OnlyChildCG Asked March 2015
How do you manage the spend down if your income is only your SS check and all goes to maintaining your home?
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My wife and I receive social security checks which 100% of them go to maintaining our home & basic living expenses (namely food). We have no savings, our daughter helps us tremendously to manage month to month, yet I have a spend down of close to $400 for Medicaid which is an extreme hardship.
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I can say I feel for ya! We also had a "deductible" amount to pay. The way it worked here was especially hard to manage because various vendors billed the county Medicaid office on different schedules and then that office often took a very long time to pay them. Then the vendor was to bill us for the uncovered amount. What a nightmare! I never knew what and when I was going to owe a large amount. But at least we could pay the deductible out of our income. I sure don't know know how you are going to come up with that $400 each month.
I think you are going to need help going over every detail of where your income is going now and figure out places you can tighten your belts. Yikes! I don't suppose you are spending foolishly now, but perhaps there is something you are paying for that your community has resources you could use. For example, if you are paying for lawn care, perhaps there are volunteers who provide similar services for seniors at no costs.
I am really sorry your are in this predicament. It is certainly hard enough to have a loved one with medical problems without dealing with this financial strain as well. I hope your daughter can help you search for other resources you might be qualified for.
(If I have misunderstood your spend down situation, please clarify who it works.)
Unfortunately, our combined income goes to our mortgage with the remainder going to electric, some food, telephone/internet/cable & car insurance. I'm not sure how my wife weaves it together every month (she also gets a small check from a p/t job), there is little more we can cut truly. Our daughter picks up the slack with more food, she bought the majority of the heating oil this year and other basic needs we may have (i.e.: medical supplies, my nutrition drinks). She is in the process of looking for services for seniors that can help with things we need and my social worker has been an amazing blessing getting us some discount & even free services on some important things - much needed house repair & even a free one time oil delivery of 150 gallons which was much needed this winter.
The way it works here, which I don't fully understand, but we send Medicaid medical bills I have. They "credit" that to the spend down & give me the coverage, but the bills still need to be paid by me. I have to send in enough bills that equal the $400 per month to get the coverage. The part that gets tricky is that we don't have the extra income to pay the bills, my daughter has been trying to, but God bless the doctors because they still let me get the services I need despite having outstanding balances.
Pamstegma - what do you mean by stop having our daughter help? The things she does help with, if she didn't, I'm not sure how we would maintain every month.
I was just wondering if there was something I was doing wrong/could change with Medicaid so that either the spend down could be decreased (or better yet removed) so my family didn't have this major burden.
Mortgage.It's the albatross. Your mortgage is probably the biggest issue. Pull out the mortgage agreement - what do you owe, interest rate, when will it be paid off? What % of your monthly income is mortgage payment? If its more than 25% you can't afford the current mortgage.
Find the mortgage interest statement sent for 2014 taxes, just how much interest did you pay last year? And what % of your total yearly income was that interest? If its maybe more than 10% of it, you can't afford the mortgage IMHO.
So What to do? Can you refinance to get a dramatically lower rate? If you don't have many years left on the note, could you, your kids or other family get the $ to pay off the note? If you keep things are they now are, just when would the mortgage be paid off? 5 years, 10, or longer? if you are looking at years & years of debt service on this house - giving the strain you already have in making ends meet - you just cannot afford to live there. All areas have senior subsidized housing, it will require research to find a good matchup but maybe take a realistic look into doing this.
I'd suggest you speak with a couple of Realtors as to what the house in its current condition would sell for AND clearly ask what the DOM (days on market) is for sales in your area. If the house sold for the anticipated price the realtors came up with, how much would you all have left after closing costs & mortgage paid off?
People may say buy another house, but since you are on Medicaid and if it's likely that your wife may need Medicaid as well, buying another home really only benefits the state as state will place a claim or lien on your estate due to all having to have MERP done.
Knowing the DOM is important, as it helps you to know just how soon you have to find alternative living space.
Selling your home and divesting perhaps decades of stuff is really hard to do. But
Sometimes makes best financial sense. It's a lot to think about.
