Is it best to assume that Medi-Cal will be needed in the future when caring for a parent & structure their finances for future acceptance?

Planning at least 5 years in advance is certainly the most ideal, since then you can take advantage of many more options. After five years, you won't have to worry about a penalty for transfers (say, to an irrevocable trust), since the lookback period will have expired. You may wish to review the long-term planning chapters of my book on Medicaid planning, here: www.MedicaidSecrets.com

dcoach is correct - However, my parents were & mom's on Medicaid for nursing home care. I have a "medicaid person" I have known for many years & she saved us from personal bankruptcy. Also, HolyCow, there is NO shame in putting your parent on Medicaid - NONE whatsoever! Just realized my maternal grandmother NEVER would accept "welfare" & I respect her 100% for that (she passed in 1962), & Richard (hubby) NEVER went on welfare/medicaid, whatever you want to call it back in 1989 when he almost died, was working two jobs AND going through a divorce. BUT, when Dad had his stroke, the FIRST person I called when the dust settled was Maureen (Medicaid lady). She literally saved our financial lives & once again, there is absolutely NO shame in that - @Dcoach - you are correct, You can't just start moving money around to "make her" Medicaid eligible. Richard's a CPA but he doesn't know the Medicaid rules & besides yoiu then have to deal w/ Medicaid - which I do NOT intend to do - I have enough issues w/n.h. mom's in to deal w/Medicaid too! As for your question of whether you shouild think about Medi-Cal WHILE your parents are having health problems MY answer is YES - like I said there's NO shame in in whatsoever!!! But do contact an elder care attornery ASAP.

I say Yes, plan for Medicaid to be needed. Given the current five-year lookback period, you might secure many of her assets, depending on the amount, in an irrevocable trust to have the clock start. Don't transfer the assets into your name, for example, because they would count against you if you needed Medicaid in the next five years, and your mother's care could require those assets be given back for her care.

Seek advice from a reputable, competent, ethical eldercare attorney.

It could help the check with an elder law attorney. You usually cannot just move money from her personal account to a different account in order to make her medicaid eligible. There is typically a "look back" period to make sure that someone really is Medicaid eligible and did not hide or transfer their assets in some way. Perhaps you could shift to not paying rent since you are providing care. She could probably use some of her assets to pre-arrange her final services and expenses. Medicaid is insurance of last resort which is paid for by the rest of the people in the country so it is understandable that recipient would need to use up their own financial resources first.

People with dementia and or other long-term medical conditions with relatively clear expected outcomes face a lot of expenses. Most people simply do not have the financial resources to cover the hundreds of thousands of dollars (or more) of anticipated expenses. It seems that a large percentage of them will end up on Medicaid of some form. Planning ahead makes sense. An elder law attorney and perhaps a financial planner could be of assistance - even late in the process.

All the advice above is really helpful! I hadn't thought about pre-planning for five years down the road for my mother, but I'm going to get on it right away before she starts to need more care and while she has the money to pay for an elder law attorney.

I would consult with a good elder law attorney. The planning is generally a good idea, but often people who give you advice really don't understand the correct things to do for eligibility for Medicaid if needed in the future. There is a five year look back period, so I would get the advice sooner rather than later. Good luck, I know with caregiving duties we really don't have time to mess around with the legal/financial planning but it has to be done for your mother's benefit.
Good luck, it would be nice to live in a country which provided NH care without such considerations, it is an additional burden when you surely don't need it.

I would suggest that you visit your local Alzheimers Association office for a list of people & places that offer "low cost" or "no cost" information. I was able to gather a wealth of information from my local associations contacts.

Also, agingdaughter, I would stop paying the rent, as that would be reasonable compensation for the care and assistance you're giving your Mom. I realize you wouldn't ask for compensation for being there and caring for her, but think about the peace of mind that you being there gives your Mom, and the good fortune she has to have a daughter like you who cares enough to give of yourself in the way you have so that she doesn't have to (right now, anyway) go into a nursing home. I care for my 88 year old Mom in my home, and I am hoping to be able to do it to the end, as well, but I worry about what may be ahead, and if I am going to be able to handle it. I am planning to look into options ahead of time....just in case the worst scenario rears its ugly head. It definitely is best to be prepared. :(

Medi-Cal planning is not for the week willed nor faint of heart! My company has been doing advanced Medi-Cal Pre-planning for 23 years now and completed more than 4,000 cases. We have successfully salvaged untold assest and resources while preserving a legacy for the families of the elderly. We conslutant feebased for this service and explain exactly what needs to be done before any fees are paid. Knowledge should be free and not be 'held hostage' with retainers or advance payments of fees.

Don't forget what generation is the primary user of Custodial Nursing Home Care. It's our "Greatest Generation"; that amazing generation of young men and women who fought for you country during WWII & Korea. They're a proud, frugal, feisty and private generation that hates being a burden to family or community. The youngest WWII survivor just turned 88 and the oldest is 107 and still drives the ladies to church every Sunday in West Texas.

This Greatest Generation has two primary goals in life: 1.) Trying not to outlive their money, 2.) They don't want to be a burden to their family and would like to leave a financial legacy to the next generation.

We have to honor those lofty goals even though our generation (Aging Baby Boomers) couldn't care less about inheritening their money and assets under most circumstances. We're doing just fine thank you and, more often that not, don't need their assets and resources to survive.

I agree, get some advice from an Elder Law Attorney or Medi-Cal Advocate licensed to give financial advice. Be very careful here, there are many organizations looking to profit off the elderly by selling annuities and other insurance related products that you probably don't need.

At my firm, we call our team of Medicaid specialists (Called Medi-Cal in CA)a "Strategic Alliance". It's made up of an Elder Law Attorney, a Investment Advisor Representative speicalizing in 'Catastrophic Planning" and a CPA specializing in generational asset transfers.

Be sure to do your own 'due diligence' by checking out their credentials and reputation. Some websites inclued: www.bbb.org (Better Business Bureau), www.naela.org (Elder Law Attorneys), www.FINRA.gov (Securities licensed Advisors) and www.NAIFA.org (National Association of Insurance and Financial Advisors) to name a few.

Don't forget about Veterans Aid & Attendance benefits for those vets and widows who are "medically needy" due to non-service connected disability. Unfortunately, there is no easy website to navigate the 'maze of VA benefits', but there are firms out there that can help you understand the process. Remember, watch out for annuity scams....it's against the law to charge vets and their families for this service.

Plan for the worse and hope for the best. Assume that your mom will need Medicaid to pay for the nursing home and get started on the paperwork. As everyone said, an attorney should be very helpful. I've read posts on other threads giving good advice on spending down money wisely. I also read somewhere that if you've lived in the house to be your mother's caretaker, thus keeping her out of a nursing home, you can stay in the house once your mom is in a facility.

I've been working for the past six months to get my mom on the Elderly Waiver. It is paid for by Medicaid and will provide services to my mom in her home, and then in any facility she will need in the future. It also provides nutrition assistance and the Lifeline service. The main idea of the Waiver is to help people stay in their homes as long as possible, which is cheaper (for taxpayers) than having them in a nursing home. My dad is still living, which changed the financial situation somewhat.

My parents have worked hard all of their lives, but we were never rich in earthly goods. We looked into private pay to have a public health nurse come into their home to help with blood pressure checks, blood sugar checks, and medication management, but it would have cost around $400 a month. They just don't have that money to spend. When/If my dad needs a facility in the future, I guess we'll sell the house.

For myself, I have long-term care insurance and hope to have enough pension and social security money to keep me off Medicaid, but who knows?