Ralph Robbins
Certified Financial Planner
Ralph S. Robbins, CFP©, is a licensed Certified Financial Planning Practitioner and an Accredited VA Claims Agent specializing in Eldercare Financial Planning. He works everyday helping families in crisis find creative ways to fund long-term care expenses and deal with family financial issues.
Show:
Articles Question
Question
If both disabled parents are using Medicaid (one in a nursing home and one still at home), can their house and...
Let me assure you immediately that no one is going to "take" your parent's home while they alive. The home may be subject to... Let me assure you immediately that no one is going to "take" your parent's home while they alive. The home may be subject to estate recovery upon the last to die but that is only if the house is subject to probate.
In most states this can be avoided either by creating what is known as a "enhanced life estate" deed or placing the home in a revocable living trust.
Here is what you need to know about applying for Medicaid (Medi-Cal) when both husband and wife will be receiving benefits:
1. Assets - when just dad went on Medi-Cal he could not have more than $2k in assets and anything over that would have been transferred to mom. If she applies she will not be permitted more than $2k also. Don't spend the money down. There are ways to preserve the money for your parents benefit and still qualify her immediately.
2. Testamentary documents - you must not let one inherit from the other. Restructure wills, trusts, life insurance, etc., so the beneficiaries are other than your parents.
3. DPOA - this really should have been at the top of the list...make sure you have an adequate Durable Power of Attorney (or a trust document naming you as successor trustee in the event of disability)!
4. If you have your name joint on any accounts remove your name immediately and file the aforementioned DPOA with their financial institutions so you will have the ability to manage their affairs.
Dude, you are a hero in my book. Good luck. see more
In most states this can be avoided either by creating what is known as a "enhanced life estate" deed or placing the home in a revocable living trust.
Here is what you need to know about applying for Medicaid (Medi-Cal) when both husband and wife will be receiving benefits:
1. Assets - when just dad went on Medi-Cal he could not have more than $2k in assets and anything over that would have been transferred to mom. If she applies she will not be permitted more than $2k also. Don't spend the money down. There are ways to preserve the money for your parents benefit and still qualify her immediately.
2. Testamentary documents - you must not let one inherit from the other. Restructure wills, trusts, life insurance, etc., so the beneficiaries are other than your parents.
3. DPOA - this really should have been at the top of the list...make sure you have an adequate Durable Power of Attorney (or a trust document naming you as successor trustee in the event of disability)!
4. If you have your name joint on any accounts remove your name immediately and file the aforementioned DPOA with their financial institutions so you will have the ability to manage their affairs.
Dude, you are a hero in my book. Good luck. see more
Question
My sister stole my dad's money. What can I do about it?
To Annlidiot: Hi Ann, I have noticed in your postings you seem virulently opposed to any form of financial planning around Medicaid. I... To Annlidiot:
Hi Ann,
I have noticed in your postings you seem virulently opposed to any form of financial planning around Medicaid. I very much appreciate your sentiments and I, too, hate the concept of "go on Medicaid and protect your money for your kids" and will not work with families where that is their primary goal.
But to disparage the whole notion of long-term care financial planning by combining personal resources and public benefits is simply not fair and does an extreme disservice to those in need.
For instance, in the case of this poster, what if instead of spending down all of their father's money to qualify for Medicaid I was able to move that money into a trust that would allow the income and principal to be spent on what the father will need but Medicaid will not pay for? Like what you may ask? Well, how about eyeglasses, dentures, hearing aides...how about clothes?!? Entertainment, transportation, the list goes on and on...
Upon the demise of the father if there was anything left in the trust Medicaid would be paid back for what they spent on his care and if after that there was any residual it would go to family.
I don't see a problem with that, do you?
Or, instead of spending down all monies I showed this family how to keep Dad at home by using Medicaid in combination with an immediate annuity that would supplement Dad's income. At his death the same would happen with residual funds as above.
I don't see a problem with that, do you?
Or what if I could have shown this family how to pay for an assisted living facility using a combination of their own resources and Medicaid benefits? If that were the case, he might very well be able to transition to an assisted living facility as opposed to staying in skilled nursing. Where would you rather see your loved one?
I don't see a problem there, do you?
I don't ask these questions rhetorically because I believe this is a legitimate debate and I am genuinely curious as to what people feel is fair and reasonable and what is not. Let's face it, we have to deal with this as individuals but also collectively as a society so I appreciate everyone's point of view.
So tell me Ann, is what I do a good thing or a bad thing?
