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I need a break. I need help and to get my life back. I need to work but lost my business and my motivation. I can’t leave her alone most days, I feel like a slave. I wanted to move her into a facility for many reasons. She has vascular dementia and a very serious heart condition. She has had 9 mini strokes, the last one being the most severe. Once you move them into your home you can never get them out. Our entire healthcare and government treat the elderly like roaches keeping them drugged until they die. I am so extremely overwhelmed.

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MediCARE is health insurance. If she is paying $500 a mo for Medicare she either 1. did not work the 40 quarters to have her Original Medicare Part A be completely premium free so she has to pay a Part A premium (varies from $278 mo to $506 mo) PLUS the standard abt $180 Part B premium (that all on Original Medicare pay for);
or 2. She did not file for Medicare at age 65 so has late fee attached;
or 3. She switched from Original Medicare to a Medicare Advantage Plan. & her Advantage Plan has tacked on costs.
How she is on Medicare for her primary health insurance matters as to just what could possibly be done to reduce that $500 a mo. cost. So exactly how is MediCARE as health insurance coverage being done?

The LTC Medicaid program is the one that will pays for care in a facility. It is different than Medicaid as health insurance although it will be intertwined for those in a NH on LTC Medicaid. Medicaid as health insurance is done often for those lower income and it pairs up with MediCARE. So they become a “dual” on Medicare + Medicaid for health insurance coverage. It is a different application than LTC Medicaid.

Medicaid has many programs and each with different requirements. Which Medicaid has your mom applied to? Or is it that she actually has not applied for Medicaid but you have heard she “has too much $”?

If moms monthly income is under $2,901.00 and her savings or investments and any other nonexempt assets are no more than 2K, and there was no gifting of her $ or assets to others the past 5 years, she financially should be eligible for LTC Medicaid. Does she have this??? LTC Medicaid program also has “at need” medically requirement that she requires skilled nursing care in a NH / SNF. Does she have this???….. does her health chart clearly indicate that she requires skilled nursing care with oversight? LTC Medicaid requires both “at need” financial & medical with documentation that supports both. If she becomes eligible for LTC Medicaid, she will also go onto Medicaid as health insurance. Those in a NH end up on 3 programs: MediCARE + Medicaid as health insurance and LTC for custodial care costs, so btween the 3 all costs covered. She will be required to do a Share of Cost to the NH of almost all her $1800 SSA $.

At $1800 a mo income, she’s ok for LTC Medicaid income eligibility.

So what is keeping her ineligible???
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Reply to igloo572
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Yes, I wondered why 1800 a month would not be under the limited needed. And Medicare costing over $500 a month? Are you talking the premium being taken out of her SS payment everymonth? If so, that seems awful high. Together my husband and I don't pay that much in premiums.

I suggest you call your Office of Aging and ask if someone can help you understand how Medicare and Medicaid work.
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Reply to JoAnn29
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According to the Georgia Medicaid page*, the income limit in 2025 for nursing home and nursing home-level community care is $2901 a month.
Please call them (again?) - (404) 657-5468 or (877) 423-4746. Maybe someone's there today

Best wishes for Mom to get the care she deserves and for you to get your second wind and revive/pivot your business in 2026.

* https://medicaid.georgia.gov/how-apply/basic-eligibility
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Reply to ravensdottir
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You will be able to get her into a facility, though it will take all of her social security. Have you spoken with Medicaid. What number have they given you to get help with in-facility placement? By how much have they told you her income means she is overqualfied.
None of this, these days, is DIY. You should consult and attorney. They will counsel you on division of assets, of QIT or Miller Trusts if needed, etc. And if not, on how to spend down her personal assets until she is qualified for her.
Consult them in the New Year.
Wishing you best of luck. Your loved one now needs more than you. She needs qualified caregivers (multiple) on multiple shifts. This will, one way or another be doable; you simply have to find out how.
I am so sorry. A New Year is coming. It is the time we attempt change to help us better our lives. I wish you the best.
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Reply to AlvaDeer
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Go see an Elder Care attorney who can advise you about Medicaid requirements in your state and how to qualify mom for long term care.

I don't know who you think is "treating the elderly like roaches keeping them drugged until they die" and if so, why you'd want mom living in one of "those places"?

I can assure you my mother lived in Memory Care and every medication she took I myself had to approve. They were each written by her doctor and not administered willy nilly by Nurse Ratchet in a bad mood. She was treated with kindness and dignity, and nothing like a "roach".
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Reply to lealonnie1
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