Lawyer was handling the application but once the application was approved, they dropped me like a stone without giving me the chance to ask questions. All along I've been required to forward copies of my mom's bank statements every month to the lawyer who was forwarding to the case worker (I assume). Now that the application is approved, do I need to forward the statements directly to the case worker or was that just for the application. I'll have to look through my paperwork. I don't even know if I have contact information for the case worker. I have invested so much time and money into getting this application approved, I don't want to mess it up now by missing something.
For us & TX Medicaid, once approved, the state sent whomever is the contact person on file (usually the dpoa) all correspondence. You imho do NOT want this stuff going to mom at the NH; needs to come to you at your address. In the approval letter, there should be a to the penny figure that is your mom’s copay or SOC (share of cost) that is what she must pay to the NH each month from her monthly income. She will be allowed to keep a small personal needs allowance. PNA varies by state, like for TX it’s $60 a mo. So say mom got $1150 retirement plus $800
SS$, so $ 1,950 total for her mo. income. If PNA is $60, then her Medicaid required copay is $1,890 a mo to be paid by her to the NH.
Now your mom can continue to keep her SS as direct deposit to her old checking account and then you write a check to the NH for the copay & the PNA $ stays in her checking account & builds each month by the PNA amount.
OR
mom let’s the NH become her payee and the NH will put the PNA $ into a trust account in her name at the NH & you as her dpoa can go and withdraw from it, usually at the business office.
NH cannot require mom to have them become the payee. Although they will heavily impress that it must be done this way. Nonsense! Mom can chose not to. We did it this way and just had to make sure that NH got paid her SOC by the 5th of each month. For us, it was better as I live in another state and this way I could let the pna build and do a bigger buy of toiletries and clothing replacement every 3 mos or so as it fit my timeframe. Whichever way you choose, you must, MUST, make sure that each month, she never goes over $2k in assets. 2k seems to be the max asset limit for most state LTC Medicaid.
there will likely be an annual recertification or renewal of her eligibility. I didn’t know this happened and had boxed all up & into storage. It had a 14 day deadline and was postmarked days after the actual interior letter. That was a fun weekend..... For us, the renewal the first year came 1 month & a yr after mom was deemed eligible. It was a questionnaire that required some of the same info submitted initially (like her annual awards letters, funeral pre-need, life insurance) and the current months bank statement and prior 3 months as well. This is why it’s mucho importante that mom starts and ends each month under the 2k asset limit in her bank statements. If she’s over, it can jeapordize her eligibility.
When her second renewal came, I was totally ready with everything in a binder that I basically updated as mail came in.
The awards letters are especially important. These are the trifold mailings that like SS, federal retirement, other pensions mail out like in Oct or Nov of this year, that indicate to the penny what they will be paying mom starting January, 2020. Medicaid uses this info to recalculate what her copay or SOC is starting Jan for her (or you as dpoa) to pay the NH from her checking account. If your mom was just approved, likely renewal goes out next September. But you may get a awards letter questionnaire in December. My experience is that the state sent letters have a tight schedule for submission. Like 14 or 21 days, so you kinda need to continue to stay organized with her paperwork. I had 3 binders for each year - banking, medical (like those mailings CMS sends out that list for MediCARE who was paid & the code & amount) and then 1 for everything else. Medicaid didn’t send out any statement or summary as to what they paid ever.
In NYS there is five year look back rule and Medicaid looks at everything suspiciously. Organize, put it in a binder and call your social worker with any questions. I was so fortunate that our elder attorney was amazing and also responds to my emails promptly.
What a nightmare! At one point I had to get 5 years of bank statements and turn them in to them. Oh my gosh. It is very scary and stressful.
I did everything on my own. When I tried reaching out to Medicaid
I got very little help which was very frustrating, I am sooooo glad that
is all behind me now and I feel for anyone having to go through the
process. Good luck.
Now I’ve got my own questions to ask as My Mom is still living with me.
Thanks & GodSpeed.
Medicaid is a huge HUGE program run by each state uniquely but under overall federal guidelines. Medicaid is everything from those Happy Teeth vans that kids enrolled in Medicaid CHIP visit, breast pumps loaned out to new moms on Medicaid via WIC, to paying for room & board costs in a skilled nursing care facility via LTC Medicaid. Again each specific program has its own both medical and financial “at need” criteria.
So which medicaid did she apply for? Really you want to know exactly which program and what the exact details are.
My experience is that for LTC NH Medicaid, they have to already be a resident of a NH, so living in the NH at the time of filing the LTC Medicaid application. LTC NH Medicaid has tightest “at need” criteria imo. Like they basically are financially impoverished with most states having that amount at a maximum $2,000 in nonexempt assets and their medical chart documentation clearly showing need for skilled nursing care.