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My Mom is in a nursing home in KY. She has been on a pay-down program and is moving from self-pay to Medicaid. She only has about 3 months of her funds left.

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I received a telephone call concerning a medication that might not be covered. I was told by the company that I had to go to the nursing home and have my aunt give permission to the insurance company to tell me more. So I will first ask the nurse at the desk, as the nursing home was not the one who called. That way it might be resolved. She is covered by more than one policy.Seems like there shouldn't be a problem...marymember
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I am so very grateful for the feedback. Thank you.

A personal needs accoount is available through the NH however if anyone puts money in it, Medicaid will count it as income and it can hurt her benefit amount. The NH tells me I can work something out directly with the beauty shop to get her wishes met.

marymember what drugs are not covered by Medicaid? I understood that Medicaid covers drugs. Are you finding that is not the case?

Again...thank you everyone for the comments. It's invaluable to know we are all experiencing similar issues and experiences.

I love you all.....
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One of the rules when in Medicaid is that you can't go somewhere and be gone over three days or you will lose your Medicaid. A family member wanted to take my aunt out of state to visit her sister, but there was no way it could be done within three days.
The nursing home where my aunt is provides basic cable. That isn't an additional fee.
Anyway, there are pros and cons. So hard to solve everything..marymember
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Rock - for TX the personal needs allowance is $ 60 a month. PNA vary by state from $35 - 90 (Minnesota) as each state manages the Meducaid program uniquely.

Really if they have to pay for cable for their room (& they want cable) that alone is $60. PNA just barely covers incidentals - hair salon or barber, modest hair stuff and cosmetics. Family is fully responsible to provide all other items needed or replaced. Families that can't or won't then usually salvation army brings them items that SA gets donated to them.

About the PNA, all the NH can set up a personal needs trust fund account in the residents name. Now if the facility is getting all their income directly, then the trust account builds by the $ 35,40, 60 or whatever PNA amount each month AND you have to go to the business office to sign out for withdrawals. You as DPOA do not have to do it this way (expect the facility to press on you to set it up though) and you pay the required co- pay or SOC to the NH from moms checking account and keep the PNA in moms checking account. You can set up a direct prepaid set schedule for hair salon as they are independent of the NH. If you want cable or phone for mom, you can set these up independently as well. If you live afar, often you cannot get to NH till weekends and the biz office closes at noon on fridays so that just cant work to get PNA $ out. A lot depends on how much hands on management you prefer to do on all things mom. Good luck.
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My aunt is in a very nice nursing home. She has to share a room, which is expected being Medicaid. (that she doesn't like). She receives $60.00 a month , but so many services are provided. She gets daily physical therapy, necessary medications, three meals a day. The beauty shop there is inexpensive (about 10.00). But when she gets a shower the staff worker washes and dries her hair, so it is only when she needs a haircut that she pays. I help pay a prescription plan, which isn't much. But all in all, her needs are met. Also, one of her nieces sends me $100 about every four months, and for her birthday she usually gets money from relatives, which I keep and use for her. I may be out a bit by buying other items. But she doesn't need much. Visits are most welcomed. marymember
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Yes. Depends are provided by Medicaid and I am in the process of stocking her up on clothing, etc We have made pre-arrangements on her funeral however the price is not locked in and if the costs increase, they will need to be met wihen the time comes. We have been advised along the way so I think we're doing everything we can to prepare.

I was just wondering if anyone else has experienced the KY $40 allowance. My mother-in-law in TN received slightly over $100. I've researched the internet to be sure the $40 is correct but have been unsuccessful verifying the KY allowance.

I'm so appreciative for your comments and your experiences and advice. What is the allowance in other locations?
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Chicago, Depends are proivided by Medicaid. Thank goodness! Even someone getting $90/month allowance could not afford Depends!
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The spend down needs to include her funeral expenses or it sounds like she won't have money for that. Also, Depends would be $40.00 a week, at some point.
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Can you do some of your spending down to pre-pay for beauty shop appointments?

Each state sets the personal allowance amount. I believe my mother gets $90/month. That covers her hair appointments and incidentals nicely, allowing some build up for purchases like a jacket. If your state personal allowance is set at $40, I don't know what on earth they are thinking!
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Robin, while you are doing the spend down, I would buy mom several sturdy pairs of shoes, whatever type of serviceable clothing she likes to wear, and other non perishable items.
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Yes Medicaid should pick up the NH & medical costs and I'm told all but $40 of her social security will be the co-payment for that care. I have heard of others that paid much less and were left with $100+ per month. I'm not sure how anyone can live on $40 per month for incidentals such as toothpaste, lotion, etc., clothing, haircuts, soft drinks, snacks, or an occassional hamburger from her favorite fast food. Of course, we pay for many of these things when we visit but honestly, she can't even visit the NH beauty shop for $40 month.
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I hope that is not the total allowance for Medicaid. From what I heard it should cover the costs of NH care. Here in MD I was told that Medicaid would pay a particular assisted/long term care facility $7,000 per month per patient.
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It's called a personal needs allowance, I think. For haircuts and the like.
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