I put our house and car in my name because my mother can no longer sign her name. I am trying to keep her Medicaid, so we can have Respite and lifeline. With the state, they want so much information it's overwhelming, I sort of feel violated.
Is it worth it? We don't really need lifeline, we have a house phone for 911, and I can wash her as well as a helper. I would just hate to lose Respite, I need a break badly.
Good Luck!
I think you have different things going on and are getting them overlapped:
MediCARE versus Medicaid - Now mom has MediCARE and if mom can qualify for hospice, then MediCARE will pay for all hospice services and a part of hospice is for respite care at a facility for the hospice patient to give the caregiver (that would be you some time off). Many hospice groups (the larger national chain ones usually) have a free-standing facility that is hospice only and the respite care goes there. It is a good system as the hospice already has dad's care plan in place and understand his needs. In my mom;s city, VITAS has turned an old women's & children's hospital into a hospice only facility, other places do this also. See if mom is at the point medically to qualify for hospice - speak with mom's doctor.
Now MediCARE & MedicAID are very different in what they do and pay for. This site has many good articles on all this. In general Medicare everybody over 65 has and paid into it from working and then from their SS after they retire.
MedicAID is a program for those "at-need" and you have to be very poor to qualify. Most of the elderly in a NH are there with Medicaid paying for their stay and it is very expensive stay. The states have to qualify the Medicaid applicant to show they are both financially at need and medically needing skilled nursing or home health services. Medicaid looks at both mom's ASSETS & INCOME to determine if she qualifies. Her INCOME is her SS or other monthly retirement and the amount varies by state. For ASSETS it would be her savings, or other investments and are usually set at a maximum of $ 2,000.00. Now her home and 1 car are exempt ASSETS and remain exempt assets for Medicaid for her lifetime in most states. But if she sells or transfer or gifts the property from her ownership to another (like you), then the property changes from an exempt asset to an non-exempt gifting or transfer of assets. She will face a penalty from Medicaid for the value of the property. By your doing the paperwork to change the property ownership (house & car) from mom to just you, you gifted yourself items of value which Medicaid will find out about and penalize your mom for doing this. This is called a transfer penalty and each state has it's own formula for how it is done as it is based on the state's Medicaid reinbursement rate for care. Like in TX, the rate is about $ 145.00 a day while many states on the east coast are $ 300 - 400 a day.
The Medicaid application has to be pretty specific with information so that they can accurately determine if an individual is truly "at-need". My mom's application was over 100 pages (with about 30 pages of that just for her old-school style insurance policy front & back legal size pages) and required a look back of 3 years & 6 months of all her financials (which were all bank statements and a notarized letter on bank stationary on the disposition of the closing of all accounts, CD's etc from her bank - took a full morning to get done and her bank was very helpful, not all are or will do for free). The state can do a dovetail search of recorded title transfers - like for homes and autos - for a 5 year lookback. All proprerty transfers are recorded by the local tax assessor and then go into the state system. So if you transferred the house & car into your name, OR mom sold the house or car to someone, it will show up eventually and the state has no choice but to do a transfer penalty inquiry. Whether the penalty is enforced depends on the situation, it seems. But the states are required to look in detail on income & assets in order for them to get $ from the feds to run a Medicaid program. Medicaid is a joint federal and state program and run by each state according to it;s own specific rules. Medicare is a national federal program so the rules are more universal.
It is good you are seeing an attorney as doing the transfers has made the application totally sticky. Please take all the documents on the house with you, also take the last couple (3 if you can find them) of tax assessor statements on the house; bank statements and any insurance policies mom has with you too.You want to use the time best and so mom can update her will (a codicil to her will) and do a fresh new DPOA, MPOA and if your state allows a "Guardianship in Case of Incapacity" then one of those too. Mom should pay for the attorney visit and write the check for it herself. Attorney will likely want to speak to mom independently of you and you will need to leave the room. It;s not personal just needs to be done.
Good luck and yes Medicaid application is maddening. But you can & will get through it! let us know how the attorney visit goes too.