P.S. It is a shame on this poster's sister that she has no problem stealing her dad's money feeling that he going on Medicaid anyway...if that is indeed the fact pattern. But note that in this case it had nothing to do with a planner of any stripe...it was just the sheer narcissism and greed of a family member yet you were quick to point to unscrupulous professionals. So I'm curious about the chip on your shoulder! see more
Hi Ann,
I have noticed in your postings you seem virulently opposed to any form of financial planning around Medicaid. I very much appreciate your sentiments and I, too, hate the concept of "go on Medicaid and protect your money for your kids" and will not work with families where that is their primary goal.
But to disparage the whole notion of long-term care financial planning by combining personal resources and public benefits is simply not fair and does an extreme disservice to those in need.
For instance, in the case of this poster, what if instead of spending down all of their father's money to qualify for Medicaid I was able to move that money into a trust that would allow the income and principal to be spent on what the father will need but Medicaid will not pay for? Like what you may ask? Well, how about eyeglasses, dentures, hearing aides...how about clothes?!? Entertainment, transportation, the list goes on and on...
Upon the demise of the father if there was anything left in the trust Medicaid would be paid back for what they spent on his care and if after that there was any residual it would go to family.
I don't see a problem with that, do you?
Or, instead of spending down all monies I showed this family how to keep Dad at home by using Medicaid in combination with an immediate annuity that would supplement Dad's income. At his death the same would happen with residual funds as above.
I don't see a problem with that, do you?
Or what if I could have shown this family how to pay for an assisted living facility using a combination of their own resources and Medicaid benefits? If that were the case, he might very well be able to transition to an assisted living facility as opposed to staying in skilled nursing. Where would you rather see your loved one?
I don't see a problem there, do you?
I don't ask these questions rhetorically because I believe this is a legitimate debate and I am genuinely curious as to what people feel is fair and reasonable and what is not. Let's face it, we have to deal with this as individuals but also collectively as a society so I appreciate everyone's point of view.
So tell me Ann, is what I do a good thing or a bad thing?
P.S. It is a shame on this poster's sister that she has no problem stealing her dad's money feeling that he going on Medicaid anyway...if that is indeed the fact pattern. But note that in this case it had nothing to do with a planner of any stripe...it was just the sheer narcissism and greed of a family member yet you were quick to point to unscrupulous professionals. So I'm curious about the chip on your shoulder! see more
Question
My sister stole my dad's money. What can I do about it?
This is exactly why I recommend AGAINST joint accounts between parent and child. The fact is that once the joint account is created,... This is exactly why I recommend AGAINST joint accounts between parent and child. The fact is that once the joint account is created, unless both parties can demonstrate they contributed equally to the account, half of the account well be deemed by Medicaid as an uncompensated gift to the joint holder. Period.
Medicaid does not care about what happened to your father's money. The only thing that is important to them is that the money was there and now it is not and it is now considered a gift.
Medicaid does not "go after money" until the recipient is dead. At death, the state will initiate an estate recovery process and if there are probatable assets they will attempt to recoup the cost of care. If fraud is perpetrated against Medicaid a referral could be made to the states attorney's general office for prosecution but nothing of the sort has occurred here.
It is ludicrous to think that a state agency is going to go running around looking for applicant's money either before or during claim...they just deny benefits if there is any question.
What may happen is that a penalty period of ineligibility will be imposed. I have no idea what the amount in question is, but if it is around $35k as your account was your father could be looking at a penalty of up to 3 or 4 months. (One half the account value divided by your state's medicaid rate = number of months of penalty).
What to do? Forget the lawyer!!! He has no authority and in the end, really no interest. You will pay ridiculous amounts of money and get no result...I promise you!
Instead, call whatever the equivalent is for Adult Protective Services in your state (the Long-Term Care Ombudsman typically only deals with matters between a facility and a resident, not matters between family members and residents so they would be the wrong agency to contact). They LOVE cases like this.
The reason you want to do this is: 1. It will scare the bejeesus out of your sister, 2. It will be a lot easier to have a third party involved instead of he said/she said and you don't have evidence to call in the police. 3. When you apply for Medicaid you are going to ask for a "hardship exception" to the imposition of penalty so you want your story documented. Having it documented as elder financial abuse will help you in your dad's cause.
If, other than this issue your father's assets are spent down, forget about the lawyer when applying for medicaid as well. Let the facility do it. If you need an attorney to handle the hardship issue (which you shouldn't) find one who will bill you hourly without a retainer. see more
Medicaid does not care about what happened to your father's money. The only thing that is important to them is that the money was there and now it is not and it is now considered a gift.
