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I just put my mother in rehab ,she only has Medicare and I am currently trying to get her Medicaid. Is there a way to get her Medicaid quicker when she is in the rehab. My worry is when she gets out she cannot live by herself anymore. Thank You
why is your 95 yr old mom on chemo anyway? seems like a tough road when a person is that old...medicare is generally for people 65 and older who (or spouse) have made contributions to ss medicaid is for those with low incomes (this is my understanding) the person ahead of me who spoke seems more familiar with the programs that are different from state to state again my main question is re the chemo....and talk to a social worker about the $ questions
Doug - is mom in a NH that has a rehab facility or just a rehab facility?
That is going to make a big difference. If it's purely rehab (these usually are cancer or major brain damage rehab facilities maybe adjacent to a hospital), then you will need to find a NH for her to go into. The social worker at the rehab center can help you wilth this. But if it is rehab wing within a NH, then speak with the admissions office regarding how this NH approaches Medicaid application for residents going from rehab to long term skilled nursing.
Mom is right now in there and paid for by Medicare, correct? If so, you need to speak with the PT/OT dept to see how she is "progressing". Medicare after a hospitalization will automatically cover rehab. In theory, the rehab can go for like 100 days. Although I have never actually spoken with anyone who was able to pull that off....Most elderly rehab is about 21 or 28 days and then if they are going to stay at the NH part of the facility they either do private pay or go on Medicaid. You have basically 21 - 28 days to get all the paperwork together to do the application for Medicaid.
This site has really good info on the difference between Medicare and Medicaid - you need familiarize yourself with what they do and more importantly do NOT do. For Medicaid, it is a joint federal & state program which in administered by the state. So each state gets to put it's own twisted spin on the qualifiers for Medicaid. MedicAID is totally at "at-need" program in which they have to be at-need BOTH medically (for skilled nursing care) and financially (impoverished). The state will set exactly what the financial is. You will have to get all of mom's asset & income stuff together to do the application. Admissions @ the NH should be able to guide you on all this BUT you or whomever in the family has to get all the documents on mom that the state requires to be submitted. For my mom the application process from document turn in (over 100 pages but about 1/3 of that was my mom's old school life insurance policy - so go ahead and freak out but not freak out totally) to her being accepted into the program was just short of 6 months. Now the NH did accept residents as "Medicaid Pending". But not all NH do that so get that checkbook out or look for other NH that do.
Regarding Pending applications, my experience with the 2 NH my mom has been in and with my MIL was that the NH does their own review of the documents (that you get together that is sent via the NH to the state caseworker along with their bill to the state) to determine IF they will accept an applicant as "pending". If mom has gaps in money (like 1 year ago she had 50K in savings and now has 2K), then they know there is going to be a problem and may not take her as a "pending" resident; or if mom has a whole life insurance policy, they know that is going to a spend-down clusterF so they may require that family sign off on financial responsiblity to pay just in case Medicaid declines her or mom has a financial penalty. If mom is basically poor and has been so for a long time, then no worries but you still have to provide the documentation to show her financial "need". My mom's financial review was for 3 years & 6 months of banking. They are looking for patterns of spending that make sense. So if mom was in AL then every month she was writing checks for 2K to pay for AL so her assets get depleted. A clear pattern of spending. But if mom is at home and has no real costs, then she may have money in the bank that will have to be spent-down to 2K before Medicaid will accept her.
The NH should have a 1 or 2 page list of items that your state requires and they will want to review before they accept her as "Medicaid Pending". Personally I think it's better to do this a one big giant dump of documents rather than piecemeal.
Please don't leave anything out or try to hide stuff, it will surface eventually and will result in a transfer penalty inquiry and those are totally sticky to deal with.
Also realize that whatever income mom gets right now (like her SS and any retirement) will have to be paid to the NH as her co-pay less her state's personal needs allowance. So say mom gets 800 SS and 1K retirement, mom's "income" is $ 1,800 a month and mom's lives in TX who has a $ 60 a mo allowance. So every month mom has to write a check to the NH for $ 1,740.00 for her co-pay. So if mom still has her home or debt, she really won't have any $ to pay on that.
If mom has a house, post that info and I'll give you a couple of suggestions on how to deal with that.
