My husband is POA for his brother who is in a nursing home. Brother will spend down all his assets in about a year, including his IRA and the proceeds from the sale of his house. He'll need to go on Medicaid, and we have a bunch of logistics questions. (1) His current income is social security and 2 small pensions. The amount is ever so slightly above the Medicaid income allowance, but of course he has huge nursing home costs. Would he continue to have social security and the pensions direct deposited into his checking account, as he does now, and my husband would send the nursing home a check for his care, with balance to be paid by Medicaid? I know there is a small personal needs amount that can get held out from social security. (2) He is currently paying a lot for a Medicare supplement plan through AARP, $232/month. Would he continue to need to have that insurance if he goes on Medicaid? If it's advisable to continue, how would he pay for it if his entire income has to be turned over to the nursing home before Medicaid will pay? (3) He also currently has a cell phone, with a very basic plan, and a basic Netflix subscription. If he has to pay those out of the tiny amount Medicaid allows him to keep, it would leave him nothing for other personal needs. We are fortunate in that our state allows a person on Medicaid to retain a higher level of assets than the national standard. I believe it may be $5,000 rather than $2,000. Presumably my brother-in-law could continue to have his phone and Netflix by paying from those assets. (4) He is eligible for VA benefits and gets a few services from a nearby VA hospital, e.g., hearing aids. How do VA benefits coordinate with Medicaid? He does not have a service-connected disabilty or injury, so he's just getting "ordinary" VA coverage. He's also in a veteran's home, not run by the VA but by a private non-profit corporation. I suspect the social worker at the home might be able to answer some of these questions, but we haven't been too impressed with his general level of knowledge. Many thanks! People on here are so helpful

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Thanks very much. We're definitely going to consult with an eldercare attorney about all this. We might also go to a state DHHS (department of health and human services) before the time comes to do the application, just to make sure we can round up all the records we need for the 5-year look back period. My brother in law does not get VA aid and attendance benefits. He generally sees non-VA specialists if he needs them, covered by Medicare and his Medicare supplement plan, but there are a few types of things not covered by Medicare where he goes to the VA hospital, e.g., hearing aids. I would suspect that if people have several coverages, Medicaid would be payer of last resort, but I'm not sure abiout that. I've read about Miller trusts, but our state is not on the list of those where this is possible. However, I believe our state does allow medical expenses to be deducted from the monthly income cap when figuring if the person is income-elgible.
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Reply to newbiewife

Believe me, the Social Worker will not know the ins and outs of Medicaid. As Barb says you need an elder lawyer versed in Medicaid to help you thru this.

I know with Aids and Attendance thru the VA you can't have that and Medicaid too. Both government entities. You really won't need the VA once on Medicaid but I would ask about it. They pay what Medicare doesn't. You need to check with your state to see if Medicaid covers hearing aides. Once on Medicaid he will not need that supplimental costing him $232.

The PNA (personal needs account) is considered part of the spend down limit. So make sure it gets spent. This could be used for his phone and netflik.

If he is over the Medicaid limit for his SS and pension totals, some States have a Miller's trust. The overage goes into the trust and reverts back to Medicaid when the person passes.

I am finding out that the cost of a lawyer can make things a lot easier than trying to figure it out on ur own. The cost can come out of BILs money and should.
Helpful Answer (2)
Reply to JoAnn29

Has your husband consulted with a certified Eldercare attorney who in knowledgeable about both Medicaid and VA benefits in BIL's state?
Helpful Answer (1)
Reply to BarbBrooklyn

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