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For a homeowner with 2 people.

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my father went into NH in August 2014, privately paying as of right now. our mother still living in house, needs no repairs or work done, the elder attorney told us (we are in PA), that we need to get down to 2400.00 before they will help us apply for Medicaid.
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Personally, I think the best spend down is getting them into a private pay facility for two years, that will agree to convert to Medicaid afterward. If you wait until you are Medicaid only, your choices are very limited and waiting lists are quite long.
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During the spend down period, so long as the money is spent for the benefit of the prospective Medicaid patient, there is no dollar limit. So if the patient is living in the home, then any expense related to taking care of the patient or the house is allowed as a deduction.
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Before medicaid will help your mom
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As l careong as you have caregiver agreement made up with lawyer signed by your parent that you have been doing everything that needs to be done for them even getting paid every month for all that you do is a legal contract I had this done since I'm the only one on my family that does everything for my father all the running around appts. Paying bills taking care of an empty house upkeep grass cutting so much more making sure that be is being taking care of in the residence house I found for him that can give him 24 Hour care there really isn't a limit to spend down then the liquid assets must be gone before Madi aid
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Each state administers their Medicaid program uniquely but within an overall federal guideline. So you need to go to your state's Medicaid site to see what the program is like for your state.

Now for the spend-down, they can legitimately buy things for themselves and their needs. So my mom could have spent the last 10K in her bank account to put in a new roof at her home the month before she applied for Medicaid. May not be the best idea of how to spend her last 10K, but it is her homesteaded property & she can do that with her funds.

? for you - is your grandmother living with you at your home OR are you living with grannie at her home? This will make a huge difference in what would be an acceptable spend-down. Like grannie can pay for a new roof if it's her home but cannot pay for the roof if the home belongs to you. For the Medicaid application, the state can require up to 5 full years of all financials. So if she has been paying for things for your home that are significant, then there likely will be issues with her Medicaid application. Really if she is living with you and you are providing caregiving, then the best way to approach this so that there is no future Medicaid problems, is for you all to do a "personal services contract" and rental agreement, so that it is clear as to where her $ went and was not gifting or giving away of her assets. Good luck.
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