Medicaid look back period. What can mom spend money on?

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My mom new in nursing home...just now in early mid stage alzheimers....self paying until she is low on funds...then will try to get on medicaid..please tell me ...at this time if my mom can ..still get a perm...still buy little things for herself...new eyeglasses etc....and should we prepay her funeral...what do we do with her life insurance policies ...and ......my brother n law wants to take my mom out to eat but have her pay for her own meal....all receipts will be saved...will any of this red flag medicaid...or will any of this cause her a problem getting medicaid approved...esp....the eating out ...paying for her own meal

Answers 1 to 6 of 6
As far as I know the look back period is up to 5 years. They will allow your mom to keep at least 2000 in the back to use for the purpose of death and burial. But after that they do like things to be documented. Medicaid will not qualify her until she has her savings spent down to 2000. But with record of the spending...because it must be used for her, be it care or equipement to help her with her care. I am not a lawyer so please double check with someone who knows for sure. But after doing much investigation and talking with my mom's hospice social worker this is as much as I know. But keeping receipts and documenting what the money is being used for is for sure a must.
sorry...that should read, 2000 in the bank. :\
Top Answer
I don't think there is any problem with Mom getting her hair done or going out to eat or treating herself. She can buy new clothes, shoes, coats and jackets, etc. Definitely this is the time to get new glasses, hearing aids, a fancy deluxe wheelchair or walker, etc. If her tv is old, perhaps she should replace it now. Extend her magazine subscriptions. As long as she is spending money on herself its OK. It is probably OK for her to treat her son-in-law or others to lunch, too. She should definitely have a pre-paid funeral plan. It isn't OK for her to give large cash gifts to others, or to give away anything that Medicaid would consider assets.

Insurance policies are considered assets should those should be cashed in and spent. Another good use of some of her money is consulting an attorney specializing in Elder Law, to make sure all her financial ducks are in a row before she applies for Medicaid, and also to draw up POA, advanced health care directive, etc. if that is not already done.

The look-back period is 5 years. If Mother has given away assets in the last few years that would be something to discuss with the lawyer.

Best wishes to you as you guide your Mother through this process.
My MIL has permanents, coloring, and weekly $10.00 sets for her hair. These things are important to her. I buy her a few new pieces of clothing every couple of months as her clothing wears out in the SNF laundry. I do not bring her laundry home as she has occasional incontinence issues which can make quite the mess. Some people have said that they wished they had bought clothes more regularly and put them away for use in the Medicaid years. (Alfred Dunner polyester pants hold up quite well in the commercial machines - JC Penney)

When she is having a good day I take her shopping at $ stores, she never spends much and enjoys the outing so much. If she buys food products I leave the snack items in her drawers at the SNF and take other food items (she likes to buy wheat bread) to the SNF kitchen. They put her name on it and she has it for her toast at breakfast.

In regards to glasses, her current glasses will be covered with food as she leaves them on her chain to eat sometimes. I did not have her get new glasses as she doesn't notice the food particles. She is stage 6 dementia. I do clean them each time I see her.

She still likes to send $30.00 checks to her kids and grandkids for Christmas and birthdays- this is important to her so we do it.

Like yours, someday she will be on Medicaid. She has one whole life insurance policy that has a face value of $2,000. In accordance with Texas Medicaid laws, we will cash it out someday before she needs Medicaid and use those funds toward her care.

Nice of the BIL to be willing to take her out to eat. Paying for her own meal is fine in Texas.

We keep some money in her personal trust account at the nursing home for whatever - sometimes they do costume jewelry sales, lunches out, whatever.

We do keep a personal frig in her room filled with Sprite and we keep snacks in one of her drawers to help prevent additional weight loss. She has lost 100 pounds in the past 2 years- dementia decline and dementia blocking her eating. We just pick up the Sprite and crackers when we shop at no charge to her. But certainly, it would be okay for such items to come out of her funds.
I recently sold my Dad's house that was in a trust. Now I am placing the money in the trust. I know that homes are not considered up to a certain amount for medicad but, what about the cash conversion put in the trust?
Jo - you should consult legal to see how your state specifically views trusts.
Not all trusts or annuities are Medicaid compliant (which kinda means the state becomes the beneficiary of the trust or annuity upon death).

My understanding is that the elder's homesteaded property is an exempt asset for their lifetime by & large in most states Medicaid program. Assessed value is limited to 500K (or 750K in some states). BUT when you sell the property the proceeds from the sale becomes totally an asset. Remember Medicaid review is from 5 years back from the date of the application. So that would mean if he applied today it goes back to May, 2008. Please keep in mind that real property (homes, land, cars) is recorded by the local assessor and then dovetailed to the state. So property sale or transfer will show up in just a few keystrokes by the Medicaid caseworker - so you can't try to get cute and leave stuff out. It will show up and trigger a transfer penalty inquiry by Medicaid. Transfer penalty can get pretty involved and complicated. I'd suggest you take some of the $ from the sale and get Dad's financial & personal information together and see an elder care attorney and see what they suggest and update all his legal too. This site has a drop down list by state of elder law. The attorney will likely have stockbrokers or financial advisors that they work with and can craft a trust and investment profile for your dad if that is the best option. But realize that the states are mandated by the federal govt that in order to participate in Medicaid, they have to do a look back; do MERP (estate recovery); and require a spend-down on assets. Medicaid is a needs-based program with specific financial and medical required in order to benefit. Good luck and keep a sense of humor, you'll need it!

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