Why is it always a goal to put aging loved ones on Medicaid?

My husband has battled with ALZ for over 11 years. Every call I have made in the last five years to try to get assistance I state up front that we do not qualify for Medicare, and they always try to convince me to apply, I always refuse. We have savings and no debt. I private paid for home care for years, eventually I received VA benefits to cover four mornings a week, and this year he was put on hospice, so Medicare cover three mornings a week and home health needs. At this stage in his life it would be impossible to make the changes required to be Medicare qualified, and really I see that as a blessing. We have both worked very hard to be financially blessed. Our son is grown and his children are his responsibility. My only financial concern was somewhat selfish I suppose, I have many years to live and I know a nursing home would deplete our savings in only a few years. I own a small business, but it’s not enough to live on.

I went through this issue with my mom the last year before she died. My mom had funds that were quickly being spent down for in-home care and I faced the prospect of her going into a care home and eventually qualifying for Medicaid. She died before she went into a facility, so it all became a nonissue. However, I believe that a person's funds should be used to pay for their care, not to fund children's inheritance. I am heartened by the replies here that advocate that position. I talked with a Medicaid attorney while doing my research and asked why I would want to pay him to work toward speeding up the process to get my mom qualified. When he said, "to protect her assets for you", that was it. I was out of there. Again, my personal view, but government funds are supposed to be used to help the needy, not the greedy.

Their money runs out because they live so long with all the excellent care they get.

We spent every last penny of my mom's money on her 24/7 care at home, including selling her home and using that money. As we saw the "writing on the wall" with her decline in health, we tried our best to make sure all her money was spent exactly as it should have been so she wouldn't be penalized by Medicaid. It was my mom who was screaming and hollering that she wanted to buy new cars for my two kids, NOT me.

At the advice of her financial planner, my mother worked with an elder care attorney in California to create an Irrevocable Trust. The reason was to prevent my mother from being bankrupted by my father’s dementia. Also to reduce (or was it eliminate?) inheritance taxes for me, their only child.

My father passed two years ago after three months in memory care and one month for rehab after breaking his hip. This was paid for out of their savings. I helped my mother sell the house and move her to the lovely retirement community she couldn’t convince my father to move to. Her common refrain was “after your father passes, I will move to Rossmoor, and then I’ll be happy.“

The PA who ran in my dementia support group warned me that after my father passed I would notice the deficits in my mother. Boy did I. She had been mismanaging money for awhile. She had cancelled my Dad’s medigap insurance and had to pay out of pocket for his rehab after his hip replacement. When her financial planner told her not to worry about paying off her home equity loan until after the house was sold she stopped paying altogether, adding $20,000 to the bill. I wrote these off as hearing mistakes. The new hearing aid hasn’t helped.

I have had mixed feelings about this trust. If I were the state of California I would be trying to eliminate these trusts which allow families with an expendable $8,000 to bilk the state out of billions in estate taxes. However, when my mother spent $500 on a paper shredder because she is an important business person and had three months of $1,000 PG&E bills after she “adjusted” her thermostat, I am grateful that she does not have access to the money from the house sale. Scammers abound, and I am sure you’ve heard the stories of seniors giving their money to bad actors.

The deal with the trust is that I am not allowed to use the money to directly benefit her. But how I spend my money is my business. This requires me to move trust money to my account before putting it into hers when her expenditures exceed her bank account.

My thoughts on trusts are that while they are legal, they are not exactly ethical—a convenient loophole for people with money to hang on to their money. However, as my mother has been recently diagnosed with dementia, I will use trust money to take care for her when her savings run out. As memory care in her neighborhood runs $12,000 to $14,000 a month, this is a distinct possibility. If she outlives that, we will have no choice but to apply for Medicaid on her behalf as I my husband and I need to save our money for our possible care.

There is absolutely No Other Reason But Money. People want their inheritance money and don't want it spent on Caregiving which is a bunch of poop.

My 96 yr old Dad worked and saved and had a nice nest egg that us 4 daughters thought we'd be divinding once he past but last year with his dementia worsening, he needed 24 7 Care.

Im the youngest and lives the closest so I've always done everything for my Dad as he aged like Dr's Appointments, Groceries, manage his money, pay his bills, ect. I am also the Executrix of his Will.

My Dad always wanted to stay in his own home and not go to a Senior Home and I promised him that would happen.

