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My mom has late stage Alzheimer’s. She moved from Memory Care to a skilled nursing facility at the end of February 2024. She had been broke for about 18 months at that point.
I have POA. I applied for Medicaid immediately. After several months, Medicaid has now come back and denied my mom based upon a $5000 TERM LIFE insurance policy that was given to her from her former employer as a retiree benefit.
All parties involved have known all along that she had this policy - Medicaid office and the nursing facility. At any point, they could have told me to get rid of it. But I was told by the nursing facility that it wasn’t countable. Now that the Medicaid agent says it is, the nursing home is just shrugging.
I question whether a term life plan truly is countable. There is NO CASH VALUE.
Mom does have a prepaid burial contract if just over $9000. The Medicaid agent stated that, after she deducted certain non-countable items like the casket and then added in the $5000 life policy, mom is about $350 over the $10,000 limit.
I’ve spent two days now attempting to find the appropriate party at her former employer to surrender this policy. I’ve had no luck yet. But the clock is ticking. I’ll continue trying.
Now that we’ve been denied, we’ll have to reapply and I believe any acceptance is retro for only three months prior to the application date.
The nursing home keeps telling me that we’re considered “private pay”. And I’ve made it known to them that “nobody has the $$$ to pay for all these months”. They are currently receiving a little of $1300 each month from mom’s social security check.
Any advice is appreciated! I feel like I’m staring at the abyss.

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FINAL UPDATE:

The funeral home rewrote the contract for $500 less. He issued a $500 refund to my mom. I’ve already deposited it into her account. I then gave him $500 of my money for a separate contract in my name (on her behalf) to be able to add back in that $500 funeral service. And I really appreciated them doing this for us.

I’m taking the new contract and proof the money was deposited to mom’s bank account in to the nursing home tomorrow. The Medicaid agent has told them that mom should now be eligible. So, let’s hope Medicaid doesn’t change their mind on this (or find something else).

The only other hurdle we have now is a whole life plan that we discovered. Its cash value is around $2300. We’ve requested a cash out of it, and that money should be coming to us some time in the next couple of weeks. Mom has a couple of things she needs, and whatever money is left can just be given to the nursing home.

I THINK our 8-month wait for Medicaid may soon be over! Hoping she’ll be officially approved by November 1st
🙏🙏🙏

PS - I appreciate you all sharing this nightmarish journey with me. Lol.
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Geaton777 Oct 6, 2024
Yay! Thanks for taking the time to update us. We all benefit from the information.
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Just reread your question. If your looking for a paper policy, I have never received one from any employer I have had. I don't have one for my husband. Its part of his retirenent package. They have everything on file. A lot of companies, the policy amount dwindles down as the person ages. My FIL had a 100k employer policy. At 70, it decreased to 80k, at 71 ( he passed) it was 60k, 72 40k, 73 20k at 74 my MIL would have received nothing.
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Second update;

I’ve spoken to the funeral home. They’re willing to rewrite her contract dropping off $500 of the charges. And my husband and I will get a contract for those $500 charges and we’ll pay for it on her behalf.

I’ll just need to get a check back from the funeral home for $500 (made out to mom) and then swap him out a $500 check from us.

The Medicaid agent has stated this is acceptable.

And, if she denies us after that, I’ll proceed with the cancellation of the term life plan. I just need to give the employer a few days to process my POA and then “open her record”.

This whole process is enough to bring you to tears. 🙁
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AlvaDeer Oct 1, 2024
She is so lucky to have you. Folks without your abilities would be so lost in this. Thanks so much for your updating and know it's so appreciated.
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Don't think canceling that policy will work. Did you ask Medicaid if that will solve your problem. If it has no cash value, then it can't be used for her care.
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SatchimosMom Oct 1, 2024
The Medicaid agent was the one who told me to cancel the policy.
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Before surrendering the term life insurance can you consult with an eldercare attorney to confirm that the denial explanation is true? I would hate to see that lost because you are feeling pressure. The state you are applying should have a law in place that protects the resident from eviction if unable to pay while the application is pending as lomg a their income is being tranfered to facilty to pay a portion of bill. Or can you spend $500 from her account on personal items like clothing, blankets, dental or eye wear to get below the threshold.
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SatchimosMom Oct 1, 2024
I can’t just spend the money. That life insurance plan combined with the funeral contract puts us over the limit.
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Thank you for your update to us and hope you will continue to let us know how it is going.
I am so sorry for all the frustration in this. Such a mess of a beau acracy.
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UPDATE: I so very much appreciate everyone’s responses! Just to let y’all know - all of mom’s paperwork has been signed by me “as agent for (mom’s name)”. So, I think my husband and I are legally covered against owing any money.