Medicaid does not "go after money" until the recipient is dead. At death, the state will initiate an estate recovery process and if there are probatable assets they will attempt to recoup the cost of care. If fraud is perpetrated against Medicaid a referral could be made to the states attorney's general office for prosecution but nothing of the sort has occurred here.
It is ludicrous to think that a state agency is going to go running around looking for applicant's money either before or during claim...they just deny benefits if there is any question.
What may happen is that a penalty period of ineligibility will be imposed. I have no idea what the amount in question is, but if it is around $35k as your account was your father could be looking at a penalty of up to 3 or 4 months. (One half the account value divided by your state's medicaid rate = number of months of penalty).
What to do? Forget the lawyer!!! He has no authority and in the end, really no interest. You will pay ridiculous amounts of money and get no result...I promise you!
Instead, call whatever the equivalent is for Adult Protective Services in your state (the Long-Term Care Ombudsman typically only deals with matters between a facility and a resident, not matters between family members and residents so they would be the wrong agency to contact). They LOVE cases like this.
The reason you want to do this is: 1. It will scare the bejeesus out of your sister, 2. It will be a lot easier to have a third party involved instead of he said/she said and you don't have evidence to call in the police. 3. When you apply for Medicaid you are going to ask for a "hardship exception" to the imposition of penalty so you want your story documented. Having it documented as elder financial abuse will help you in your dad's cause.
If, other than this issue your father's assets are spent down, forget about the lawyer when applying for medicaid as well. Let the facility do it. If you need an attorney to handle the hardship issue (which you shouldn't) find one who will bill you hourly without a retainer. see more
Question
If my in-laws move to a senior living facility and I am the one taking care of them now, will Medicaid pay me...
Isn't the point of moving to assisted living so that you will not need to take care of them? I ask this with a bit of tongue in cheek... Isn't the point of moving to assisted living so that you will not need to take care of them? I ask this with a bit of tongue in cheek as we all know that those receiving care no matter what the venue require advocacy and often additional care - if only to manage the personal affairs and care.
Medicaid will not pay you and in general will do so only very limited circumstances (see Medicaid waiver programs: Cash and Counseling).
What you may be thinking of is creating a personal service contract with your in-laws. This is a technique sometimes used to help those seeking Medicaid benefits reduce assets while providing funds to a family member to provide personal services.
If properly executed and performed, the personal services contract between a parent and child will permit a lump amount to be transferred to the child without creating a penalty period of ineligibility. see more
Medicaid will not pay you and in general will do so only very limited circumstances (see Medicaid waiver programs: Cash and Counseling).
What you may be thinking of is creating a personal service contract with your in-laws. This is a technique sometimes used to help those seeking Medicaid benefits reduce assets while providing funds to a family member to provide personal services.
If properly executed and performed, the personal services contract between a parent and child will permit a lump amount to be transferred to the child without creating a penalty period of ineligibility. see more
Question
If my wife and I are both on disability and have health problems can we get life insurance?
Life insurance can be a very unwise purchase for those who are older with limited incomes and failing health. Your options will be limited... Life insurance can be a very unwise purchase for those who are older with limited incomes and failing health. Your options will be limited to guaranteed issue plans like those you see on TV. If you have the disposal income and really want it, go for it.
However, if you are younger, let's say in your mid 50's, you may want to consider saving the premiums in a dedicated account (if you have the discipline) instead of buying insurance.
When you do the arithmetic on these plans you will be surprised how quickly your premiums make up the bulk of the death benefit. see more
However, if you are younger, let's say in your mid 50's, you may want to consider saving the premiums in a dedicated account (if you have the discipline) instead of buying insurance.
When you do the arithmetic on these plans you will be surprised how quickly your premiums make up the bulk of the death benefit. see more
Question
If my mother is caring for my father and they are divorced, is she still eligible for compensation through his...
I re-read your question and want to make sure I have it right. My first reply was under the scenario that your father is a veteran and... I re-read your question and want to make sure I have it right. My first reply was under the scenario that your father is a veteran and needs care that your mother is willing to provide even though they are divorced.
My reply was based on your father applying for benefits as a single veteran with the desire to compensate your mother for caregiving.
If that is correct, then my answer stands.
If, however, the question is, as Patricia intimated, whether your mom is eligible to receive a benefit herself directly the answer is absolutely not. In fact, as a divorced spouse she will not be eligible for a surviving spouse benefit either. see more
My reply was based on your father applying for benefits as a single veteran with the desire to compensate your mother for caregiving.
If that is correct, then my answer stands.
