Hello. My mom (88yrs) has been receiving Medicare and Medicaid for many years. Her only income is her Social Security check of $675/month. She has no other assets. She has been living with me (her son) and my family for over 20yrs, since my father passed away. In the last 5 years, she's been deteriorating quickly with Alzheimer's and now needs full-time supervision and care. Her monthly social security checks land in a bank account that we share, but that I don't regularly use. Because she has been living with me all this time, I've just been covering all her expenses from my other accounts. This has led to a buildup of money in our shared account (now about $25K, which I always considered my savings, given that I've paid for everything from my other family accounts. We just started the process to possibly move her to a nursing home when the issue of "assets" came up. When I innocently disclosed that we "share" an account that has $25K in it, this has trigged the "Client is over assets and failing for Medicaid" letter. The letter wants us the send a "spend down/distribution" via mail or fax in the next 6 days. What can I do to save her Medicaid coverage this quickly? I'm getting mixed messages in what I read, particularly because we aren't applying to Medicaid, she already has it (for the moment). THANK YOU in ADVANCE.
Can it be fixed? Yes and imho it will not be a DIY for you to attempt. I’d get a CELA level of elder law atty who works with a forensic accountant or CPA firm, as they will unthread the source of all deposits with a match up to her & yours FICA / SSA / employment/ banking / tax filings. This will take time, not in the 6 days caseworker is requesting.
Although you could try imho IF this was a fixed deposit coming from an income source that is only - ONLY - yours….. like each & every 2 weeks you did a ACH direct deposit of $275 into the account from a joint account of you and your wife AND you have past 3 years of your bank statements that show this. So there is deliberate pattern on that “income” to her which now is an “asset” of 25K that must be spent down for her to ever be eligible. But if this was $ here and $$$ there so no pattern, imho crazy to unthread.
So is caseworker wanting details on this and a spend down plan within 6 days? OR is it spending down 25K within 6 days??? way waaaayyyy different time crunch.
fwiw my experience with caseworkers is they know this kind of clusterF happens. They may let you take a verifiable with documentation portion out. But there still probably is the problem IF mom did not spend her low SSA income of $675 a month and she let it build up in her bank account for beyond 3 months, she will still be over the 2K limit that most states have as a hard and fast $ # for assets.
Quite frankly, 25K is pretty teeny amount of $ for Long Term care costs. Could be 2-4 months of private pay in a NH. It might be worthwhile to just forget about fighting this and use the $ to get her as a private pay resident in a NH that also takes LTC Medicaid.
Heres why…
- If she is not coming into the NH as a post hospitalization discharge rehabilitation patient - which means Medicare is paying for up to 100 possible day's at this NH - but coming in directly from living in your home to being a custodial care resident now filing LTC Medicaid application, her being private pay could be a good move. It gives her more choices of NHs. And perhaps more importantly, it enables the NH to do things to build up her health chart to show she absolutely is “at need” for skilled nursing care. Being “at need” medically is a requirement for LTC Medicaid and often overlooked in the hubbub of financial documents. Often those living at home flat do not have a nice fat medical history and chart so a couple of months on private pay enables that to Voila! appear in their chart.
and…
- her SSA at $675 a month is super really low. Avg SSA is now about $1700 a month. Once on LTC Medicaid, a Nh gets all their SSA mo income less a small personal needs allowance which average $50-$75 a month. A resident who can only be counted on to only do a copay of $600 a month to a NH is not the same attractiveness of one with monthly income of $2100. The monthly income max now is now $2,829 so your moms at $675 is beyond low.
In theory, NH should not show preference for a higher income entry but they do. Back when I was touring Nh for my mom, once they found out my mom was within couple of hundred of the income max at that time, they were positively giddy on having her move in. Your mom paying a few months private pay helps her be more financially attractive LTC resident. Yep, unfair but is what it is.
Let us know what happens, we do all learn from each other.
You should never co-mingleing a parents income with your own. Her SS should always have been kept in separate banking account. You should have used her money for all her needs. Her bank statement would have shown her money going in and out. Any account with her name on it, Medicaid determines is hers. Especially if her SS is being deposited in it. (My Moms name was on my disabled nephews acct when she went to redo her Will at 80. The lawyer told her to get it removed because of Medicaid)
Can you prove you have been covering her expenses and have just allowed her SS to sit? I think I would find a Medicaid planner first. An Elder Lawyer can help. I would suggest though, if he asks for a retainer, that you use the money in the acct Moms SS is deposited to. That will help to spend down her money. The lawyer can verify if I am correct.
