If you make too much money to qualify for Medicaid, but not enough to pay for care, does this mean only the wealthy or the very poor can get care? - AgingCare.com

If you make too much money to qualify for Medicaid, but not enough to pay for care, does this mean only the wealthy or the very poor can get care?

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My father needs to be in a memory care facility. They make to much money to qualify for Medicaid, but not enough to pay for care.

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The place to go for a good answer to your question is: the office of an Elder Law Attorney in your state. The Elder Law Attorney can explain how the Medicaid program can help your parents.

If the problem is "over - under" (meaning an income amount that is "over" the monthly amount that Medicaid would pay for care in a nursing home, but under the amount that is needed to pay the nursing home's "private pay" rate), the Elder Law Attorney can help your parents plan a monthly spend down program that will bring them into compliance with Medicaid regulations in your state.

If the problem is that your father can't afford memory care and an assisted living facility that can also accommodate your mother, consider whether home care can fill the gap. Again, the Elder Law Attorney should be familiar with home care programs that provide hours of care to supplement services provided by you or family members.

Guessing about your circumstances here can't provide specific solutions. An Elder Law Attorney can bring you understanding all of your options, if you take the time to explain your circumstances.
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This should really not be as complicated as it is!

I think a lot of people fall through the cracks, between too much money and not enough to pay for care. Hugs to you.

Use some of that so-called excess money to consult an attorney specializing in Elder Law. The specialty is critical.
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There is also a thing called financial separation. It is not a divorce but funds are counted separate. My sister and her late husband did this and medicaid paid for her NH care and still does. BIL has since passed away but her care continues. Since she has ALS she qualified for SSI which helped her a lot. BIL would visit nearly everyday.
This may be something to discuss with the elder care attorney.
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Regarding too much $...... so is it that your parents have assets beyond what is allowed for couples?
OR is their assets within Medicaid maximum but their monthly income is over Medicaid limits?
OR is too much assets & income?
Getting assets and income to be within Medicaid limits can be done but to me it’s a very different path to do it for assets vs. income. And if just dad is needing a facility but mom is fine and can easily stay living at home, it’s a lots more complicated math problem.

So what’s their backstory?

And does their states Medicaid program routinely pay for MC?
Or is it that Medicaid pays for NH but for MC it is paid by a Medicaid waiver?
For some states, MC - since it isn’t always skilled nursing care - it won’t qualify for dedicated Medicaid funding like a NH does.
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