Medicaid approval: Are receipts are an issue?

Life26ez-Go to Medicaid.gov.

Co-mingling accounts / finances is problematic, as you now realize.
If I were you, I would all Medicaid and tell them what you did and ask how to rectify it.

As you likely now know, you need 'trace-able' receipts and documentation for all transactions. Once you start using your own income, Medicaid presumes that 'mom' is financially okay and doesn't need Medicaid or government financial support.

You could also contact an attorney specializing in the field and ask them how to manage. Ask about social security payments, too (and your legal rights to manage).

Be sure that you have all legal documents in place to manage Mom's income. Your name has to be on all the banking / financial / government healthcare forms.

Gena / Touch Matters

If A and D ointment doesn’t work. See doctor

Come clean and tell them you had to withdraw money because you weren’t set up and you haven’t got / kept receipts
Did you order anything online that you can show receipt of goods?
If you said by your account statement to show?
you need poa and joint access

Receipts are essential for one who handles another persons transactions. This has been my experience. I found this out the hard way. I was able to obtain copies of receipts for major purchases which helped. Consult your elder attorney regarding daily care like food, your time giving care,

Life26, what LTC Medicaid (the program that pays for care costs in a facility) will look at is your mom’s income & assets, her pattern of spending and to whom her $ was paid to and IF it now makes sense for her to be basically impoverished.

The big issue is - based on what you posted - all her $ went to you. Right now her finances show every mo she “gifts” most if not all of her monthly income to you. Gifting not allowed & places a transfer of assets penalty on her LTC Medicaid eligibility. Medicaid does not expect your mom to live on air but it does want to ensure that her $ was used to pay her own living costs. That’s what the 5 yr lookback does.

You will have to be able to show to some degree that the $ she gave you was then used by you to pay for specific expenses of hers. That it was not “gifting”. How you can do this is via a match up that shows a pattern of spending by mom to you to pay her bills. Probably the easiest to start with is utilities as she/you can do an online account and then see prior bills. Ditto for her credit cards. I’d try to do at least 2 years if not 3 but do it quarterly (Jan, April, Aug, Dec so that you can show how she started and ended those years). Print them out so you can establish there is a match up for her $ to you that is actually for bills due by you for the amount due. That there is a pattern of spending by her / you to deal with her bills. For something odd & over $500, that is something you may have to provide a receipt for. This is something you as her POA can DIY.

A ? to you related to this….. are you living w/mom? If you have your own home/apt & have a job, it will be easier for the caseworker to accept how y’all did payments on her bills as really bad bookkeeping. BUT if you actually live with mom and do not yourself have you own reliable source of income (your own salary/retirement, spouses income, investments, etc), this gets way WaAAAy more complicated as you are commingling $ to pay for shared living expenses. If this is your situation, I’d suggest that mom gets an elder law attorney to shepherd her LTC Medicaid application. It imho is not a DIY by her or you for that LTC Medicaid application. She pays the atty as all this is being for own behalf.

Also please be aware if mom is in a NH on the date she files for LTC Medicaid, that date will be the start of her Share of Cost / Resident Responsibility paid to the NH. SOC will be all her monthly income less whatever her State has as the Personal Needs Allowance /PNA. PNA varies by State. Like if a mom paid $1800 mo SSA income + $500 a mo in another income and lives in TX, her SOC to the NH would be $2,225 as TX has a $75 a mo PNA. That $75 will be it for any $ this mom has to spend and IT IS RESTRICTED SPENDING. PNA $ only used to pay for things that LTC Medicaid does not provide for… like clothes, shoes, toiletries, beauty shoppe. As LTC Medicaid pays her room & board, she cannot use her PNA to pay for anything for her old apt / home. If she wants to continue to keep a home or apt, you &/or other family members will have to pay all those expenses.

Also due to the Share of Cost requirement, she will realistically have no $ to pay her credit cards. She will default on them unless you are willing to have them become your own responsibility.

LTC Medicaid eligibility is very narrow…. have to be “at need” medically and financially. Medically is needing skilled nursing care in a facility for most States. Financially is under $2,901 in monthly income and under 2K in nonexempt assets for most States (basically impoverished).

So often POA & family is totally gobsmacked by the Share of Cost requirement. If they have been interdependent on their elders income to keep a household afloat, this becomes a crisis. If this could possibly be your situation, please please think about what this could mean for all of you.

I agree with Alva that this is not the way bills should be managed, however, I don't know why you need receipts. Just copy the activity from your bank account and hers, showing funds taken from her account, going into your account, and the bills which were paid. If you were sloppy about this, or mishandled funds in any way, its not going to look good.
The utility companies and the landlord should be able to provide receipts or a printout of her bills being paid.

