If you are a DPOA, then the answer is most likely, "No.". If you are a guardian for a non-parent . . . possibly. You can Google Medicaid for your state, then search for "estate recovery." Also, if you pay your "loved one's bills" with Social Security funds, you may be asked to provide a list of all expenses and income on an annual basis. So, on the safe side, I wouldn't use your "loved one's" money for anything that does not contribute to the health and welfare of the Medicaid recipient. I know, it doesn't seem fair; however, the State and Federal Government spend an average of $170,000 for each person's long-term care. The rules are changing to make sure they government's receive every last penny for all assets of the medicaid recipient, otherwise, the recipient may lose benefits and you could be assessed a very heavy fine.
Wow, I didn't know this. Mom is moving into supportive living this week (Sunday), and we have been using some of her money for these types of things because they ARE for her health and welfare because we have been told that she can no longer live alone. We're not spending much -- most of the help we're getting is on a volunteer basis so we're going real cheap, but there still are costs. What's a person supposed to do?
A few things I've just learned about Medicaid's Estate Recovery and my parent's assets: If their home, life insurance policy, funeral plan, bank accounts, vehicles, and any asset of value is placed in an "Irrevocable Trust," the state can't touch it. The irrevocable trust must be established at least 5 or more years before the Medicaid recipient goes on Medicaid. Five or more years prior to requiring long-term care funded by Medicaid, the assets can be transferred to an immediate family member without repercussion. If a family member lives with the Medicaid recipient (in the recipient's home) for at least a year prior to that person being committed to long-term care, that family member can remain in the house, but Medicaid will put a lien on the recipient's property and they will take the proceeds of the sale of that property as soon as the family member moves out. Unfortunately, our family did not know these things, and my parent lost everything. A few hundred dollars, the right timing, and a good attorney would have prevented all of this. Most families do not know the rules of Estate Recovery, and most people do not want to think about making these decisions while their parents are living at home and doing well. The parents don't often like the idea of transferring the titles of their assets 5 or more years before they decline. There are many other stipulations, so do your homework. Stay current on the laws, and be proactive. Failure to abide by the state and Federal laws can get a well-meaning caregiver in a whole lot of hot water and deep into financial debt. Good luck.
Helenk: You do what I have done . . . absorb your personal expenses. I have spent thousands of my own $$ taking care of my parents. It has taken a toll on my ability to work while managing their care, wading through hours of their paperwork and phone calls, and my personal funds are now completely exhausted. We care for our parents because it is the right thing to do. If there is $$ to spend down, it's better spent on a funeral plan, cemetery plot, (which must be "irrevocable,") and for anything your parent might need, such as clothing, personal care items, and yes, they even allow you to purchase a reasonably priced TV, radio, pillows, blankets or throws. But, none of the $$ can be used to reimburse the caregiver, or there's hell to pay. If your parent has a considerable amount of cash, it must be used to pay for their long-term care until the money is exhausted, then you can re-apply for Medicaid benefits. Caregiving is a thankless job. Save all of your receipts. Use online banking to track every expense. Execute a DPOA, if you don't have one (as long as your parent is still of sound mind); otherwise, you might be able to petition the court for guardianship. Some states don't even allow family members to be guardians. It's difficult for the caregiver, so keep good records and spend wisely. It's a quagmire, but I think it will be worth it. Hope you do too. Best wishes.
I don't know - Mom's on Medicaid diversiion program & I'm just not sure about tha since we didn't move - My best advice would get an ELder Care Attorney!!!He/she would be literally a Godsend - & do it ASAP!!!We don't have an attorney, BUT I'm a Hospice volunteer & the President of Medicaid services for the elderly was at one of their seminars, I grabbed her card & sure enough a few months after that seminar I need her - Daddy had his stroke...
About the rent on your mother's home (I assume), that should be covered. You can pay her bills associated with her home (utilities, insurance, etc.), and that will should also be covered. Another word of advice, don't rely on a local social worker's advice about Medicaid, you must contact the Estate Recovery representative for your state's Medicaid office to get the rules. I was often misguided by well-meaning social workers and local-office Medicaid reps, but in the long run, none of them knew the rules. Go to the source, which can be frustrating. It took me 15-20 phone calls before I reached the right person through my state's Medicaid web site (had to send an e-mail through the Medicaid site to finally get in touch with the right person). Google helped with the research, but until you have a definitive answer from your state's Main Medicaid office, tread lightly.