If, however, the question is, as Patricia intimated, whether your mom is eligible to receive a benefit herself directly the answer is absolutely not. In fact, as a divorced spouse she will not be eligible for a surviving spouse benefit either. see more
Question
How do you become a caregiver?
There are several considerations to take into account. Besides the obvious (is she qualified, do you get along, can you count on her, rate... There are several considerations to take into account. Besides the obvious (is she qualified, do you get along, can you count on her, rate of pay, etc.) you must determine the nature and formality of the agreement you will have with her.
I am sure that if there is one thing you have learned in your 80 years it is that whether by happenstance or design, things change. When hiring or conducting business with family members it is always difficult to make changes if needed so you must keep that in mind and afford yourself the most flexibility as possible.
It is with this thought, and the possibility that public benefits of same nature may be required down the road, that I suggest you enter into a formal Personal Care Agreement with your niece.
If executed properly you will have established a bonefide agreement and you will be able to point to the agreement in the event that things are not working out.
As importantly, without such an agreement if you or your husband find that you want or need to apply for public benefits in the future your payments to her could be deemed penalty imposing gifts as opposed to payment for services (with the agreement you could even make a lump sum payment for services which could be very helpful in Medicaid planning).
If she is only working for you in a service capacity it is unlikely she will be deemed an independent contractor from an IRS perspective which means that you and she will be responsible for regular employment taxes such as FICA and Social Security. If she is working in the same field for more than one person then she may be eligible for independent contractor status and will be responsible for her own tax filings.
I believe you should give you and your husband the most protection and execute a formal agreement (including terms of dismissal). If you do decide to pay her "off the books" please make sure you get a receipt from her describing the service provided and always pay her by check.
Lastly, although an RN, if she has not had formal training in geriatric caregiving I would encourage you to encourage her to take a Certified Home Health Aide course so she at least knows the basics of elder care. see more
I am sure that if there is one thing you have learned in your 80 years it is that whether by happenstance or design, things change. When hiring or conducting business with family members it is always difficult to make changes if needed so you must keep that in mind and afford yourself the most flexibility as possible.
It is with this thought, and the possibility that public benefits of same nature may be required down the road, that I suggest you enter into a formal Personal Care Agreement with your niece.
If executed properly you will have established a bonefide agreement and you will be able to point to the agreement in the event that things are not working out.
As importantly, without such an agreement if you or your husband find that you want or need to apply for public benefits in the future your payments to her could be deemed penalty imposing gifts as opposed to payment for services (with the agreement you could even make a lump sum payment for services which could be very helpful in Medicaid planning).
If she is only working for you in a service capacity it is unlikely she will be deemed an independent contractor from an IRS perspective which means that you and she will be responsible for regular employment taxes such as FICA and Social Security. If she is working in the same field for more than one person then she may be eligible for independent contractor status and will be responsible for her own tax filings.
I believe you should give you and your husband the most protection and execute a formal agreement (including terms of dismissal). If you do decide to pay her "off the books" please make sure you get a receipt from her describing the service provided and always pay her by check.
Lastly, although an RN, if she has not had formal training in geriatric caregiving I would encourage you to encourage her to take a Certified Home Health Aide course so she at least knows the basics of elder care. see more
Question
Do Independent Living Facilities accept social security checks or Medicare for payment?
Hi... As far as I know, there is never a circumstance where "...a person's Social Security check will be taken for payment"... Hi...
As far as I know, there is never a circumstance where "...a person's Social Security check will be taken for payment" for anything.
Social Security is an entitlement benefit. It is income to you. It is up to you how you spend it. Sometimes when applying for public benefit programs an individual is required to spend their income on care first. In that case the individual may "assign" their Social Security benefit to a third party but that is a voluntary action in the process of application, not a seizure.
In other cases, Social Security benefits may actually be protected for the benefit of a spouse or a minor/disabled child when applying for benefits.
If you are a disabled vet looking for care assistance I urge you to look into non-service connected disability pensions called basic, homebound, and aid and attendance. The largest benefit being the last. You can find information at the VA website http://www.vba.va.gov/bln/21/pension/vetpen.htm see more
As far as I know, there is never a circumstance where "...a person's Social Security check will be taken for payment" for anything.
Social Security is an entitlement benefit. It is income to you. It is up to you how you spend it. Sometimes when applying for public benefit programs an individual is required to spend their income on care first. In that case the individual may "assign" their Social Security benefit to a third party but that is a voluntary action in the process of application, not a seizure.
In other cases, Social Security benefits may actually be protected for the benefit of a spouse or a minor/disabled child when applying for benefits.