You are right. Medicaid for an individual (my mother, for example) is a walk in the park compared to Medicaid to keep a couple in the community (my husband). It is much less expensive for the state to rely on a spouse providing most of the care, shelter, and food, than to place the person in a care center, and so the in-home arrangement should be encouraged (in my opinion). I think that is the intention of the waiver program, but its complexities are daunting.
What I see as a red flag in this is for LilFlea, is IF finances are tight and there is a mortgage, it is so easy to get behind on payment. The mortgage holder doesn't care if it goes to foreclosure, they already have done this to others and have a system set up for it. if they get behind, it is in the mortgage holders best interest to foreclose rather than the time to work something out. This is why it's important that IF they can refinance to get low interest and more manageable mo payment that they do it now & before there is an issue.
On another tangent, I think that this big push to PACE is to get totally away from the states dealing with doing the complex medicaid determinations that often are just subjective for community care situations. My state of LA is pretty well over passing out medicaid waivers (even with a huge waiting list) with the Medicaid diversionary $ going to PACE & it's set capitation. Pace centers need big population enrolled to be profitable, so they are going to sign up a lot who are not daily costing Medicaid or Medicare presently. The one just a few block from us (benson center) seems to have lots of "well" elderly going there. The issue for the "not so well" is that if you really need lots of more complex services, pace is going to have to disenroll you (to NH or back to day to day at home care done by family) as the really ill cost too much to have as a participant. The #'s are going to look really good for what PACE is supposedly saving but will be deceptive.
Looking at my crystal ball, gettin' old in the US is not going to be pretty...
My mother wrote a spousal refusal letter for my dad to receive Medicaid, all he gets is a SS check which is $400 over the $825 single person limit in NY - which is outrageous considering NO ONE could live on that in this state, ever. It's mind-boggling the spend down is so high, which precludes him from getting other services (i.e.: SNAP that he could benefit from).
Indeed Igloo, getting old in the US is not going to be pretty. We do not value our seniors in the least.
If the wife isn't currently in need of Medicaid, isn't she allowed to keep up to $109,560 in non-exempt assets?
I don't know that I have any helpful advice to offer, but I'm currently trying to understand more about the Medicaid rules & regs myself.
Alison, I would give reverse mortgages a thumbs down... the ads on TV make it sound so easy, but once the mortgage holder passes on, then it could become a nightmare.... the loan becomes due and payable, and if the heirs cannot refinance the house, then the house has to be sold or it goes into foreclosure. I saw the down side of reverse mortgage when my boss' wife had passed away, he couldn't stay in the house they had owned for 30 years even though the house was willed to him because his name wasn't on that loan, he couldn't re-finance, thus he was forced to sell.
Point taken freqflyer and has been experienced (appliances, big jobs on the house). I must say it has always worked out. It isn't the best way to live at all, but if my mom wants to keep this house I'm going to do everything I can to help her do it so she can live out her life in her dream home.
What I have learned from this thread is that SS is different in practically every state, which is stupid to me, but what can you do. I still don't understand why the standard of living for Medicaid in NYS is $825 when nowhere in this state can you live on that and pay rent/mortgage/insurance, life insurance, medical insurance, utilities, car insurance, food and have much left over on that or, the $1,196 my dad gets per month. That's the overarching issue & question at hand, is my dad missing out/doing something wrong that this is his existence? On one hand he "makes too much" which precludes him in some cases from getting straight free services.
About the $ qualifications, it isn't so much that SS is different but that Medicaid is. Although Medicaid is a joint federal & state program, EACH state manages or administers it's own program uniquely. So what works for qualifications or income level for TX is going to be different than for NY. State law differences is especially important when it comes to how Medicaid and it's MERP program runs on property and probate after death. Has anyone talked with you all about what MERP is?
House is your & mom's name, right? but parents are legally married & mom has done a "spousal refusal", right? So how is house set up for ownership if mom dies first? Does she have life insurance policy that will pay off the mortgage or will you have to? Does Dad inherit mom's share of the home? Or it all reverts to you?
Since mom & dad are a married and dad is on Medicaid, does MERP have the ability to file a claim on house? - does spousal refusal apply for MERP? Now mom can get the MERP spouse exemption but if she herself ever needs to file for Medicaid, then MERP has to file to recoup her costs. If that happens, you will have to pay off whatever her share of the value of the house is for you to own the house
completely. I bring this all up, because it would be awful for you all - all 3 of you - to be up against the wall in affording the house and all it's costs especially the mortgage, only to a few years from now having to sell it to settle the required MERP recovery.
