I had to apply for Medicaid for my BIL at least 3 times before he got it. They kept denying him because all the paperwork wasn't sent in correctly.
On the form letter saying it has been denied did it tell you why because they have to do that. I just received a letter stating my BIL is canceled from Medicaid as of Dec 2023. There is a worker's name on that letter that I called and she told me that the review wasn't sent in and that we had time to send it in so that he stays on Medicaid. I don't handle his Medicaid anymore the nursing home does now because they are rep payee but until the nursing home sends in that letter stating they are his legal rep payee I will still get that paperwork.
Call the person on that letter to see why they can't get it. If its spending down their finances until they are under a certain amount for Medicaid. Which we had to do for my BIL because he was already in the nursing home I had to spend down his finances that meant to pay the nursing home what he had in savings then the Medicaid took him on.
OP, your profile says that your mother is ‘79, living in AL with age-related decline, incontinence, mobility problems, and UTI’. The UTI should be cured. The other issues are fairly normal, and wouldn’t normally justify 24 hour nursing in a NH. Perhaps that’s why Medicaid was refused.
OP, your profile also says that you ‘take care of everyone in the family who needs it now’. Perhaps you could reconsider all the needs of ‘everyone’, and prioritise your time. You can’t do ‘everyone’ or ‘everything’.
My father worked with an elder attorney to file the Meidicaid application on behalf of my mother, and she was accepted the first time. It is a ton of work, but they know exactly what to do to get approval. It cost him 15 grand and I know that’s exorbitant, but there was a ton of time put into it and it’s important to do it. Otherwise, you’ll probably keep getting denied because the application is not being filled out in such a way that you’ll get approval. Please go to an elder law attorney with plenty of experience doing nursing home Medicaid applications.
For context, my mother went in as a private pay individual and I think she paid the first month private and then Medicaid kicked in. But the attorney can guide you around the strategy for this as well. Don’t mess around, you don’t have time.
We had to apply for Medicaid 4 times before being accepted. My mom needed 24/7 care, she had no money left, no assets of any kind etc. The good news, as soon as she was approved, medicaid covered the months for me that we were billed from the nursing home, while we were applying for her.
It would be time for some expert help. I would attend an elder law attorney. When you call the office be certain that you want to spend an hour discussing Medicare eligibility option for your state. They should have it at their fingertips. Take with you the POA and all documents about assets.
Each State is Different. Sometimes things can be done that help. When expert medical input is needed you go off to the doctor, and here, as Igloo who is so SO smart on all this medicare and medicaid stuff says, this often isn't a DIY project.
Wish you good luck going forward. Hope you will update us.
* Confer with Elder Law Attorney They can often review Medicaid Application and help with it or have other significant input to consider
* Request a Geriatric Case Mgr or Licensed Social Worker be assigned to case. . They can help with care options and, assist with communication to PCP , and help with Medication application etc
* You can always call APS , report PT as " unsafe" in home . APS makes home visit and assess the situation and go from there... ( This may be last resort but sometimes it takes a drastic step like this)
If patient is a Veteran or spouse of a Veteran, speak ASAP with VA Services in area . There are sometimes significant veterans' benefits for veterans and or their spouse
Mom needs to be 24/7 care for Medicaid to pay. What you have listed on ur profile does not seem to be 24/7 care. Is the AL asking your to transfer her because they no longer can care for her? Does she have Dementia? Why was she turned down?
On the form letter saying it has been denied did it tell you why because they have to do that. I just received a letter stating my BIL is canceled from Medicaid as of Dec 2023. There is a worker's name on that letter that I called and she told me that the review wasn't sent in and that we had time to send it in so that he stays on Medicaid. I don't handle his Medicaid anymore the nursing home does now because they are rep payee but until the nursing home sends in that letter stating they are his legal rep payee I will still get that paperwork.
Call the person on that letter to see why they can't get it. If its spending down their finances until they are under a certain amount for Medicaid. Which we had to do for my BIL because he was already in the nursing home I had to spend down his finances that meant to pay the nursing home what he had in savings then the Medicaid took him on.
Prayers
OP, your profile also says that you ‘take care of everyone in the family who needs it now’. Perhaps you could reconsider all the needs of ‘everyone’, and prioritise your time. You can’t do ‘everyone’ or ‘everything’.
For context, my mother went in as a private pay individual and I think she paid the first month private and then Medicaid kicked in. But the attorney can guide you around the strategy for this as well. Don’t mess around, you don’t have time.
The good news, as soon as she was approved, medicaid covered the months for me that we were billed from the nursing home, while we were applying for her.
Each State is Different. Sometimes things can be done that help. When expert medical input is needed you go off to the doctor, and here, as Igloo who is so SO smart on all this medicare and medicaid stuff says, this often isn't a DIY project.
Wish you good luck going forward. Hope you will update us.
They can often review Medicaid Application and help with it or have other significant input to consider
* Request a Geriatric Case Mgr or Licensed Social Worker be assigned to case. . They can help with care options and, assist with communication to PCP , and help with Medication application etc
* You can always call APS , report PT as " unsafe" in home . APS makes home visit and assess the situation and go from there... ( This may be last resort but sometimes it takes a drastic step like this)
If patient is a Veteran or spouse of a Veteran, speak ASAP with VA Services in area . There are sometimes significant veterans' benefits for veterans and or their spouse
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