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Any help would be great. Thanks!

How it worked for me

3 months before Mom ran out of money for her AL I contacted Medicaid. In my state you only have 90 days to spend down the money to 2k, get them all necessary paperwork and get them placed. I started in April. I chose to place Mom in LTC on May 1st using up the rest of her money to pay May and June. That took her under the 2k. I provided all info needed, confirmed it with her caseworker and Medicaid started paying July 1st.

In my State, to keep Mom in her AL she would have had to pay privately for at least 2 yrs to be able to apply for Medicaid and stay in the AL. Then staying depends on if the AL has reached the % of residents they allow on Medicaid. If they have then the resident will need to go to LTC.
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Reply to JoAnn29
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Please please make sure that the facility will accept LTC Medicaid for payment and if there are qualifiers.

I’m not aware of IL ever being covered by LTC Medicaid.

For AL, it’s done on a waiver program and if an AL participates in the waiver, it will be for a limited # of beds. Often there will not be an open on Medicaid waiver bed available and the elder will need to private pay till they eventually do a spend down to get to the Medicaid 2k in assets max allowed and secure an open bed. Realize there might be a gap between these 2...... comprende? Tends to be a year, 18 mo to 2 yrs of Private pay till $ waiver bed opens up. Ask how many others are ahead of your mom on the waiver list.

Our experience was the facility was the one that dealt with the LTC Medicaid application and got all the documents from DPOA and then the facility turned all in to the state with thier bill once they went into a Medicaid bed. If they are wanting the info now, to me, implies that they are going to be monitoring as to when shes likely to hit the 2k asset max and plan to get a bed ready ahead of that or get her to do some kind of big legit spend like 6 -8 weeks ahead of that point. They also will look at the documents and see if they detect anything that might just pose a transfer penalty. Make sure you only give them a xerox of the documents and keep a list of what they got.

my moms first NH billing office was like Geatons.

Also you may be asked to have the facility become mom’s representative payee for her SS monthly income or other retirement. It may be implied that this just must be done. It does not have to be. That SS$ Can continue to go into her checking account and you write a check to the place for her monthly fee. Should mom need to move to a different facility, trying to get rep payee status changed will be difficult as SSA does not recognize DPOA and she will likely not be quite competent and cognitive to either just go to the SsA office or answer questions over the phone with a SSA rep.

Did facility clearly explain Medicaids required copay of her income once she applies for it? If she has debts, you need to give some though as to what the plan is to deal with her debt.
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Reply to igloo572
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Thank you, Geaton! When you initiated the spend down, did you go through Medicaid or the facility? I received a lengthy application from the facility asking for all my mother's financial information such as bank accounts, SSN. Is this normal or do we go straight to Medicaid? Not sure what to do. Thanks again!
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Reply to GreenTree
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Geaton777 Aug 7, 2020
Once we got MIL into a facility during Medicaid spend down (i.e. the facility knew she was pending approval) we just paid the facility invoices out of pocket. Eventually we were notified by Medicaid that she then qualified and the facility sent invoices reflecting it. This was the first facility my MIL was in and they turned out to be terrible communicators -- they "assumed" we understood the process, which caused all kinds of problems I won't bore you with. This was several years ago and I'm trying to remember...we were just flooded with letters, communications and forms -- felt overwhelming. Make sure you are in frequent and friendly communication with the facility bookkeeping and admin. Let them know you are not familiar with the process.
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Medicaid sends you a letter outlining what the spend-down amount/status is. The info doesn't come from the facility, in my experience. Every year I have to reapply for my MIL on the anniversary of when we first applied, even if nothing financially has changed.
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