If you are having $ issues now and a mortgage, dealing with MERP is likely to be difficult as doing the point/counter-point with MERP requires a deep enough pocketbook to pay for house related costs for years & years and through probate is not an issue for you the ultimate owner of the house (well imho that and a good sense of humor and pitt-bully detail-driven approach to dealing with paperwork)
Its so common for any of us to be totally emotional on a home. I went through all this in dealing with having a home gone by Katrina and having so many many of our friends & their parents having homes gone. But sometimes you have to stand back and take a reality check on if a house and its costs are affordable. For your parents sake - especially for your mom - I hope so but try to be realistic if all this works for the long view. Also try to find out exactly what MERP can do on the house and if spousal refusal is a defense to a MERP claim/lien. Good luck.
It's equally true that nobody just gets a free ride in life, and especially not in retirement. Everyone must work. Everyone has choices to make in how they spend their money. If you earn a basic wage and carefully save, and also buy insurance including long-term nursing home insurance, there is absolutely no need for anyone to be going on Medicaid. The US is 18 trillion in debt right now and unfunded liabilities (things like nursing homes, welfare, Medicare, Obamacare) are estimated to be 100 trillion. How much is a trillion dollars? If you spent a million dollars a day ever since year 1 (I would say the year Jesus was born but someone will.get offended) that only gets to 750billion, still not even 1 trillion. This country has a HUGE DEBT problem--I'm not trying to be political, but this debt
Is not.going to disappear. My point is, if you're expecting "government" (i.e. taxpayers now and for next 150 yrs) to bail you out, I cannot say that that is a Rational Idea. To put it mildly. Everyone who owns a house HAS ASSETS that must be used for their needs....if your needs increase, you sell your house and live someplace less expensive. And you certainly shouldn't be paying a cable bill.
So, the daughter should chip in $420.00. Then LIFleabag1934 or actual benefits recipient SHOULD REPORT THIS TO SS MONTHLY, and you just watch how damn fast they snatch that $400 bucks! This adjustment brings your benefit down to meet the monthly asset limit. When that check comes each month, pay your mortgage and removed the rest out of the account imediately as cash. Keep the account at zero until next month's check and repeat, maintain the daughter's assistance with the $420 bucks which is reported to SS monthly as income and they (SS) MUST adjust each new check. NOW be it known - SS makes these rules, not I. This is how SSI would be worked out. I could be wrong, but I see nobody getting a SSI check that would cover a typical
mortgage payment. So, if your benefit check is regular retirement SS check, I must ask this of you...... are you on Medicaid or Medicare?
Have you come up with any viable options? I'm wishing the best for you!
Jeannegibbs - nothing yet, but I'm optimistic. It is indeed the low income threshold, which truly confuses me considering the cost of living here as I've mentioned. I've definitely going to try Annajane's suggestion and call SS directly & become that "dog with a bone" if you will.
1. Spousal refusal
2. Trust application. Rochester charges an application fee of $240.
3. Once approved into the trust, you pay the trust the overage or the amount you want, but it MUST beat least the amount of the overage, plus $20 management fee.
So as an example in NY state. Let's say your dad gets $2,000. Instead of paying the rent let's say its $1,500.you give the trust at the very least $1,200 and add $20 so send the check to the trust for $1,220.
Now that will protect his check and pay your rent with a few of $20. I consider this the cost of insurance for my husband. I also have the trust take an automatic withdrawal so it's done and paid right away. I also make sure I give the trust the full amount of rent so it's not in two Payne td and just a smoother transaction over all. So the cost for using the protective trust (makes sure it's approved or your state or $money will be taken by medicaid. It's a $20 fee a month for protection. Then once per year in January there is an additional fee of $50 for audit. Medicaid was about to take my husband money. Seriously they reading and prepared and waiting to take money from bank. Thank god at that time I had proof that the trust received my application and the trust notified them. Otherwise it would have been too late. So for everyone out there who thinks they are safe. You are not unless you follow thru with a protective trust.