I find the information in this thread confusing....one says if your DPOA you can't spend your loved ones funds on things that you provide for THEM...the next said make sure your DPOA so you can legally spend down their funds before Medicaid....I have been caring for an aunt for over 10 years now...she is in AL now but within a year she will be out of money.....this Medicaid business is creeping me out......my husband and I are about 4 years out from retirement and just got back on our feet....this is just crazy....I have taken over her finances because she has moderate dementia and nobody else to handle things for her....Social Worker is recommending I get DPOA over finances ....do I really want to do this?? I am thinking maybe I should just wait until she is down to $2000 and have someone else take over when she has to go into a nursing home......I have mad $53000 last for almost three years when her income is very limited and her expenses enormous......she is completely incontinent and requires a memory care unit which is very expensive.....If I had to use $300 to move her then I did....I can't afford it....I do all the work, why should I pay for crap myself......I am thinking I will avoid the State at all costs.....walk away...fun away....far, far away......
Hi CureDementia: I don’t think I said that I haven’t been helping my mom. But I was surprised by your statement specifically regarding moving expenses. The move IS for her health and welfare and ordered by her doctors because she can no longer live alone. I have been helping my mom financially and otherwise for years. But I have been going through cancer treatment, have to have my fourth surgery in a year’s time and have limited finances myself. I have stacks of my own medical bills to attend to once we can get mom moved and settled. There isn’t extra cash in my pockets to be spent.
I am her POA, and she had taken care of and paid for her final arrangements long ago. I don’t expect to be reimbursed for caring for her, and we totally understand that all her cash (i.e., savings, checking, or anything of that kind) must be spent down before Medicaid can be approved down the line, and I only spend her funds for her benefit – never to pay us or for our benefit, ever.
The need for mom to move has happened very quickly, and we have been running from morning until night doing what she needs, working, and going to my own many medical appointments (12 in a 3 week span, with more that need to be made). I love my mom dearly and do a ton for her and want her to be happy, not because anyone tells me to, but because she’s my mom, and I love her. Nobody has to tell me that. But I do ask why these types of charges that ARE for her benefit, such as for a required move to a facility, should not be paid for by her funds. What is the rule? What is the reason? Not much is being spent in that way as it is (mostly a UHaul truck, and some related costs). I certainly can’t haul her belongings on my back, with a busted knee while going through cancer treatment, can I?
Amen helenk.....I can't see how Medicaid could reasonably ask a caregiver to fund their loved ones expenses.....we do take care of them because we love them and they need us.....but for the govt to be able to take from us what they think we spent for our loved ones is ridiculous.....if that's how it is then I am prepared to walk away....my aunt will have to go into a nursing home soon anyhow and I think I will just let Medicaid and the social worker handle it all....I'm tired.....it seems to me nobody knows the rules....you get a different answer from everyone you turn to.....
The parent's own money can safely be used on anything for their own benefit without it causing any Medicaid problems. In other words, it cannot be a gift if the person's own money is spent to benefit themselves. It is only when the money is spent on someone else that it CAN cause a problem (and indeed, if there is a Personal Services Contract, a parent can legally hire a child to care for them to avoid the gift trap). I hope this helps!
My family and I moved in with my mother 5yrs. ago. I have a good friend who happens to be a lawyer. She guided me through some treacherous waters (Medicaid). The first thing she had me do was add my name on the deed. which was a very smart move. Mom ended up living in the home with us for 4yrs. before she went into a nursing home. In Nebraska if you are living in the home and taking care of your parent and keeping them out of a nursing home for 2yrs. then the house becomes yours. I was glad of this because we had sold ours to move in with mom. And we were paying more then half of the bills. Because there was 4 of us. 1 of her. I was her POA also. I saved every receipt bank statement anything that had to do with her care.. You never know if they are going to ask you for it. They didn't in my case. But, I still have everything and will keep it for awhile even though she died in January. We are now just getting the house out of her name. Lawyer said to keep only her name on the mortgage. Don't know why but, it did have something to do with Medicaid. We had taken her name off the deed when she died and added my husbands. I know every situation is different. Even with help from the lawyer it was still hell. I am still feeling the effects. I just feel lost. You go from doing so much to nothing... I hope I can get my life back soon!
