During Medicaid spenddown, how should I purchase items for Mom? I need to buy her a new mattress and bedding, clothing, adult diapers, new walker, etc. Can I use her debit card and order them from her Amazon account and have it mailed to her? Is that sufficient?

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Use your mother's funds for all purchases.
Do NOT transfer money to yourself and then pay for items.
Using a debit card is fine, just make sure you save receipts.
May I ask if you are taking any steps to avoid spend down of all of your mother's funds?
I suggest that you investigate methods of transferring assets away from her prior to Medicaid application so funds will be available for her use while receiving Medicaid benefits.
As you are discovering, care is expensive and I can promise you Medicaid will not adequately cover all needs.
Helpful Answer (12)
Audvich Sep 2019
Hello Mr. Robbins,
I'm new to this situation with caregiving mom. You mentioned that we should be taking steps to avoid spending down all of mom's funds, prior to applying for medicaid. Please refer me to a good source of information on exactly what to do and how to do it please. Or, maybe you could advise me here on this forum? Thank you for your time.
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My experience is that all purchases need to be paid via her bank account. That is an account that’s tied to her SS # & whether it’s done by writing an actual check or debit card doesn’t matter. If she has currently multiple bank account, consolidation needs to happen so it’s just 1 solo account & it gets her SS or whatever other retirement income.

You mention a new mattress...... so what is the future placement for mom? If she’s going into a NH, usually they will not allow outside mattresses to come in. It’s a health & safety issue required under state laws. So find that out before you buy a mattre$$, ok!
Now ALs sometimes do as it’s not skilled nursing care so different rules. But most AL isn’t covered by LTC Medicaid unless she’s in the handful of states that have AL waivers & lots of ALS who happily participate in them.

Regarding other spend down ideas:
- multiple pair of eyeglasses
- new hearing aid & multiple packs of batteries
- extra shoes
all of these seem to flat go MIA in a NH. My mom loved those hideous SAS shoes & inevitably just 1 of a pair went mia every 3 mos or so. On retrospect could have bought & stored several pairs & she’d used all.

how are you planning on storing stuff?
If it’s in your home, Id suggest you do a Target run and buy a storage “closet” or shelving unit if you have an empty closet to use exclusively. Whichever is ONLY for mom & you take a foto before & after. Buy boxes of Ziplock freezer grade 2 gallon bags & Sharpie & put her whatever’s in them & marker as to contents. Freezer grade important as impermeable to outside dampness, dust, etc. Target & BedBathB have coordinating “dorm” items (shelving, crates, open bins) & on sale now as it’s past college move in time. If she could use a mini frig & the place allows it, she might buy one. & yeah these too available in dorm decor. & buy a plastic shoe box to throw every receipt in every time. Really stuff adds up, from replacement light bulb to shampoo to thermal pjs.

Id suggest you look at her wardrobe to see if what she has will actually stand up to the serious high heat big machine laundry systems facilities use. These are brutal on clothing & elastic. If not buy new everything and in multiples of 2. Ditto for her bedding.

Other stuff: clock (biggest you can find), reading lamp &/or torch lamp, large print magazine subscriptions.
Electronics kinda depends on what she truly can manage on her own. But all this stuff “walks”, so keep that in mind

If she needs dental work, that might be a way to spend down a HUGE amount of $. Few implants, crowns, etc easily be 20k++. My mom did $$$$ in dental & well worth it. Dental care is imo pretty nonexistent once in a facility & not covered to any real extent by Medicare or Medicaid. It’s those pink nibbled sponge sticks flouride wipes across teeth unless they can on their own actually brush & floss.

buy door hanger & floral wreath for her. Helps her find her room!

also decide what path she & you as DPOA will take for how her required by Medicaid copay or SOC (share of cost) will be done. NH tend to heavily imply that they need to become financial rep & so her SS goes direct to them with her PNA (personal needs allowance) going into an Trust account at the NH. So if you want to buy stuff you have to go to biz office and fill out a withdrawal request...... BUT it does not have to run this way. She can continue to have $ going direct deposit into checking acct & you as dpoa write out a ck to the NH for copay each mo. This way the PNA stays in her account & there for you to use as needed to replace clothing, toiletries, etc. You do need to make sure that never ever a mo ends at over 2k tho, as 2k is usually max assets LTC Medicaid allows. You can open an Trust account at the NH with like $200 for the on site beauty shop to auto draw from for her weekly or bimonthly visits & she uses for buying snacks or outing $.
Helpful Answer (14)
Getkicksonrte66 Sep 2019
This post was so good! Just wanted to say that.
1- I had an elder care lawyer , expensive , very worth it . You may can find someone Pro bono if you need one . 2- I kept all receipts , made copies of checks ( had cancelled cks too ) . Turned everything / all receipts with details into them . On occasion they came back and would ask what an amount was for and it would be something I forgot to send them and I would just send the receipt to them . All in all I didn’t have any problems . I saw where someone mentioned to purchase a burial plan and I did . That was a big help in spending down and esp when my family member passed I didn’t have to make many decisions.
Best of luck to you . It’s nerve wrecking!!
Helpful Answer (4)

Keep your Receipts. These are NECESSITIES for Mom. No one will Frown on this, You are doing everything correctly but make sure it is Not too close to the date you may be thinking of putting Mom in a nursing home.
Helpful Answer (3)

From what I've read on previous posts, I believe one can also prepay a funeral when spending down for Medicaid.
Helpful Answer (3)

Keep receipts that explain in detail every item that you purchase for her. All of the things you described would clearly be for her care. You should have no problem. If you need something that you simply are not sure about, call the Medicaid worker who helped get the spend down going.
Helpful Answer (3)

When we started looking into it when she went into Assisted Living I was told it was too late to do much with her money. It might not have been good advice back then but we are applying for Medicaid for November. I'm using a service to help, but to be honest they are not the most helpful and I don't always trust their advice. We just did an irrevocable funeral trust, and I was hoping to get her as many every day necessities as possible before November.
Helpful Answer (2)
disgustedtoo Sep 2019
You didn't say when that initial attempt was, however for anyone else it is NEVER too late. It might not cover everything, but ignoring it mean it won't cover ANYTHING!!! That was likely bad advice, but that's water over the dam already.

Do you have an Elder Care attorney? At the least you could get an initial consult and pose your questions with them. If documents are not already in place (DPOA, MPOA, will, etc) they can assist with that. They can also provide advice for Medicaid, spending down (legal and prepaid burial expenses I do believe are allowable expenses.)

Since you were talked out of taking care of this before, understand that now you will have that 5 year look back, where anything and everything spent or taken from mom's account will need to be 'justified' (needs documentation so they can determine if it is allowable expense.) Any cash withdrawals could be a problem, as they could be viewed as "gifting", even if it was spent on necessities (unless there are receipts that could back up the money spent.)
I hope you seen an eldercare attorney for estate planning; Medicaid has variations in accordance to state and you are dealing with the *government* red tape.
Helpful Answer (2)

As long as the items are for your mother or the upkeep of her home, they are legit expenses. Save all receipts. Keep meticulous records. Don't intermingle her debit card expenses with your expenses, ever. All these items above are for your mother and her care, so they should be OK from a Medicaid stand point. They should have an elder services org in your town or hers, you may want to visit them and talk things through. It's good to have someone to talk to.
Helpful Answer (2)
Bella7 Oct 2019
My dad never saves receipts !!!
Call Medicaid - your local office - they helped my neighbor spenddown for her disabled husband.
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