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Mom is almost 96 with dementia. I paid for LTC for her and it will be coming to an end in 3 months. She has had a live in aide for the past 2 1/2 years. It enabled her to stay in her apartment and we were very lucky to have had a wonderful woman stay with her. My concern is what will happen 6 months from now. Mom's only asset is one bank account. The options are to use up her bank account to continue to pay for in home care or to use that money as an "entry" fee for a "nicer" facility with memory care. I could also start to apply for Medicaid (when does one start that process?) for the inevitability of her money running out, but will Medicaid only pay for nursing home care or would they continue to pay for live in care? Her only income is her Social Security. We live in NY

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obrok2727, depending on your state, there may be waiting lists for Medicaid beds in the nicer places. This is because the facilities don't dedicate many for Medicaid since they are poorly compensated for them. The existing private pay residents in a facility that go onto Medicaid get first dibs, then non-residents are at the bottom of the list. A Medicaid room is a shared room. For my broke MIL we private paid to get her into a nice place then she applied for Medicaid. If your mom goes onto Medicaid while in a facility and there's no M beds available I'm not sure what they'll do so you may need to ask this question -- our family had to pay the difference between the private rate and the Medicaid rate until a bed became available. FYI not every place has Medicaid beds so be sure to ask.
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My granny could not self pay at all and she was in a beautiful facility, in an upper class neighborhood. So it doesn't mean that you go to a crappy facility, it means you get an available bed, and almost all facilities have Medicaid beds available.

You have a couple of months to make a decision, time to do some legwork.
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This is what I did.

Mom was in an AL and money was running out. In NJ you have 90 days to give them what they need for the application, liquidate any assets, like bonds, IRAs, insurance policies with cash value, ect. Spend down Moms money and find a facility. Mom paid privately for two months in the LTC facility. This spent down her money. I cashed in her insurance and used the money for a prepaid burial. Mom paid May and June and Medicaid started paying July.

There is Medicaid homecare. Mom will need to fit the criteria for income in your state. She will get aides based on her needs. I think, the cost depends are covered. You need to go to ur Social Service Office and talk to a caseworker about options. Each State is different.

ALs are not usually covered by Medicaid. But you can ask. In my state you have to private pay at least two years before Medicaid can be considered. Then that depends on how many beds are Medicaid and if already used.
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worriedinCali Jan 2020
Medicaid pays for memory care which is where the OPs mom would go. Medicaid in most states provides financial assistance for assisted living, not always room and board but there is assistance for Medicaid recipients.
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I would use the money to get her into a nicer facility that accepts Medicaid when her money runs out.
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obrok2727 Jan 2020
Hi Becky,
That's why people have told me to not spend down the money in her bank account and use that to get her into a nicer facility. My quandary is whether I should use it to continue to pay for live in care or move her into a facility now while there is money to pay for a "nicer" place.
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Of course you should use her money for her care. At her age you just don't know how long she will be with you.

Private pay while you check into the services available to her in her city.

Area on aging is a valuable resource for finding what is available to people that want to stay in their home.

Gosh, at this age I would have to think long and hard about any drastic changes, like a facility. I hope that you find between her money and the assistance available that she can be where she is most content.
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You’ll probably be better off putting in her in memory care as self pay & transitioning to Medicaid when her money runs out.
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