My mom's SSI is slightly over the income level to qualify for full Medicaid. How do I go about setting up a spend down?

The process is far from simple. The spendown commences
AFTER you apply...Do not spend down half of assets and then apply...You need a specialized attorney. Your county social services should be able to help as well, but competence of staff varies widely in my experience.

Grace + Peace,

Bob

Now I am glad my mom didn't have loads of money,house,bonds or life insurance. Her savings was $2000 over limit of $15,800 so the nursing home advised me to pay one months rent so it would be ok. They have been sooo helpful and only took 2 months for approval. This is so less stress for me. I love the n.h. She is in.

My Dad lived in Georgia and went to a Nursing Home for 4 years. Your Mother will have to have less than $2000 in the bank at all times for the entire time she is on Institutional Medicaid. My Dad's income was about $200 too high for the program but they did eventually open it since he was a long term resident of the Nursing Home and didn't have enough income to pay the monthly fee.
He used his Medicare days first.
When he passed away he owed the Nursing Home about 19,000$ but they kept him on anyway because a full bed is better than an empty one and they were getting however many thousand $ a month for his triple room,.
Sorry I am not aware of any non Institutional Medicaid Programs there.
Good Luck

Ambriel - what are you hoping that Medicaid will do for your mom?
The type of program to be paid by Medicaid will make a difference as to what type of application is done and what documents needed and degree of copay. Medicaid rules vary by state so what the rules are for GA may be slightly different than that for MS. All Medicaid programs are "at need" entitlements and mom will need to be " at need" both medically and financially for the exact program.

If this is about mom getting into a NH & having Medicaid pay, those situations will require that mom medically needs skilled nursing care & has MD orders for this level of care and documentation in her chart to establish that need; financially for NH they need to be under whatever GA has as their monthly income limit and under 2k in non exempt assets. Usually NH Medicaid is done when they actually move into a NH as they need to be an actual resident at a facility for the application to proceed. This process is called "Medicaid Pending". Exempt assets are a home, a car, an atty done special needs trust, no cash value life insurance & funeral policies. In general, they have to be impoverished (2k in assets for individual application) to qualify. Paying for home health, dental work, new eyeglasses & hearing aids, walkers, their rent at IL, AL, NH are all allowed spend downs. If they have a home, the costs on the home are a spend down item. An elder law atty can be invaluable in going through the details on all this.

But financial dealings with others & for others - like grandkids tuition or wedding, giving kids $, selling items under FMV to family/friends, transferring ownership of assets (any property or insurance policies) - will cause a transfer penalty inquiry when the medicaid application is reviewed. An atty done personal services contract in which parents pays family for caregiving is an allowed spend down.

It's kinda important to keep in mind that IF mom moves into NH & on Medicaid, she must do a copay or SOC (share of cost) of all her monthly income (like her SS) to the NH less a very small personal needs allowance. She will realistically have no-none-ziltch of her $ anymore ever again. So if there are debts mom needs to pay off....like her funeral policy or life insurance...she needs to do these in full during the spend down. Otherwise family will need to pay in order to keep them in force. If mom has her home, family will need to pay all house costs if mom wants to keep her home. Ditto for moms car. Realize that any assets mom has upon death will have a MERP / estate recovery attempt on them.

Now if you want mom to get into some sort of community based Medicaid program - like PACE - then mom will need to qualify for the specific program. These are paid by medicaid waivers so vary by program as to cost & eligibility requirements. For community based Medicaid, they are expected to keep some income to enable them to continue to live in the community. So they may just pay a smallish daily fee for whatever program they enroll into. A 3day a week PACE program could have a copay of 25 a day/$300 a mo co pay; while an in-home care program could require a higher copay.

Realize that if your calling GA Medicaid, they are dealing with all types of Medicaid......from WIC, SNaP, TANF, plus ACA related Medicaid expansion insurance issues. The caller before you could have been calling about baby formula needs on WIC.

For elderly programs, you may be better contacting your Agency on Aging. AoA are clearinghouses and planning entities for programs just for the "aged" in your community or region. This site -Aging Care - has a drop down list of AoA by state.

See a elder law attorney. They know the tricks of working with Medicaid

Try calling during off peak hours. Never call on Monday morning or after a long weekend. Try Mid week at 7am when they first open the call lines.

Spend down is for assets -- like money in the bank or stocks and bonds or property. Income is a different issue. Pam has given you good advice about getting through to talk to someone.

Ultimately you may want to to consult an attorney whose specialty is Elder Law. He or she will know how to set up Mom's income so she can still qualify. A number of years ago we paid a "deductible" to make up for the "excess" income. But that wasn't in Georgia, it was not this year, and that was for a situation with a spouse. If you mom is single, that makes a difference.

I encourage you to believe this can be resolved. Good luck in finding the resources you need.

uninformed, I pretty much agree with you about how it SHOULD be. But it isn't. Our capitalism has been modified to a certain extent with socialism, but the profit motive still drives medical care. Medicaid is not considered something we have paid for or earned. It is considered welfare and the recipients are at the mercy of those who make the rules. You've heard of the the Golden Rule? Them thats got the gold, rule.

Ambriel: Easy answers to your questions are as follows: #1 find out the correct phone number for medicaid in georgia and don't hang up; stay in the que of calls holding. if you hang up and redial, you're essentially going to the bottom of the pile. #2 do your research on line for medicaid filing.

Uniformed - Medicaid is an "at need" entitlement that one applies for. You have to show need for whatever specific & limited medicaid program you are applying for. You haven't been paying specifically into Medicaid like you have been for Medicare & Social Security. Like for Medicaid's WIC (women's infants & children), it covers prenatal care for the pregnant mom but won't pay for her visit to an ophthalmologist. For those wanting Medicaid for NH you have to show with documentation to be at need both medically and financially at whatever terms your states Medicaid LTC program has.

Medicaid is not an entitlement we have been paying into like Medicare & Social Security - which we all pay into via our FICA contributions during our working years. Btw the detailed estate recovery, spend down and transfer penalty aspects of LTC Medicaid are how required due to the Deficit Reduction Act signed into law by Bush in 2005.

Ambriel - if you find that moms monthly income is over whatever GA has for the income ceiling, you could look into mom getting a Miller Trust. Miller is a totally legit way to redistribute guanteed income sources to qualify for Medicaid. Miller has to be done by an atty, it is not ever a DIY project. In a nutshell a miller works like this: say moms state has income max at $2100 mo; mom gets $ 800 in SS & 1k from late hubs pension & also 1k from her pension. $ 2,800 BUT $ 700.00 too much for Medicaid. What miller does is becomes the recipient of the income so mom gets 2100 and miller 700. Viola! Mom now qualifies! Just how it exactly runs depends on your state. Most have it simple trust paperwork with the NH getting all income directly with a personal needs allowance (around $ 70 a mo) set aside for her in a personal needs account at the NH, which she or you as DPOA can withdraw from to buy stuff or use for the beauty shop at the NH to bill to. So if you initially hear moms too much income to qualify, don't panic, but find a elder law atty to work with you & mom to figure out what to do. There are solutions to whatever hurdle & it's good you are looking into all this now for mom.

Perchance is mom railroad retirement?