My mom is makes too much money? She has no other assets than her retirement. She needs assisted living but can’t afford it? Am I just waiting until she is so unwell that she has to be placed in a nursing home? I just don’t understand how everyone on here is talking about assisted living like it’s no big deal?
Most ALs offer marketing promos on the value of downsizing as they assume people will bring the house. If you don’t have that, well, they just move on to the next customer.
when she needed LT care, we applied for medicaid and they now pay the difference that her benefits don't pay. Her VA benefits have changed over time and been (believe it or not) decreased and because of that Medicaid has increased their contribution.
Attaining Medicaid was a long hard struggle but now that it's in place it is helping. We live in MA.
Im not sure how else to be helpful but feel free to add followup questions if we can be of help.
- Poor quality funded services.
- Not enough funded services, or none at all.
- Much lower incomes for medicos providing services.
- Much higher taxes to fund better services.
It’s always a problem, and always a balance exercise. Everyone wants high quality services ('just like a hotel'), but no-one wants high prices
Those who can't, stay home now and end up in nursing home. Her income may not even be enough for NH, but state Medicaid is very likely to cover the difference.
If there's a chance of using Medicaid, keep records of expenses she pays that, don't give her home to any family member or sell below value. Don't do gifting to others. Those things create penalty periods for Medicaid to start. Medicaid looks back 5 yrs in most states.
At the moment it works a lot of the time because older people often have adult children to step in, plus assets that can be sold to pay the private sector. Heaven help the others when they need it. Think about the political problems Obama had with acute care. The private age care sector has more players and would fight even harder.
It all comes down to pay as you go or qualify for Medicaid programs....meaning based on income and you've spent your savings down to a minimum ($2000 in Texas)
A friend of mine - his dad went to Thailand to an assisted living there, as he loved the country, and he was still reasonably healthy upon moving, and costs there were much lower than in the US
The next level is the NH for care that Long-Term insurance will help, but unfortunately, Long-Term care insurance is not available for everyone. They will ask you too many questions, especially memory tests to determine eligibility. Coverage is expensive, too. Medicaid will cover the difference between your limited income and NH costs when all your assets run out.
If you get sick or injured, you are forced into a nursing home. The government doesn't care about people. Hope no one gets tossed into the street.
Some say it bumped up their income so that it wasn't enough to pay for anything BUT was too much to qualify for any aid.
Some say they cannot get coverage unless their MC has a full time 24/7 RN, and that just doesn't exist.
All mention the cost which can be onerous.
And then there are those that LOVE it.
So I would say this is one contract you MUST read every word of and in fact I would have an elder law attorney look it over.
There same varying feelings exist on reverse mortgages.
Worked GREAT for my partner's mom and kept her in her home until her death.
For others it is a nightmare.
Tough to make all these decisions to be certain.
Really imo the only “insurance” option out there would be if you did a hybrid - so it's a whole life with LTCI benefit bank as part of the policy. These are the sexy new trend. But these need a lump sum buy in. Like 100K -300K. But unless ya have the six figures liquid to start this, it’s not even worth thinking about. If u have the purse for this, there are choices. But pay attention to the initial exclusion period as it will be bigger window than the old LTCI did. Like a hybrid will do 90 - 180 days as opposed to old school LTCI which did maybe 60 day exclusion.
the only way imho for get into traditional LTCI are if you are still working, below age 60, work for a large group (school district, university) that still has these with open enrollment within their regular employment benefits options. So premiums paid from your check. And once you retire, then you pay premiums and all increases. Most do $260 max day rate paid if deemed medically eligible for a set time period. Maybe 18 months.
My mom’s 2nd and eons better NH did not take LTCI at all. Private pay or LTC Medicaid only. Signs up on this. I asked why and billing said it was just too much paperwork of filing and refilling to get paid. Often insurance wanted details on staff and staffing patterns, like if work done by a RN vs LPN. Immense foot dragging. That it was way better to have a bed be LTC Medicaid resident as most residents had the NH be their representative payee for SSA ($ ach usually on 3rd of each mo) and the State Medicaid $ was paid in real time to the facility. Bill & pay, no fuss no muss once a resident was eligible.
