Can you or do you apply for Medicaid before you actually need it?

Elena - your son who is 28 & on Medicaid does NOT need to worry about any MERP - Medicaid Estate Recovery action for his care right now. MERP via a claim or a lien on the Medicaid recipient assets after death ONLY is for a specific list of Medicaid programs for those 55 and older. You state Medicaid MERP site should have the details on all this.

MERP is not done for Medicaid programs like WIC (Womens Infants & CHildren); CHIP (Children's Health ); brain trauma ltc for young (most of these are 18 - 30 from accidents) or other Medicaid programs for those under 55 years old. Now if 27 years from now, your son is still in a facility and on Medicaid, then there could be recovery but only for the years he is 55++.

Decatur30033 is incorrect about liens / claims on younger Medicaid recipients.

Thank you for all the great info & responses. This seems like a very long process which I guess in the back of my mind I knew it would be but I am sure others have survived and I will too although sometimes I wonder.

regarding Veronica91,
You illustrate one reason for those reading about this to engage in Medicaid Planning and legitimate asset transfer. If done correctly preserved assets when combined with Medicare; can still provide the better accomodations. It is foolish to just spend down.

If a facility accepts Medicaid patients, then such facility cannot evict a private-pay patient who later switches to Medicaid. However, there are many facilities that do not accept any Medicaid patients (i.e., they are ONLY private pay); in such facilities, if the patient runs out of money and needs to apply for Medicaid, the patient must then move to a Medicaid-accepting nursing home. Thus, it is VERY important to find out before the patient enters a nursing home if it accepts Medicaid payments (assuming that is a possibility in the future). Hope that clarifies the rules!

Veronica91, I hate to tell you this, but you're incorrect: "Once a patient is admitted to a nursing home and later needs Medicaid they can not be moved to an inferior facility."--this statement is absolutely NOT true, I have been with my parents to several facilities and there are many that are "Private Pay" only, and if you run out of $$$$$, you're evicted, and at least one of them said very clearly, they have no social service worker to help you find a place elsewhere.

IF you anticipate needing Medicaid to pay for your care, you should avoid the private-pay-only facilities.

AND if you are in a facility that accepts Medicaid, when you DO run out of money, they are under NO obligation to keep you in your same room: they will move you out of your private room with a nice view, into a 2, 3 or 4 person room as soon as they can. All facilities need to reserve their private rooms for private pay clients (they charge more for private room and Medicaid is not obligated to provide anyone with an upscale private room).
I know this is true because of many visits with my parents to assisted living, also grandparents who died in nursing homes after many years there (running out of money and being moved to not-so-nice rooms).

You can help your loved one if you can put together enough money to pay for the first six months of nursing home care in the facility of your choice. Once a patient is admitted to a nursing home and later needs Medicaid they can not be moved to an inferior facility.

https://www.healthcare.gov/do-i-qualify-for-medicaid/#howmed go to the medicaid web site this should answer your question about qualifying for medicaid

As the other posters here have commented, it is important to make sure you understand the rules and get your paperwork in order before you apply for Medicaid, particularly if the applicant has made any gifts within the prior 5 years. However, you will not be granted Medicaid benefits unless at the time of application there is a real financial as well as medical need for such assistance. As such, although you can apply months before such financial need exists, with the thought that it will "kick in" once you really need it, Medicaid will be denied and you will have to apply again later once the actual need begins.

Catholic Charities will help anyone, not just Catholics.

Start by pulling together five years of bank statements and be sure you can account for every penny spent. Failure to account for cash withdrawn is the biggest stumbling block.

Apply for welfare before needed?

None can get Medicaid benefits [welfare; DSHS] until they've spent-down assets to their State's limits.
BUT....you CAN go to DSHS [welfare] offices, start paperwork, and get someone to evaluate where Mom is on that scale.
Medicare monthly premiums can be paid by one program, so those no longer get debited from SSI check--at least.
It's possible she might qualify for other assists.
AND, she'd be in their system then.
It's not hard to get someone into the Welfare system.

When you go to DSHS:
Bring a book to read while you wait.
Choose a mid-week day, like Tuesday or Wednesday.
Make it the 2nd or 3rd week of the month.
Come as early as they open--usually around 8 a.m.--that makes for less people crowding the waiting room.
These all help avoid crowds that can happen there [crowds usually come later in mornings/afternoons]
IF you, or applicant, have breathing problems, you might want to tell the reception desk that you need to wait where the air is more breathable than the waiting room [welfare office waiting rooms can have some really "thick" air sometimes---DSHS wait-rooms sometimes smells more like a drunk-tank of heavy smokers, than a waiting room; some wear way too much chemical body products...NO room air-freshener can fix that--those only add more chemicals, usually.].

Bring receipts/documentation for bills, bank accounts, pink slips from vehicles, etc. to show proof of asset-levels.
Bring your ID, bring the applicant's ID. [Driver's license, State ID card, Military ID, birth certificate, etc., can usually fulfill this]
Know names, addresses, for bills paid where, bank account numbers, investment numbers, etc.

