (whatever ur state allows) then you need to spend that down. Lets say it costs 10k for a month in LTC and he has 11k. You pay for one month of care. The 1k is under the cap. It will depend on how much he has to when u apply for Medicaid. In my state u apply 90days before you need Medicaid to take over. For me in that 90 days Mom had enough for 2 months private pay. I stared the application in April. Mom paid privately May and June. That spent her down, all paperwork needed was done by June, Medicaid started July 1st. Your brothers SS will be used to offset the cost of his care and a very small amount (my state $50) will go into a Personal Needs Acct for him to use on personal things.

I bet this is overwhelming. I had no problem in dealing with a Medicaid caseworker. He actually did the application for me. I supplied the info. What I didn't have with me, he gave me a check off list. We used email. When I felt I did all I needed to do I confirmed it with him and he put the application thru. I did the work so then I knew it was done.
cweissp Jun 2021
Dad was in a CC went from AL to SN. He paid 1st mo and then SN estimated what they thought would be his share after medicaid. (However, in this case there was a spouse.) So mo 2-6 dad paid the estimate at which point he died. Because of spousal division dad overpaid and a balance was due mom afterwards.

Don't know though if it works that way for most SNF.

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Daughterof1930 Jun 2021
When my mom needed Medicaid my dad cashed out an old life insurance policy and used the money to pay off their remaining debt, and also prepaid both of their funerals. Doing this considerably sped up Medicaid approval. Wish you the best looking out for your brother

Stacy0122 Jun 2021
You can cash out the value of the life ins. policy and prepay a funeral/expenses. It is state specific, so in MI it is $10,500. The other money would need to be spent on his needs, ie chair, clothes, debt, dental, etc. to get him under the threshhold which is $2k here.
cweissp Jun 2021
Sorry to butt in but make sure the prepaid burial/funeral is irrevocable. At least in my parents state it had to be irrevocable.

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