Looking to see how we can afford assisted living for my Mom. I'd love to have her in CA, but she makes 2400. a month. The limit is 2100. Ugh. My Dad was a veteran, in Korea, but it wasn't during war time.Also, she has Parkinson's. She needs help with medication, and laundry and appointments
MediCal is State of CA entire Medicaid system. Texas used DADS as the separate system for dealing with aged/disabled seeking long term care services; but now DADS ceased to exist and now it all under TX HHSC system.
Imo If mom is in CA, there will be way more choices than TX. Texas did not take Medicaid expansion and their programs are as narrow and limited as possible for eligibility and low for reimbursement for participating providers.
In general, for those looking for a State to pay for AL, that is done via a waiver program. The $ for this is taken from the federally dedicated funding for LTC in a SNF program and done by a waiver. States do not have to even do waivers at all. For States that do, the issue for ALs to be participating in waivers is the funding is not guaranteed and the reimburse rate tends to be low. So what ends up happening is most AL do not even choose to do them and those that do will set aside a few waiver beds, which in turn creates a waiting list for those beds. And the elder private pays to be in the AL till they are #1 on the waiting list. Tends to be a 2 yr wait time. CA does their AL waivers thru the ALW program of MediCal, there’s an online PDF that explains their system. For TX it’s the STAR + PLUS program within HHSC.
AL as it is not skilled care is done as a HCBS Medicaid program. Home and Community Based Services & it has a slightly different financial “at need” that LTC Medicaid program does. For CA last I looked the income max is low at $1,820 but if she’s over her income just goes into the required Share of Cost. For CA, she has an nonexempt limit of 130K. Tx is different for waivers, it has income max abt $2900 & nonexempt asset max of only 2K and she has to be able to show she is a resident of the State. If she’s right now a CA resident, there will be a gap period before she can be a TX resident and then file for a TX HHSC Star + Plus waiver and then eventually get a waiver bed, she will have to be able to private pay during this period.
Becoming a TX resident has a lot of requirements as you will pretty much have to have either a State drivers license or State issued ID. Go onto the TX DOT to see all the items you have to have to do either of these. It’s very very tight.
Medicaid in most states does not pay for AL or MC, but I would check to make sure and also see if there's other state-specific programs.
You really need to go where she is and talk to people one on one. Same with CA. Seems they don't allow Qualifying income trusts but there is something they do allow.
"California does not allow Miller Trusts (also known as Qualified Income Trusts or QITs) for Medi-Cal (California's Medicaid) eligibility; instead, California has a different system where most income must go toward care costs, but it offers other trust types like Medi-Cal Asset Protection Trusts (MAPTs) for managing assets and eligibility, requiring consultation with a local elder law attorney."
In order to bring her to another state she would need to establish residency there first and there are likely rules around how long she would need to live there in order to qualify.
Medicaid is a federal program that is administered by the individual states which is why it has various names.
So applicants being over resourced in income don’t have to do extra legal as they just turn all monthly income over to the facilty less the PNA.
The elder still has to also clearly show with health chart documentation to be “at need” medically for skilled nursing for LTC MediCal to cover their stay in a NH.