My 95 year old mother is in a nursing home and it is time to get her on Medicaid. The NH contracts with a company called ParentCare USA which does the Medicaid process. They charge $2,950 for this service. My husband suggests we should just do the Medicaid application ourselves online, but we started that process months ago and the application was so long I was a bit terrified of it and we never completed it.
What has been your experience with applying for Medicaid, if you did it yourself? Is it better to just pay the fee and avoid the headache? Another issue is that Mom is in MA and we are in CA. Thank you.
From ParentCareUSA website: we “review and process all your information you submit”. Please pls plz note: it’s “you submit”
& also:
“If there are legally issues, we will work to resolve them with you or the attorney of your choice”.
fwiw, this company has a separate division that is… wait for it…. attorneys that do Estate Planning, wills, DPOA, etc. but it is separate entity from 3K Medicaid application.
Personally I think you can do the application IF:
- existing PoA, will or codicil to her will (if it was old).
- U r existing signature on all banking & other financial she has OR mom can be still relatively cognitive to go to her bank and do forms. Like you take her to the bank but she on her own says ok to the bank officer and can do a signature.
- she has assigned you to either representative payee for SSA or named you as her advanced designation for SSA.* This nowadays is beyond mucho important as SSA does not recognize POA authority at all and SSA is loosing staff and shuttering offices all over the US due to Trump / Elmo actions. And changes like this have to HAVE TO be done for you to have SSA access as that Medicaid application will require her “award letter” from SSA (& any other retirements) to determine her eligibility and her Share of Cost to the facility.
- for a lot of States withdrawals $500+ = red flag that caseworker will want details to determine if gifting. Like check for $678.90 written to Joe Smith, did she gift $ to Joe or was Joe actually her mechanic & it was for auto repair. I cannot see this company being able to delve into stuff like this; this is POA and/or family work to get done on the behalf of their elder.
LSS You are still going to have to find stuff even with paying $$$.
On application that left you frustrated, Medicaid HUGE # of programs. LTC Medicaid application different than Medicaid as health insurance or ACA eligibility. Usually NH SW or admissions will give a residents / POA list of all documents to accompany LTC application & either actual application (you fill out) or online link for application process and you deliver a copy of all the documents on that list to the NH or scan as an attachment online. If NH gets all, it’s bc they are going to review to kinda determine IF resident seems ok to be Medicaid Pending for how their bill is dealt with and then NH does a big submission to LTC caseworker with the application + your elders documents PLUS their own NH bill and paperwork for State daily Medicaid reimbursement to them. Was it the correct application you tried to do?
NH cannot require a resident to use this company. To be eligible for LTC Medicaid means elder is impoverished or about to be impoverished with $2829 income max & nonexempt asset max of 2K for most States. If elder impoverished, they simply do not have $2,950 to pay for this. If family does not have the $, what then? There has 2 B a way to do this without using PCUSA.
fwiw States do annual renewal LTC eligibility w/fresh documentation. So….. More $ for that by PCUSA???
Now it’s up to the resident or their POA to decide how to handle the elders income once they go onto LTC Medicaid & in a facility. They can let the NH become the rep payee for income sources OR they can let the elders income continue to be direct deposited into elders existing bank account & POA does a check or set up autopay to the NH set for a date right after all income comes in for the SOC amount. Pro’s & cons for either decision.
Say a dad, a widower, in TX gets SSA $2340 & separate pension of $500. Dad gets SSA awards letter and pension benefits Notices and both submitted for his application. Dad makes $2840 a month income so he’s totally under TX income max of $2829 for individual applicants. Dad sold his house ages ago and was living in an apt b4 the move to the NH. & Dad has a mere $1300 in his bank account so totally under TX nonexempt assets of $2,000. TX has a $75 a mo PNA. Dad, under LTC SOC rules, is required to pay NH $2,765 SOC and retains that $75 PNA. This dad’s POA hopes to eventually move Dad nearer so there needs to be no change to how Dad gets his income paid to him as PoA needs the flexibility that continued banking allows for. This POA sets up an at the NH in-house trust account with $300 to pay for Dads weekly shave & barber stuff. $300 is ok as it added to his savings is only $1600 so it’s still under 2K asset max. $300 kinda takes care of 5-6 months of barber costs, so all good for months. POA buys stuff for Dad periodically using a debit card attached to dad’s checking account - which increases every month by $75- and POA makes sure bank statements always end under 2K.
But another Dad has the same income situation, but his POA cannot deal with any of Dads banking, barber payments, etc so this elder makes NH representative payee for SSA & pension. NH gets all income from both directly. NH adds $75 each month PNA to the Dads in-house trust account. If PNA gets over 2K, the NH will find something to buy asap to lower the balance and can do it without consulting the POA as they are the rep payee. If this POA wants to get some of their Dads in house account PNA $ to buy Dad new clothes, etc, they have to arrange to go to the business office and do a withdrawal from the resident’s ledger. Or they draw from Dads old checking account with the $1300 in it. This could be just fine as a system or a PIA.
If a POA wants to, they can resign. Something to clearly speak with an attorney about as its a serious move as the elder would likely become a ward of the state with a court appointed guardian or conservator. If done, any input or decisions former POA would like to have can be of little interest to the guardian.
Elaine, if any of your angst is due to gifting or very questionable spends that could be lurking in moms past, I would suggest that you find an elder law attorney that is CELA level to shepherd everything related to your moms application from the get go.
he application is a very long and time consuming. Medicaid will take many days to review (in my uncles case it was 90 days before the first update of additional information package) and if there are any questions they will send a letter and response time will be 14 days. Do you have the time and energy to complete on your own. If so, the the expense isn't justified. If you have little time to complete then the expense is well justified.
You will still need to gather the bank statement for the last 60 months, provide receipts for large expenditures to confirm they are for her care or were items purchases for her wellbeing.
They can only complete the application by asking you all of the questions. So, really you are doing it, and they just type your answers!
Try calling the medicaid office in your mother's county. Talk to a real person. Explain the dilemma. They may be able to complete the application over the phone. A county worker may even meet with your mom (and you).
When my husband was in a NH, because he was a vulnerable adult, it automatically triggered a visit from a county social worker, who helped complete his medicaid application. Then, when we moved to another state, I called, and a worker asked all questions over the phone, and sent me a request by mail for supporting documents. It was not that complicated!
No matter what, you are going to have to provide documentation, such as bank statements, income, assets, and monthly expenses. Try getting all that information together beforehand, so you are ready. You can do this!
Gena / Touch Matters
However per your stated starting and stopping an application, you need help. Even if it's from an aging agency service provider, there are free help providers nationwide including the toll free number for Medicaid.
Like others, you and/or whomever is the POA are going to need to know a lot and know how to access what's needed. Thankfully in my situation, my sister and I were already ahead at knowing certian things and having access to what was needed.
Best to you guys as you move forward and get it done!
Make sure you have all the documents needed. The five years of bank statements is the hardest part. Scan all her records so you have these electronically. Make sure you have on line access to bank records, her utility and cable/phone accounts so you can pull the monthly statements. You don't know what they might ask for as you get into the process. The easiest thing is to keep it all electronic if you can.
Like you I'm in CA with my father in NYC.
I've done the app for my MIL. If your Mom doesn't have much then there's not much to do on the app! My MIL was completely broke, didn't own a car and her husband, same thing only he was a ward of the county in a MC facility. You'll need to know basics like DOB, SSN, provide 3 months of bank account statements, provide 3 months of most recent medical bills, etc. THere's no way for the 3rd party company to get that info except through you.