If you are a disabled vet looking for care assistance I urge you to look into non-service connected disability pensions called basic, homebound, and aid and attendance. The largest benefit being the last. You can find information at the VA website http://www.vba.va.gov/bln/21/pension/vetpen.htm see more
Question
If my mother is caring for my father and they are divorced, is she still eligible for compensation through his...
If Dad's disability is not due to service connection he may be eligible for an improved pension benefit. There are three levels: ... If Dad's disability is not due to service connection he may be eligible for an improved pension benefit. There are three levels: basic pension, housebound, and aid and attendance. The greatest benefit is the last (up to $1,650 per month for a single vet).
The benefit is intended for those veterans who meet service and financial requirements. For housebound and aid and attendance there is an additional medical or disability requirement.
The benefit is paid monthly direct to the veteran or his/her fiduciary. The veteran can use the funds in any manner they see fit including professional home health care, assisted living facilities, AND TO PAY VIRTUALLY ANYONE WHO IS WILLING TO PROVIDE CARE INCLUDING A FAMILY MEMBER.
Depending on how the case is presented to the VA, your Dad may indeed be eligible for the benefit. He could then in turn make whatever arrangement he would like with your mother.
You can learn more at the VA website: http://www.vba.va.gov/bln/21/pension/vetpen.htm see more
The benefit is intended for those veterans who meet service and financial requirements. For housebound and aid and attendance there is an additional medical or disability requirement.
The benefit is paid monthly direct to the veteran or his/her fiduciary. The veteran can use the funds in any manner they see fit including professional home health care, assisted living facilities, AND TO PAY VIRTUALLY ANYONE WHO IS WILLING TO PROVIDE CARE INCLUDING A FAMILY MEMBER.
Depending on how the case is presented to the VA, your Dad may indeed be eligible for the benefit. He could then in turn make whatever arrangement he would like with your mother.
You can learn more at the VA website: http://www.vba.va.gov/bln/21/pension/vetpen.htm see more
Question
What is a last will and testament?
I am sorry to hear you are facing such a challenging situation and, as you are learning, one of the most important aspects of elder care... I am sorry to hear you are facing such a challenging situation and, as you are learning, one of the most important aspects of elder care planning is making sure the correct documentation is in place.
There are two aspects to handling your parent's affairs; while they are alive, and when they are deceased. A will, and the segment you quoted above, only operates upon death. To handle the affairs of a disabled or incompetent parent while alive you need to be named as attorney in fact via a Durable Power of Attorney or you could act as a successor trustee if assets are held in a revocable living trust.
So the first question is: Do you have a Durable Power of Attorney? I'm assuming "PG" means Personal Guardian which is what happens (guardianship) when an incompetent or disabled individual does not have proper advance paperwork. If your mom has a guardian then I'm guessing you do not have proper paperwork in place to handle your father's affairs and, just like your mom, a court appointed guardian may be required.
As far as what the guardian is permitted to do, typically their activity is very limited in scope in terms of what he/she can or cannot do with assets/income and is also closely monitored by the court. You can always go to court to protect your father's interests but you will have obtain standing via guardianship or one of the documents mentioned above.
Most importantly, if Dad is on Medicaid you do not want him to inherit anything of value that will potentially disqualify him from benefits. see more
There are two aspects to handling your parent's affairs; while they are alive, and when they are deceased. A will, and the segment you quoted above, only operates upon death. To handle the affairs of a disabled or incompetent parent while alive you need to be named as attorney in fact via a Durable Power of Attorney or you could act as a successor trustee if assets are held in a revocable living trust.
So the first question is: Do you have a Durable Power of Attorney? I'm assuming "PG" means Personal Guardian which is what happens (guardianship) when an incompetent or disabled individual does not have proper advance paperwork. If your mom has a guardian then I'm guessing you do not have proper paperwork in place to handle your father's affairs and, just like your mom, a court appointed guardian may be required.
As far as what the guardian is permitted to do, typically their activity is very limited in scope in terms of what he/she can or cannot do with assets/income and is also closely monitored by the court. You can always go to court to protect your father's interests but you will have obtain standing via guardianship or one of the documents mentioned above.
Most importantly, if Dad is on Medicaid you do not want him to inherit anything of value that will potentially disqualify him from benefits. see more
Question
How do we try applying for medicaid to help pay nursing home when she makes too much w/ benefits to reduce VA...
The key phrase in the question is "...makes too much." This indicates to me that you are concerned about income and not assets. ... The key phrase in the question is "...makes too much." This indicates to me that you are concerned about income and not assets.
