She gets my father’s: SS, work pension, VA pension plus her own small SS. Her monthly payment to the facility is over 4,000 and growing. At the moment she can make the payment but her funds may not last for as long as she may live.
As others have said, get proper legal advice for the State where your mom lives/her primary residence as each State law/rules are different. Finding an "elder care" attorney is best, and one who has experience with Medicaid! Most of these attorney's know a lot about local "nursing home" or Medicaid approved long term care skill nursing facilities (SNFs). They can not only help with the legal aspects of applying for Medicaid, but will likely have great advice as to which SNFs to consider and which to steer clear from.
Also (perhaps others mentioned) do NOT wait until she runs out of funds. Most SNFs "like" it when one comes in a private pay for 9 months to a year if possible; to "spend down" via making private payments (a sweetener to the SNF) and thereafter once the income/asset threshold for your state (most are around $2K in total assets) then one can apply for Medicaid. Once your LO is "Medicaid pending" the total bill due is not expected BUT the State "Cost of Care Contribution" is expected. THIS amount is generally the total income per month received (SS, pension, investment income, IRA minimum distributions, income from assets sold) minus what the person may keep (generally about $80 or $90 can be kept, but the total asset threshold MUST remain below your State's max!).
By the way, the fees for an elder care attorney are allowable as what one might spend before qualifying for Medicaid. So make sure to pay the attorney from your mom's funds. Ditto (sad) one can and should prepay all funeral expenses before spending down. Pre-paid funeral expenses (within reason, NOT a $40K end of life ceremony) are allowable expenditures under Medicaid. The funds would need to be put into a non-revocable fund/trust that is locked in to be spent on future funeral expenses. We did this pre-paid funeral expense thing for my mom, so about $8-9K of her funds went to a funeral home to a irrevocable account with a bank (interest bearing, not much but something) which in theory should cover it all as the price points were also locked in with the funeral home. The plot -- thankfully -- was gifted by a family member otherwise that would have been another $10K. So the total is value is for the last thing is about $19K and that is for everything simple and w/NO funeral service, not even something a the burial site day of (all of those extra things would have cost another $10-12K -- ouch!)....
Basically, all assets (once sold: car, house, valuables) ALL go to the State as part of the spend down. My mom had nothing, so there was nothing of any value to sell or otherwise get rid of. The attorney in your State can figure out if there are any possible ways to "shelter" or "save" something but generally it is very hard to do that without proper planning YEARS in advance of needing Medicaid as there is a 5-year look back provision; whereby the State and Feds will want to know what your LO spent their money on in the 5 years prior to applying for Medicaid AS THEY need to assure there was NO effort to hide, gift, or transfer ANY ASSET.
Good luck with this, it is all so hard and complex. And getting proper legal advice is key as there is no "do over."
Many thanks for this thorough, detailed response. I have been mulling over next steps myself in recent days, and this was very timely. The private pay entree is great advice, although the 9 month lead time caught me off-guard. Guess I will be making plans sooner than I thought. This entire voyage is horrific, in every possible way. I had hoped by the time my mom was in the situation, there would be a better and more life-honoring solution.
Planning for the financial aspects of long-term care for an elderly loved one, especially when considering the possibility of outliving their financial resources, can be challenging. Here are some options and considerations:
Financial Assessment: Conduct a thorough financial assessment to understand your mother's current financial situation. This includes income, savings, investments, and any potential government benefits.
Explore Government Assistance Programs: Investigate whether your mother is eligible for government assistance programs such as Medicaid. Medicaid can help cover the costs of long-term care for those with limited financial resources.
Evaluate Long-Term Care Insurance: If your mother doesn't already have long-term care insurance, consider exploring this option. Long-term care insurance can help cover the costs of assisted living and other care services.
Downsizing or Selling Assets: If your mother owns a home or other valuable assets, consider whether downsizing or selling certain assets is a viable option to generate additional funds for her care.
Speak with Financial Advisors: Consult with a financial advisor to explore investment options and discuss strategies to make her savings last longer. They can provide guidance on managing expenses and maximizing income.
Review Assisted Living Costs: Review the costs associated with the assisted living facility where your mother resides. If the current facility is too expensive, explore more affordable options while ensuring that her needs are still met.
Explore In-Home Care Options: In some cases, in-home care may be a more cost-effective alternative to assisted living. Evaluate the costs and benefits of different care arrangements.
Consider Shared Living Arrangements: Some assisted living facilities offer shared living arrangements or shared rooms, which may be more cost-effective than private accommodations.
Legal and Estate Planning: Consult with an attorney to explore legal and estate planning options. This may include setting up trusts, updating wills, and considering ways to protect assets.
Family Support: Discuss the situation with family members and explore whether they can contribute financially to help cover the costs of your mother's care.
Regular Financial Reviews: Regularly review your mother's financial situation and adjust the plan as needed based on changes in her health, care needs, or financial circumstances.
This is very common. I am in the same situation with my mom. But I am not living in fear and I suggest you don't either. It is what it is at this point. As lea said, when my mom's money runs out she will have to move into a nursing home and go on Medicaid.