So, as of a year ago, I informed everyone that Dad would no longer be giving out money for Xmas and Birthdays and No Loans to anyone that he needed his money for Home Care.

I hired Cargivers and my Dad had 24 7 Care.

I had my son install Nest Cameras so I can check in and see and hear my Dad 24 7 and make sure the Caregivers are treating him right.

24 7 Home Care is very costly and hopefully his money doesn't run out.

Aflyer a year of 24 7 Care doing their shifts. I'm now thinking to make his money go farther, I'm going to look in to hiring a Live In which would be 1/3 of what is being paid for multiple Caregivers doing their shifts.

People should only concern themselves with what the Loved One wants, not be selfish and spend and or hide the loved ones assets so they can qualify for Medicaide which you could end up in a not so desirable place to lay til you die where they are just a bed to most and where they will feel sad, abandoned, lonely, scared and will lose their will to live.

Im sure they're are some nice places but even the nice places that look pretty and are made to sound so great is only for your observance and it's a different story behind closed doors.

The Loved ones should be able to live out their last years doing whatever they want.

Do to them what you would want done for yourself.

Tall to them, they know what they want. Make it happen for them.

Only if and when the money is gone should you seek Medicaide.

Best thing one can do for an aging Senior is let them live out their life in their own home where it's familiar to them.



Even

I always have the same question. There are no doubt people who truly need it, sometimes through poor planning and sometimes not

But often, not ALWAYS its basically a scam to have taxpayers pay for ones care rather than oneself. I have seen plenty of examples in that in my own extended family.

This month has been horrendous! All at once my husband got an infection (not Covid) & also lost all strength. One week of hospital and the rest of this month in Rehab. So far our insurance is paying, but we almost had to have private pay. Our appeal & his progress has kept him in Rehab via insurance. $350 a day would be impossible. He has an autoworker's pension, Social Security, almost no savings, and a long-term care insurance that currently requires 90 days before kicking in. I say currently as they're about to re-do the plan.
I'm the owner of this home (2d marriage for both of us), but he may be considered part owner, I'm not sure. I, too, get a pension from where I worked, Social Security, long-term care insurance, but I've saved like crazy including 2 annuities. I also normally am a freelance worker. (Covid currently has unemployment coverage for freelancers.) I'm concerned when I read the Spousal Impoverishment rules <https://www.medicaid.gov/medicaid/eligibility/spousal-impoverishment/index.html> . I'm not concerned about what either his or my kids might inherit, but have tried responsibly to plan for the financial "joys" of old age. I'm the one who talked him into the long-term care policy because I knew he had some health issues.
Yes, we'll pay privately (home health care?) while we can, but that doesn't look like it will continue to be enough? Does this mean I need to give up on my own continued work and savings? I'm glad there's at least some provision, but it sure doesn't speak well to those of us trying to be responsible.

I am concerned and confused about these issues. i am an 86 year old retired teacher with a tragically mentally and physically ill and crippled 65 year old daughter. She is in an excellent assisted living facility because i could not be her caregiver. I want her to give me popwer of attorney so i can sell her home. i want to use the profit of at most $128, 000 to pay for ongoing excellent care for her. The money would pay for her excellent care for at most 5 years.Then, she could apply for medicaid. I am being urged by a lot of so called experts to have her apply for medicaid now. i have been called by 3 "group home managers" so called urging me to place my daughter with them. They sound very unintelligent and disorganized.My income is $3100 a month and my daughter's Social security income was dropped from $2400 a month to only $1225 a month at her husband's recent death.Obviously, i cannot pay for her care very long.However, I want her nearby and with excellent care for as long as possible.Why do so many people urge me to have her apply for medicaid now/ What can i do? Thanks

Though it differs from state to state (and you have to check on the state where your mom lives) typically Medicaid only kicks in once you’ve exhausted all your assets and are down to your last $2000. You’re expected to use your own funds to care for yourself until then.

However, you have to use your funds on only yourself, and cannot transfer/gifts assets or funds to anyone within the last 5 years in order to qualify. If you do, you will have to figure out how to “pay back” that amount before Medicaid starts (or pay a penalty.)

Because, depending on where you live and the level of care that you need, nursing homes and/or assisted-living can cost anywhere from $2000-$10,000 a month, you can see how quickly you can burn through your assets, and end up on Medicaid.