- board and care home. Will be way less than a NH and probably at the lower end of day rate for what AL do in your region.
- congregate living type of facility run by a nonprofit. These are usually a division of a religious organization. Like Catholic Charities or JFS or Methodist Ministries
-section 202 housing, this is low income senior only housing. Kinda like Section 8 housing but the property is seniors only. Most have supportive services (meals, transpo, wellness cks) that tie into other “at need” programs. They will have to go through the documentation process to show “need”.
- if your area does PACE, get them on their list to have an assessment (of health care need) done and then onto the PACE system. I personally am not a fan of PACE, but for those who have parents of limited means who live with them or vice versa, their folks both going onto PACE could be the bandaid till they enter a NH.
all of these have an application and a process to show eligibility. And a waiting list. There is no placement manana anywhere unless you have significant assets to hand over 3 months worth of private pay to a facility. Or they are currently in a hospital and being discharged from the hospital to a skilled nursing facility for rehabilitation as all this is a Medicare health insurance benefit. That flat is what it is. So get your folks applications done and get them on lists. If you are rural, go beyond your county.
Mom had a little equity in her home so when I sold it, that money was put into her bank account and I pulled from that to combine with her pension to pay her rent. When she worsened and moved into the locked down memory care section of the building, the cost was $4600. She ran through all of the funds in two years and we were told she would need to apply for Medicaid and find a facility that accepted Medicaid. Her pension was more than the Medicaid cut off so we hired an elder lawyer who suggested we create a Miller Trust. So I basically have to put all of her money into the trust except $52. Then I write a check to the facility from the trust and Medicaid covers the rest of the bill. The $52 she gets to keep monthly are for haircuts and clothing. I have supplemented my moms income for the past 15 yrs. Doing her laundry, buying all of her toilet paper, deodorant, and haircuts and clothing. I was trying to make her money last as long as it could.
I don't know what state you are in, but how much is an assisted living apartment? Can she find one for $3,000?
I tell people all the time now, "SAVE MONEY FOR YOUR OWN ASSISTED LIVING. Stop buying things. Get rid of those TV packages. You don't need a nice car or the newest phone or more clothes...you need $500,000 in a savings plan."
My husband is only 72 and we are caught in the hole.
‘Also, I’m shocked at how many people pay for their parents’ care! I can see taking them in and trying to make that work, but, paying your own savings for their care in a facility?? No way! My parents both told me that’s horrendous to put that on your adult children with their own families. I feel the same way! I would never take that from my grown children and their young families! That’s on me - my fault if I didn’t plan correctly or squandered money on bs stuff like jewelry or just having to take that cruise once a year, etc. etc. As you age you need to “somewhat” prepare for the fact you may need a backup plan in case you become incapacitated and don’t expect your adult child to be compromised! I know my sons’ spouses would go ballistic if I expected them to help their dad live in his facility. The spouses have parents, too. You can’t support everyone!
She gets $2,000 a month in SS & dividends, the balance comes out of her investments.
If your mother has a home, it should be sold and the money used towards her AL expenses. Liquidate everything that you can and go from there, that is what we did.
If one doesn't plan they plan to fail, too late for any catch up. We are all living too long, just the reality of this thing we call life.
Example: (Not me, but a friend.) She bought her very ordinary "2 BR with den and no garage home" in Florida in 1975 for $40,000. It was in a pleasant but not fancy neighborhood. The house sold a couple of years ago for $700,000. Subtract the real estate commission, and that's a healthy chunk of change. Her really nice continuum of care apartment costs $84,000 a year and includes transportation, field trips, a clinic onsite, housekeeping, three great meals per day and snacks. She won't run out of money for years, and she is now living a carefree lifestyle with no costs of running a home.
Assisted living is not a big deal if it's been planned for over a lifetime.
You need to speak with a Medicaid caseworker to see what the assets and income limits are. Your Mom does not have a home?