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I have a call in to an elder atty, but checking to see if anyone has used this in MA? It doesn't appear to be available in MA, rather all income is turned over to the program for private pay except an allowance.
I hope that Igloo is around to discuss a bit about PACE rules with you.
I can only say that I have seen her discuss them here with others, and the long explanations are so very complicated that I cannot fathom even the answers themselves. Often I see Igloo end her explanations with the fact that the rules are so many, so varied, so dependent on state's individual decisions that it just isn't DIY anymore.
I am glad, therefore, that you are seeking help to get the right information for your area. I would think such programs, given their complexities, would have counselors and advisors; I surely would call and try to reach one.
Did an epistle to another ? of hers couple of days ago.
in my not an atty opinion, what makes Miller Trusts work easily for those filing for LTC Medicaid for NH (in a State that allows for Miller) is that the Miller becomes the new owner of the too high income problem and the Miller pays all that $ to the NH directly. Easy! Remember for LTC Medicaid NH residents, all income $… whether SS retirement income, pension, annuity in payout mode, $ placed into a Miller… it’s all $ paid to NH every month as LTC Medicaid requires Share of Cost paid. All paid to the NH less their States teeny personal allowance, which most have at $50/$75 a mo. As long as at or under their personal LTC Medicaid limits - most States have it at $2740 income and 2K assets - they are ok for NH LTC Medicaid. Miller owns whatever pays too much so it doesn’t count for the personal anymore. Voila! & Happiness!
But PACE doesn’t do this. PACE has a capitation rate paid by the Feds and no Share of Costs, no copays, no deductible due because PACE geared to cover all services w/enrollees being on Medicare, PACE center Medicare Part D drug program, Medicaid as health insurance and needs based community Medicaid program. PACE set up 2 b all inclusive with no billing. Enrollees get one (1) new single # for all & any services. So you have to qualify for Medicare and the Medicaids to have the above system work.
CMS - the federal agency for Medicare & Medicaid - pays PACE center / organization a mo capitation rate for each enrollee.
I'm just not sure how Miller could work for this to get a Medicaid program low income requirement done as it’s more of a pass through to pay $ via its new ownership of all the excess $ & paid as a Share of Cost each month to a facility. PACE has no Share of Cost. Will be an interesting atty answer. Hope we get an update.
If you do not qualify for Medicaid but have Medicare, PACE has to allow for enrollment (if openings) but will be at a State set monthly flat rate PREMIUM to cover the long term benefits paid by PACE and an additional PREMIUM for Medicare Part D. Seems to be in the 4K - 7K range, still is less than private pay in a NH.
They have to be at need for nursing home level of care (certified as however done by your State) to be enrolled at a PACE and have to be able to live safely in their community… which realistically means someone is at their home / apt so on premises doing oversight & care needed all non PACE time. I’d be concerned that if the OPs mom & Dad are both “at need”, unless she or another fam lives with them there may not be enough in person oversight to provide the “live safely in the community” requirement. Unless they pay for in home services as well.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
https://www.familyassets.com/resources/government-resources/maine-nursing-homes-medicaid-rules-information/
I can only say that I have seen her discuss them here with others, and the long explanations are so very complicated that I cannot fathom even the answers themselves.
Often I see Igloo end her explanations with the fact that the rules are so many, so varied, so dependent on state's individual decisions that it just isn't DIY anymore.
I am glad, therefore, that you are seeking help to get the right information for your area.
I would think such programs, given their complexities, would have counselors and advisors; I surely would call and try to reach one.
in my not an atty opinion, what makes Miller Trusts work easily for those filing for LTC Medicaid for NH (in a State that allows for Miller) is that the Miller becomes the new owner of the too high income problem and the Miller pays all that $ to the NH directly. Easy! Remember for LTC Medicaid NH residents, all income $… whether SS retirement income, pension, annuity in payout mode, $ placed into a Miller… it’s all $ paid to NH every month as LTC Medicaid requires Share of Cost paid. All paid to the NH less their States teeny personal allowance, which most have at $50/$75 a mo. As long as at or under their personal LTC Medicaid limits - most States have it at $2740 income and 2K assets - they are ok for NH LTC Medicaid. Miller owns whatever pays too much so it doesn’t count for the personal anymore. Voila! & Happiness!
But PACE doesn’t do this. PACE has a capitation rate paid by the Feds and no Share of Costs, no copays, no deductible due because PACE geared to cover all services w/enrollees being on Medicare, PACE center Medicare Part D drug program, Medicaid as health insurance and needs based community Medicaid program. PACE set up 2 b all inclusive with no billing. Enrollees get one (1) new single # for all & any services. So you have to qualify for Medicare and the Medicaids to have the above system work.
CMS - the federal agency for Medicare & Medicaid - pays PACE center / organization a mo capitation rate for each enrollee.
I'm just not sure how Miller could work for this to get a Medicaid program low income requirement done as it’s more of a pass through to pay $ via its new ownership of all the excess $ & paid as a Share of Cost each month to a facility. PACE has no Share of Cost. Will be an interesting atty answer. Hope we get an update.
If you do not qualify for Medicaid but have Medicare, PACE has to allow for enrollment (if openings) but will be at a State set monthly flat rate PREMIUM to cover the long term benefits paid by PACE and an additional PREMIUM for Medicare Part D. Seems to be in the 4K - 7K range, still is less than private pay in a NH.
They have to be at need for nursing home level of care (certified as however done by your State) to be enrolled at a PACE and have to be able to live safely in their community… which realistically means someone is at their home / apt so on premises doing oversight & care needed all non PACE time.
I’d be concerned that if the OPs mom & Dad are both “at need”, unless she or another fam lives with them there may not be enough in person oversight to provide the “live safely in the community” requirement. Unless they pay for in home services as well.