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My parents purchased a burial plan in another state (where my dad is buried). My mother has since relocated near family in another state. She will probably end up on Medicaid before it's all said & done. Can she set aside $ for the additional out-of-state transport, etc., expenses now--or would that be subject to the look-back? What do you do about final expenses when they have little or no resources? (and you have your own $ issues)

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Should she go onto LTC Medicaid in a NH, Medicaid will require basically almost all her monthly income (SS$) to be paid to the facility and her exempt assets will have a maximum of 2k. Once in a facility on Medicaid her only flexible $ will be whatever your state has as the personal needs allowance (usually $50, $60) which for most ladies pays for the on site beauty shop and perhaps some toiletries replacement.

So she probably wants to - before ever filing for Medicaid - to pay in full the extra costs to transfer her body back to her old state so she can be buried next to her late husband. Funeral & burial preneed are allowed spend downs. There’s going to be costs from a local FH to get body, prep it and a transportation fee to the old NH. Plus I imagine some sort of state required paperwork fees. Maybe as a first step call the old FH to see if they have an affiliation with a FH in your area. If so it will be easier. I bet it’s going to be lots more co$tly than you’ve imagined.
You cant do a DIY “weekend at Bernie’s” with the body.....

My mom had had a preneed done in the 1980’s and my experience is similar to what the others wrote..... there were all sorts of additional costs not included.
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I would also caution about any funeral contract. There have been many many examples of shonks in the industry. The business has already spent any money that you mother has paid them, and they won't necessarily be happy about being out of pocket over the final events. You may be better off cancelling the contract and going for the most appropriate funeral you can find when the time comes. It won't affect your mother if it is different from her present expectations. Get a copy of the contract and read it.
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I would contact the agency where the pre-planning contract is held. Explain to them the circumstances and ask if they could arrange transport and apply the funds to your mom’s contract. . However, I would caution you to be extremely cautious with these “preplanning” contracts. My mom paid $36 a month for decades. I added it up once and it totaled nearly $13,000. When she passed, even with the preplanning, it still cost me $2,000 at the funeral home and another $5,000 for the very basic of grave markers. Thank heaven they already had their plot. To this day, I don’t know what the preplanning paid for and I believe we all got ripped off.

You can also call Medicaid in the state where Mom lives and ask them. She shouldn’t be penalized for wanting to be buried next to her husband.
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