Question 1: In the state of NJ. Once on Medicaid the VA A & A goes down to $90. The PNA for NJ is $35. I have been told several times that the PNA with Medicaid and VA is $109 in NJ. Is this correct? If so...where does this figure come from? $35 and $90 is $125.

Question 2: Also if the VA is sending the $90 check to my mom and she also receives a small annuity direct deposit, both into her personal checking account, can I just retain the $109 in her account and send the nursing home the difference?

Question 3: I assume that the nursing home who gets her social security will pay for her secondary insurance and prescription co-pays and deductibles out of her ss then balance bill NJ state Medicaid. Is this correct?

Question 4: I am her POA and I maintain her account of $2000. Assuming I am able to keep the $109 per month in her account and spend it for personal needs before month end to get her under $2k, do I have to show the state what personal needs are spent on? It is her money isn't it personal?

I would probably be able to get some of these answers but my mom has been pending Medicaid since September 1, 2016 in the State of NJ. They are very, very far behind with no resolution in site. Since that time, my mom was at an assisted living medicaid pending for 3 months, in the hospital, now at rehab, then finally will stay for Medicaid bed at rehab facility which has nursing home beds for Medicaid patients.
I want to be proactive and not do anything wrong as I am now dealing with medicaid pending back billing the state from September on at 2 different facilities.

Thank you very much for your time.

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Thank you. The state knows about the A&A presently it is $1153.00 it will go down to $90 once Medicaid pending is over and the Medicaid kicks in. My mothers's ss income is enough that she can keep her secondary and Medicaid will be her tertiary. The state had informed me of this fact. I do not want a PNA at the NH.  I am more than capable of handling and maintaining her $2000K as I have handled all her finances for 20 years.  I want to know if I am able to hold back the $109 for her personal needs from her income and spend accordingly for her in the given month.  The law does not require them to keep a PNA account for her not sure about the hold back.  Then again if they are not doing the PNA who pays the secondary insurance or medical copays/deductibles, etc? 

Prior to the nursing home the assisted living place she resided at  set up a PNA for her.   Since she was Medicaid pending at this facility waiting for Medicaid billing I had to watch the PNA balance to not go over the $2000K.  I know this is normal but, it was a pain because they would not routinely take out the cable, phone, hair dresser the same times per month and sometimes miss doing it entirely.   

This is why I want to control it so there is no Medicaid disqualification. 
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The A&A goes to the nursing home. You have to inform Medicaid that the A&A is coming in. They will adjust her share of cost payment.
The annuity also goes to the nursing home.
On Medicaid there is no need for insurance and no co-pays. You give up the MD's you have and only see the managed care network.
As POA you must send all her income, SS/annuities/A&A to the nursing home. All of it. On time. Every month. POA's who do not do this are quickly removed by court order.
I do not even manage my sister's PNA allowance. I hate paperwork.
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