Medicaid experience?

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Medicaid experience?

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I’m realizing that I cannot continue to care for my Mom. Has anyone here had experience with Medicaid? I’d appreciate your help as I begin the process of applying. Thanks!

Family Caregiver Medicaid Paying for Care

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Hello Momsonlychild, I applied for my MIL in MN. You can download the form from your mom's county website (Dept of Health and Human Services). If she only receives SS and has no other assets (no house, no investments etc) it is pretty easy. You will need things like her birthdate, SSN, most recent bank statement and any other "proofs" they ask for. Once you complete the form and send it in, it will take about 3 months to here whether she qualifies. They will only contact you via mail. If you get a letter from them, open it immediately and check the deadline for response. If they require for "proofs" you need to send it in asap or you'll need to reapply all over again. You can contact a their office and ask questions to a social worker.

I don't know what the financial "lookback" period is for your state, but MN is 5 years. If your mom has gifted you any money, or casual "loan" or you own anything jointly (or she does with anyone else), this makes things a little more complex. If this is her case you may need to consult with an elder law attorney who has experience with Medicaid. She may need to spend down her monies before she can qualify. It may turn out that she should be transitioned into a care community while privately paying and then eventually will need to apply for Medicaid. Make sure any facility she goes into does accept Medicaid as not all do. I made a copy of the form and filled it out as a rough copy to make sure I had all the info complete and correct. I hope it goes quickly and smoothly for you!

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Geaton pretty well Covered the basics for what’s required “at need” financially for Medicaid.
BUT
and this is really important, your mom will also need to be medically “at need” for whatever Medicaid program she is applying to.

If this is about her going into NH aka a skilled nursing care facility, she will need to have an assessment & health chart that clearly shows that’s what she is “at need” for. The assessment is not subjective done by you; it’s not just a note from her MD that reads she needs a NH. Assessments are usually done 2 ways. The most common is that there’s an incident that happens (like a fall) that causes a hospitalization then a discharge to a SNF for rehab and then they are determined to be done with rehab but unable to return home and transition from rehab patient to NH patient and there’s a big fat health history file to support this and clearly shows they are “at need” for a NH / SNF.
BUT
if they are still living at home, there may not be an existing detailed health history that clearly shows them to be “at need” medically. So they will need to get a needs assessment done. These are usually done by a geriatric RN & SW duo.... they will review her health chart and medications and do some sort of in person evaluation. NH / SNFs will know of someone who does them; some better ALs do them to determine when a resident needs to move out of AL and over into an associated NH facility. The medically at need part of Medicaid is equally as important as the financial and in some ways more difficult imho to get done if they are still living independently in a home or IL. If your her dpoa and mpoa, you probably are going to have to work with her providers to get her chart to show “at need”. My mom was in IL and did the jump from IL to a NH bypassing the AL phase. It took about 5 months of seeing her docs to get to the at need with documentation in her chart. The visit she had significant weight loss, bad H&H labs and some other issues was when her internist wrote orders for SNC needed. Just being old, or needing medication management or some help with ADLs, or that family have run out of caregiving ability, well in & of itself is just not enough to be “at need medically” for a NH nowadays for Medicaid. Having a medical needs assessment done will help you figure out what level of care she can be eligible for or what might happen or be done to have needs documented in her chart that is ok for Medicaid.

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igloo, thanks for the deeper details. Yes, this is the exact progression of how it went for my MIL.

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Agree with PP. Would also suggest you start looking at the higher rated NHs and see not only do they take Medicaid, but will they accept a patient with Medicaid pending, or do you have to be private pay at first. Try to get an idea of how long it takes Medicaid to be approved in your state, and how many months of private pay the NH wants.

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Thank you for your advice everyone. I’m thinking an elder care ATTY may be my first order of business. I need someone to advise and help me with this crazy process. This group is a godsend to me! God bless you all!

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Please start with hiring a competent elder law attorney that deals with Medicaid. My parents had their trust made out by a law firm specializing in all aspects of elder law including one attorney that does nothing but Medicaid. Yes, it costs money to hire an attorney but, without it, I would never have been able to get through the process. It starts with your mom's liquid assets as well as her other investments such as her home, stocks, bonds, etc. She may need to spend down to get to the figure needed to be on Medicaid. The attorney will explain in detail as everyone's case is slightly different. Medicaid will only pay for a skilled nursing facility but how much they pay towards the nursing facility and your mom's patient pay depends on those other factors I mentioned and your elder law attorney. While trying to get on Medicaid, your mom may need to private pay until she spends down to allow for Medicaid. It may sound confusing but, trust me, it will become easier once she's able to be on Medicaid. Your mom will also need to be evaluated for at a least three things. Is she able to use the bathroom on her own, can she walk on her own, eat on her own, shower & dress on her own? These are considered activities of daily living. Another factor of Medicaid besides the financial part is that she needs to meet at least three of those activities of daily living. Once on Medicaid, it needs to be renewed each year. There is a $2,000 a month limit on money your mom is allowed to keep so keep all receipts. She is allowed $60 a month for personal needs.
It sounds daunting but, in the long run, it will be worth looking into through an attorney. I wish you the best on this journey.

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