If the perceived problem is that Social Security + Vet benefits + any other income brings the Medicaid applicant to over $2022 and, therefore, over the qualifying income limit, then here is the solution:
The Irrevocable Qualified Income Trust (aka QIT or Miller Trust), permitted since the implementation of OBRA '93, allows the applicant to gift excess income over the cap to the trust and thereby qualify for Medicaid if all other eligibility requirements are met.
So yes, there is a very effective way to qualify for Medicaid if income is too high. see more
If the perceived problem is that Social Security + Vet benefits + any other income brings the Medicaid applicant to over $2022 and, therefore, over the qualifying income limit, then here is the solution:
The Irrevocable Qualified Income Trust (aka QIT or Miller Trust), permitted since the implementation of OBRA '93, allows the applicant to gift excess income over the cap to the trust and thereby qualify for Medicaid if all other eligibility requirements are met.
So yes, there is a very effective way to qualify for Medicaid if income is too high. see more
Question
Can my mother still receive my father's social security after she dies?
Perhaps you misstated your question? Did you mean after "he" dies? If that is the question, then here is the answer: If both... Perhaps you misstated your question? Did you mean after "he" dies? If that is the question, then here is the answer:
If both are receiving Social Security when he dies then mom gets to pick either his benefit or her benefit. Usually the highest is selected (sensibly!). This is a huge problem for so many elder households, losing a third to one-half of income upon the demise of a spouse.
Was dad a vet? As a surviving spouse she may be eligible for up to $1,000 per month for care when the time comes. See: http://www.vba.va.gov/bln/21/pension/vetpen.htm#7 see more
If both are receiving Social Security when he dies then mom gets to pick either his benefit or her benefit. Usually the highest is selected (sensibly!). This is a huge problem for so many elder households, losing a third to one-half of income upon the demise of a spouse.
Was dad a vet? As a surviving spouse she may be eligible for up to $1,000 per month for care when the time comes. See: http://www.vba.va.gov/bln/21/pension/vetpen.htm#7 see more
Question
What should I do if the facility my parents are living in put them in independent living, when they really nee...
I don't believe I have ever heard of a facility refusing to move a resident to assisted living. However, from what you are describing,... I don't believe I have ever heard of a facility refusing to move a resident to assisted living. However, from what you are describing, your parents don't need just assisted living, they need secure dementia care. Is that the reason they don't want to move therm?
My first reaction was if the staff where they are is not responsive, move. However this is not, obviously, at all easy. If the community does not have a way to ensure your parent's security then a move may be in order in any event.
I would request an appointment with the Executive Director and the Director of Nursing together. I would avoid engaging in antagonistic language or tone. I would ask them point blank if they have the interest and/or, more importantly, the capacity, to ensure your parents well being and safety and see what they have to say.
You will then be able to make your decision. see more
My first reaction was if the staff where they are is not responsive, move. However this is not, obviously, at all easy. If the community does not have a way to ensure your parent's security then a move may be in order in any event.
I would request an appointment with the Executive Director and the Director of Nursing together. I would avoid engaging in antagonistic language or tone. I would ask them point blank if they have the interest and/or, more importantly, the capacity, to ensure your parents well being and safety and see what they have to say.
You will then be able to make your decision. see more
Question
Will Medicaid pay for my mother to go to an Assisted Living facility?
As mentioned, it depends on the state in which you live. Many states have what are known as Medicaid waiver services. This means the... As mentioned, it depends on the state in which you live. Many states have what are known as Medicaid waiver services. This means the state has gone to the feds with a plan to use Medicaid dollars in different ways. Sometimes these waiver services include nursing home long-term care diversion programs.
These programs are generically known as Home and Community Based Services and are intended to help those who would otherwise be eligible for nursing home benefits receive care in less intensive and therefore, hopefully, less expensive, venues.
So, for instance, here in Florida we have nursing home long-term care diversion program. It is managed by private companies that receive a monthly fee (called a "capitation") from the state to offer a continuum of long-term care services to those eligible for both Medicare and Medicaid ("dual eligibles").
Services may be provided in the home, in an assisted living facility, or a nursing home. Most diversion programs will pay approximately $1,000 towards the cost of an assisted living facility.
To participate in long-term care diversion the applicant must meet the same Medicaid requirements as for institutional care; both medical an financial.
Was dad or mom a veteran? If so, you may be looking at another $1,000 + per month towards assisted living via the non-service connected disability benefit known as "Aid and Attendance". see more
These programs are generically known as Home and Community Based Services and are intended to help those who would otherwise be eligible for nursing home benefits receive care in less intensive and therefore, hopefully, less expensive, venues.