You ARE reading the situation correctly. “Good” nursing homes have all manner of methods to resist taking Medicaid patients up front, though they claim to take Medicaid patients. What they mean is that they don’t eject then after a good stint of private pay exhausts their resources and they end up destitute and on Medicaid. We had the same attitude you do. Mom died in an excellent nursing home on private pay to the tune of $12,000 per month and her children, most of whom could have really used my deceased father’s inherited wealth, ended up with almost nothing split five ways. Most families are looking for ways to avoid paying for nursing home care. Whole cottage industries of so called “elder attorneys” exist for this very purpose.

Using Medicaid to pay for nursing home care becomes a necessity for many for a stay that extends over many years, but should never be used as a dodge to pay one's fair share. This program is going broke!

I speak with experience. My husband has been a private-pay long-term resident for the past five years. He entered long-term care at age 59 due to frontotemporal degeneration. Some time next year, we will run out of money to pay 100% of his nursing home bills. He will still be able to pay about 50% of the bill. To extend his private-pay status, I will take out a mortage on my paid-up condo, which I should be able to pay off in five years. I also fully intend to pay Medicaid back every cent they pay for his care, even if I am into my ninth decade. Once I begin taking Social Security at age 68, I will voluntarily contribute about $10K annually to his care. That will decrease the amount I must reimburse Medicaid.

There are legal ways to shield assets. A competent elderlaw or estate planning attorney can help. Our attorney will convert what is left in my retirement accounts to a Medicaid-compliant annuity. The good news: I get to keep the money. The bad news: it's a fixed income stream.

There are several views regarding Medicaid.
1. A couple has assets but spends freely, having every possible luxury, and save nothing. So they go into a nursing home later in life and Medicaid foots the bill.
2. A couple live frugally, doing without luxuries, and accumulate a sizable savings account. So they go into the same nursing home and use their savings to pay for their care.
3. A couple with considerable wealth sign over their assets to their children well before the five year look back period. So they go into the same nursing home and Medicaid foots the bill.
it seems that the couple that scrimped and saved lost out!

We spent my parents' retirement money on their care. The problem is that it's very, very expensive. If they had not had good pensions, we would not have been able to afford it, and that's what most people discover as they start pricing things like in-home care or assisted living. You would be surprised how quickly $8,000 plus medical expenses paid out on a monthly basis goes. In addition, if children are involved in the care of their parents, which is quite often necessary as home care workers need help and supervision and facilities are pitifully understaffed, parents generally want to leave their children something as well for all of their efforts, which are frankly, considerable. This is the beginning of her decline. Things may look a little different to you eight years down the road.

People who can afford to pay for care should do so. Medicaid should be reserved for those in legitimate need.

It is a difficult question.  If you believe that legal Medicaid planning (gifting 5 years before a NH is needed) is immoral or unethical, do you think that gifting to legally avoid estate tax is immoral or unethical?   I would insist that no matter how my mom's money is titled, she get the best care, but I do not think the morality of Medicaid planning is so clear.

You are very wise to question it! I do NOT recommend getting medicaid unless you absolutely need it. In order to keep it they want you to live in poverty. NO WAY! There are many changes that are going to be coming soon to insurance and how hospitals operate. The cost will come down and our coverage will improve. WAIT before making a decision that would limit you mom's happiness by taking AWAY everything she worked so hard for her entire life. I am praying for your mom's health and that soon we will also find answers to the many diseases out there. God Bless You! Very Smart observation!

I have not read any of the other comments . I think it might be so prevalent because of the cost of care in a facility. My sister was in a beautiful 3 step facility For 7 years .. It cost the better part of $650,000. And yes, I have the right amount of 0’s She was very fortunate, most of us do not have that amount of $$$ available to spend for elder care and Medicaid is a back up ..

Because my mom will be running out of money in less than 3 years , maybe add a year or so. I worked hard all my life. She did not work. She could have. My father could have taken better benefits, did not. I cannot afford $2500 a month to take care of my mother when she runs out of cash. I never even had a house payment that high.

