I'm going to be starting the agonizing process of applying for Medicaid for mom and dad. I found a good law firm that specializes in all this and will be meeting with them soon. The meeting is going to cost 450 dollars is this a fair price? I have no idea what the retainer will be but I imagine its a lot. Is it worth it to hire a firm to help us through this process? Mom and dad don't have a ton of assets. A modest house, a small piece of land and well under 40K in bank now. My dad is worried that Medicaid will take all of it. That is why I'm going to talk to someone who specializes in all this. Input appreciated.
Applying for Medicaid for a person who is married and whose partner will become the "community spouse" (person not living in a care center) is far more complicated. I felt I needed a lawyer. Applying for both spouses? Yikes! I have no idea.
Medicaid rules attempt to not leave the community spouse impoverished. Therefore the asset limits for a married person is quite a bit different than for a single person. Reassure your dad on this point. (When you say for mom and dad, do you mean both of them need Medicaid?)
The HICAP program that Sendhelp mentions operates in California. Research whether your state has anything similar. Start by contacting your Area Agency on Aging.
Decades ago anodized aluminum cake pans had labels that claimed they were "dishwasher safe." Well yes, they won't rust. Aluminum doesn't rust. What they didn't mention is that they will discolor and look blotchy. I think the claim that you don't need an attorney to help you through some of these applications is like those old labels. Yes, you can legally do it yourself, but you might not be happy with the results.
(I collect novelty shaped cake pans -- Mickey Mouse, a Lemon Tree, etc -- and I am very familiar with the discoloration from dishwashers. That's why I chose that for an example.)
I doubt it would include preparation, filing and follow-through with Medicaid. That's an issue that should be clarified.
I don't have any experience with Medicaid, so I can't offer any other input, but there are plenty of people here who do have Medicaid experience and I'm sure they'll post tomorrow - postings seem to be higher in the mornings.
So what are you thinking that Medicaid will provide for your parents?
& is this realistic for what Medicaid has in programs your state?
You can research on your own but a good elder law atty will know the minutiae of details for how Medicaid reviews applications in your state AS WELL as dealing with how to do a spend-down or restructure financials to be totally Medicaid compliant. If the atty you are meeting with just deal with financial, I’d look for another & probably look from those NAELA certified.
I would suggest that before the atty meeting you find out what each of your parents health history is in detail. & if the goal is about getting both of them into a NH in tandem, will their primary MD write orders for skilled nursing care needed with the ICD-10 codes to show need and with a fat health chart to support & document that skilled nursing needed? Some states are now doing a required pre-admission review for any infacility Medicaid & for those coming in from living at home clearing the review now will not be easy. (I moved my mom in TX from IL to a NH and without an AL stay in between in 2011, & now with TX requiring PRHHS there would be no way she’d ever show the level of need now to qualify for 2017 requirements.) Most NH admits are coming from a hospitalization & discharged to a facility for “rehab” under the mediCARE post hospitalization rehab benefit (usually 21 days but could go to 100) BUT then are found to need to stay in the NH so then apply for Medicaid to start coverage after Medicare stops. I’d ask the atty what the eligibility review is like for Medicaid for your state and if your folks as they are now would both be qualify.
Both medical & financial important for Medicaid.
If it’s such that they both qualify medically for skilled nursing care a NH, the Medicaid financial rules are pretty narrow.... usually 3k in assets, a (1) car, a home. That land would more than likely be a non-exempt asset & need to be sold at FMV with proceeds used in spend down.
Also please keep in mind that once on NH Medicaid all their monthly income - such as SS - will need to be paid to the facility as the required copay or SOC (share of cost) less a smallish personal needs allowance. PNA varies by state from $ 35 - $115 a mo. Realistically if both in a NH & they continue to keep their home & car, there will not be any $$$ ever again to pay for home / car expenses (like taxes, insurance, upkeep). Often the caregiver is living with parents at their home & providing care for free & without compensation & finds themselves unable to really cover property costs, living expenses...... If this is you, pls address this issue with the atty as to how to deal with property costs, the caregiver exemption for estate recovery & caregiver contract till they go into a NH. If your parents home ownership & their income is what is keeping a roof over your head & you cannot cover costs on your own, you may need to rethink NH move and instead look at in the community waiver programs such as PACE.
40k in assets is pretty modest sum. Preneed funeral & burial could be 16k-20k. If atty fees run 5k per parent, that leaves very little $$ to actually have to spend down & maybe could be all used for property costs. Let us know what’s what & good luck.
Contact HICAP (Health insurance and Counseling Advocacy Program).
Sissy, geez..... that is going to be it’s own drama.
If your dpoa and named executor for each of them, with Sissy left out totally, it should lessen the drama as your in control. Get their legal all updated to have this done. If folks insist to leave everything as per their will 50/50 between you & Sissy & it kinda needs to stay this way for family peace, I’d let it happen. Ask the atty about who they do probate referrals with as probate probably is how you are going to successfully deal with her.
Also folks need to have bank accounts to you as POD. Pay on death to you as your the dpoa & will be executor. Not Sissy.
But not everybody named executor is cut out for the pitbullie OCD needed &/or has the purse or wallet to stay in probate if time is needed. Or they are just too still grieving or too exhausted to deal with probate. Those “we buy houses” flippers will relentlessly contact executor (all on file all public records) to buy assets of the estate for a song and it happens as Sissy or Bro executor is beyond over dealing with “estate”.
Let us know what options the attys suggest, if you would. We all learn from each other!
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