Qualifying for Medicaid? - AgingCare.com

Qualifying for Medicaid?

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My mom is moving in with my husband and children from out of state for better care as my father is elderly also. Recent new cancer diagnosis and she has been falling 1-2 times a day. She is leaving my dad in their rental home and has a low income which qualifies for Medicaid with no assets whatsoever. I have lots of questions, any info would be helpful. Does our family income counts as part of her income? How long does it take to qualify, when should we start the process?

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Your family income should NOT be a factor. BUT what could be a significant hurdle in Medicaid is your moms eligibility or ineligibility due to residency. Medicaid although a federal & state program is administered by each state uniquely. As such it can require that in order to be eligible for Medicaid you must be a resident of the state of application. Once residency is ok, mom will have to determined to be "at need" both medically and financially for Medicaud.

Whether residency change is simple or hard varies. It could mean getting mom a new drivers license or state ID. A new & in your state bank account of her own at the new address. Filing IRS & state taxes showing an address in your state. You get the idea......

I'm going to dial back your ? a bit...What are you thinking that Medicaid is going to provide??? If its community based Medicaid, it could be as little as an aide coming to the home a few hours a week to do bathing, wound care or medication management. If your area has PACE, & PACE has openings then she would need to participate in that. Medicaid will evaluate your moms health situation to determine the level of care needed. If she is determined to be needing over 34/38 hrs of care, community based Medicaid usually won't pay as they are better served in a skilled nursing facility / a NH with 24/7 oversight. if mom is a significant fall risk and cannot do her ADLs, she may be over 40 hrs a week of care needed so community based Medicaid won't be an option.

But what could be a big issue in the move is that medicaid requires a copay or SOC (share of cost) of her monthly income to the NH or towards her community based care. Which means dads income if they are pooling their funds will be reduced significantly as he is not a community spouse for the new state.

You know Medicaid situations for couples is a whole different level of complexity to begin with even when they live in the same state. Mom moving from 1 state to another makes it even more so. I'd bet moms initial application will be rejected as she's going to be considered non-resident unless she lives in the new state for several months. You are probably best off to get all of her & dads financials together and see an elder law atty in your state to figure out how to do this to overcome the eligibility problems.

Has anyone mentioned hospice? If mom is terminal, her doc in your state could write orders for a hospice evaluation. Hospice is a Medicare benefit & as such available to her no matter where she lives & it is self directed which means she or her dpoa can pick the hospice provider. They will come to the house to do an evaluation. If she meets the criteria for hospice, she could get in-home hospice. It will vary as to what done. There are lots of hospice providers - VITAS & Compassus are big ones & it can make a difference as not all hospice have large enough staff to deal with class 2 pain medication that cancer patients need. Could be 3x a week care by an aide with once a week RN visit. It could provide for adaptive equipment (pressure mattress & bed) and specialized nutrition. If in home hospice, it will never be 24/7 care & in home hospice requires family to take care of all other caregiving needed (whether family does it, or family or elder pays for home health agency). Hospice is totally paid by Medicare. My mom in a NH on medicaid was on hospice as well her last 18 mos as she was bedfast. You may want to give some thought to get mom eligible for at home hospice asap and have it going. While on hospice you do whatever to get her eligible for your states medicaid so if & when she needs 24/7 care mom can move into a NH.

My moms medicaid application took almost 6 months. It was around 130 pages pf supporting documentation too. 3 & 1/2 years of bank statements. And an on bank letterhead statement with bank officers signature as to the disposition of any & all accounts, CD, etc closed out within 5 years. All pages of all insurance policies. Once approved, it will retro to the date of application.

Good luck & get organized & get calls going.
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My friend need Medicaid now for meds, Dr. appointments to stay out of hospital every 3 days. Is their a care facility for her and can she be authorized right away for insurance to help pay for Depends,and mobility devices for immediate, overdue need.???
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