My parents had put their home into a trust per some estate planners who were actually out of state and did not know any better, and to keep it exempt when my dad was on Medicaid and my mom was the "community spouse" I had to do a lot of fancy footwork with the county to get it back out of the trust and into her name. And yes, the paperwork is onerous and they have rights to ask a lot of personal questions and income related stuff, but yes, yes, yes, it is absolutely worth doing and worth doing right. In our case, my Dad's getting Medicaid on two separate occasions meant that Mom got to live in her own home for several years with enough to live on that she otherwise could not have had, while Dad got rehab and hospital care he needed - the first time it even got him well enough to be home again for a while. You will find that your negotiating the unfamiliar territory on behalf of your mom is one of the greatest gifts you can give her. My mom did most of it the first time, but when it was needed again, she could not grasp what documents they actually needed and things were stricter I think, so I had to step in and do it. Not easy, but worth while.
We already did the POA stuff. When my mom was still coherant. Now she doesn't even know what town we live in. I'm just trying to keep her alive and well and comfortable. I mind my own business. It really is overwhelming. I'll see what I should do when i see the lawyer.
It is very overwhelming. I went to the Medicaid office and was assaulted with hundreds of people sitting around on card table chairs, waiting for their number to be called.
I don't know if we got lucky or if it was because my dad had very little money going in but his Medicaid application was pretty straight forward. He didn't own anything so I suppose that's why it was pretty easy. But he did have a annuity worth about $10,000 and the family wanted me to take that money since I had been caring for him in my home for years. We worried and worried about that annuity during Medicaid's look back period but then I read on here somewhere that annuity's were exempt. I don't know if that was true but we never heard word one about it from Medicaid.
I stayed in close touch with our case manager from Medicaid too and I think that helped. We weren't just a number to her, she knew who I was. The nursing home bill was racking up during the Medicaid process and I'd get bills for, like, $11,000. I knew we wouldn't owe that but just looking at that bill stressed me out.
Medicaid finally approved my dad......after he died.
Who needs a break from caring for a parent 24/7... going on 14yrs...right?
I was unclear in my post. I meant to convey that I didn't think the Medicaid process was that complicated. In our case at least it was a fairly simple process. We waited for a long time to get approved, yes, and the fact that my dad was finally approved after he passed away just goes to show how inept government entities are. But I stayed on it, calling Medicaid often, trying to push it through as quickly as possible. During this time I was stressed out of my mind, I had never known so much stress, but it got done, just not in time. I didn't care that the nursing home wanted their money. My job was to cross "T"s and dot "I"s and keep the NH up to date on what was going on with Medicaid. But at the time my dad didn't own anything. He had sold the house and had a leased car. That's why our application was pretty simple.
If Medicaid will enable you to get a break you should do it. But is there something you can do in the meantime to get some respite? There are so many people on this site who know so much more than I. Can you throw out a question on how to get some respite ASAP? I'm sure you'll get tons of ideas. My wheels are spinning right now trying to come up with an idea. What about a caregiver from an agency? Not on a regular basis because I know they're expensive but what about for 24 hours? Then maybe you can go visit a friend or even go to a decent hotel and just decompress. Would that be an option? A caregiver for 24 hours would be considered a live-in so I'm not sure if you can hire someone for ONLY 24 hours. I don't know what your mom's money situation is but if it's possible, the benefit may far outweigh the cost. And it's a quick process. You find a reputable agency and give them a call. They're accustomed to dealing in last minute placements. They'll probably send out a nurse ASAP to assess your mom and the living situation and talk to you about what you need and I think it could probably get done in 1 day depending upon the availability of the nurse.
I'm thinking that if you had someone who come and relieve you for a little bit you would have mentioned that and done that already but still thinking about the caregiver thing, what if you hired 2 people who would each work 12 hours each just for 24 hours. Is there someone you know who could be at your house at the shift change, just to make sure everything's going smoothly? A friend? Neighbor? Family member?
Could you call Adult Protective Services and tell them that you are in dire need of a brief respite? I don't know too much about APS but I see them referenced on this site all the time.
I wish I had better ideas for you and I know I'm not much help. I don't want you to have to wait until your mom gets approved for Medicaid. It's not right. You should have respite available. EVERYONE should.
(((((Shanz))))) big hugs
As a backup or insurance only, Medicaid is certainly worth the trouble.
While bureaucracy and red tape are crazy-making, let's not get too nostalgic for the good old days when there was only charity to rely on. The people giving out charity could just decide on a whim that you didn't deserve it, and then you were totally on your own!
My three brothers are totally useless.
Fingers crossed and so far so good. One can only hope for the best.