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My mother is 68 and currently covered under Medicare Part A and B. She is currently in a rehab facility. I am trying to apply for Medicaid in the state of New York but she is not being forthcoming about her assets. I know she has 401k that she received in her divorce and annuity that she has surrendered and is withdrawing funds from. If I don’t provide the documentation with the Medicaid application, will Medicaid locate the assets while reviewing her application? I’ve been trying to explain to her that she will need additional Medicaid coverage for her long term care, such as medications, etc.

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Cturner; Welcome to the forum!

Are you applying for Community Medicaid for your mom or for Long Term Care Medicaid?

Does she have a prescription plan (Part D) right now?

If she has assets and decent insurance, she may not need to apply for Medicaid now.

Is the rehab going well, or are they recommend that she stay there for long term care?

Do you have durable Power of Attorney for her?

Sorry for the many questions, but you will get better information the more information WE have.
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You do not want to apply for Medicaid until she has less than $2,000.00 in assets. And it does not sound like that is the case. Her assets need to be used for her care. Is mom incapacitated or being stubborn and saying her assets are none of your business?
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Turner's last post
https://www.agingcare.com/questions/need-to-transfer-mother-to-hospital-in-another-state-does-anyone-have-any-advice-or-resources-469003.htm?orderby=oldest

Last week my mom was admitted to the hospital with a perforated bowel and sepsis. She lives in Brooklyn, NY by herself and I live in Northern Virginia. She had surgery to repair her intestine and treat the sepsis. She is on Medicare and I would like to transfer her to a hospital in Northern Virginia to continue her care. She is currently admitted to Mount Sinani in Brooklyn, NY. I am very new to this and I don't know where to start. Does anyone have any advice or resources?
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If she has assets they must be used to pay for her care. Once she has spent most of her money only then can you expect to receive Medicaid. Medicaid is not a retirement program you pay into over time like Social Security. It's a welfare program meant to provide care for the truly indigent who have no funds.

And in many cases Medicaid can legally recover fees from the "estate" of a deceased person, money and assets that were reserved for the support of a spouse or dependent.

So in answer to your question your first step is to arrange a meeting with a Medicaid case worker. If you don’t have a POA then you can’t really discuss specifics but can at least get a better understanding of their process and what information will be needed and what information they can access.

Also, talk to the business manager at your mom's facility. They are usually pretty familiar with dealing with Medicaid.

Please note that it might take several month to get the info processed when you do apply.
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rovana Aug 2021
I suspect that Medicaid workers are not really willing to do the work of a forensic accountant (such as a divorce attorney would hire). Frankly don't see how they would have the time or skills of a forensic accountant. Why would they not put it on the applicant to do the ferreting out of financial information? Does this elder understand how LTC Medicaid works?? Or is it more a case of simply stubbornly refusing to give out financial information, but perhaps hoping Medicaid will accept her stubborn refusal and cover her because "she is a poor old lady"?
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CT, I hope you're still with us!

So mom is currently in rehab, right? Is the plan for her to stay there as a long term resident?

Is the social worker suggesting that you apply for Medicaid for her?

If mom is indeed in Brooklyn, you can call JASA: https://jasa.org/about/locate#tab2. If they aren't thecright agency, they can most likely tell you who is.

What you are looking for is Case Management services (there may be a waiting list).

You need a social worker who can be in touch with mom and you and explain the process of getting her help at home.
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Yes, we need to know what type of Medicaid. Just for health insurance or for her stay in the Rehab or LTC.

You need to find out what money she has. Medicaid at this point may not be needed. She needs to be forthcoming. With Medicaid for health, she can have some assets. Medicaid for her care in rehab or LTC, as said, she can only have about 2k in assets. Her house would not count.

I have a feeling that Mom has reached her 20 days that Medicare pays 100%. The next 21 to 100 days Medicare pays only 50%. So Mom is responsible for paying the other 50%. If she has a secondary insurance they may pay it all or partial but with my Mom they didn't and she owed $150 a day. The Rehab is trying to find out if Mom has money to pay the balance. Mom needs to prove to them she has or doesn't have the money. With a 401k and an annuity plus her SS sounds to me she has money. If so, doing a Medicaid application is useless and time consuming.
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rovana Aug 2021
If mom refuses to cooperate, then how should OP proceed?
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Assume Medicaid will find everything. It is always better to be honest than to pay back benefits that she may not be entitled to.
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Kashi60 Aug 2021
They found a CD that we didn’t know about and my Dad had forgotten..so assume they can find anything.
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FPOA:

A steady income, such as Soc. Sec., a 401K and a checking or savings etc is a good start. She likely has a checking account into which any monthly incomes received are direct-deposited.
Social Security earnings records will show all earnings reported to Social Security within her lifetime. Medicaid can obtain this document if you or your mom can't.
401K or other financial deposits/activities may be easiest by looking for steady, regular deposits into/out of accounts. Bank statements are a good way to view utility expenses, any regular credit account activity, and just give you a good, educated sense of where she's at today. Information from this can lead you to other important sources of information.
You want to impress upon Medicaid and those to whom you ever need to present your FPOA document, that you are performing your due-diligence.
If you can't locate Mom's tax returns, the IRS sends transcripts of prior tax returns to Medicaid. During the Medicaid application process, my spouse and I were required to sign a consent form to release 5 year's tax forms to Medicaid. We were never required to present in person. I knew the information on our tax forms but still reviewed as if I'd never signed a form in my life.

Due diligence is the only reason I reviewed our taxes the 5 prior years.
If Medicaid or any others are asking for any piece of information, it needs your careful thought and review. I was ready with answers/documents per inquisitions. Sometimes, one department or agency calls. They can't make sense of something or want to verify or detect information. If Mom has not been forthcoming about anything financial over the years, the lookback will be more of a hunting expedition.

Any documents you are asked to submit are worthy of your review first. They will be reviewed by many and perhaps multiple times. Each set of eyes may see something different. Each computer data base may figure things a little different. So what you see prior to turning over any document is important. Due diligence on your mom's behalf will save both of you many headaches and heartaches. 5 year's lookback is a bit much.

As if you don't already have enough to do, an upfront task solely for your own sanity - create a chart that works for you. I suggest both a hard copy on a bulletin board or in a steady paper folder, and a stored document on your computer. Each bit of information you obtain about any account/whose name/s is on that account, doctor contacts, auto registration etc.

Give yourself the gift of organizing upfront. Column 1 listed the dates all payments were due on existing accounts.
Column 2 listed the address to which I had to mail any payments or correspondence.
Column 3 listed payment due date and whether by mail or bank draft.
Column 4 listed the name as it appeared on that account. (Names may be listed any number of ways - full name, nick name, birth name, hyphenated name, deceased spouse's name etc.) The exact name + DOB + SS = access to many accounts once you've established yourself as representative of Mom's affairs. (FPOA) Any inconsistent or non-match can lock the account.
Column 5 listed the contact phone number/s.
Column 6 listed the account number.

IF willing to give direct extension line, I listed the name/number. Important given 2 states and COVID considerations these days.

FPOA permits online review/payment, balances/debits/transfers.
Since you're in separate states it may pay - financially and mentally to make appointments to either submit documents in person, by mail, FED-EX, FAX.

Since this is new to you and the persons, businesses, or providers don't know you, if you must visit anyone in person be dressed for business. Just like a job applicant, or when put in a position of establishing your identity and honesty it's a good idea to act professional and express concern for your mom. They are vetting you during this whole process.
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They will locate it and she can get in trouble for fraud. You’re only allowed 2 to 3 thousand in assets to qualify for Medicaid.
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Sorry to say it is the duty of the person applying for medicaid to provide the information. When applying for dad to go on medicaid, I used an attorney since my mother would be the non-medicaid spouse. I ran myself to death tracking down documents.

Luckily they no longer owned property or car. But while going through the documents they previously gave me for safekeeping I found 2 life insurance policies for dad - I assumed they were no longer in force but did due diligence and while the company was no longer in business did find which company took over the policies and surprise they were still in force. One showed, they were policies his mother bought when he was about 14 and then when he was about 21. I thought his mother who'd been dead for 50 years and his brother who'd been dead 30 years were still beneficiaries - later found the benes had been updated to mom.

You'll need to see if there are any safe deposit boxes, insurance policies, real estate holdings, car ownership, stocks/bonds, bank accounts, retirement accounts, canceled checks - the state or the attorney you may use should have a list of what to look for.

Dad's attorney gave me an initial list of documents which included IDs, birth certificates, marriage certificates and on and on and on. As I scanned documents and forwarded them to the attorney and checked off what was found and forwarded. Of course after the first round of documents there were others needed as well.

Good Luck.
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