Ok, long story short is that I can see the time coming very soon that my mom will have to go into assisted living. I know that she has to spend all of her money before Medicaid/Medicare kicks in but with her finances her money won't last more than about 18 mths. How do I go about getting her qualified before she runs completely out of money so that it kicks in when she is out of money? Does this question make sense?
The worst part is that even though I am semi intelligent I have a huge problem when it comes to understanding written documents and anything legal or governmental is just like A DEER IN THE HEADLIGHTS. Are there people that can help idiots like me to understand this stuff?
Also one other thing. My mom has been asking for a twin bed instead of her big queen size bed and a kitchen table. Right now she doesn't have one. Should I buy her these things or would that be considered wasting her money?
Unfortunately my husband and I aren't in any better shape monetarily than she is or I would buy her these things myself. I just don't have the extra money.
And although your mom may eventually be on Medicaid if she receives a pension or social security that money will have to be used in addition to the Medicaid and will have to be used as a monthly payment to a facility while your mom's application is being processed by Medicaid.
But if your mom has money at this moment you're going to have to spend it down in Medicaid-acceptable ways. She can't just go throwing it into the streets or giving it all away. Your state's website will tell you how you can spend it down. Some people buy pre-arranged funeral packages, some hire in-home help, etc. There are ways to spend it down but you'll have to account for it when you apply for Medicaid for your mom.
Start gathering documents. Her yearly statement from social security that tells how much she's getting, any kind of pension award letter from any company she may be receiving her pension from, a birth certificate.....again, check the website and they'll tell you what you'll need.
A bit of background, mom was in her home and it got to be just flat unsafe for her. She has Lewy Body and it pretty competent even now in her mid-90's. So when I was looking for placement for mom, I thought a "tiered" community that ran from IL to AL to NH etc would be just ideal because as mom aged and her needs changed she could seamlessly move from level to level AND as her money decreased she could move into either the AL or NH and apply for Medicaid. Yeah, wonderful idea and totally not what happened or realistic in my experience. The Medicaid for AL program in TX is a waiver based program and so it does not happen accross the board by AL's. My experience is that the AL is the big profit center for the facility and they want them in and on private pay in AL as long as possible. Yes there's a waiver but it is limited. At the IL my mom was not ever going to qualify for the medical necessity for Medicaid for NH - their medical director's stance was that she was fine for AL and no NH needed. I got her into a free-stnading NH and qualified both medically and financially for Medicaid. Now if she had had a six-figure nest egg then doing IL and then AL for years and year would work. But she needed to be someplace that could provide the care she needed and she could stay for the rest of her life and with no medicaid complications which meant NH.
You really want to be very direct and have in writing that the AL will accept her on the Medicaid waiver for AL program and if there are any qualifiers needed that you all or she has the funds to be able to private pay for the whole period of time. Whatever you do try to not rush into a decision but evaluate a couple of places. Good luck and keep a sense of humor!
Although Medicaid will pay for ALF, Assisted Living Facilities do not have to accept Medicaid payments (which are generally less than what ALFs charge private-pay residents.) So your challenge will be finding a suitable ALF that accepts Medicaid.
I don't know about Texas, but here it is common for ALFs to require private pay initially and then, when the resident's money runs out, to accept Medicaid. Usually there is a minimum requirement for private pay. You would need to ask "If my mom can pay for 18 months and then runs out of money, do you accept Medicaid?" You may find some that will accept Medicaid right from the start (we found such a place for my mother), and if it is suitable and has a waiting list, get on the list!
There is lots of material available online from the Texas Department of Aging and Disability Services.
Start researching what is available and what forms of payment they accept. It is good that you are doing this at least somewhat ahead of need.