So, for instance, here in Florida we have nursing home long-term care diversion program. It is managed by private companies that receive a monthly fee (called a "capitation") from the state to offer a continuum of long-term care services to those eligible for both Medicare and Medicaid ("dual eligibles").
Services may be provided in the home, in an assisted living facility, or a nursing home. Most diversion programs will pay approximately $1,000 towards the cost of an assisted living facility.
To participate in long-term care diversion the applicant must meet the same Medicaid requirements as for institutional care; both medical an financial.
Was dad or mom a veteran? If so, you may be looking at another $1,000 + per month towards assisted living via the non-service connected disability benefit known as "Aid and Attendance". see more
Question
Where can my mother, who can't be alone during the day, live on Social Security Income alone?
If mom's only income is SS, has no assets, and is age 65+, she will, if she applies, be a "dual eligible" which means... If mom's only income is SS, has no assets, and is age 65+, she will, if she applies, be a "dual eligible" which means eligible for both Medicare and Medicaid.
As such, she will have many options depending on the level of care required. Something to be mindful of when accessing resources from public agencies is that, some agencies are more prone to recommend or, at the very least, be much more familiar with, some programs more than others.
It may not surprise you to learn that just as in the corporate world, there is competition in the non-profit world and the social service sectors of government as well. Mostly they are competing for funding whether federal, state, or local or private.
Some agencies are also "lead" agencies for certain programs and not others. To overcome this just make sure you contact both resources mentioned above. Additionally, the Texas Medicaid program is administered by this agency
http://www.hhsc.state.tx.us/
To specifically answer your question, your mom will be eligible for low-cost independent housing or, if there is need, she may be able to find an adult family home (an assisted living style residence but much smaller) that Medicaid will help subsidize the cost of.
Parenthetically, if your only concern is here being supervised during the day, you might consider adult day care. Many programs are free or again, mom may be eligible for help.
Lastly, if mom or dad are/were veterans, help is also available. Contact your county elderly and veterans services division. see more
As such, she will have many options depending on the level of care required. Something to be mindful of when accessing resources from public agencies is that, some agencies are more prone to recommend or, at the very least, be much more familiar with, some programs more than others.
It may not surprise you to learn that just as in the corporate world, there is competition in the non-profit world and the social service sectors of government as well. Mostly they are competing for funding whether federal, state, or local or private.
Some agencies are also "lead" agencies for certain programs and not others. To overcome this just make sure you contact both resources mentioned above. Additionally, the Texas Medicaid program is administered by this agency
http://www.hhsc.state.tx.us/
To specifically answer your question, your mom will be eligible for low-cost independent housing or, if there is need, she may be able to find an adult family home (an assisted living style residence but much smaller) that Medicaid will help subsidize the cost of.
Parenthetically, if your only concern is here being supervised during the day, you might consider adult day care. Many programs are free or again, mom may be eligible for help.
Lastly, if mom or dad are/were veterans, help is also available. Contact your county elderly and veterans services division. see more
Question
How can I get dad to move without having the house condemned?
Carol is right. There are many circumstances that are beyond the control of family or other loved ones. Frankly, I'm surprised more... Carol is right. There are many circumstances that are beyond the control of family or other loved ones. Frankly, I'm surprised more families do not take advantage of what in Florida we call Adult Protective Services.
As a unit of our Department of Children and Families, trained caseworkers are sent to the home to assess and evaluate the health and safety of an elder. I have had cases where siblings were squabbling to such an extent that mom was being neglected and placed in danger. You wouldn't believe how quickly everyone started singing a different tune once the "authorities" were involved.
For those that are alone, Adult Protective Services will make sure that there utilities, food, and medical care available or move the elder to another venue if required. see more
As a unit of our Department of Children and Families, trained caseworkers are sent to the home to assess and evaluate the health and safety of an elder. I have had cases where siblings were squabbling to such an extent that mom was being neglected and placed in danger. You wouldn't believe how quickly everyone started singing a different tune once the "authorities" were involved.
For those that are alone, Adult Protective Services will make sure that there utilities, food, and medical care available or move the elder to another venue if required. see more
Question
Can an assisted living facility require a resident to pay for a personal sitter?
Yes. The facility has an obligation to make sure their residents are safe. They may request that to continue residing there that... Yes. The facility has an obligation to make sure their residents are safe. They may request that to continue residing there that additional services be implemented. If not agreed to, they have the right to ask the resident to leave (45 days notice).
