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Husband has uncontrolled diabetes, dementia, alzheimers..is on Medicaid, medicare a, b & d plus humana drug program, federal. Has rental apt leases a car. No properties ..we are living on our ss checks - small pension. I want Medicaid to pay a nursing home room and board bill without them touching those checks..I need a roof over my head need to pay health ins have s mall 15, 000 $ life ins policy for his burial...can and will Medicaid oblige?

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my mom is thinking about getting married to a man with a 4000 month pension I have been her paid care taker will I lose my job and pay as caretaker? he is buying a hous that cost 2000 a month
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Vegas - great detailed answer! For what it's worth about the federal insurance stuff. My dad was a fed so they were on a most excellent high option BCBS. Like zero co-pay, doc's love patients with it. Dad died in the mid 1980's and then mom went into a NH just a couple of years ago. She applied for Medicaid, once she went onto Medicaid, the fed's sent a letter to her on the health insurance. I submitted it for "suspended" as you never know. You are spot-on on doing it this way as you can never get it back if you do the other.

But BCBS did do a clawback for all those services which Medicaid could / should have been billed for as Medicaid retro'd the eligibility back to the date of her application. So a time lag of about 5 months. Some of the vendors were pretty nasty about it as BCBS pays just so much more and BCBS does the clawback from their future payments. We were fortunate as all the vendors also take Medicaid, so other than a flurry of letters, it was all resolved. But there could have been a costly problem if a vendor did not also take Medicaid and could have billed at full private pay rates for services. Although they couldn't have collected.
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Stefani - as others have said, for Medicaid you are considered the "community spouse" and Medicaid does not require that you become impoverished for hubs to get Medicaid. In most states the CS is allowed about 113K in liquid assets plus a home and a car. I bet you have less than $ 113,000.00 so no worries on that front.

Now also the CS can file for MMNA - Monthly Maintenance Needs Allowance. What the MMNA does is divert whatever payment hubs would need to pay the NH as his co-pay or "SOC" under Medicaid rules, and instead pay (divert) to you the CS. Think of it as alimony for the nursing home set. The MMNA varies by state (as everything Medicaid does as each state runs it's program uniquely). There is a formula for MMNA. For TX, the max MMNA is about $ 2,300 (that is more than most elderly ever get as monthly income, so really this benefits younger spouses with older hubs in a facility). From what I've heard, TX MMNA is pretty high & most states are lower. But the key is YOU HAVE TO FILE FOR IT! There was a poster on this site, whose dad was in a NH on Medicaid and their mom still was the CS and dad's copay to the NH was about $ 45.00 a month once mom's MMNA was diverted.

You do need an elder lawyer to deal with the MMNA to make sure you get all you can based on your own finances, etc. Good luck.
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Have you talked to an administrator of a nursing home? I agree that you need out. I would not mention the porn to them. What happens to him, if he outlives you? Whatever that would be, needs to happen, now. Good luck and let us know how it goes.
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stefani, he belongs in a facility to treat the mental and medical problems. What is holding up making this happen? What does the waiver mean? What does the lawyer advise you to do now?
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Yes we have an elder lawyer. I signed a waiver for non pmnt since he gambled all his ret irement away. The dementia is getting worse. I just cannot live under the same roof w h im he doesn't shower or wash anymore..I have to do everything snd the smell is unreal . He stays u p 24 hrs a day watching porn..
I wsnt out. His last fall was through my plate glass table....glass everyhwhere...
At night I have to sleep w an eye open to make sure he foesn't set the house on fire..last wk he left the tea. cooking on the stove...everyday is something new...I need my life back..which went from normal to abnormal..it wd be nice to be able to have a conversation with a normal person who actually knows what your talking about..I lost my fiance when ge went through the Korean war as a navy SEAL UDT underwater demolition team and got back home only to get crushed under his car when it fell on top of him...then three close friends passed from diabetes. And .cancer.
Now this...I just want some happiness left in my life. Since I w/ be 75 in Sept..
He belongs in a facility to treat the mental and medical problems. I have just about had it
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Talk to your Medicaid case worker. As Pam says, the spouse left at home is allowed to keep some or all of the income, depending on circumstances, when the Medicaid recipient goes into a nursing home. The case worker should be able to guide you through the process.
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You are already on Medicaid, so that's a good start. If he goes into a Nursing Home you get a community spouse allowance based on your expenses. He only goes into a nursing home if that is what his doctor recommends, and you will probably have to wait for an open bed. You still keep your check and your assets. Start by talking to his MD about placement.
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To start with, I think you have too much insurance now. Medicare A & B are good. Add to that the Federal Blue Cross. Stop there. The federal BC covers meds. I know because we have that exact same coverage. Why in the world are you paying for Humana or a part D medical plan? Or do you mean you have Humana as a Medicare Advantage plan, in which case it should have drug coverage. If you have Medicare Advantage you could look into SUSPENDING your federal BC coverage, NOT CANCELLING. You can't get it back if you cancel. Next, about Medicaid. Go ahead and apply. You can look into the rules for your state online when it comes to assets such as the burial insurance. Do you have any life insurance, group term, left over from the federal employment? It would be exempt. However, depending on whose coverage it is, there may be a way to get money out of it before death if death is expected within the next 9 months. Contact OPM for details. Next, back to your money needs. If he goes into a nursing you are what is called the"community spouses", the one left in the community. Each state looks at the family income and allows a certain amount for the spouse in the community to live on, with the rest going for the care of the spouse in the nursing home. BIG however here, if you petition the local family court to increase that amount for you, they can easily do it. Get help from an elder law attorney. Hope this helps.
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