If she is getting Medicaid for health insurance this amt of money can effect it. Community Medicaid where she is getting help with aides has an asset limit so 25k will mean the Medicaid will stop till she spends down the money.
I suggest you contact the caseworker on the letter and ask if you can set up an appt with them because you are confused about what you need to do. Take the bankstatement and check register with u. I so hope you kept records on what money you spent on her. You may be able to use that to offset the 25k.
Medicare has nothing to do with this. Medicare is tied to Social Security.
You need to go to a funeral home that does this and you need to pay right away using bank checks so the money is immediately taken from the account.
You and your siblings and spouses will need to provide birth and marriage certificates.
If she doesn’t have a funeral trust set one up for her.
not sure if you have time to see a lawyer in such a short amount of time but you should if at all possible.
All States but 2 (NY & MI) allow for IFT for the NH resident and their community spouse and $ comes from their assets. So lowers overall assets. NY and MI allow for an irrevocable funeral arrangement or contract. A State can limit the amount of the IFT allowed as exempt. It could be 15K each which is the max that most States do but could as low as NE $6,346 or Utah’s 7 K or GA @ 10K.
For buying them for adult family, only 4 States allow for this: AZ @ 9K max, CO, IL $7,719 max, Missouri $9,999 max and Oregon.
LSS it’s on you to verify whatever you are buying - that is irrevocable $ paid - meets your States regulations.
Again rules of your State will be very much important should you do an IFT as to whether or not it will meet Medicaid compliance, in addition to rules like the above, could also be…
- if your State requires a Good & Services document that must be submitted by the IFT company selling it to you and that the G& S meets State standards as to included costs. Right now half the States require a G&S.
- States can require registration with State entities. Like TX requires 3: Dept of Banking, Dept of Insurance and Funeral Service Commission. So missing 1 of the 3 too bad, so sad on that IFT eligibility as an allowed spend down.
- States can require the seller to hold a valid preneed funeral permit in their State.
- States require that the State is listed as the residual beneficiary. It’s done to have the policy be OK for estate recovery required attempt. State may have specifics on timeframe as to by when any residual must be paid by and interest if not.
I'm not posting this to be all smartyIgloo but it’s really easy for families under time crunch of a spend down to hear what they want to hear. And then it becomes an expensive bite on the butt. That $ paid is irrevocable, pffft! It’s gone.
You should have been POA for your Mother, or guardian or conservator as she became too incompetent to appoint you as POA. You would have been on her account only as her POA, and signing as such. All funds in the account would have been hers, and your own accounts were for your own assets, whatever you chose to do with them.
Instead you added yourself to her accounts. You are now without records to prove much of anything to anyone I would imagine, and "your word of honor" doesn't count whatsoever in these complicated legal matters.
You need the help of an Elder Law Attorney at once. There's one unhappy way to start spending down this money now. But this isn't DIY and this isn't something we can "help you" to do. This is governmental rules, and they apply. It's complicated at the get-go, and now with this mess over the years it is impossibly complicated.
As they say "ignorance is no excuse before the law". Your best chance of getting this cleared up is with legal help.
I am so very sorry, but this is what happens when one proceeds over time without doing it right, and the fact that it wasn't caught by the government before now just shows how backlogged they are. My friend who died a year ago never paid taxes the last 8 years of her life. They never caught her before she died, but it certainly has left a mess for the administrator of her estate, and for attorneys trying to wind it all down, and has robbed any inheritors of money they might otherwise have got.
Sad when these things happen, and I am, again, so sorry.
See an attorney now.
Perhaps you will get better advice from a lawyer. I am just telling you that it will be easier to come to terms if you realize that in their eyes her social security money is hers and cannot be shared. I am sorry for your predicament and I hope you find some resolution. I lost my mother last year and the one or two times I had to deal with social security for her they made it quite difficult.
Also, you DO need to provide Medicaid with the info they request in the timeframe they told you.
She is now applying for Long Term Care Medicaid, which has much stricter financial qualifications. You need a certified Elder Law attorney or Medicaid Planner asap.