You must have all the receipts in hand, all checks made out to the moving company and landlord. Do not attempt to reimburse yourself for anything or it will bounce.
IF you are a DPOA, the State and Federal government does not allow you to charge any fees or get reimbursed for any of your expenses, which includes any travel, meal, fuel expenses, or loss of work income, IF you are a guardian, reasonable expenses and fees are allowed. IF your parent is not on Medicaid, but is moved into Medicare/Medicaid funded long-term care within the next 5 years, NONE of the Medicaid recipient's assets or money may be transferred to ANYONE else, or the recipient may lose their Medicare/Medicaid funding and the person to whom the assets were "transferred" can face a huge financial penalty (up to $200,000). IF the person you are caring for has household expenses . . . those may be paid legally, but you cannot pay your own expenses nor can you receive funds from the person as a GIFT from that person. WHEN a person goes into long-term care that is paid by Medicaid/Medicare, their assets are payable to that person's state's Medicaid Estate Recovery UNLESS those assets were placed in an irrevocable trust or transferred to someone else AT LEAST 5 years before that person goes into Medicaid/Medicare-funded long-term care, at which time the cash in their bank/savings/pension/401k/investment accounts cannot exceed $2,000.00. IF their funds exceed $2,000.00 after the recipient's bills are paid, that money must be spent down for the Medicaid Recipient's healthcare, personal care, and debts. IF the recipient owns their home, it must be sold and the funds from that sale must be paid to the state's Estate Recovery division AFTER all of the Medicaid recipient's expenses are paid, (i.e., outstanding utility and medical bills, property taxes, and the purchase of personal care items (clothing, TV, radio, linens, shoes, cemetery plot, pre-paid funeral expenses, etc.). I do not dictate these laws, the state in which your loved one resides dictates the rules and laws. This information is not all-inclusive; however, it is based on recent experience and extensive research. Again, Google your state's Medicaid web site for your state's laws. Google Estate Recovery for your state. Consult an attorney in that state, if you have the funds. Consult the Estate Recovery representative in your state. Every state's Medicaid laws are different. Do your homework, and protect yourself and your loved one's ability to receive Medicare/Medicaid benefits for long-term care. If you have the luxury of planning ahead 5 or more years prior to your loved one's long-term care, and if your loved one owns a home or has even a moderate amount of assets, consult an attorney and execute a DPOA and IRREVOCABLE TRUST. Good luck to all of you. Hopefully this information will at least point you in the right direction. Blessings to those who are willing and able to overcome these obstacles and care for your loved ones.
Dear Tip1643: I think Attorney Heiser and Cure Dementia provided some good information. What it sounds like for all of us, is that you should be able to move your Mom and use HER funds because it is for HER benefit. If you were moving to be closer to her, although it would still be for HER benefit, it doesn't sound like you can use HER money to move YOU and it be acceptable by Medicaid.
Another issue was mentioned about caring for your parent and being paid for it. Helenk, mentioned that she did not want to be reimbursed for caring for her mother and seemed a little upset. What was trying to be told to everyone however was that if a parent has too much money and cannot get Medicaid assistance and you are having to spend every cent of their wealth down to the allotted 2 thousand dollars, you can sign a contract with that person to provide care for them at the going rate in your area and thereby spending down their wealth by $1,000 a week, or there about (40hrs x $25.00 per hour= $1,000).
I do believe however that you will have to count this as income and pay taxes on it unless your attorney can help you set it up to where the taxes are paid by your loved one. This is not under the table money, you have to report it to the IRS as income.
Gayle 189: Unfortunately if your relative has moderate dementia, she has already gone too far to give you her DPOA. She has to be of sound mind, because she has to agree to GIVE this to you and if she is in a facility or not and has moderate dementia she is no longer legally capable of GIVING DPOA to you. So it may just have to play out as you said, her money will be completely spent and she will then be transferred to another facility and placed on Medicaid. You just have to know in your heart that you did everything you possibly could for her up to that point. You cannot put yourself at any further financial risk.
Medicaid is very tricky and you cannot rely on the advice given by the Social Workers you MUST wind your way through the maze of red tape until you find the Estate Recovery Specialist and get the correct information, because in the end you will be the one left holding the ball and simply saying, "Gee I didn't know that" is not going to help you.
