My Mom is way below the eligibility rates for medicaid and I just got the forms to fill out. We have nothing to hide and Mom has no money, or assets. She moved in with us 8 years ago and she is full care. Why do we have to tell Medicaid OUR business, our checking accts, our savings accts, our 401k, etc information to them?
RR
And the states have all sorts of waivers.....
Medicaid paying for AL is paid on a waiver program. PACE is too. Choices I'd bet is also. Couple of issues with waivers is that funding is not dedicated so programs can be defunded. Like in my state, PACE is the new model for care so new AL waivers are on a waiting list till forever.
Also care provided has to meet a cost benefit analysis to be done & paid by a waiver. Once care needed is at a certain point - like over a certain # of hours needed weekly - then at home or PACE will not be cost effective so Medicaid won't cover it as they need to be in a NH. I didn't have to deal with this for my mom as she went from IL to a NH, but from what I gather if "at home care" is more than 36/40 hrs or more than 50/60% of costs of a NH, then the waiver is stopped as it is not cost effective. Comprende? So keep that in mind, when mom is being evaluated for care needed by the state.
As a part of this, there will be required documentation to establish "need" for a NH and payment to the NH for that "need". The state can ask for the past 5 years on financials & property ownership to make sure there was no gifting or transfer of assets. (because if there is there can be a transfer penalty issued against the applicant which has to be cleared). They need to know what income is paid to yiur mom (like SS, retirement, annuities), to determine IF income is below whatever exact amount your state has set as a ceiling for Medicaid monthly income AND to determine the exact copay or the SOC (share of cost). Medicaid is asking about your moms financial details as she is the applicant, not yours. If, as you say she is way below the eligibility rates, it will all work out.....just find the documents required and provide a copy of all. For my moms initial application, it was over 100 pages for her NH Medicaid application. Her awards letters from SS and federal retirement were central as they showed to the penny what her copay to the NH had to be.
Now if you have been comingling finances (like your income & moms income went into the same bank accounts), that is going to require establishing who's $ is who's....well that is a total hot mess.....if that is your situation I'd ASAP schedule an appointment with an NAELA atty ASAP to get the application done. Medicaid will view all $$ as moms. A hot mess, really and not a DIY application IMHO.
Also your state may do an annual renewal. So keep all these items in a binder at the ready as you may need to resubmit for the renewal. When mom gets the annual next year awards letters from SS, etc. put them into the binder. Doing this will help maintain your sanity in the mice maze of Medicaid. My moms annual renewal would run about 25 pages of rerequired documents along with a 4 page questionnaire due within 15 days of date on letter which btw was always mailed after the date on letter.
If you or mom don't want to provide the information Medicaid requires, then don't apply for Medicaid. No one is forcing mom to apply for Medicaid. The elder or their family can private pay or buy ltc insurance or caregive for free or use the elders or thier families income to pay for care. Medicaid as an entitlement is not like either Medicare or SS as entitlements - both of which you have been paying into via FICA. If mom wants Medicaid, mom will need to provide her info & her documentation her state requires for her application.