How do you manage the spend down if your income is only your SS check and all goes to maintaining your home?

I will tell you what I did and how it works. If you do what others assume to be correct medicaid with send you a notice. That notice will make you faint. Just spending money properly is not how you go about spending down. You might not need to notified an elder care attorney. Please do not let people suggest what to do unless they know for a fact that it worked for them. I'm not trying to scare you. Also if your daughter helps you it is no ones bz. Stop guessing seriously. This behavior is not going to help.

Medicaid questions are always state-specific, so the ideas in this post can't be applied as an answer to LIFleaBag1934"s question. But their situation does sound dire, so I wanted to pass along some ideas that could provide hope for people who feel caught in the middle of Medicaid's income rules.

If the question is about home care services paid by Medicaid, the Medicaid agency in my state (Massachusetts) has regulations that allow people who have income over the Federal Poverty Limit to pay a deductible amount over the course of 6 months, and then qualify for Medicaid during the rest of the year. The deductible in my state is the amount that the family’s income before taxes and deductions exceeds the income standard for a six-month period. This deductible can be met when your out-of-pocket medical bills equal or exceed the deductible amount. There are many expenses that can quickly add up to meet the deductible: Medicare premiums and other health insurance premiums (which can be credited prospectively) medical treatment co-pays, over-the-counter remedies, supplies for incontinent adults, foot care, lifeline monitoring, alternative medical treatments such as acupuncture, and, of course, home health care.

If the question concerns a spouse who is already in a nursing home, federal law provides that "if either spouse establishes that the community spouse resource allowance (in relation to the amount of income generated by such an allowance) is inadequate to raise the community spouse’s income to the minimum monthly maintenance needs allowance" the state can allow an amount of assets adequate to provide a minimum monthly maintenance needs allowance (MMMNA). In my state, the community spouse may receive income in excess of the MMMNA if there are exceptional circumstances resulting in significant financial duress that justify the additional monthly income.

The take away concept here is: Mediciad regulations in many states make it possible for people to qualify for coverage. The regulations are intended to help people continue to live safely at home. The benefits of getting help from an elder law attorney who understands your specific circumstances usually make it worthwhile to consult a professional advocate near you.

As others noted, Medicaid is state-specific; each state manages their own Medicaid and sets their own rules.

However, having said that, Medicaid was NEVER intended for middle-class people. It was created for persons at or below the federal poverty income level.

The Medicaid formula is based on (1) income, (2) assets and (3) family size. For example, let's say a couple has a fairly low income but has a 401K and a second vehicle. Medicaid would say that you need to sell the second vehicle and dip into the 401K to pay for your own medical expenses.

In the case of a spouse who needs to go into a nursing home, the remaining spouse is allowed to keep the house, one vehicle and a small amount of income. But everything else is supposed to go towards nursing home care. Medicaid is NOT going to pay a dime until a person is fairly impoverished.

Again, I want to stress that Medicaid was never intended for middle-class persons. A lot of people don't understand this.

BTW....the worst thing adult children do is to help their parents pay their bills. This financial assistance could be considered as "income" from the standpoint of qualifying for Medicaid and it will delay when the parents can "spend down."

If they need help, better to pick up a few extra groceries for them when they do their own shopping, take them out to dinner once weekly, etc.

In reading over all of the above posts, I must add something. Social Security was NEVER intended as a retiree's sole income, and not meant "to live on." It was only meant to provide approximately 1/3 of a retiree's financial needs. The other 2/3 were meant to come from (1) pensions and (2) personal savings.

SS is never a sufficient income level to enable a person to afford a mortgage and the upkeep on a house, even with two SS checks coming into the household.

When the SS act was passed in 1935, the retiree benefit was meant to protect seniors from "total impoverishment" - not to enable them to live comfortably.

So, I am always left shaking my head. Why do retirees believe that they are supposed to be able to live middle-class on SS alone?

Dragonflower is absolutely right. They should be teaching financial aspects of 40-50 even 60 year long retirements to today's middle- & high- schoolers. More and more seniors are now living for 30-40 years after their last job. If longevity trends continue, people will need to work much longer, to save that much more money. My own family is crimping and saving 20 percent because we're very concerned with how there are NO helps for middle-classed. To us, we feel lucky we have jobs even without college degrees, we have a home, 2 old cars (go from.A to B) and our kids aren't spoiled. They need to teach hard-core savings values in the schools.

I am not sure that it works with everyone, but I do know that if you dont ask, you wont get any help. my mom had to apply for a widows check through social security. They do not want us to know this, because she lived for many years with barely anything and they knew my dad had passed while on social security. We happened to find out by mistake. Then we had someone at the social security office slip and told us that they would accommodate for living expenses. Her new humana agent told us that since I stay home for her and get no income that we could increase our family size through her social security and get another accommodation. I would never say to take my word on it, but it is worth a try.

Now for a social worker you can contact their PCP, or get one through the hospital if they ever are admitted. Then last option would be to call APS adult protection service) and just ask them questions for info. You can call your local health dept too. Good luck to you all