In California the Social Worker I was dealing with had been on the job for numerous years, however she admitted to me that I probably knew more about Medicare and Medicaid (Medi Cal) than she did.....she did not know the difference between them!!!! And this woman was suppose to be giving me information.
I worked for several MD's for many years and you can be assured that most employees at Medicare, Medi Cal, and most other insurances, do NOT KNOW about the plans they are dealing with and will give erroneous information. The turnover in these insurance companies is huge so they have newbies coming in all the time and they are reading you information from a book or their computer screen which is NOT always correct. I found myself correcting them and educating them on what was and was not covered on more than a few occasions. I dealt with this all the time and read everything than was mailed to us but for the average person they had no way of knowing they were getting wrong information, which was heartbreaking. It really made me want to become a seniors advocate.
God Bless us one and all on this enormous journey we are on!
Raven 1...I do realize that it is too late to obtain DPOA...the social worker is pushing me to get it so I can make more decisions for her. I have skated by so far without financial power of attorney. I do have health POA. My concern is, how do I deal with Medicaid when the time comes she has to leave her facility because she is down to $2000? Could the state hold me responsible for her, she is an aunt, not my parent. Should I just leave it to her AL facility to manage all that when the time comes? Should I become her guardian? Should I walk away? My Mom, aunts sister, has thankfully made me DPOA for health and finances years ago and within a couple years it will be her turn for me to take over and do for her when she can no longer handle things on her own. They are both stubborn independent woman and I have a long road ahead of me. Even at 96, Auntie won't let staff help her. She insists she can do it all herself. They have a tough job and the facility she is in earns their money for sure :)
Go talk the AL facility and tell them what is happening and ask them what they can do to help. Can she stay, does she have to be moved, can they help you, find out now. I would not sign for guardianship nor take on any financial liability.
Thanks Raven1...I have spoken with her AL facility and the caregivers have discounted her care fee by $300 a month.....next I am going to talk with the facility manager and ask if she can get a break to give her some more time. $500 won't buy her much time but you never know a couple months could mean the world to the situation. she is down to $20,000 now and am having to withdraw $2000 a month to cover her expenses every month. I have canceled her cable TV and stopped buying her special snacks (fruit cups and pepsi) :) that she loves and she gets off brand diapers now .....once she gets down to $2000 she can also apply for the Medicaid waivers and they may make up the difference so we will see. I am sure the AL will not want to lose her but there is only so much they can absorb also. Also her income is like $25 over the limit for the waiver now so she doesn't qualify....ugh...she will be 96 on August 10th and her 93 year old brother and his wife are coming in from 1600 miles away to celebrate with her....her nieces and nephews have come through to see her last week from flordia and Arizona but she doesn't even remember they were here. such a shame but glad they made the trip and extra effort to see her.
I realize that you are trying to keep her there for a longer period of time but I find it so sad that you are not buying her the fruit cups and Pepsi any longer and stopped her cable as well. She will eventually wind up on Medicaid anyway so I would have just kept things the way they were.
Being $25 over the limit is just crazy making! I once worked with a young woman who had gone through classes to become a medical assistant and she accepted a job in our office as a receptionist until a position opened up as an assistant. She was single with a baby and had been on welfare and was currently getting help for childcare. She was a very good worker and in six months received a raise which put her $20 over the limit and she was no longer able to get childcare. She wound up having to quit her job and go back on welfare and was heartbroken. It is horrible when limits and regulations set by government agencies basically "keep a person down."
I feel for you all in this situation and hope and pray for a good outcome!
Just read all of these replies......all heartache, trouble, financial difficulties.....you name it. Where does it all end? It boils down to one thing......getting old and/or caring for an elderly person.......is TERRIBLE! It is nothing but life altering trouble. the lucky ones will never have to endure......the hell of being a caregiver.
I believe you can spend that money for moving out /rent/etc. as it is being spent for the elder person's benefit and not your own. I spent Mom's money to do just that right after Mom went into the NH (we had been informed that she could no longer live alone and therefore went straight from sub-acute/rehab into the LTC/nursing home unit). Mom was still in the "Medicaid pending" status. I had been continuing to pay her rent with her SS money up to that point, then used whatever was neccessary to vacate her apt. I had no problem with any of this. I think you just need to document every expense as proof that it was money spent on her behalf, not your own. In addition, I suggest you consult with an Eder Care attorney as he may be able to help you protect any other assets she has besides cash.
