My mother has SSDI but can't get Medicaid because she has too much income, what should I do? - AgingCare.com

My mother has SSDI but can't get Medicaid because she has too much income, what should I do?

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My mother used to be eligible in the income side of things until she started getting SSDI and now she makes too much according to Medicaid. She is in a nursing home. I am in Texas so I can't do a spend down. I know there is a Qualified Income Trust but the problem is I lost my job and I am unemployed and cannot absolutely afford a lawyer, not even one that will charge $100. What options do I have?

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No, my Medicare Part A has $0 taken out, Part B has the co-pay premium that can be covered by Medicaid if you qualify. Part A is "free" while receiving SSDI because you paid for it while working. So it's not free, but in that case, they don't take any money out of SSDI payments for Part A. I have been covered by Part A for 6 months, they do not take anything out of my SSDI direct deposit. I'm not sure if retired, but in this example for SSDI.
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Reply to asylum23
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Medicare is not free, they take $134.00 monthly from AS before recipient receives their check, or you have a Medicare advantage plan. 54 years old on SSDI and makes 1400.00 a month and has a 1500.00 IRA and she has to much, how much money is sitting in her account?

That account is more than likely the issue.

Have you seen the application? It could be a simple error. If your mom has assets, legal assistance would be a legit expense, she should pay for the attorney, not you. Can you take the time to go to her to help? I know money is an issue but the bus or train could be affordable and maybe the attorney could figure out how mom could legitimately pay your expenses.

Good luck getting this sorted out.
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Reply to Isthisrealyreal
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After 24 months of being deemed "Disabled", Medicare would start for her. The Part A is usually no cost because she paid for it while working, Part B Premium is paid by Medicaid/her state (TX) if eligible, Part D has a premium for prescriptions. When she is eligible, make sure to apply for the "Extra Help" for Part D, or if already receiving Medicare, you can apply online for her thru SS website. That pays the monthly premium, lower cost for drugs, for ex. Generics are $3.35.
For the Medicaid eligibility, you can talk to the state worker, who are not always helpful, or speak to her local Area Agency on Aging. They help Seniors, but also those receiving SSDI. They should be able to help you straighten out what she is eligible for.
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Reply to asylum23
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Any other suggestions or should I just give the unused SSDI money sitting in her account to the nursing home and have them reapply again?
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Reply to janeAnne91
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She has an IRA of a little over 1400 but that is it. The money from her SSDI has been deposited and has been sitting in her account unused. The nursing home has withdrawn money once from her account. Her monthly income is below the limit Texas allows to apply for medicaid but her assets are above the required limit. She is 54 years old. She is not eldery, but disabled and can't work (she had a stroke). The last time she worked was in 2016 and those were part time jobs.

The problem is I am unemployed and cannot afford a lawyer. I'm sure New Jersey is one of those states that don't have an income cap like Texas has. I don't know. I thought a spend down is not allowed in Texas but I'm being told on here that you can do that. Spending down would be ideal since the money could go to the nursing home to keep her asset amount down and there is no expensive attorney involved. Without her SSDI check she has less than $1500 in assets (her IRA).
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Reply to janeAnne91
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I think you need to be there in person. How old is Mom. By SSDI I think you mean Social Security Disability? I thought this had to be gotten prior to the age of 65 or 66. Once you start collecting regular SS you can't claim disability.

You say Mom has no savings. No IRAs or CDs? What about insurance policies other than employer. Medicaid will ask that insurance policies, not held by an employer, be cashed in for her care or prepay a funeral. So if Mom has none of this, all she is getting is SSD. The amount is more than allowed by Medicaid? Then I think a Miller trust comes in but you need a lawyer. Spend down comes when she has money. With my Mom, I paid 2 months in NH and then Medicaid took over. She was below the 2k NJ allows.
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Reply to JoAnn29
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The letter says: "the value of things this person is paying for or owns is more than allowed by program rules". So hopefully that is referring to her assets. So you're saying that, at least in the state of Texas, I am allowed to do that? She doesn't have a savings account but if that is the case, then I'll speak to the nursing home person that was working on her medicaid tomorrow to see what they can do.

But one problem that I noticed and confused about is on the back of the letter, they list out all of her assets for each month all the way back from november of last year (when she first got ssdi) to march. More than half of the amount of her assets since then the nursing home took to pay for her stay there. Maybe the november date was the original date the initial medicaid application was sent in so all the asset amount from that date was counted?
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Reply to janeAnne91
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So, if her ASSETS are too high at this time, you spend her money on the NH costs until she's within a couple of thousand dollars of the limit, right? that's what mom's money is there for, to pay for her care.

My mom paid 12K per month for 4 1/2 years in a NH. That's what she and my dad saved for.
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Reply to BarbBrooklyn
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To correct myself, it's her assets that are too high and not her income but either way it will lead to the same rejection. This is what I read on one elder law site: "Texas is one of the unlucky 13 states with a Medicaid eligibility income cap with no allowance for medical expenses." and for income cap states "impose an "income cap," which means no spend-down is allowed".

The nursing home applied for the medicaid for her. The only part I took in was to provide documents like bank statements and copies of ID
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Reply to janeAnne91
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I don't know what you mean when you say "I'm in Texas so I can't do a spend down"? Who told you this? In looking on Elder Law websites specific to Texas law, there are quite a few references to doing a spend down, i.e., being able to qualify for Medicaid by spending excess funds on Medical care.

Is the Social Work/Business office at the Nursing Home helping you apply for Medicaid?
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Reply to BarbBrooklyn
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