Live in mass when is the only time medicade w fully cover nh expenses..rent apt and lease a car..he spemt his full retirement monies nothing in bnk just ss vhecks
Stefani - For Medicaid, you are considered to be the "Community Spouse" and that means you will continue to live in your community and as such will need some income to do that. The state does NOT expect you to become impoverished. If your now living in the NH spouse was the main source of income and you need some of his income to be able to live in the community, then part of his required under Medicaid co-pay (his SOC -share of cost) can be diverted to you to cover your living in the community expenses. This is called the CRSA - Community Spouse Resource Allowance and also is called the MMNA - Monthly Maintenance Needs Allowance / Assessment. It's kinda like alimony for the NH set.
Now the states (each state manages the Medicaid program uniquely under an overall federal guideline) have a formula or a set amount that is a baseline for what the "community spouse" can keep. Like for TX, the CS can have up to 113K in liquid assets, the standard exempt assets (a homestead & a car) and up to $ 2,931 a mo in CRSA. TX Medicaid NH resident a maximum $ 2,163 in monthly income.
The whole CS situation can get complex & it's a lot to deal with as you are likely more focusing on hubby's care & needs and exhausted with just dealing with all that. Personally I think you need to get an elder law attorney to work with you to maximize what you get to keep each month.
You should get an awards letter from Medicaid for you & your spouse that details what his copay or SOC to the NH is and what you as the CS keeps. My suggestion is that you really need to appeal the amount no matter what. The appeal needs to be in writing &/or sent by fax to your state's Medicaid program and asap after you receive the letter too. By doing an appeal it buys you some time to get legal (whether it's a paid attorney or done for reduced or no cost by pro-bono legal clinic) to get your CRSA / MMNA increased. But you have to do something definitive in writing or fax to the state on this. Good luck.
stefani, if he needs to go on Medicaid, go ahead and apply. The state will make the determination about how the SS check will be used. I take it that you do not have your own SS check to help out. They will take that into account.
Is the life insurance policy term or whole life. If it is term, the state will have no interest in it. It will continue as long as someone keeps up the payments. If it is whole life, you may be asked to surrender it in favor of a smaller amount. The amount may differ between states.
It sounds like you are not in the best economic shape. I don't know how much your husband lost to the lottery tickets or how Medicaid will see it. You can always try. The worst they can say is either no or not yet.
Jimmy - Medicare does not pay long term care. or does Medicare have an Interest in your life insurance.
Medicaid does pay for LTC but you have to qualify both medically - you have to show the needed for skilled nursing care; & financially - be impoverished with 2k in assets & be under whatever your state has set as the limit for monthly income. Contact your state program to get details.
He is on medicaid (mass health) he has altz/dementia w/ uncontrolled diabetes. .fallen a dozen times..now transfer ed from hospital re another fall w burns from tripping. W hot soup all over himself. .now the hospital put him in a nursing home..to continue to care and control all mental and medical problems he has along w incontinence bowel seepage. .hepatitis c..no washing himself. .control over his insulin w two pages of medication. .now because of him spending his whole retirement money 35, 000 to the lottery we just have ss checks..I need to keep them for rent food electric health ins lease car pmnt ins ..why cannot Medicaid pay for him to be in a nursing home and when is the only time this happens?
JessieBelle is right - just go ahead to the office and apply. Your husband without a doubt qualifies for nursing home care. You may have special needs/low income options or exemptions and be left with plenty to live on. Medicaid is not as able to just pick up the tab for everything needed in the long term care arena, but they are also not in the business of deliberately impoverishing people or making it impossible for you to stay in your own home. I'm thinking the hospital social worker, discharge planner, or financial counselor could possibly help you sort things out. Maybe you don't actually have to do anything else, but its hard to tell...
You could also go to the Social Security office too and get "representative payee" for his check and that could allow you to retain some control over it; otherwise the nursing home might want to do that and use it towards the cost of his care, leaving him a small monthly allowance, but again, get specific individual advice on what is possible and what is best in your situation. Rep payee is separate from POA and guardianships and almost everything else. I think you still have to go in person to get that done.
Stefani, make a list of your expenses for the apt, car, utilities, food and your medical bills per month. You will get enough to cover that. They only take what is left over, to cover his care, and Medicaid pays the rest.
Stefani, you have received very valuable advice. One more thing to consider as you plan for your future. When he passes you will be entitled to one Social Security check not two as I believe you collect now. I believe it will be the higher of the two that is what happened to my mother.
Massachusetts will assess your financial needs as to how much of your husbands SS check will be used for his nursing home expense. As for the money he used for his gambling, there is the five year look back that will be considered to his disadvantage. Term insurance policy will have no affect, but a cash value policy will factor in. Transitional assistance in Massachusetts is for two years only. Are you also on social security?
Now the states (each state manages the Medicaid program uniquely under an overall federal guideline) have a formula or a set amount that is a baseline for what the "community spouse" can keep. Like for TX, the CS can have up to 113K in liquid assets, the standard exempt assets (a homestead & a car) and up to $ 2,931 a mo in CRSA. TX Medicaid NH resident a maximum $ 2,163 in monthly income.
The whole CS situation can get complex & it's a lot to deal with as you are likely more focusing on hubby's care & needs and exhausted with just dealing with all that. Personally I think you need to get an elder law attorney to work with you to maximize what you get to keep each month.
You should get an awards letter from Medicaid for you & your spouse that details what his copay or SOC to the NH is and what you as the CS keeps. My suggestion is that you really need to appeal the amount no matter what. The appeal needs to be in writing &/or sent by fax to your state's Medicaid program and asap after you receive the letter too. By doing an appeal it buys you some time to get legal (whether it's a paid attorney or done for reduced or no cost by pro-bono legal clinic) to get your CRSA / MMNA increased. But you have to do something definitive in writing or fax to the state on this. Good luck.
Is the life insurance policy term or whole life. If it is term, the state will have no interest in it. It will continue as long as someone keeps up the payments. If it is whole life, you may be asked to surrender it in favor of a smaller amount. The amount may differ between states.
It sounds like you are not in the best economic shape. I don't know how much your husband lost to the lottery tickets or how Medicaid will see it. You can always try. The worst they can say is either no or not yet.
Medicaid does pay for LTC but you have to qualify both medically - you have to show the needed for skilled nursing care; & financially - be impoverished with 2k in assets & be under whatever your state has set as the limit for monthly income. Contact your state program to get details.
You could also go to the Social Security office too and get "representative payee" for his check and that could allow you to retain some control over it; otherwise the nursing home might want to do that and use it towards the cost of his care, leaving him a small monthly allowance, but again, get specific individual advice on what is possible and what is best in your situation. Rep payee is separate from POA and guardianships and almost everything else. I think you still have to go in person to get that done.
One more thing to consider as you plan for your future. When he passes you will be entitled to one Social Security check not two as I believe you collect now. I believe it will be the higher of the two that is what happened to my mother.
See All Answers