Good luck and keep a sense of humor in doing this. The Medicaid application can seem to be a maddening maze but about 65% of all NH room & board is paid for by Medicaid. It is very expensive (5 - 15K a month cost) for the states to do Medicaid, so they are very strict in the requirements for the review.
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.
seems like a tough road when a person is that old...medicare is generally for people 65 and older who (or spouse) have made contributions to ss
medicaid is for those with low incomes (this is my understanding) the person ahead of me who spoke seems more familiar with the programs that are different from state to state again my main question is re the chemo....and talk to a social worker about the $ questions
That is going to make a big difference. If it's purely rehab (these usually are cancer or major brain damage rehab facilities maybe adjacent to a hospital), then you will need to find a NH for her to go into. The social worker at the rehab center can help you wilth this. But if it is rehab wing within a NH, then speak with the admissions office regarding how this NH approaches Medicaid application for residents going from rehab to long term skilled nursing.
Mom is right now in there and paid for by Medicare, correct? If so, you need to speak with the PT/OT dept to see how she is "progressing". Medicare after a hospitalization will automatically cover rehab. In theory, the rehab can go for like 100 days. Although I have never actually spoken with anyone who was able to pull that off....Most elderly rehab is about 21 or 28 days and then if they are going to stay at the NH part of the facility they either do private pay or go on Medicaid.
You have basically 21 - 28 days to get all the paperwork together to do the application for Medicaid.
This site has really good info on the difference between Medicare and Medicaid - you need familiarize yourself with what they do and more importantly do NOT do.
For Medicaid, it is a joint federal & state program which in administered by the state. So each state gets to put it's own twisted spin on the qualifiers for Medicaid.
MedicAID is totally at "at-need" program in which they have to be at-need BOTH medically (for skilled nursing care) and financially (impoverished). The state will set exactly what the financial is. You will have to get all of mom's asset & income stuff together to do the application. Admissions @ the NH should be able to guide you on all this BUT you or whomever in the family has to get all the documents on mom that the state requires to be submitted. For my mom the application process from document turn in (over 100 pages but about 1/3 of that was my mom's old school life insurance policy - so go ahead and freak out but not freak out totally) to her being accepted into the program was just short of 6 months. Now the NH did accept residents as "Medicaid Pending". But not all NH do that so get that checkbook out or look for other NH that do.
Regarding Pending applications, my experience with the 2 NH my mom has been in and with my MIL was that the NH does their own review of the documents (that you get together that is sent via the NH to the state caseworker along with their bill to the state) to determine IF they will accept an applicant as "pending". If mom has gaps in money (like 1 year ago she had 50K in savings and now has 2K), then they know there is going to be a problem and may not take her as a "pending" resident; or if mom has a whole life insurance policy, they know that is going to a spend-down clusterF so they may require that family sign off on financial responsiblity to pay just in case Medicaid declines her or mom has a financial penalty. If mom is basically poor and has been so for a long time, then no worries but you still have to provide the documentation to show her financial "need". My mom's financial review was for 3 years & 6 months of banking. They are looking for patterns of spending that make sense. So if mom was in AL then every month she was writing checks for 2K to pay for AL so her assets get depleted. A clear pattern of spending. But if mom is at home and has no real costs, then she may have money in the bank that will have to be spent-down to 2K before Medicaid will accept her.
The NH should have a 1 or 2 page list of items that your state requires and they will want to review before they accept her as "Medicaid Pending". Personally I think it's better to do this a one big giant dump of documents rather than piecemeal.
Please don't leave anything out or try to hide stuff, it will surface eventually and will result in a transfer penalty inquiry and those are totally sticky to deal with.
Also realize that whatever income mom gets right now (like her SS and any retirement) will have to be paid to the NH as her co-pay less her state's personal needs allowance. So say mom gets 800 SS and 1K retirement, mom's "income" is $ 1,800 a month and mom's lives in TX who has a $ 60 a mo allowance. So every month mom has to write a check to the NH for $ 1,740.00 for her co-pay. So if mom still has her home or debt, she really won't have any $ to pay on that.
If mom has a house, post that info and I'll give you a couple of suggestions on how to deal with that.
Good luck and keep a sense of humor in doing this. The Medicaid application can seem to be a maddening maze but about 65% of all NH room & board is paid for by Medicaid. It is very expensive (5 - 15K a month cost) for the states to do Medicaid, so they are very strict in the requirements for the review.