Same, but it is sooo hard to not worry. My mother is in a great assisted living for dementia care, I just hate the thought of having to move her anywhere else. I have to continually remember that it is all in God’s hands…
Then you apply for Medicaid on her behalf and she moves into Skilled Nursing care. I had the same worry about my mother who was living in Memory Care Assisted Living at over $7k a month with only her SS, VA Aid and Attendance widows income, and savings to rely on. But she passed one day at a month over 95 years old, so I didn't have to apply for Medicaid after all.
Hope I make my Final Exit before I need Medicaid. I think running out of money is a HUGE concern for many of us in the "forgotten middle". We have too much money/assets to qualify for any assistance but not enough to pay today's sky-high eldercare charges for more than a short timeline. Many of us absolutely do not want to rely on our adult children financially. I know I don't--they'll need that money to finance their own retirement.
Even though we tried to provide for our old age, including buying long term care insurance, we will fall short in 21st century America if we live too long. Private equity firms (the super-rich) are buying up eldercare facilities and hospice services. They view eldercare as a cash cow. I don't know how we could have foreseen that this would happen, but we live in the era of Vulture Capitalism.
This is true. This is about the best you can do, is hope. I am assuming you have spoken with the facility and that they do not accept medicaid funding when a senior has been there some time. You may want to check facilities that DO, but to be frank they're rare as hen's teeth.
You can only do what you are doing. Keep hoping that the money lasts a lifetime. When the money is gone you can assist in finding the best facility you can that accepts medicaid's help with payment.
Interesting that I saw this today as I just spoke with an eldercare attorney yesterday. He advised that while my mom still has her house and some funds in the bank, to find the best assisted living place possible and move her in. As the funds decrease to pay for it and she winds up with medicaid, she won't be kicked out. The facility will accept it. However, if I deplete her savings with in-home care, by the time medicaid kicks in, she'll be stuck with not so nice options to move into. This is New Jersey. I was also told that if I could get her to NY, where I live, before April 2024, there is no look-back for Medicaid. Lots of conflicting info between NY and NJ lawyers.
NY has a 5 year look back. I have an elder law attorney and live near NY/NJ area and they have 5 years. I think it’s terrible- my opinion. A lot of people love to help grandkids go to college, give a trip as a gift for adult children for anniversary gift, etc. etc. All of that is illegal in the look back. Ugh! I’m disgusted with “the system”!
She likely will and this is complicated. First b-r-e-a-t-h-e with awareness, deep long breaths.
THEN . . . .
Call Medicaid / Medi-Care and see what they say. Look for forms on the computer.
Be sure to keep all this in a TABBED binder ... with computer pass words for each account.
I have found that an A-Z tab - binder works very well (for all my p/w). And then when I change them, I note it on the page, with the date.
With your binder, you may want ... to start: Medicaid Medi-Cal Medi-Care Blank forms (as you make them)
Date/ time/who-what journal everything so you have an ongoing record of what transpired as you will need to refer back to it at some point. Have a tracking of everything.
Usually, the social worker or someone is designated at the Assisted Living facility who knows all about this. They should be able (willing) to help you sort it out.
Some people (medical social workers or ind people, i.e., fiduciaries may be able to help you for a fee. (I became a fiduciary although my friend was already set up with Medi-Caid and/or whatever gov't agencies pay for indigent people.
Be sure to keep accurate records of her income / her money. Do not co-mingle or you pay for anything. Entities will want to see bank statements and anything else that is income making (investments for instance).
Don't want until the last minute. And I am not saying you will or are.
The worst that can happen (as is my experience with my friend-companion):
With a democratic president and as much in the other two branches ... is that she will go into a nursing home and Medi-caid (?) will pay for everything, If republicans get into office, we will be lucky to keep our social security and who knows.
So ... vote and ask for assistance as prescribed above. Then go out for a drink or a walk in the rain (or sunshine).
If that day happens, talk to case manager/social worker at her facility to help her apply for Medicaid. Seems likely that will not be a reality since those incomes will continue throughout her life.
What funds do you mean? She's getting at least $4k per month from all the sources you mentioned. How many more rent increases will that cover? One year? Two? Start looking for a cheaper AL or nursing home.
Also (perhaps others mentioned) do NOT wait until she runs out of funds. Most SNFs "like" it when one comes in a private pay for 9 months to a year if possible; to "spend down" via making private payments (a sweetener to the SNF) and thereafter once the income/asset threshold for your state (most are around $2K in total assets) then one can apply for Medicaid. Once your LO is "Medicaid pending" the total bill due is not expected BUT the State "Cost of Care Contribution" is expected. THIS amount is generally the total income per month received (SS, pension, investment income, IRA minimum distributions, income from assets sold) minus what the person may keep (generally about $80 or $90 can be kept, but the total asset threshold MUST remain below your State's max!).
