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Hi, My mother is showing sign of dementia. She is in her mid 80 and my dad is 88. They are living by themselves right now. They have medicare and Blue Cross/Blue Shield for sec insurance from his work (many years ago). they currently have some assets (totaling about 100K in 401K and some small pensions). We are looking to see if we could apply for Medicaid for my mother in anticipation of her having to have home care or assisted living. They live in VA. First, how do we start the process of application and if they qualify. How long of a look back in terms of documentation is needed. I think I see somewhere about 5 years. they have been retired for about 20 years now and most of the income come from SS benefits, pension. What documentations may be needed.

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The 4O1k maybe a problem. Half of that could be considered Mom's. You really need to talk to a Medicaid. Get together all assets they have no matter whose name. This includes stocks and shares. Insurance policies etc.
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Line up bank documents, any property related documents, birth & Soc. Sec., military, pension documents for last 5 years!! Any property or insurance policies, regardless of value or how it's owned - individual, community, joint survivorship. Tax records may be needed. This is a start. We had to produce many documents for both spouses - NOT JUST THE ILL SPOUSE!!! The experts can give you even better advice if you can produce this information for their review ASAP. We don't have experience with VA, but have been told by others at my spouse's facility, they had lots to do for the VA too. Be prepared to be fatigued by the process - it's very strenuous for everyone.
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I'd have them both consult with an Elder law attorney who knows Medicaid rules well, immediately. I might explore planning and asset protection, though, time is often important. Still, I'd get professional advice.

Some states have benefits that cover AL and MC for those who need it by doctor's order. I'd find out if that is the case with VA. These are often state run programs that are similar to Medicaid, but, provide assistance other than nursing homes.

I hope you'll get other responses here, but, I would still get expert advice from professionals in their state.
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