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I am co-caregiving my mom with my step dad as the 2nd caregiver. I just found out that they don't have long term care insurance. So if she goes into a facility it will have to be private pay. As far as I know that is not possible. What do people do? I have been told about spousal refusal, but when medicaid comes knocking to be paid back he won't be able to pay that back. I don't have the money to do anything. I am providing my time now with out working its going to be hard. She doesn't want me in her house much less an outsider from an in home care place. Ive only been doing this a month and I am trying to see down the road what the options are going to be. Im learning everything I can as fast as I can but this part has me stumped. You guys on this forum have been so great and I am open to any and all ideas. Thanks

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When an elder cannot pay on their own to be in a continuing care facility, yes Medicaid will step in and help pay for that person's care.

If your Mom and step-Dad have nothing then Medicaid won't be able to collect anything from them... the taxpayers will be footing the bill.... but think of it this way, if your Mom had worked outside of the home and so did your Step-Dad, while THEY were working they were helping to contribute via taxes for the previous generation to be helped by Medicaid... now it is their turn to be helped.
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Well, yes, Medicaid will pay for "something" but it's very likely not going to be a private apartment with a view in the nice new assisted living center in your own neighborhood.
Before you can GET Medicaid, you have to apply, and have no more than $2,000 in assets. Also they do a "look-back" for 5 years of transactions and can be disqualified if they transferred assets within that time.
Once you do get approved, Medicaid will first provide services in your parent's own home, if feasible, since that is cheaper than a facility. Once the bills for that exceed the cost of a dormitory room in a facility, they will require mom to live there. Dad will still be allowed to have enough to live on, he will be the Community Spouse.
Medicaid varies from state to state. Check with your state for what they will do. But do not expect to have any choice of where your mom goes as far as AL or even NH. They might try to accommodate you but in my family's and friend's experience, you have to take what is available, and Medicaid has many many seniors in need of care, so they will try to provide in-home services before a facility.
Your parent's predicament is exactly why all high school and middle school kids need to be taught, they must save like the dickens for their senior years---they are going to have to live into their 100's---and there are not enough younger folks to pay for them to live, each person has to provide for their own retirement.
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Medicaid should be an option, but please don't worry yourself sick about what may or may not be ----like they will TAKE mom and dad's house. Every situation is different and since there is so MUCH misconception about Medicaid and the Medicaid laws are always changing, I would contact your local legal aid or legal services organization offices to see if you your parents would qualify for some free advice on Medicaid planning. If they are over resources to qualify for free help, you should consult with a certified elder law attorney for medicaid planning advice. DO NOT rely on advice given by anyone working in a long-term care home or (in my opinion) any other individual who is not an attorney practicing this type of law. I have seen several people get bad advice (costing them thousands of dollars) from business office managers who think they know but don't, or who are just looking out for the nursing home. Take a deep breath and enlist a professional to advise you on your parent's specific situation.
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I just today read that the average cost of a private room in a nursing home in the US is approximately $91,000/year. The cost of long term care insurance is out of financial reach for many and because of health conditions many wouldn't qualify for it anyway. Even those of us who have saved, have not saved nearly enough for a long stay in a nursing facility. We will have no option but to rely on Medicaid. It is a shame in this country that those who have worked all their lives and have been productive members of society will be reduced to poverty in their senior years. It not only affects them but also the future generations. No longer should todays children expect to receive an inheritance left by their hard working parents. No, not only will there not be an inheritance to help boost the next generation along but they will have to pay increasing taxes to care for the elderly.
I doubt if most folks have even thought about their old age and how they will pay for it. Those of us who are caregiving elders have had the cost of long term care abruptly brought to our attention.
Don't be ashamed to take Medicaid if you can get it. Your folks have probably paid taxes into it, just as most of us do today. The hard core reality is that if we all live to the life expectancy predicted, many of us, if not most, will be financially reduced to needing Medicaid. It's a sad situation and I certainly don't have the answer to this societal issue.
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