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My husband is in a nursing home and qualifies for Medicaid. The nursing home wants all of his social security and pension each month. I cannot afford to pay my bills each month if they take it all. What can I do?
As the Community Spouse aka a CS, you are not yourself required to be impoverished. Only hubs is. So your own SSA $ and any other retirement income or work income is yours & yours alone. It is subject to a cap, but I doubt your even close to that! BUT Hubs as the NH on Medicaid spouse is required to do a copy of almost all his income to the NH each month UNLESS the CS can show to be themselves “at need” for his income to pay for their in the community expenditures. The CS would file for a waiver to have some or all of his income be waived over to them rather than be a copay to the NH. It’s called CSRA or MMNA depending on your state. It’s a resource allowance or needs allowance/ assessment.
just how a State does them varies. Some States have a preset $ amount waived, while others require you to show “need”. Please pls go with JoAnns suggestions first on speaking with billing at the NH and insist they give you the info so you can contact your hubs Medicaid caseworker to get your CS waiver started. Until then, You need to gather together your household costs too. Like get your utility bills, CC bills, mortgage & insurance costs, if you yourself have extraordinary drug costs, etc. If you need 80% of his income, then his copay will be just the 20% left over less that personal needs allowance he gets to keep each month. Getting a CSRA or MMNA is pretty standard stuff and I think you can DIY it and not have to find and pay for an attorney.
& ask caseworker if it can be retroactive to Day 1 of hubs Medicaid eligibility. The NH are used to having $ clawbacks done with Medicare and Medicaid….. they may not like it, but gets done all the time. Good luck in your quest.
When the application was made out you should have claimed Community Spouse. As such you get partial or all of your monthly income depending on what you need to live on. If you have any assets above your monthly income, they can be split with your husbands split going to his care and when spent down Medicaid is applied for.
If the NH is doing the application and they don't know this, I would question them doing it for you. If all you have is your monthly income, filling out an application with a Medicaid caseworker should not be hard. You just have to establish that there is a Community Spouse. You will remain in your home and have one car. If you have some assets, I would still go to Medicaid first and if then you feel you need to hire an elder lawyer do it.
I do not trust people to do their jobs so I keep on top of things and try to understand what is going on. You only have, if ur State is like mine, 90days to spend down any assets and get info needed to Medicaid.
Contact his Medicaid social worker and tell them that you can not live without some of his income. Ask about being the community spouse and what you need to do so you do not become homeless.
The system is designed to keep community spouses from becoming impoverished.
When my mom was in a NH they took all of her SS and Medicaid paid for the rest. This was after a time of using up a long term care policy, which was exhausted amazingly quickly, and private pay. My dad kept all of his larger SS, all his pension, and what was in their bank accounts (which wasn’t a lot) There are rules with Medicaid to prevent the spouse called the community spouse from becoming without funds to live on. Please seek counsel from a Medicaid counselor or lawyer well versed in this and have your concerns put at ease
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.
BUT
Hubs as the NH on Medicaid spouse is required to do a copy of almost all his income to the NH each month UNLESS the CS can show to be themselves “at need” for his income to pay for their in the community expenditures. The CS would file for a waiver to have some or all of his income be waived over to them rather than be a copay to the NH. It’s called CSRA or MMNA depending on your state. It’s a resource allowance or needs allowance/ assessment.
just how a State does them varies. Some States have a preset $ amount waived, while others require you to show “need”. Please pls go with JoAnns suggestions first on speaking with billing at the NH and insist they give you the info so you can contact your hubs Medicaid caseworker to get your CS waiver started. Until then, You need to gather together your household costs too. Like get your utility bills, CC bills, mortgage & insurance costs, if you yourself have extraordinary drug costs, etc. If you need 80% of his income, then his copay will be just the 20% left over less that personal needs allowance he gets to keep each month. Getting a CSRA or MMNA is pretty standard stuff and I think you can DIY it and not have to find and pay for an attorney.
& ask caseworker if it can be retroactive to Day 1 of hubs Medicaid eligibility. The NH are used to having $ clawbacks done with Medicare and Medicaid….. they may not like it, but gets done all the time. Good luck in your quest.
If the NH is doing the application and they don't know this, I would question them doing it for you. If all you have is your monthly income, filling out an application with a Medicaid caseworker should not be hard. You just have to establish that there is a Community Spouse. You will remain in your home and have one car. If you have some assets, I would still go to Medicaid first and if then you feel you need to hire an elder lawyer do it.
I do not trust people to do their jobs so I keep on top of things and try to understand what is going on. You only have, if ur State is like mine, 90days to spend down any assets and get info needed to Medicaid.
The system is designed to keep community spouses from becoming impoverished.