Application packets are picked up from the from the front reception desk.
There may be a computer check-in--those are easy to use; if confused, ask the reception desk person for help.
Make sure to check off all the little boxes for things being applied for [food, medical, supplemental income, etc.].
Fill in, correctly, all questions;
Assets allowed is likely around about $2000 liquid assets per one person--A house is different category, as is a car.
IF a applicant owns their home, those are counted differently than bank accounts, retirement, etc.
A married couple can have far more assets than One person [counting their house, or part of it]-[[-whoever came up with those numbers, had to have had some really twisted strange logic!]], the married couple's assets are somewhat protected for the survivor.

Completed Application is turned in to the reception desk clerk;
You/applicant wait to talk with a case worker--that could be minutes or hours--block out your whole day to do this--or at least half the day.
The Case Worker goes over the application, correcting it as appropriate for applicant's situation, explaining things; you get to ask as many questions as needed, to make sure you understand everything, and make sure the CW understands how things are.
The CW will make sure the Applicant [in your case, Mom] gets benefits she's entitled to, but nothing she's unqualified for.
Then benefits [if appropriate] get started, unless the Mom doesn't qualify yet.

But that's OK too--you started, and got questions answered--you'll know far more than when you walked in, and, will be able to put things together to fast-jump on it when the time is right.

IF in a nursing home, a Social Worker / Case Worker [CW] often helps put this together pretty seamlessly.
IF the facility lacks this, you have to do it, OR, you contact your local Area Agency on Aging, and get them to point you in the right direction to get help.

SOMEtimes facilities deny they have anyone in their offices to help get benefits going.
NO facility wants to deal with Welfare--ALL simply hate dealing with Welfare--it barely pays for the paper used to apply for it; it uses tremendous human-hours and energy for little pay-back....so some will try to deny it exists, or deny they do anything to help get it going. That's OK--let 'em play their games.
YOU circumvent that by taking the case directly to DSHS on your own--even if the case must wait for Mom's assets to get spent-down.

An adult child can help apply for benefits for their parent, if situation warrants it.
Having a POA makes everything easier, but it's not always needed =depending on circumstances=.
IF Mom is able to come with you and tolerate sitting thru the waiting times, she can be seen, as can her problems be seen by the Case Worker--and give her verbal authorization to talk with you, her caregiver, about her case, instead of putting Mom through that again later--a paper can be signed in their offices allowing them to talk with you about Mom's case.

Even if you don't get the DSHS help at first, talking with them in person helps reduce your anxieties over it, and can answer many questions to help prepare you and pave the way for when she does qualify for it.
Trying to call DSHS by phone is awful, usually [endless pizza-menus, circuitous calls, endless waiting, hangups, etc.]

Welfare workers are regular human beings; I've met very nice, patient, helpful people, while helping others with that system. It's more humane now, than in the 1950's, for sure. How you treat those workers, will help determine how they treat you, too...I've watched people come in acting angry/inappropriate, and seen CW's nearly shut down those cases, or tell them to leave, or make them wait longer.

It can be time-consuming in the waiting room. But once they determine a person qualifies for help, it's pretty fast.
Then it's just keeping paperwork updated--they send letters telling what's needed--be it a phone call or more paperwork.
Their job is to weed-out the real applicants; prevent anyone getting benefits a single minute longer than necessary--most States are broke, and can't afford the Welfare they currently dish out.

Good luck!

Simply applying for Medicaid is not to be taken lightly, and without consideration. There are ALWAYS unintended consequences with uniformed decisions!

Has any one thought of the young man applying for Medicaid, and later being subject to estate recovery, or liens? I don't know what that situation is; is he permanently disabled, or just a rough time?

You can choose a nursing home if you start on private pay, once on Medicaid there is no choice, nor assurance of proximity, quality.

Assets limits are key; you can't be a dollar over! Cash value of a Life insurance policy of which you thought "you would get the death benefit" often will be a disqualification. In Georgia I have helped many families with the Funeral Trust (Medicaid Approved), in both pre planning and crisis planning, to preserve those funds, values, for the 'patient', and for family members, instead of losing it to the nursing home, / risking months of disqualification. Do not make that mistake, and a funeral home should NOT be the beneficiary, (visit to a funeral home is NOT required)

Something forgotten: again for my Georgia clients I can convert an inforce Life Insurance policy of any kind with a face value of at least $50,000 into a benefit to pay for private Care or even Home modification, in contrast to letting those polcies lapse or be subject to Medicaid Recovery, it is Medicaid approved and encouraged

However most social workers are not conversant regarding these options

Regarding VA benefits (for WARTIME ERA VETS & SURVIVING SPOUSE), you cannot apply unless the need is present, it is not simply done; "so we are ready in a year or six months". However the preplanning & asset preservation must be! VA guidlines are confusing and misunderstood!
Do not make the mistake of not having a SOLID Health and Finanancial POA in place before some one is mentally incapacitated.