But my concern is that they’ll get tired of waiting and evict my mom. And it took us over a year to find a nursing home willing to accept her in the first place. My husband and I footed the majority of the memory care costs for about 18 months while we searched.

Anyhow…I made a lot of calls on Friday. I did eventually find someone willing to talk to me at mom’s previous employer. They’ve found mom in their system but cannot even open her record without my POA.

I have now faxed them my POA. It’ll take a few days to process. Basically I’m asking them to cancel my mom’s life insurance policy.

But I’ve also been speaking to the nursing home regarding the burial contract and whether or not we can rewrite that contract and delete a few of the services of which we prepaid. (Since they’re saying we’re only about $350 over the limit). That would bring mom’s funeral/life insurance assets down below that $10,000 mark. This would be the quickest and easiest way I can think of to get the job done. The nursing home has reached out to the Medicaid agent to get an answer.

PS: I had previously read that the Medicaid process can be torturous. I THOUGHT I had all my ducks in a row going into this. I had all necessary paperwork to get this approved quickly. And I relied on the nursing home and Medicaid agent to navigate us through this - THEY ARE SUPPOSED TO BE THE EXPERTS! I know nothing about Medicaid! It’s been terribly disappointing to sit back for over half a year only to have them say “denied” based upon a life insurance policy that they’ve known about all along - and actually had me hunt down the policy papers months ago to prove it was a term life policy versus a whole life. After all of that, to pull the rug from under us seems cruel.
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Relax.
WE aren't private pay.
MOM is private pay.
And Mom has no assets. She is completely judgement proof.
Be very certain to sign NOTHING that makes you responsible for any bills. Sign only as POA or as Guardian or do not sign. Read everything you sign.
I know what that means because I did it; it's not pretty. Ask for coffee.

Now on to all this ridiculous; you are handling it correctly. If it continues to go south you may require an elder law attorney for a few hours of options on direction to take here.

What a mess. You must be SOOOOO frustrated. I think we are all getting more and more frustrated with how EVERYTHING works (more appropriately does NOT work) these days. I wish you luck. I just told someone else, deep breathes in and out. At least 10 of them. Often. I don't think I have more than that to offer you. I sure hope you will update us.
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I understood that employer policies did not count because the employer pays the policy. No cash value then it should not count. I don't know how it works with these policies but maybe Medicaid can become beneficiary. Its only 5k, won't even pay forv1 month in a NH. You need to talk to someone higher up than this caseworker.
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swmckeown76 Oct 6, 2024
It may depend on the state. In our state, I checked w/our elderlaw/estate planning attorney. She said that term life insurance was Medicaid-exempt, but whole life insurance was not. My late husband had term life insurance. Even if he hadn't died before requiring Medicaid (we could have paid for about another year before he died), I still would have received the proceeds of the policy so I kept paying the premiums and received the policy's face value + a little interest (they calculated interest from the day of his death until they received my application for the proceeds of the policy).
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If you are your Mom's PoA then contact HR at her former employer and tell them to stop paying the premiums on the term life policy. If you have your Mom's name (when she worked there), the dates when she worked there and the insurance policy in front of you (with the company and policy #) then I don't know why they can't figure it out.

When my 100-yr old Aunt passed away in 2023, she had a very small life insurance policy from an employer she worked for in the 70s. The company was still in business but had been bought twice since. Still, I was able to find a person in the company to cash out the policy.

You may be able to go through the insurance company and tell them your dilemma. They may be able to follow a payment trail back to the company. Someone is writing a check or authorizing a monthly payment somehow in that company.

Just today we had to deal with a similar issue: in a Medicaid re-application, my MIL was denied due to a recent purchase of a pre-paid cremation insurance policy (because in MN this is the only way to have it pre-paid). The only beneficiary is the Crematorium, not my MIL or anyone else. Somehow the processors at Medicaid don't know this even though it's been like this for a while. This is after we were on hold for *2 hours* waiting to talk to a human.

I wish you success in getting your Mom qualified.
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