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70 year old with dementia lives in an assisted living facility, but money has run out. He did not qualify for Texas Medicaid due to a medication he takes for his symptoms. That does not sound right to me.


Any advice?

Bet that It’s not the meds per se, but rather that the meds he is prescribed fully enables him to go about his ADL / activities of daily living on his own, perhaps with a bit of occasional help. His care plan is not involved enought to warrant being “at need”.

You see this a lot in ESRD / end stage renal disease patients. They are medically just fine if they do their mutiple time a week dialysis & do proper diet. The issue often is they don’t have anyone to get them to/from dialysis or do an in home machine; they fail to stay in compliance with their dialysis schedule and ESRD diet. It’s a social problem not a medical problem. For those in this situation, if there is a PACE program in your area, it may work for him.

Based on my experience with TX Medicaid, the # of AL waivers is small as it’s hard to get facilities to participate as TX reimbursement day rate is low. AL can find private pay residents pretty easily so no need to bother with all the paperwork and regulations that being on waivers entails. Those with waivers tend to have an affliatedr adjacent NH and the AL waiver beds are placeholder beds waiting to move to the NH. For facilities this is a real efficient way to keep their beds full and coordinated care.

If there is anyway to get him into a SNF, imho that should be your goal. It may mean his health chart needs to be filled out more, see specialists, have more comorbidities, have a change in how he gets his meds from meds that he can self administer to ones that need skilled medication management. May mean he has to get a hospitalization and then discharge to a SNF for rehab and then he can hopefully qualify to remain as a custodial care resident.

Think outside of the box. Please pls realize the AL can evict him. So ya have to be proactive in all this.
Helpful Answer (2)
Reply to igloo572
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Always go to a Medicaid expert from the very beginning since rules and its processing are extremely complex.
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Reply to Patathome01
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kellytalbot: Retain an attorney.
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Reply to Llamalover47
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In Texas, Medicaid eligibility is primarily determined by financial and medical necessity criteria, not by the specific medications an applicant is prescribed. However, certain medications may indirectly influence eligibility decisions, particularly if they suggest that the applicant does not meet the required level of care for specific Medicaid programs. Understanding Medicaid Eligibility in Texas To qualify for Medicaid in Texas, applicants must meet specific income and asset limits. Additionally, for programs like long-term care Medicaid, applicants must demonstrate a medical necessity for services, such as requiring assistance with daily activities or needing nursing facility care. Role of Medications in Eligibility Assessments While the medications themselves are not a direct criterion for eligibility, they can provide insights into an applicant's health status: Indication of Health Condition: Certain prescriptions may suggest that an applicant's condition is managed effectively, potentially leading assessors to conclude that the individual does not require the level of care provided by Medicaid-funded services. Assessment of Medical Necessity: If an applicant's medication regimen indicates stability and independence, it might impact the evaluation of their need for long-term care services. It's important to note that each case is unique, and decisions are based on a comprehensive assessment of the individual's health status, not solely on their medications. Appealing a Denial If an applicant believes they were wrongly denied Medicaid benefits due to misinterpretation of their medical needs: Request a Re-evaluation: Contact the Texas Health and Human Services Commission (HHSC) to discuss the decision and provide additional medical documentation if necessary. File an Appeal: Applicants have the right to appeal decisions. Detailed information on the appeals process can be found on the Texas Law Help website. Consult a Professional: Engaging with an elder law attorney or a Medicaid planning specialist can provide guidance tailored to the individual's situation. Source: ChatGPT search
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Reply to Geaton777
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I thought that AL was usually private pay, perhaps a couple of Medicaid beds, but you usually needed NH level care to qualify for Medicaid beds. Perhaps that’s wrong, but it ‘doesn’t sound right to you’. If you aren’t in control of this, you may not be being given the correct story.
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Reply to MargaretMcKen
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You said "assisted living facility". In many states Medicaid does not cover Assisted Living. Per the search I did for Texas however, there are certain programs that will cover assisted living - in certain cases. So its not an all or nothing situation.

"Yes, in Texas, Medicaid can cover assisted living under certain conditions and through specific programs. While Medicaid generally doesn't cover the full cost of room and board in assisted living facilities, it can help with the cost of services like personal care, medication management, and onsite therapy. Texas uses Home and Community-Based Services (HCBS) waivers, such as the STAR+PLUS program, to provide coverage for assisted living."

I would call his caseworker and find out if the application was submitted to the appropriate programs to cover his care, and if those programs have limitations on anything like medication specifically?
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Reply to BlueEyedGirl94
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I would call his caseworker and ask this question.
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Reply to JoAnn29
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That doesn't sound right to me, either.
I can't know, and you seem not to know the full story here.
Did you make the applications and receive the denial.
I am afraid you may need some expert advice now on what exactly is happening here, and that would entail a POA, perhaps an Elder Law Consult.
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Reply to AlvaDeer
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