Must you be Catholic to apply with Catholic Charities?

You really need to go to an Aging and Adult Services in your area. I think Medicare and Medicaid are often confused. It sounds like you are looking for Medicaid benefits for nursing home care. The above answer about spending down assets, etc. Is correct. If the only thing she has is a car, and as long as her bank account is in the $2000 to $8000 range (in PA you can have up to $8000 in assets depending on certain things) you are in the eligible period of NH Medicaid. You should APPLY NOW. The reason is, it does take time, and if your loved one has to go into a nursing home before being approved and approval starts at some future point in time, the nursing home will want someone to pay that 'gap' in the bill. Even if you are rejected the first time around, because of assets or not in the NH yet, appeal if you think by the time they get to you she will be in the NH. Of course, and Elder Lawyer could help but often that Aging and Adult services of your community can get you on the right track right away.

Another note: don't assume the facility your mom is at will assist you in the Medicaid application process. Some do not offer any assistance at all--ours did not & even threatened to evict mom because we "assumed" they were on board in the process with us.

We went into this process completely ignorant and boy, is hindsight 20-20. Start by contacting Catholic Charities. They can provide the first light in the tunnel. Depending on where you live, there may be social service agencies in your area that can offer terrific support as well. The important thing is to be PROACTIVE!

If you need help in getting started with applying for t 19 you may be able to get assistance from a government benefit specialist or if you have the money consult an attorney. If you have to spend down assets to be eligible, you could set aside money for burial costs such as a burial plot, marker, funeral, etc. This applies to the application process in Wisconsin. In Wisconsin you must not have any more than $2000.00 in assets to be eligible for T 19. Each county has a benefit specialist. I wish you the best in doing this.

Check with the social services dept in your area. We live in a NW suburb of Chicago and were able to get the assistance of a professional who was wonderful. It wasn't cheap-$1K total-but she did all the legwork, got mom approved after the State of IL originally turned her down & was worth every penny.

Contact Catholic Charities too-they turn NO ONE away. If they cannot help directly they will supply you with social services in your area that can. This is what we did.

It may be initially daunting but don't be put off! Keep contacting every single social service agency in your area and be persistent! You will find help out there!

Apply now.

I would go visit a couple nursing homes and talk to them about their residents going onto Medicaid as some residents start as private pay then have to apply for Medicaid. There are a lot of differences between nursing homes and you want to know who the good ones are and who will take people on Medicaid. We had to make fast decisions for my parents as each had a major surgery in the same month which was the end of independent living for them and it would have been nice to have visited more facilities ahead of time. You can also check with your state's department of aging for information in general on issues like this. They can tell you about Medicaid and ratings of nursing homes both. Good luck. It's a difficult time for your family.

Actually people apply for Medicaid because they are a low income, have no assets and they need medical health coverage. It's little too late to apply when you already have an emergency. Though, your application will be processed faster if hospital case manager is applying on your behalf. The sooner you are approved, the sooner you will feel comfortable/secure. If your mom qualifies for it she will have it! My older son (28 y/o) who lost his job, applied just one month ago and is approved already. His coverage begins on April 1st.
No, do not look for facility year before you actually need it. That market is very fluid. You might find what you think is great opportunity, but it might not be available when you really need it. How do I know? I own and operate a family group home in MI. It always amazes me when people come over and tell me they need "home" for loved one in 6 month.... Who knows what will happen in 6 month? Some of those facilities may not be here any more. BUT, getting your finances all ready is very wise. You also should think about any other help your mom could benefit in the future. Veteran's benefits, funds from Aria Agency on Aging -- these grants come with a long waiting time. Apply as soon as you can! AAA usually has 2-3 years waiting list. You will be lucky to have their services in the time your mom needs them.

You can APPLY but I seriously doubt they'll do Anything w/your application since thousands of other people are applying who REALLY need it now!!! LIke my mom, who's been on it in her nursing home since summer of 2011...

Look at facilities now! They are usually quite adept at guiding you through the Medicaid process, but they can't do it for you. If you know the facilities,, put her on waiting lists. If she is hospitalized, it will make the process of getting her in a bed quickly, easier. From experience, it's tough to run around and look at facilities when your elder is very ill, recovering from surgery or otherwise in need of hospitalization.

Thanks for the responses. She only had Medicare are we are anticipating the need for NH care probably within the next few months to year so want to be prepared.

Two reasons it can take a long time: the sheer volume of applications and the potential complexity of some peoples financial situations that need a lot of documentation and analysis to determine.

Do you mean to apply now because she has no health insurance or maybe only Medicare? She may be eligible for help on her Medicare costs through Medicaid. If this is to help like this apply now. Or are you anticipating the need for nursing home care many months or a year down the line? Then you could wait. However, it wouldn't hurt to apply just on the chance that she qualifies now for some type of assistance. If you get turned down be sure you understand exactly why so you can prepare for the next time. You can always reapply whenever you want.