Yes, this will be VERY problematic.
I would consult an attorney to see how best to try to form a paper trail with the entities you have been paying in this manner.
Call Medicaid and ask their advice about next steps.

Consult with an attorney about bills paid with your funds that were transferred from your mom's account to yours. Then on, your mom should have checks for her own account to pay her bills, not from your account. Order checks from her bank. Some bills can be auto-paid from her funds.

It probably is a problem, however one that could be worked through. Getting an elder care attorney or some have free consultations will help get you going in the right direction. It will be a lot of work, but not insurmountable. Start by gathering all of your moms bill information. Her rent amount, Electric, Internet, etc. Most of The those things you should be able to find records of or get records from the companies. Make a clear list. If you have your credit card record showing where you paid those said bills, that is all the better to add. Print off copies of the bills if you can get them & your credit card statements. If that’s all you took money out to pay for, the totals should match what you took out. It’s a lot of paperwork & searching, but well worth it. A letter stating what happened, why you took the money out to put in your own account would also be wise.
If there is more money that was taken out for odds & ends that have no record, that gets harder. However, hopefully worst case scenario, the bills you can prove might be ok’d & there would only be a penalty for the smaller stuff. If it’s just the bills, you should be able to prove that & be ok after some work.
Get as much of the records together before going to an attorney so you have a head start & they can look them over during the free consultation.
Try not to get too overwhelmed. They had us so stressed about how we had done things & in the end, it took some work gathering info, & there was a much much smaller penalty than was said at the start, but it worked out.

Are you POA? On Moms bank acct? Why did she have no checks?

I was my Moms POA and had been on her bank acct since Dads death. I had no problem writing her checks. In the beginning, I wrote her checks and she signed them. Later her handwriting got so bad I signed them.

Is Medicaid actually asking for proof of payment? Is it a large sum of money they may question? Since its a monthly transfer, they may not question. If they do, you have the checks proving you were paying Moms bills. Hope you noted that on the memo line and her acct#s are on the check.

I don't think that anyone here thinks you were committing financial abuse. Unfortunately, there are limited funds for Medicaid, so the system is set up with various hurdles and roadblocks (e.g., detailed recordkeeping requirements for applicants) that serve dual purposes: 1) finding the few cases of fraud; and 2) increasing the number of applications that can be denied.

Seach state is unique but the Medicaid application is reviewed and any red flags involve additional questions and required documentation to verify the respnse.
In my uncles Medicaid application, receipts were absolutely essential when Medicaid application was under review.

When you withdrew money it should have been recorded and exactly the amount of the bills that were being paid. Then you can crosswalk the deposit into your account and have an recording of the checks you wrote with the bill as documentation. No issues if done this way.

I always suggest consulting with an attorney when applying for Medicaid if the applicant has assets, a house and income. In your mothers circumstance is essential to have an attorney review for her benefit.

So if my mom had asked from the beginning that she wanted her bills etc paid the way why would it be elderly abuse? Everything was done to pay her bills, buy food, drs and at least 4 eye operations. I was clueless obviously on Medicaid and their rules/expectations. This is really difficult. Yes. 5 years.

Mom gets a statement for her acct and you get a statement for your account. These will show the transfer going from her account to yours. You have the copy of the bills, you then show the money you transferred and the bills total the same amount. You can show them with your checks that you are paying Moms bills. Do a spreadsheet. Total money transferred. The amount of the bill and who its for. Your check # and amount showing you paid it. Hopefully you have not been doing this a long time.

This is a lesson for everyone, never co-mingle your money with your parents. My Moms statement showed her SS coming in and her expenses going out. Dads pension, she received, came by check. That she used for her spending money. Once I handled it, I kept every receipt I used it for. Placed them in an envelope every month and had a small spreadsheet with a running total. Anything I paid out of pocket, I wrote myself a check once a month. Again using an envelope to keep the receipts and putting the check# on the outside. When Medicaid may be needed, you must keep records. TG, nothing was questioned.

I agree with AlvaDeer that you now may need advice from an actual professional. If you are not your Mom's financial or durable PoA then this may be an extra concern since what you were doing may appear as financial abuse. Please see an elder law attorney for guidance.

Yes, this is a serious problem.
This is exactly how bills should NOT be handled.
You must have bills and receipts and cancelled checks to prove your proof of payment and the reimbursement and it must be meticulously done in excellent records.
I am certain that you can understand that the government doesn't "take your word" for the fact that what you did was paying your mother's bills?

I think at this point you may require an attorney. This could have serious consequences for your mom's being able to get Medicaid. Your message here, sadly, does serve as a message.

I am not certain what you can do at this late date to remedy or to fix this. You need expert advice.