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I am in the process of trying to get my mother transferred from a skilled nursing center in one state to another. She is still under her Medicare payment window and I am trying to get her moved before it runs out and then apply for Medicaid in the process in case it is long term. I assume I have to wait until she is in my state before I can apply? Also she is the surviving spouse of a Vietnam Vet. Is Medicaid best or A & A?


This all so new to me and I am trying to do the best I can for her, but all is very confusing. Her income resources are limited and so are mine. I would appreciate any suggestions.


Thanks

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Aid & Attendance would not provide enough reimbursement to cover the full cost of care in a Skilled Nursing Facility. Unless your mother has other monthly income that would cover the cost of private paid nursing home care, Medicaid would be the source of payment when Medicare benefits are exhausted.

Aid & Attendance is reduced to a small monthly benefit once a nursing home resident qualifies for Medicaid.

The best source for a strategy on how to safely transition your mother to another state is to talk with an elder law attorney in the destination state, close to the facility you are considering. If you hire the elder law attorney in the destination state to prepare to file the Medicaid application, you should be confident in knowing it will comply with the eligibility regulations there.

In my state (Massachusetts) all that is needed for a new nursing home resident is the intent to remain here.

There are nuances in every state governing the interplay of Aid & Attendance and Medicaid. For example, the Massachusetts legislature has added Veterans Benefits to the list of resources that are exempt from the Medicaid income and asset calculation in Massachusetts:

https://malegislature.gov/Laws/SessionLaws/Acts/2018/Chapter218

https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVII/Chapter118E/Section25

But that's just an example of how state specific your question is, and the value that an Elder Law Attorney in your destination state can bring to you and your mother.
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Reply to John L. Roberts
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Have you checked with the state ur transferring her to if she will gualify for Medicaid there? Medicaid is federally funded but each state controls their Medicaid program. There maybe a waiting period before u can file so Mom would have to private pay.

Aid and Attendance takes a while to receive for a surviving spouse and not guaranteed. You would receive no more than $1200 a month (amt when I applied for my Mom). It cannot be used when receiving Medicaid and Medicaid will cover a bigger portion of Moms care. She will have Medical, Dental and vision with Medicaid. Moms Social Security and any pension she receives will go to the home to offset the cost of her care.
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Reply to JoAnn29
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Richards Sep 19, 2018
Thanks JoAnn. I actually thought before that Medicaid sounded like the better option. I have tried a few times to reach the Medicaid office in my county with no luck. I am trying find out if I can go ahead and file or if she has to be an actual resident. I believe I heard she has to be here at least 30 days. I am now looking at personal home care help until I can get her approved if it comes to that which I think it will eventually.
Thanks again
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Do you realistically think she will be able enough to do a move and do what will be needed to establish residency in a new state? Have you clearly discussed this with the SW or her MD? If doc won’t do a discharge report this could be real complicated.

She’s going to need to become and be able to show to be a legal resident of your state. Whether easy or hard depends on your state.

Id suggest like this week you take her so she moves her banking to a bank that is in both states (with you as a signatory and it’s POD to you) or she opens an account where you bank. If your with a local or smaller community bank, that might be easier. If so speak with a bank officer asap. Not a teller but a bank officer. Ask clearly what you as the dpoa needs to do and what documents needed. Out of state dpoa may not be acceptable.
Your mom is going to need to be able to pull herself together to go to the bank with you and meet with an atty to have a new dpoa done at some point in all this but you should be able to do some of the front work to make this manageable.

Then once she has an account you help her go online to change her direct depsit of her SS, etc to the new bank. Remember to get the routing # exactly as needed. Some banks have a SS & federal civil service direct deposit FAQs for you to refer to.

She will need a state ID. Call your DPS as to how to do these. Usually you can schedule then for those disabled. While your there you want to get a handicapped sticker to use when your driving her places.

often kids find themselves in the situation that thier parent is too ill or too frail or too incompetent to actually move and do what is required to become a resident in a new state. If the parent cannot do things, then you likely have to look into doing an out of state guardianship for her which I’d suggest you really speak clearly with experienced guardianship attorneys in both states as to feasibility.

All these things will have costs. I think you’ll find that it will not be as simple and seamless as your hoping it will be. If your mom is very frail and doesn’t seem competent the move out of state plan may not work unless you can private pay for all costs from ambulance transportation to NH fees. If it takes 5 months to get her approved for residency and LTC Medicaid can you private pay for those 5 months in a facility? or have her with in your home with private pay caregivers? You might want to go ahead and apply for A&A as that $ may come in handy,
good luck.
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Reply to igloo572
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Richards - also in regards to your “ trying to call Medicaid with no luck” please realize that Medicaid is a huge program. It ranges from WIC / women’s, infant, children program; community based programs, like TANF and PACE; to tying into existing supplemental programs like SNAP or summer / after school feeding; as well as LTC Medicaid. The phone call before you could have been ?where do I pick up a breast pump? and the one after yours ?where are they doing fall flu shots? Imho you are not going to get the answers your needing via a phone call.

For both my my mom and mil (applications done in 2 different states at different times) the LTC Medicaid application was tied into being an actual resident in a NH or about to enter the facility within a day or 2. For us for each of them, LTC Medicaid application was done on site at the facility and we provided a stack of documentation- based on a printed list of items required to accompany the application- which the NH reviewed (this to determine IF the NH would take them in as “Medicaid Pending” residents); and then in turn the NH submitted the individuals application, their documenation paperwork along with the NH bill to Medicaid for the mom’s room&board and the NH skilled nursing need form to the Medicaid caseworker assigned to the NH.

My understanding is LTC Medicaid requires them to be in a facility in order for application to be filed.
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