It’s also prevelant because assisted living homes take advantage. My mom is now one point into level 2 care.... that point is caused by a home visiting nurse coming in for care on my mother’s legs. The visitin nurse is paid thru my mother’s insurance . The assisted living is getting $400 a month cash from my mother. Do the math....draining her medical savings

Because the rules and loopholes are archaic. More care and services should be provided by Medicare but they are not - so you are either forced into a nursing home when you cant manage on your own, spend all your money on long term home care OR spenddown and transfer your assets(legally) so your children can have something left AND then get on MEdicaid for home care. Im single and so when i die, i will likely spend my money on help since i dont have kids to transfer to ,etc but if you have kids, it makes sense. When My father was suppose to come home from rehab 2 yrs ago, I knew he would need 24/7 care and so I applied for medicaid for he and mom. He never made it home and passed away. My mom was approved for medicaid - we had an estate lawyer plan the irrevocable trust years ago, etc. I am her fulltime caregiver and refuse to get paid for it via medicaid program that pays caregivers. I only want mom enrolled in medicaid when it becomes too much for me to care for her alone - knowing its there gives me serenity but chances are i will probably only use it at the very end(if that) - now im doing all the chores(including bathing mom etc).....So far, we havent used any of moms medicaid benefits - she has been approved for it now 2 yrs+

Medicaid was never a plan!
My parents had money & a big CA house near the beach. Then dad got cancer & they spent all savings/reverse mortgage to pay for his non-helpful chemo then experimental drugs. Poverty & dementia hit my mommy hard as soon as dad's funeral was done.

Moved her in with me, her only child, until while I'm at work, she walked into highway traffic thinking she was "crossing" her childhood street. Again.

With my own health, job, & finances in tatters to juggle care for her at home, I relented to Medicaid for mommy's 24 hour memory care because there's no personal money left. Awful. Heartbreaking. With COVID I can never kiss or hug her. But, she is safe now & is "ok" with her routine. I'm thankful for Medicaid for my mommy's protection & care.

Medicaid was NEVER the plan. It's a safety net.

I think part of the answer is that people (parents) want their children to have something when they are gone. Now unless the children don't need/want it...then use the money (their money) to care for them for whatever they choose (in home care or NH).  Its their money and can be used for them.  No one says you have to get them on Medicaid.  Besides you would have to spend down their money on them before going onto Medicaid anyhow.  Check with an Elder attorney and you can ask them all those questions.  they will be able to help you sort things out.  wishing you luck.

I thought there would be some responses here but I don’t see any. But my response is of course you are right. If your mother has provided well for her retirement, then it is my belief that the money should be spent on her comfort. It’s expensive though.

In our case with my stepfather his old age during which he needed assistance and oversight lasted 10 years, from the time he was 80 until he was 90. And he needed ultimately to be in a nursing home (about $140,000 a year in the New York metropolitan area and the place didn’t take Medicaid). There were all sorts of other expenses as well. Luckily there were few painful procedures and he had a DNR so without a great deal of oversight, things might not have gone well so far as making the money last.

My mother is now 90 and although seeing to her needs and keeping her company has begun to really intrude upon my lifestyle, especially with COVID19 looming, financially she and he provided well for themselves. Generally people get involved in spending down in order to safeguard their own resources, and to get their parents the care they need although they haven’t been able to save for it. Also one hears that some elders would prefer to leave their children or grandchildren provided for and to scrimp on their own care. Sometimes children and grandchildren can move them in that direction. So there are many issues here.

The desire to leave a legacy becomes very powerful for those who have worked hard all their lives without having much to show for it. But the big question here is usually whether the elder will be able to stay in her home (she will eventually need help she approves of probably in addition whatever you can do yourself) or whether she may need assisted living or nursing care. If so, then a minimum of at least weekly visits are part of the expense. If the elder lives far from you, this too can run into money, not to mention time if you, yourself, are not retired.

I find that the biggest need for both of my parents wasn’t actually financial in nature, and that was the need for congenial adult companionship and attention.

I thought there would be some responses here but I don’t see any. But my response is of course you are right. If your mother has provided well for her retirement, then it is my belief that the money should be spent on her comfort. It’s expensive though.

In our case with my stepfather his old age during which he needed assistance and oversight lasted 10 years, from the time he was 80 until he was 90. And he needed ultimately to be in a nursing home (about $140,000 a year in the New York metropolitan area and the place didn’t take Medicaid). There were all sorts of other expenses as well. Luckily there were few painful procedures and he had a DNR so without a great deal of oversight, things might not have gone well so far as making the money last.

