How do we try applying for medicaid to help pay nursing home when she makes too much w/ benefits to reduce VA Benifits for medicaid approval?

There is something entitled "Spousal Impoverishment" which simply put ensures that a community spouse-the one who remains in the home, does not have to go broke to ensure their loved one receives care. It allows a maximum of $104,000.00 to remain with the community spouse. This number is rounded to the nearest dollar but it is pretty close. There is also a monthly needs maintenance amount that is allowed so the commuinty spouse can maintain their living expenses as well as a monthly housing amount. As I recall the monthly needs maintenance amount can be as high as $2,400.00 a month and the monthly housing something like $500.00-although this may be a bit low. Now you also needs to know that their is a rule called "name on the check" which means just that. Yours is yours his, his. So when all is said and done an Elderlaw Attorney is crtical to assist with eligibility. BTW GeriSW and EricJ are one in the same. Didn't mean to confuse.

Hang in, Austin. It's a lot of stress, and you are already stressed, but you'll get through it. Keep us posted on how you are doing.
Carol

Carol and Eric I really thank you both for your commets I feel a little folish for blindly following what the social woeker at the nursing home told me I thought she was sure of her facts we have a meeting sometime this week but yesterday he started going into CHF because they switched his meds around and I am going to see an elder lawyer after our accountant faxs our assests to him he still has all my paper work my husband is not helping me at all with this so it is hard but you have given me some very good advice and I now know the social worker has no right to tell me how maney hours of aides I have to hire her way will cost $4500.00 a month and she is not aware if he is placed it will not be in her nursing home but she does not need to know that-again thank you for your assistance.

Very well put, Eric. I hope you continue. The five year look-back is important, too. They will check back five years to see if you've given away any substantial assets in order to qualify for Meidicaid. Medicaid is for those who truly can't pay their own way.

Carol

First off,if a doctor is discharging an elder from a Nursing Home to home likely their custodial care needs are not high enough to met the standard of Long Term Care in a Nursing Home. This simply means that the elder can be cared for in the community and will not qualify for placement YET in a Nursing Home. You see the current standards for placement in a Nursing Home require a doctor or the state social worker to say an elder needs 24/7 care with their ADL's. The second standard to receive assistance from the state in the form of Medicaid is that the elder either be receiving SSI/SSP and deemed blind or disabled or 65+ and need a nursing home. Now there is Medicaid assistance if an elder has more income and it is the Home and Community Based Servives Waiver-Medicaid Waiver. There are 2 standards that need to be met. 1-Be Nursing Home eligible as determined by a doctor and/or state social worker. 2-Receive no more that $2,022.00 in income per month and have no more that $2,000.00 in assets/resources. The standards here are for an individual. My allowable space is almost up and there are a couple of additional pieces of information that you all need to know in order to qualify and pay for a nursing home.

Austin, I can see why you are overwhelmed! The paper work is a nightmare. The thing about Medicaid is that your assets do have to be spent down. An elder lawyer may be able to help you in some states, but states have the say. They follow Medicaid rules (Federal) if they want funding, so most do. That means you can’t have much besides your house and car before they will pay.

I don't think the nursing home can tell you the number of hours of aides you have to hire, but social workers from social services may be able to do an evaluation, and then maybe they can get you some help.

But Medicaid is for those who can no longer pay, and unfortunately, the amount of money you have must be very little in order to get help. Your Social Services people can help you there, but if you can find an elder attorney, I'd go there first.

The social worker from the nursing home is not the person who knows Medicaid. Medicaid is complicated and these social services are specially trained. They are specialists with your county/state. Usually a social worker at a nursing home is there for discharge purposes. It all gets very confusing as everyone's job is limited. That's why a legal representative is good if you have significant assets. If you don't, the Medicaid people can help you sort it out. Once you go to see them, they will want records of everything and will need proof of all of your assets (and your husband's if there are things that are separate).

The elder lawyer will need to know all of your assets, too - how much money is coming in, bills owed, property owned, cars, everything, in order to help you. The attorney can’t help you without knowing everything you have.

I hope you can go that route first. It's all a nightmare when you aren't feeling well and don't know what to do with your husband. Our hearts are with you.
Carol

What questions do you need to ask the elder lawyer we first went to an accountant who was going to help us see if we woukd qualify for medicade but after meeting him and taking papers with investments and our bills and our insurance paper 12 days later he said he could not help but would fax over our investments to an elder lawyer and then he would meet with me the nursing home wants the husband to leave rehab but said I had to have daily 8 hr aides in place before we could discharge him which will cost us $4500.00 a month and I just want to know if we qualify for medicade-the husband is not giving me any help or support and with my health I am not sure I can care for him at home-can the nursing home tell me how many hrs of help he has to have and the social worker is not up on the rules for medicaide and is giving us wrong info I am so overwhelmed at this point I can not think straight.

GeriSW has a good grasp on this. In general, you have to spend down the assets before you can get Medicaid - at least in North Dakota, where I live, we did. My parents were allowed tokeep very little. And the five year look back period is an issue now, where they will not exclude anything given away in the past five years from her assets.
I'll be looking for Geri's input, as she can help us all with this.
Carol

Well as a person who works daily with this issues I have a number of questions.
What state does she live in?
How much is her income?
How much does she have in assets/resources such as cash in the bank, CD's etc.
Is she in the home currently and is your father alive?
What type of VA benefits does she receive?
Has her doctor stated she needs 24/7 care for her ADL's aka custodial care?
I could help with this, without pay of course. If you wish. I will watch for your response