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

igloo572, if they sold the house, wouldn't they be off Medicaid until they spent down all of the proceeds on their own care? That may still be the best thing to do, but I think that consequence needs to be taken into consideration.

You are right. Medicaid for an individual (my mother, for example) is a walk in the park compared to Medicaid to keep a couple in the community (my husband). It is much less expensive for the state to rely on a spouse providing most of the care, shelter, and food, than to place the person in a care center, and so the in-home arrangement should be encouraged (in my opinion). I think that is the intention of the waiver program, but its complexities are daunting.

LilFlea - the whole living in the community compliance within medicaid is such a cluster. Everything seems to be a moving target for what, when & why things are paid. Jeanne's insight on couples/spouse aspects on all this is incredibly valuable as most on this site are dealing with parent medicaid issues which is very different & waaaaay simpler.

Mortgage.It's the albatross. Your mortgage is probably the biggest issue. Pull out the mortgage agreement - what do you owe, interest rate, when will it be paid off? What % of your monthly income is mortgage payment? If its more than 25% you can't afford the current mortgage.

Find the mortgage interest statement sent for 2014 taxes, just how much interest did you pay last year? And what % of your total yearly income was that interest? If its maybe more than 10% of it, you can't afford the mortgage IMHO.

So What to do? Can you refinance to get a dramatically lower rate? If you don't have many years left on the note, could you, your kids or other family get the $ to pay off the note? If you keep things are they now are, just when would the mortgage be paid off? 5 years, 10, or longer? if you are looking at years & years of debt service on this house - giving the strain you already have in making ends meet - you just cannot afford to live there. All areas have senior subsidized housing, it will require research to find a good matchup but maybe take a realistic look into doing this.

I'd suggest you speak with a couple of Realtors as to what the house in its current condition would sell for AND clearly ask what the DOM (days on market) is for sales in your area. If the house sold for the anticipated price the realtors came up with, how much would you all have left after closing costs & mortgage paid off?

People may say buy another house, but since you are on Medicaid and if it's likely that your wife may need Medicaid as well, buying another home really only benefits the state as state will place a claim or lien on your estate due to all having to have MERP done.

Knowing the DOM is important, as it helps you to know just how soon you have to find alternative living space.

Selling your home and divesting perhaps decades of stuff is really hard to do. But
Sometimes makes best financial sense. It's a lot to think about.

It sounds as though your housing costs are eating up too much of your income. Would it make any sense to downsize into an aoartment, a senior housing unit or other housing option that is less costly than a dingle family home?

Thanks for the responses! That's pretty much it JeanneGibbs, my social security check (only source of income) is $400 over the limit for a single person in my state. My wife had to write a "spousal refusal" letter in order for me to even qualify, with this $400 spend down - so now she doesn't have the secondary coverage & as of recent weeks, needs it.

Unfortunately, our combined income goes to our mortgage with the remainder going to electric, some food, telephone/internet/cable & car insurance. I'm not sure how my wife weaves it together every month (she also gets a small check from a p/t job), there is little more we can cut truly. Our daughter picks up the slack with more food, she bought the majority of the heating oil this year and other basic needs we may have (i.e.: medical supplies, my nutrition drinks). She is in the process of looking for services for seniors that can help with things we need and my social worker has been an amazing blessing getting us some discount & even free services on some important things - much needed house repair & even a free one time oil delivery of 150 gallons which was much needed this winter.

The way it works here, which I don't fully understand, but we send Medicaid medical bills I have. They "credit" that to the spend down & give me the coverage, but the bills still need to be paid by me. I have to send in enough bills that equal the $400 per month to get the coverage. The part that gets tricky is that we don't have the extra income to pay the bills, my daughter has been trying to, but God bless the doctors because they still let me get the services I need despite having outstanding balances.

Pamstegma - what do you mean by stop having our daughter help? The things she does help with, if she didn't, I'm not sure how we would maintain every month.

I was just wondering if there was something I was doing wrong/could change with Medicaid so that either the spend down could be decreased (or better yet removed) so my family didn't have this major burden.

Are you saying that your combined monthly income is $400 more per month than the Medicaid limit, so that you are expected to pay the first $400 of the kinds of things Medicaid covers out of your own pocket, before Medicaid kicks in and pays the rest? But that all of income is covering non-Medicaid related expenses so you don't have any to pay your Medicaid "deductible"?

I can say I feel for ya! We also had a "deductible" amount to pay. The way it worked here was especially hard to manage because various vendors billed the county Medicaid office on different schedules and then that office often took a very long time to pay them. Then the vendor was to bill us for the uncovered amount. What a nightmare! I never knew what and when I was going to owe a large amount. But at least we could pay the deductible out of our income. I sure don't know know how you are going to come up with that $400 each month.

I think you are going to need help going over every detail of where your income is going now and figure out places you can tighten your belts. Yikes! I don't suppose you are spending foolishly now, but perhaps there is something you are paying for that your community has resources you could use. For example, if you are paying for lawn care, perhaps there are volunteers who provide similar services for seniors at no costs.

I am really sorry your are in this predicament. It is certainly hard enough to have a loved one with medical problems without dealing with this financial strain as well. I hope your daughter can help you search for other resources you might be qualified for.

(If I have misunderstood your spend down situation, please clarify who it works.)

Have your daughter stop helping until you spend down. Always stay under the limit, every month.