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My mom is in a nursing home. She has been approved for Medicaid. And now her social security check will increase because Medicaid will be paying her Medicare premium. Her actual benefit amount won't change. But the dollar amount of her check will. Medicaid requires any income changes be reported. Is this something that needs to be reported? We are going to make the NH her payee for her SS but that won't start until after next month. Is this considered a change that needs reported since her actual benefit not including deductions is the same as before? Thanks.

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No. If Medicaid got your mom’s latest awards letters (these are the ones mailed in Oct - Nov that state what SSA will be paying for incoming year) either in her application or her renewal, or from SSA, that information would have been used by Medicaid to determine her copay. Really what you need to be mindful of is paying to the NH the amount to the penny whatever Medicaid has indicated is her required monthly copay or SOC (share of cost).

FICA expects $ to go to SSA & towards Medicare during our working years. Then once retired your SSA pays for the Part B (was $135 a mo, could be more for 2018). I don’t think you can opt out of paying the Part B.

If mom is new to NH Medicaid, remember that each mo she gets a PNA - personal needs Allowance. pNA varies by state with most having it at $50 or $60. If NH is getting her income, then NH should establish a PNA trust account at the NH for her. Sometimes the NH has set charges - like phone or cable - that are automatically deducted from the PNA & often these are magically the exact amout of the PNA..... if so mom can opt out phone or cable and use the PNA to actually buy things she needs like clothing, toiletries, beauty shoppe visits. If mom is still keeping her checking account (so it gets her income, and she / you write a check for the copay) then you deduct the PNA from the copay. Whichever way is done, Just be careful not to have PNA funds go over 2k as Medicaid for an individual has a maximum of 2k for assets.

Income change that needs to be reported would be like mom sold her home, or she inherited $ unexpectedly from a family members death. These become income for the month received and then become assets from month 2 on, so likely will take her over financial eligibility limits for Medicaid. So in that situation, they report the $$ change to Medicaid within 30 days of receipt & need to do a spend down till impoverished again & RE-eligibile for Medicaid. 

It’s a real maddening maze to get through what Medicaid & Medicare are & are not!
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