I am her POA, and she had taken care of and paid for her final arrangements long ago. I don’t expect to be reimbursed for caring for her, and we totally understand that all her cash (i.e., savings, checking, or anything of that kind) must be spent down before Medicaid can be approved down the line, and I only spend her funds for her benefit – never to pay us or for our benefit, ever.
The need for mom to move has happened very quickly, and we have been running from morning until night doing what she needs, working, and going to my own many medical appointments (12 in a 3 week span, with more that need to be made). I love my mom dearly and do a ton for her and want her to be happy, not because anyone tells me to, but because she’s my mom, and I love her. Nobody has to tell me that. But I do ask why these types of charges that ARE for her benefit, such as for a required move to a facility, should not be paid for by her funds. What is the rule? What is the reason? Not much is being spent in that way as it is (mostly a UHaul truck, and some related costs). I certainly can’t haul her belongings on my back, with a busted knee while going through cancer treatment, can I?
Thank you.
Another issue was mentioned about caring for your parent and being paid for it. Helenk, mentioned that she did not want to be reimbursed for caring for her mother and seemed a little upset. What was trying to be told to everyone however was that if a parent has too much money and cannot get Medicaid assistance and you are having to spend every cent of their wealth down to the allotted 2 thousand dollars, you can sign a contract with that person to provide care for them at the going rate in your area and thereby spending down their wealth by $1,000 a week, or there about (40hrs x $25.00 per hour= $1,000).
I do believe however that you will have to count this as income and pay taxes on it unless your attorney can help you set it up to where the taxes are paid by your loved one. This is not under the table money, you have to report it to the IRS as income.
Gayle 189: Unfortunately if your relative has moderate dementia, she has already gone too far to give you her DPOA. She has to be of sound mind, because she has to agree to GIVE this to you and if she is in a facility or not and has moderate dementia she is no longer legally capable of GIVING DPOA to you. So it may just have to play out as you said, her money will be completely spent and she will then be transferred to another facility and placed on Medicaid. You just have to know in your heart that you did everything you possibly could for her up to that point. You cannot put yourself at any further financial risk.
Medicaid is very tricky and you cannot rely on the advice given by the Social Workers you MUST wind your way through the maze of red tape until you find the Estate Recovery Specialist and get the correct information, because in the end you will be the one left holding the ball and simply saying, "Gee I didn't know that" is not going to help you.
In California the Social Worker I was dealing with had been on the job for numerous years, however she admitted to me that I probably knew more about Medicare and Medicaid (Medi Cal) than she did.....she did not know the difference between them!!!! And this woman was suppose to be giving me information.
I worked for several MD's for many years and you can be assured that most employees at Medicare, Medi Cal, and most other insurances, do NOT KNOW about the plans they are dealing with and will give erroneous information. The turnover in these insurance companies is huge so they have newbies coming in all the time and they are reading you information from a book or their computer screen which is NOT always correct. I found myself correcting them and educating them on what was and was not covered on more than a few occasions. I dealt with this all the time and read everything than was mailed to us but for the average person they had no way of knowing they were getting wrong information, which was heartbreaking. It really made me want to become a seniors advocate.
God Bless us one and all on this enormous journey we are on!
My Mom, aunts sister, has thankfully made me DPOA for health and finances years ago and within a couple years it will be her turn for me to take over and do for her when she can no longer handle things on her own. They are both stubborn independent woman and I have a long road ahead of me. Even at 96, Auntie won't let staff help her. She insists she can do it all herself. They have a tough job and the facility she is in earns their money for sure :)
God Bless you and good luck!
Being $25 over the limit is just crazy making! I once worked with a young woman who had gone through classes to become a medical assistant and she accepted a job in our office as a receptionist until a position opened up as an assistant. She was single with a baby and had been on welfare and was currently getting help for childcare. She was a very good worker and in six months received a raise which put her $20 over the limit and she was no longer able to get childcare. She wound up having to quit her job and go back on welfare and was heartbroken. It is horrible when limits and regulations set by government agencies basically "keep a person down."
I feel for you all in this situation and hope and pray for a good outcome!