What if you qualify for Medicaid but don't seek a bed right away? - AgingCare.com

What if you qualify for Medicaid but don't seek a bed right away?

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My mother does not want to put a lien on her condo or to sell. People want her to submit her Medicaid application right away because of the lead time necessary for an approval. a) If she is approved what will happen to her condo if it is not in a trust? b) What happens if she does not apply right away to a nursing home to reserve a Medicaid bed after the 30-day waiting period required by the Medicaid approval? How long does she have before she must apply or can she remain insured by Medicaid, owning her own condo, and not yet applying to a nursing home for a long term bed?

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There is no requirement to apply for Medicaid, but if your mother does not have the funds to pay the nursing home, then who will pay the bills? So usually what happens is the nursing home resident runs out of funds and in order to stay in the nursing home MUST apply to Medicaid. Once your mother is approved for Medicaid, the state will keep track of what they spend on her care, and upon her death they will seek to be reimbursed out of her estate. If the only asset in her estate is her condo, then they can force a sale of the condo to take what they are owed. If there is any money left out of the sale proceeds, it will go to her heirs or under her will.
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If she has more than $2000 in savings, she won't get Medicaid. Usually people go into a facility and spend down, sell the real estate so you can go in as private pay in a nice facility. Then when the money is gone, the application goes in. She can't afford a condo after that, because the NH gets her entire SS check every month.
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On medicaid, you are still allowed to have a place to live! If your mom got medicaid now, she would have "community medicaid," meaning that she lives in the community not in a facility. She would be allowed to keep her primary residence, one car, her retirement accounts, a $10,000 burial fund, and a nominal amount of cash in the bank. There is no look back for community medicaid, so there's no harm in applying for that now if your mom is poor and needs the insurance. Community medicaid will pay for home care and respite care (up to 30 days) in a nursing home. Those are really good benefits that could potentially keep you out of a nursing home for years, depending on your condition. You don't say if your mom needs a nh now or if this is preemptive. Here's what I would suggest: join a local chapter of the Alzheimer's Association and join a support group even if your mom does not have dementia. Its free to join and every few months or so, they bring in an elder law attorney to fully explain medicaid in your state and answer any questions you may have. It's a great service and it's all free. If you don't need caregiver support, join on paper so you get notified of the seminars.
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And to answer your questions, once you have medicaid you have it. It's just like any other insurance in that regard. Medicaid will not make you apply to a nursing home and will not drop you if you don't go into a facility right away. Usually when you go into a facility on community medicaid the financial person there will convert you to institutional medicaid. The difference with institutional medicaid is that there is a five year lookback, so if you are looking at nh as a possibility for the future, you should proceed with that in mind. Talk to an elder law attorney about that now. There are ways to shelter your mom's condo, but there are rules around that and sometimes they change so you can't do this right without a lawyer. Leins come into play only after your mom's death. Believe it or no, after medicaid has paid for your care, they will look to the estate to see if there's anything they can recoup. They will then put a lein on the house if they can. If it's in a trust, they can't since the house belongs to the trust and not to the person's estate. Please dont even attempt this without talking to a lawyer first. The lawyer can present you with several options and since there's no immediate need, you can take your time, be thorough, and choose a great option.
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I also want to piggyback pamstegma's comment. If you go in private pay with no preparation, you will lose everything. And it's not necessarily true that you get into a nice facility because you're private pay. A bed has to be available and they have to accept you. It is possible to get into a nice facility if you're already on medicaid. However, Pam is right that facilities discriminate based on financial resources. They know that most long term patients will eventually be on medicaid, so what they're looking for is large social security checks and large pension checks which will go to them every month. I know for a fact that facilities will reject you if your ss check is small and you have no other resources. They will claim there's no availability, that they'll call when a bed opens, and somehow that never happens. In the flip side, when you go in with funds, they will enter fake charges on your bill in order to get even more money. As for a nice facility, unless the place is a true dump, the decent ones are all pretty much the same. There's nothing stellar about any nursing home. The medical care you get will be a real downgrade from the care gotten on the outside, sometimes dangerously so. That said, if you have run out of options and need a lifeline, a decent nursing home is a life saver.
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Most trusts are revocable and don't protect the residence during the 5 year look back, in case you're thinking they do.

What might prevent the government from going after recovery, MERP, could be if you satisfy the provision that you took care of her for over 2 years and prevented her from meeting today in a nursing home or on Medicaid.

Then there is an application process that the time you get notified of the MERP, and you don't have very much time to respond.

I don't know whether or not an irrevocable trust would insulate you, but I have a feeling it might have had to be in place long before now.

You need to see a qualified elder law attorney and find out your options before you make a misstep. With Medicaid, you have to get it right the first time. You can't unring a bell.
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Agree fully with Pamstegma. I will add there is no free lunch. We all worked hard for what we have in terms of house, savings, etc. Medicaid for nursing home coverage is a fabulous benefit in my opinion. If she needs the care, the personal cost is merely incidental, although I admit it is potentially highly emotional.
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READ THIS and comply:
{Q}You need to see a qualified elder law attorney and find out your options before you make a misstep. {End Quote}
We are working with our elder law attorney { on a frail elder waiver} who has solid experience with the ins and outs of Medicaid politics.
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I don't know, bit this might help. 360financialliteracy/Topics/Retirement-Planning/Medicare-and-Medicaid/Medicaid-and-the-principal-residence
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I don't know what state you are from, but in NY you must sell the condo, or spend the extra money 5 years prior to entering a nursing home. You can't sell your condo today, and go into a NH right away or less than 5 years, they will recoup the money.
We just went though this, and my Mother-in-Law passed away in December. We're not really sure what's going to happen, but we're selling her coop right now.
Good Luck and God Bless.
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