By the way, the fees for an elder care attorney are allowable as what one might spend before qualifying for Medicaid. So make sure to pay the attorney from your mom's funds. Ditto (sad) one can and should prepay all funeral expenses before spending down. Pre-paid funeral expenses (within reason, NOT a $40K end of life ceremony) are allowable expenditures under Medicaid. The funds would need to be put into a non-revocable fund/trust that is locked in to be spent on future funeral expenses. We did this pre-paid funeral expense thing for my mom, so about $8-9K of her funds went to a funeral home to a irrevocable account with a bank (interest bearing, not much but something) which in theory should cover it all as the price points were also locked in with the funeral home. The plot -- thankfully -- was gifted by a family member otherwise that would have been another $10K. So the total is value is for the last thing is about $19K and that is for everything simple and w/NO funeral service, not even something a the burial site day of (all of those extra things would have cost another $10-12K -- ouch!)....
Basically, all assets (once sold: car, house, valuables) ALL go to the State as part of the spend down. My mom had nothing, so there was nothing of any value to sell or otherwise get rid of. The attorney in your State can figure out if there are any possible ways to "shelter" or "save" something but generally it is very hard to do that without proper planning YEARS in advance of needing Medicaid as there is a 5-year look back provision; whereby the State and Feds will want to know what your LO spent their money on in the 5 years prior to applying for Medicaid AS THEY need to assure there was NO effort to hide, gift, or transfer ANY ASSET.
Good luck with this, it is all so hard and complex. And getting proper legal advice is key as there is no "do over."
Financial Assessment:
Conduct a thorough financial assessment to understand your mother's current financial situation. This includes income, savings, investments, and any potential government benefits.
Explore Government Assistance Programs:
Investigate whether your mother is eligible for government assistance programs such as Medicaid. Medicaid can help cover the costs of long-term care for those with limited financial resources.
Evaluate Long-Term Care Insurance:
If your mother doesn't already have long-term care insurance, consider exploring this option. Long-term care insurance can help cover the costs of assisted living and other care services.
Downsizing or Selling Assets:
If your mother owns a home or other valuable assets, consider whether downsizing or selling certain assets is a viable option to generate additional funds for her care.
Speak with Financial Advisors:
Consult with a financial advisor to explore investment options and discuss strategies to make her savings last longer. They can provide guidance on managing expenses and maximizing income.
Review Assisted Living Costs:
Review the costs associated with the assisted living facility where your mother resides. If the current facility is too expensive, explore more affordable options while ensuring that her needs are still met.
Explore In-Home Care Options:
In some cases, in-home care may be a more cost-effective alternative to assisted living. Evaluate the costs and benefits of different care arrangements.
Consider Shared Living Arrangements:
Some assisted living facilities offer shared living arrangements or shared rooms, which may be more cost-effective than private accommodations.
Legal and Estate Planning:
Consult with an attorney to explore legal and estate planning options. This may include setting up trusts, updating wills, and considering ways to protect assets.
Family Support:
Discuss the situation with family members and explore whether they can contribute financially to help cover the costs of your mother's care.
Regular Financial Reviews:
Regularly review your mother's financial situation and adjust the plan as needed based on changes in her health, care needs, or financial circumstances.
Good luck.
Even though we tried to provide for our old age, including buying long term care insurance, we will fall short in 21st century America if we live too long. Private equity firms (the super-rich) are buying up eldercare facilities and hospice services. They view eldercare as a cash cow. I don't know how we could have foreseen that this would happen, but we live in the era of Vulture Capitalism.
This is about the best you can do, is hope.
I am assuming you have spoken with the facility and that they do not accept medicaid funding when a senior has been there some time. You may want to check facilities that DO, but to be frank they're rare as hen's teeth.
You can only do what you are doing. Keep hoping that the money lasts a lifetime. When the money is gone you can assist in finding the best facility you can that accepts medicaid's help with payment.
First b-r-e-a-t-h-e with awareness, deep long breaths.
THEN . . . .
Call Medicaid / Medi-Care and see what they say.
Look for forms on the computer.
Be sure to keep all this in a TABBED binder ... with computer pass words for each account.
I have found that an A-Z tab - binder works very well (for all my p/w). And then when I change them, I note it on the page, with the date.
With your binder, you may want ... to start:
Medicaid
Medi-Cal
Medi-Care
Blank forms (as you make them)
Date/ time/who-what journal everything so you have an ongoing record of what transpired as you will need to refer back to it at some point. Have a tracking of everything.
Usually, the social worker or someone is designated at the Assisted Living facility who knows all about this. They should be able (willing) to help you sort it out.
Some people (medical social workers or ind people, i.e., fiduciaries may be able to help you for a fee. (I became a fiduciary although my friend was already set up with Medi-Caid and/or whatever gov't agencies pay for indigent people.
Be sure to keep accurate records of her income / her money.
Do not co-mingle or you pay for anything.
Entities will want to see bank statements and anything else that is income making (investments for instance).
Don't want until the last minute.
And I am not saying you will or are.
The worst that can happen (as is my experience with my friend-companion):
With a democratic president and as much in the other two branches ...
is that she will go into a nursing home and Medi-caid (?) will pay for everything,
If republicans get into office, we will be lucky to keep our social security and who knows.
So ... vote and ask for assistance as prescribed above.
Then go out for a drink or a walk in the rain (or sunshine).
Gena / Touch Matters
Good luck😆