I feel a little duped by the ALF...What exactly does it mean that the ALF will "work with us"?
A bit of a sensational headline there... but, made you look, eh?
So, here's the story. Moved my mom into an ALF in June. I was under the impression that the ALF we moved her into has some Medicaid beds and that when we are close to running out of private pay money the ALF will help us get Medicaid.
BUT... I was chatting with the ALF business manager the other day who said that they don't take Medicaid and that when the time comes they would move my mom into a double room and work with us. The BM said that the state (NC) wouldn't let my mom have Medicaid because she gets a VA benefit.
Mom currently has SSA, and VA Aid & Attendance, which together don't cover the full cost of her rent/care, so a few hundred dollars (give or take) come from other sources to cover the rest of the rent/care, prescriptions, and everything else. FYI (for the unaware) if she gets Medicaid, the VA benefit drops to $90/month.
So, what exactly does it mean, that the ALF will "work with us"? I fully expect that even if we move my mom into a double room, eventually the cost of her care will again outpace her means.
I like the place and I think the people who work there have their hearts in the right place. I don't want to move her again, she has not even remotely adjusted yet after 3 months there. I think another move will extend and/or prolong her unhappiness.
4 Answers
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Her bill for a shared room will be the same cost or more than the private one. Them "working with you" means they'll let her stay in a downgraded double room and be on Medicaid, but they will collect more for her to be there then they did before.
Talk to her Medicaid caseworker and find out just how much they are going to be paying for. You will be surprised because it will likely equal the cost of her private room and then some.
Medicaid will give this information in writing if it's requested.
Then you show this to the AL and tell them you're willing to work with them, as in put your mom back in her private room because they're charging and collecting for it.
The contract with the ALF is both a residential lease and a contract for services, with expectations of what the resident/family will do and not do.
Medicaid eligibility and coverage is different in every state, as it is a mix of federal and state funds.
Medicaid does NOT pay for housing costs in the community.
For now, just focus on helping her get adjusted to her new home.
Stay in friendly communication with the staff, and visit often.
Your local area on aging will have information on benefits and options for the future, when you have an idea of the timeline for 'running out of funds'.
Also, look around for elder law attorneys - often they do free introductory seminars that explain the basics, and how they can help you access all that she is eligible for. Of course, the details come only after you sign a retainer.
Sometimes that is worth the cost.
Its just not ur State its all States. You can't have A&A and Medicaid too because they are both government money. Medicaid pays more. So if you were going to place Mom using Medicaid then the A&A would stop. You would get from A&A $90 towards Moms Personal Needs Fund and Medicaid allows a small amount (my state $50) to be deducted from her SS to go into that fund for personal needs like clothes, hair cuts, snacks, etc.
"Work with you" means that by putting Mom in a double room her room and board should not cost as much as a room alone. So maybe if doubling up her A&A and SS will cover the cost. There maybe a way you can get help thru Medicaid for health insurance to suppliment her Medicare. In my State you get healthcare, vision and dental. Mom got a State prescription plan because Dads employer paid for her suppliment.
There comes a time where an AL is not equipped to do continued care and the person needs to be placed in Longterm care.
Sorry you felt duped. But most ALs do not except Medicaid. They are privately owed. In my State, you need to privately pay at least 2 years for Medicaid to pay for an AL and that depends on if the AL excepts Medicaid and if so if they have already hit the % of Medicaid residents they allow.