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So my mom is now in a nursing facility, and I'm told Medicaid will allow her $60 of her income per month for expenses, and the rest goes to the nursing home. Her current Medicaid has a monthly spend-down (her income is above the "allowed" income in our state).


I called the Medicaid Assistance Program and asked how that works considering she has other bills... like all of the hospital bills that will be coming down the line, her credit-card bill, etc. The person I talked to didn't really have an answer for me. If we're supposed to pay $X for the spend-down each month, but she is only given $60-- well below that spend-down amount-- how is that supposed to work? I can't exactly pay these for her.


She doesn't have that long left (a month or two), so soon enough it'll be a case of "I'm sorry, but she is deceased and has no assets to pay the debts" and in the meantime, it's not like I'm worried about her credit score if she doesn't pay, but... I'm not sure what we should do about these bills when they start coming in? Call the creditors and explain the situation? I don't fancy the conversation of "well we can maybe send you $15-$20 a month" nor "and soon you're going to be out of luck anyway"? Should I just ignore until she dies and then just let them know then that she's deceased?


I know there's nothing I can do, but there's something that bugs me about us sitting here racking up a bunch of bills we know will never get paid or just knowing her bills won't get paid. Especially things that were incurred before she was in hospice and such, like the credit card bills.

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Yes, you let the bills go until she is deceased. Then you can send all the creditors a copy of her death certificate and they will take it as a loss.
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You have to change the way you are thinking: “I feel bad” about not paying her bills. She is on Medicaid and those other bills cannot be paid now. Let them go. I tried all that for my dad, such as paying some bills myself (then stopped), notifying companies (got harassed and even summoned to court on a credit card - I notified the judge he was on Medicaid and had no money; judge dismissed the case) and just plain ignored some collection agencies. So sorry you are going through this but the reason they didn’t really answer you is because they can’t give you this advice.
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Please, fill out your profile, helps to know your situation.

I am assuming Mom is not on Medicaid yet? You are in spend down?

By the time Mom can go on Medicaid she will only be allowed 2k and this is spent only on her if needed. Her SS and any pension will go towards her care. Medicaid provides health insurance that covers what Medicare doesn't. She will have Dental and vision too. So any health bills will be paid by Medicaid. Hospital bills prior will be paid by Medicare and her supplimental at the time. I held onto Moms supplimental until I was sure that all her previous bills had been covered then I stopped since she was on Medicaid.

The $60 is a Personal Need Acct (PNA). The 60 is taken from her SS for personal needs. Like a hair cut, snacks, clothing, etc. Its not for paying any prior bills. My Mother had a house that I had up for sale. Once on Medicaid, I paid no taxes or insurances. My nephew was living there so he paid the utilities. If he wasn't there, I would have shut off the utilities. Because, there was no money. I was not guaranteed that if I paid these expenses I would be able to be reimbursed. Being retired I couldn't afford not to get my money back.

You are just going to have to let the bills go. Someone on site has said do not contact the creditors. Once they get your info you will be harassed. You are not responsible for Moms debts. If you have POA freeze her accts so no one can use them but do not use your money.
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k12144 Sep 2018
She is on Medicaid, but she has a monthly spend-down (her SS check is more than our state's allowed maximum income for Medicaid), not an asset spend-down (she has no assets). So, she is responsible for her medical expenses each month up to the spend-down amount; once her bills exceed that, if they do, Medicaid takes over paying. This spend-down is well more than $60.

I don't mind letting the bills go once she is gone, but I feel bad just leaving them while she is still alive and technically could pay on them if it weren't for the nursing home thing.
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Do not start paying your mom's bills with your money! That could be interpreted as the balance is yours and your responsibility. Then the collection calls will begin and you will be harassed.
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k12144 Sep 2018
Oh, I wouldn't pay with my money-- that's why I was asking: I was wondering how to pay with hers when Medicaid is taking it all.
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k12144: Do NOT pay ANY of the credit card bill because once she passes, they cannot come after a deceased individual's credit card debt. Btw, the "spend down" is a function that happens when the individual applies for Medicaid, e.g. they spend down to the amount that they are allowed. In general, it is $2K. Also, I implore you to change your thought process. Do not feel badly; you're not responsible for your mother's bills.
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k12144 Sep 2018
That's an asset spend-down, which she never had because she doesn't own a house, her car is old, she doesn't have stocks/bonds/retirement funds/whatever. In my state (MI) apparently you can also have a monthly spend-down, because the allowed amount to qualify for Medicaid is only $400. Anything more than that that you make (whether pension, SS, whatever; in her case SS), you have to spend on your medical bills/expenses before Medicaid will pay the rest. (And apparently, if you don't have any medical bills for three months in a row, your Medicaid is discontinued.)
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The main point to remember is the once someone enters a nursing home, the nursing home gets ALL the money, from wherever - except for the $60 a month allowance. They supersede all other bills, to take care of your Mother, rent her a room, feed her meals, etc.
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The $60 is to be used for her expenses in the facility. My mother used her’s for the beauty salon. Why would she be responsible for her medical bills? Doesn’t she have health insurance? Medicare Part A, B, D and a Medigap policy?

You are not responsible for her credit card or other debts. The people owed can come after the estate, but if there are no assets, her bills can’t be paid. When she passes, write to the companies and tell them she is deceased. You may want to check with an Elder Law Attorney to make certain you’re doing what you need to do.
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k12144 Sep 2018
She has insurance-- Medicare supplemental-- but insurance has deductibles, co-pays, things they simply don't pay, etc. It might only be a few hundred dollars, but it's still there.
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K12144,
Tough Times with little governmental help! Been there done that! Any bill incurred under your Mom’s name is her debt alone and will be retired with her passing. This includes credit cards, hospital any. I would contact them as they come in only to explain, as is fair You will probably find most just will ignore, and the bills will arrive and feel at this point you may ignore too! You did your part in advising them. Only one creditor attempted a second go around with us after she passed and that was American Express where she had a $4,000 debt incurred after hurricane Irma came through our state. Not frivolous, but survival stuff! They have an estate recovery team, nice huh! Mom was a widow on S.S. and the 7 years I cared for her we lived on this small stipend. Estate???? Be at peace, understanding no one wishes to be a dead beat! My goodness, her payment history to the end was awesome! Just another part of the tragedy we face as AD caregivers.
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Social Security can be garnished for a federal debt only. Federal income tax or if a parent has co-signed on a child’s or grandchild’s federal student loan that is in default. A friend co-signed her granddaughter’s student loans totaling $65,000. She defaulted and my friend I’d now having 15% of her Social Security check garnished each month. And federal student loans cannot be discharged thru bankruptcy.
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Let all the bills go until she is deceased and then send them a copy of her death certificate. They will still try to come after her estate, including Medicaid. But as they say you can't get blood out of a stone. Obviously if she has sold everything and had to use that for her expenses prior to death, there won't be anything for them to come after. As others have said don't try to pay anything on the bills since then they will try to say you have taken on that liability and try to come after you and your estate. If she has a house or such then Medicaid and the other creditors will all get in line to get whatever they can of what is owed with Medicaid getting first dibs. Don't think that once she passes the bills go away. That only happens once the creditors are satisfied there isn't any estate.
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