More care = more expense. Check into Medicaid Long-Term Care Diversion programs in your state as well as VA non-service connected pensions if the resident is or was married to a veteran. see more
More care = more expense. Check into Medicaid Long-Term Care Diversion programs in your state as well as VA non-service connected pensions if the resident is or was married to a veteran. see more
Question
Does my mother need a private-pay medical policy in addition to being on Medicare and Medicaid?
Assuming she is over age 65 probably not. As a "dual-eligible" participating in both Medicare and Medicaid your mom's... Assuming she is over age 65 probably not. As a "dual-eligible" participating in both Medicare and Medicaid your mom's primary insurer continues to be Medicare. Medicaid now acts as her "secondary" and pays her Medicare deductibles and co-payments as well as her Part B Medicare premium. As a Medicaid recipient she is required to have a Part D Medicare Rx plan the premium for which is also subsidized; her Rx co-pays go down to $1 and $5 and there is no Rx "doughnut hole".
Some of my clients have employer based retirement health plans which they keep; others are in HMO's or other managed care plans which they prefer to remain involved with.
Unless there is some extenuating circumstance, there really is no reason to keep it. If anything, I would save the money to "buy-up" to a better Part D prescription drug plan.
As you may or may not know, different plans have different prices AND different formularies. The lower priced plans, those subsidized by Medicaid, may not have the meds your mom needs at some point. When and if that time arrives she can, as a low-income dual eligible, switch plans at any time of year to one that would meet her needs (and which will probably be more expensive). see more
Some of my clients have employer based retirement health plans which they keep; others are in HMO's or other managed care plans which they prefer to remain involved with.
Unless there is some extenuating circumstance, there really is no reason to keep it. If anything, I would save the money to "buy-up" to a better Part D prescription drug plan.
As you may or may not know, different plans have different prices AND different formularies. The lower priced plans, those subsidized by Medicaid, may not have the meds your mom needs at some point. When and if that time arrives she can, as a low-income dual eligible, switch plans at any time of year to one that would meet her needs (and which will probably be more expensive). see more
Question
I’m the executor of my mother’s estate. The language used in her will sounds to me like her estate will not go...
The primary purpose of a will is disposition of property. However not all property owned by a decedent is subject to disposition by a... The primary purpose of a will is disposition of property. However not all property owned by a decedent is subject to disposition by a will.
Many of the things our benefactors own are not subject to their will or probate. For instance, most life insurance and annuity contracts name a non-estate beneficiary that is paid directly upon claim (this is called operation of law or contract). Same holds true for many bank and brokerage accounts these days that have Payable on Death or Transfer on Death provisions. Joint accounts will usually pass to the other owner sans probate. Assets titled in Revocable Inter-Vivos or Living Trust agreements are administered and disposed of by successor trustees named in the document and real property, too, is often titled so as to pass to an heir while avoiding probate.
In short, anything that does not go to a beneficiary directly will be subject to the deceased will. AND ALL WILLS, AS WELL AS ASSETS THAT DO NOT PASS BY OPERATION OF LAW OR CONTRACT, ARE SUBJECT TO PROBATE. All of that other gobbledgook simply says you can do whatever you want once the estate has been administrated. see more
Many of the things our benefactors own are not subject to their will or probate. For instance, most life insurance and annuity contracts name a non-estate beneficiary that is paid directly upon claim (this is called operation of law or contract). Same holds true for many bank and brokerage accounts these days that have Payable on Death or Transfer on Death provisions. Joint accounts will usually pass to the other owner sans probate. Assets titled in Revocable Inter-Vivos or Living Trust agreements are administered and disposed of by successor trustees named in the document and real property, too, is often titled so as to pass to an heir while avoiding probate.
In short, anything that does not go to a beneficiary directly will be subject to the deceased will. AND ALL WILLS, AS WELL AS ASSETS THAT DO NOT PASS BY OPERATION OF LAW OR CONTRACT, ARE SUBJECT TO PROBATE. All of that other gobbledgook simply says you can do whatever you want once the estate has been administrated. see more
If my mother and I are co-owners of a cooperative apartment in NY and she is the primary residence, is the pro...
What would be the consequences? Upon application the amount of all gifts are totaled to determine a penalty period of ineligibility expressed in months. So she would not be eligible to receive benefits for a period of time.
All of this may be moot, however, depending on when the gift was completed. Old law: 36 month look-back on gifts. New law for gifts made after 2/7/06: 60 months
Of course this is all REALLY moot if you did indeed pay for half the coop and can prove it.
Eligibility is one thing. What happens if she receives Medicaid benefits and then passes away? Medicaid will attempt "estate recovery" from probate assets.
So, whether mom eventually applies for Medicaid or not, you should structure ownership to avoid probate...it is such a pain! see more