Why do we have to tell Medicaid our business?

You have to tell them your business because we've had many people on these boards ask about giving their children their money/property, so that they can qualify for Medicaid. That's not how it works. So the honest people have to jump through hoops because of the dishonest ones who try to hide/save parents' money by giving it to children, so that taxpayers can pay for their loved ones' care.

Reverseroles, I will guess that you deposited mom's check in your accounts, so now they have to sort out where her money went. I hope you have a written full care contract or Medicaid will get sticky.

Medicaid is an "at need" entitlement program. For NH medicaid, the applicant has to show "need" both financially (basically be impoverished) and medically (they require skilled nursing care). How that is done will depend on your states medicaid program as each state administers its Medicaid program uniquely but within an overall federal guideline (which comes from CMS - center for Medicare & Medicaid).

As a part of this, there will be required documentation to establish "need" for a NH and payment to the NH for that "need". The state can ask for the past 5 years on financials & property ownership to make sure there was no gifting or transfer of assets. (because if there is there can be a transfer penalty issued against the applicant which has to be cleared). They need to know what income is paid to yiur mom (like SS, retirement, annuities), to determine IF income is below whatever exact amount your state has set as a ceiling for Medicaid monthly income AND to determine the exact copay or the SOC (share of cost). Medicaid is asking about your moms financial details as she is the applicant, not yours. If, as you say she is way below the eligibility rates, it will all work out.....just find the documents required and provide a copy of all. For my moms initial application, it was over 100 pages for her NH Medicaid application. Her awards letters from SS and federal retirement were central as they showed to the penny what her copay to the NH had to be.

Now if you have been comingling finances (like your income & moms income went into the same bank accounts), that is going to require establishing who's $ is who's....well that is a total hot mess.....if that is your situation I'd ASAP schedule an appointment with an NAELA atty ASAP to get the application done. Medicaid will view all $$ as moms. A hot mess, really and not a DIY application IMHO.

Also your state may do an annual renewal. So keep all these items in a binder at the ready as you may need to resubmit for the renewal. When mom gets the annual next year awards letters from SS, etc. put them into the binder. Doing this will help maintain your sanity in the mice maze of Medicaid. My moms annual renewal would run about 25 pages of rerequired documents along with a 4 page questionnaire due within 15 days of date on letter which btw was always mailed after the date on letter.

If you or mom don't want to provide the information Medicaid requires, then don't apply for Medicaid. No one is forcing mom to apply for Medicaid. The elder or their family can private pay or buy ltc insurance or caregive for free or use the elders or thier families income to pay for care. Medicaid as an entitlement is not like either Medicare or SS as entitlements - both of which you have been paying into via FICA. If mom wants Medicaid, mom will need to provide her info & her documentation her state requires for her application.

Thanks everryone. I talked to medicaid today and she send me the forms and will help me. I have no problems as I have kept immaculate records for 8 years. All of our money is separate and I have every receipt for everything I ever got her, and a caregivers contract in place. I do not get paid any longer as her money ran out 4+ years ago . What concerned me was the application asking for my husbands busines!, Fortunately, they told me today to skip that part, its only my Moms money they need to look at. I cannot imagine drudging up all of our finances and showing 5 years back on ours. I do know one thing, I have done everything legal by the book. I have boxes and boxes and rolling drawer sets of all her info . I have been taking care of Mom in my home 8 years. She is staying with me and her ss and pension will still come here for her needs and caregivers out of what they will be supplying. I buy Mom the best diapers and booster pads, etc and I will continue to do that for her because she has never even had a rash or bedsore and hasnt walked in 4-5 years either. I wondered if anyone here had the At Home medicaid program, its called choices for independence. Thank you all again, appreciate it.

igloo572, thank you, I never saw this response from you until just now. As of today Mom was approved for the at home care. If I even get 2 hours a day its a mirable but I am hoping and praying its a lot more. She is full care but I do not want a nursing home. It I got 40 hours you'll hear me crying tears of joy ! Thanks again
RR

RR - ok so this isnt about NH placement. "Choices" is probably a community based Medicaid waiver program. Medicaid by law is for LTC that is at skilled nursing care level in a NH but the states can divert some of this funding to programs which could be more cost effective via waiver programs. Each state administers its Medicaid program uniquely but within overall federal guidelines
And the states have all sorts of waivers.....

Medicaid paying for AL is paid on a waiver program. PACE is too. Choices I'd bet is also. Couple of issues with waivers is that funding is not dedicated so programs can be defunded. Like in my state, PACE is the new model for care so new AL waivers are on a waiting list till forever.

Also care provided has to meet a cost benefit analysis to be done & paid by a waiver. Once care needed is at a certain point - like over a certain # of hours needed weekly - then at home or PACE will not be cost effective so Medicaid won't cover it as they need to be in a NH. I didn't have to deal with this for my mom as she went from IL to a NH, but from what I gather if "at home care" is more than 36/40 hrs or more than 50/60% of costs of a NH, then the waiver is stopped as it is not cost effective. Comprende? So keep that in mind, when mom is being evaluated for care needed by the state.