My father entered a nursing home last year., while my mother still lives independently in their home. We were in the process of getting him qualified for Medicaid since his income (SS+Pension) is below the income limit. We were denied. We appealed with the state (Ohio) and were denied. Has anyone appealed beyond that? Can we reapply?
Also, does her monthly income or 403B count towards the asset limit? Her income is much higher than his and he has no retirement account.
Finally, does anyone know if she sells her house and buys a new one (smaller one closer to me), does this negatively impact a Medicaid application?
From what I understand from reading Igloo's posts are, mom's income is countable towards the monthly income, ALL of their assets are 50/50, barring an inheritance that was never comingled in any way.
If you were using an attorney, I have to say, if they were truly an elder law attorney, they would be better able to help you.
I recommend going to www.nelf.org and look for a CELA level attorney. We found the elder law attorneys to be crooks without the knowledge I have, scary business. We found a very competent and super knowledgeable attorney using this route.
A good attorney will know how to do the asset split, the spend down and ALL of the intricacies of your stated Medicaid program.
I have read many posts here about how tough and ridiculous Ohio Medicaid is.
Best of luck. I found out that I didn't know what I didn't know until I started the elder care journey, listen and learn to every professional you can, it really helps you to navigate the system.
If you own a home, there will be MERP to deal with due to $ owed for your wife being on OH Passport.
If OH does a capitation by enrollee payment system, it could be several thousands every month as a flat base rate that becomes an after death tally paid by Passport. Right now she already has a years worth of future liens or claims if y’all own a home. All States are required to attempt a recovery or recoup of all costs paid. But each State does this uniquely as its subject to State probate and property laws. It’s something to take into consideration.
fwiw my State has PACE programs, which too involved waiver $ shifting. It’s does a base enrolled rate, which is abt $5800 a month. So the base rate alone would be 70K per year subject to MERP.
The OP should have if not already have a benefits.ohio,gov account or can create one.
Mom last year transferred her car with Blue Book Value of 18K to a grandson and gifted 50K to you or a sibling 3 years ago is a way WAY different problem than Dad does not have the deep medcial chart to show he is “at need” for skilled nursing care,
so what - in detail- did the State list as the reasons for denial???
Sometimes one would need to talk with an Elder Law Attorney as they specialize in that field, and knows the ins and outs of Medicaid.
The Passport program in Ohio is similar to the PACE (Program of All-Inclusive Care for the Elderly) program which is available in multiple states, including California where I live. Both programs provide a wide range of healthcare and support services, including medical care, personal care and social services. Both programs are designed to help seniors to remain in their homes or community settings as long as possible. Both programs serve older adults who meet certain medical and financial criteria.
PACE is a federal program available in multiple states, while Passport is a state specific Medicaid waiver program in Ohio.
PACE often operates through specific PACE centers that provide day care services and medical care, whereas Passport coordinates services through various home and community based providers. PACE is jointly funded by Medicare and Medicaid, while Passport is primarily funded by Medicaid.
Both programs aim to enhance the quality of life for seniors by providing them with the necessary support to live independently.
For more information about Passport, visit Ohio.gov. For more information about PACE, visit Medicare.gov.
Read reviews, check credentials, and possibly meet with a few attorneys to find someone you’re comfortable with.
Wishing you the best of luck.
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