My mother is now 90 and although seeing to her needs and keeping her company has begun to really intrude upon my lifestyle, especially with COVID19 looming, financially she and he provided well for themselves. Generally people get involved in spending down in order to safeguard their own resources, and to get their parents the care they need although they haven’t been able to save for it. Also one hears that some elders would prefer to leave their children or grandchildren provided for and to scrimp on their own care. Sometimes children and grandchildren can move them in that direction. So there are many issues here.

The desire to leave a legacy becomes very powerful for those who have worked hard all their lives without having much to show for it. But the big question here is usually whether the elder will be able to stay in her home (she will eventually need help she approves of probably in addition whatever you can do yourself) or whether she may need assisted living or nursing care. If so, then a minimum of at least weekly visits are part of the expense. If the elder lives far from you, this too can run into money, not to mention time if you, yourself, are not retired.

I find that the biggest need for both of my parents wasn’t actually financial in nature, and that was the need for congenial adult companionship and attention.

Having been a Certified Financial Planner with a private practice who retired when my husband was diagnosed with terminal cancer and became a caregiver myself, I understand your questioning this advice. Medicaid trusts to enable a person to meet Medicaid's requirements for a low level of income and a low amount of assets are often recommended for a variety of reasons. The major concern should always be what the care recipient's wishes are for how and where they live the last months or years of their life. Each of us has the right to decide what we want to happen. What does your mother want - what is most important to her at this time? Even though you have POA, your mother's assets still belong to her. How would she want to use her assets?
Also, get as much education about Medicaid and how it actually works in the state your Mom lives in. Medicaid is a program funded by both the federal government and each state government. Each state has a state Medicaid program and determines what is covered under that program within the requirements set by the federal government. State Medicaid programs are entitlement programs, which means all who qualify will receive the benefits covered by their state's programs. There are also Medicaid waiver programs that each state applies for. Each waiver covers benefits that are determined by the state. Many states cover Home and Community Based Services under state Medicaid waivers. A very important point to understand is that Medicaid waivers are not entitlement programs, and that states can and do set limits on the number of enrollees. This means that a person could qualify for Medicaid, but still not receive benefits provided under state Medicaid waivers if the enrollment cap has been exceeded. This means that person will go on a waiting list to receive the benefits covered by that waiver. If the only care available under the state Medicaid program is nursing home care, is that okay with your mother. Obviously, this situation should be discussed by all people involved - the care recipient, each caregiver, and other family members involved. So, if it's possible, talk to your mother about what she wants. Contact the state government department or agency that manages the state's Medicaid program and find out what is covered under the state Medicaid program and what is covered under that state's Medicaid waivers. My prayers go out to you.

"Trying to do things in increments, because I have A baby due in December."
Congrats!

Hopefully you have enough care set up to take care of mom (you indicate keeping her in her home as long as possible) for at least a few months, even better if longer, or at least only take on a few hours yourself!

Caring for a newborn AND yourself can be taxing enough without having to also care for another person.

Imho, Medicaid is generally not advisable, though some must opt for it as a last resort.

The big thing is to protect assets for the spouse of the loved one who needs nursing home care. Barring sudden death, the aging process requires people to spend quite a bit of money while they are still in their own home. It's surprisingly expensive. My dad required 24/7 care for the first two weeks following discharge from rehab. In 2014, the cheapest price for that was $4200. So, it is important to protect assets for the community spouse as he or she shouldn't be rendered penniless in the care of their spouse. That is probably the biggest reason for making advance preparations to protect assets. Private pay in a nursing home in my state costs $15,000 a month. That adds up very quickly. Yes. If the person requiring nursing home care can afford to pay the sticker price without negatively impacting their spouse, by all means, find the finest facility and pay extra for a single occupancy room.

I also just became POA and the attorney gave me extra powers to disperse 70% of the inheritance prior to my Mother going into a home. He said the 5 year clock can save 100% of inheritance. My parents have an irrevocable trust with quite a large sum of money. I didn't really understand what he was talking about, so figured I would deal with it, if the time came. He said that Medicaid was not for poor ppl and more ppl needed to understand that. Wish I had more info to help but it was a bit overwhelming at the time. Maybe, it's something more ppl should check into. The place my Mom would go is 9k a month and the only ppl that can afford it are ppl on Medicaid. Lol My MIL was there, they took her SS and Medicaid picked up the rest. Very interested in someone knowing more about this.