In a Medi Cal "look back" would they find fault with my mother giving gifts of money to her grand children and kids?

N1K2R3: I do not agree with everything you have written back to jeannegibbs. My mother does have Medicare and that expensive 2ndary insurance that pays 20%. If you don't have it you need to obtain the "Medicare and You 2014" book that goes into detail what Medicare does and does not cover. Read the book and become well versed on coverage. "Medicare does not cover long term care or custodial care."

When a person has Dementia or Alzheimer's or many other illnesses they may require long term care, possibly not in the very beginning, but as their diseases progress it may become necessary to admit them for long term care because they can no longer be cared for within the home.

Personally I have taken care of a number of people and they were taken care of at home but my Aunt had to go into the hospital and her days began running out because Medicare has what they call "benefit periods" and you have to leave the hospital and be out for a certain number of days. At that time my Aunt had to be out of the hospital for 45 days before she could be readmitted. These are all things that none of us see coming when an elder becomes ill. She had to be transferred to a "rehabilitation unit" for a while and then to a nursing home for a short time. She was eventually brought home and lived for two days and passed away. My mother was unable to get the nurse to the house in time due to traffic and she administered medication that she was told to give but my Aunt died. My mother lived with the guilt for a long time, thinking she possibly caused my Aunt to die. The other people I have cared for all died relatively fast within the hospital due to their illnesses.

With dementia and Alzheimer's we try to care for our elders at home for as long as we can, I have been caring for Mom for 7 years at home. I never thought her condition would get as bad as it has. A month ago I was willing to look for a nursing home because I was losing MY MIND due to HER condition. Hallucinations, OCD behaviors, screaming and yelling, her inability to sleep caused everyone in our house not to sleep. She was admitted to the hospital for surgery and it became worse, her doctor took me to the hallway and told me, "You have to admit her to a nursing home, you cannot handle this alone, you will fail and you will hate yourself, then you will be sick!"

Medicare does not pay for "long term care or custodial care."

At $5,000 to $10,000 a month for Nursing Home Care you would have to be wealthy because most people do not have that kind of money and if your insurance doesn't cover it, you have to come up with the cash, or you have to apply to Medicaid for help.

People mistakenly think that only totally indigent people have to apply for Medicaid help, that is not the case anymore. Many of us who mistakenly thought we were "middle class" have now found ourselves having to turn to Medicaid for assistance or in my case, trying to live by their guidelines, just in case it may be needed down the line. My mother's Aunt lived to be over 100 and my Mom is 84, what if she lives as long as her Aunt. By then I do not think I will still be alive but she will need care.

Please make sure you check out what is and is not covered by your insurance but also do not pass judgment on others who may see the need now or in the future to have to use Medicaid for their loved ones or themselves. None of us ever thought we would find ourselves here, needing assistance, but life happens and people get ill and many exhaust all their financial resources due to these illnesses.

N1K2R3, you are not going crazy. You may still give your money and other assets to anyone you please, in any amounts you want. Your gifts may have tax consequences. Your gifts may cause a "penalty period" if you ever have to apply for Medicaid. But you can give the assets away as you like.

And you can certainly avoid Medicaid -- if you are generationally wealthy, if you never get a disabling disease, if you have family who can/will support you, if you die young.

Here is an even better solution: Avoid getting dementia. Avoid having COPD. Avoid developing cancer. Avoid having any health problems that will require expensive medical care as you age.

NiK2R3: We all do try to avoid Medicaid but when you are caring for an elderly parent and you do not know how long their money will last, you have to do some asset planning. You do not want to rush out and purchase things or spend their money in a way that Medicaid, when you REALLY NEED IT, will "look back" and say your mother spent " $30,000 for gifts in the past 5 years and we will not accept that so we are going to refuse your mother medical coverage for the next year because of it." Therefore you have to look ahead at what the possibilities may be down the road and live accordingly. I would not have $30,000 to make up for it therefore I am trying to make sure her assets are handled as wisely as I know how.

I asked that question a few years back when I was POA for a relative. I was also concerned about charitable gifts and church donations. I was told that the case reviewers would look for a long-term pattern to the gifts. If your mom has been giving monetary gifts to the relatives for several years, and the amounts have not changed, there would not be a problem. Same with charitable gifts. Of course, this was in Nebraska, and was a few years ago. You could call the Medi Cal office and see if their rules are similar.

If you're talking Medicaid, the answer is "yes." Be very careful about monetary gifts. And yes, you should check the rules for your state. But keep in mind that small gifts can add up to large sums of money. And that is always a red flag for Medicaid because they see it as a way to transfer assets to avoid paying for your own care.

jeannegibbs: Regarding your reply to:

N1K2R3 said "I am greatly concerned about her hallucinations, OCD behaviors, screaming and yelling and insomnia. What you have described is a patient who has been over-medicated, or who has been given incorrect meds."

Of Balderdash!

You are absolutely correct, that is exactly what it was, "Baldersash!" When my mother was ill and doing all those things, it was NOT BECAUSE SHE WAS OVER MEDICATED, IT WAS BECAUSE SHE WAS NOT MEDICATED AT ALL AT THAT TIME!

I am very happy to say that my mother saw a Gerontology Case Manager who did a very thorough exam and began her on two medications and she is doing so well now! She has been on them for two weeks and it is a world of difference!

Everyone is entitled to their own opinion, but this person did not like the idea that I was even considering that down the line I might actually HAVE to turn to Medicaid for assistance should my Mother need to be placed into a NH. It was more of a political statement than anything else. My Mom is doing so much better however that hopefully that will never be necessary, I just think it is prudent to keep your eyes open and look down the road at what may be coming.

Thank You Jeanne

At least here in California Birthday gifts and such are exceptable as long as the amts are within reason and not large as well as not to the same person. I guess what I am saying is, lets say grandma wanted to give $25.00 to great grantdaughter for her birthday well okay do it. If in 3 months she wanted to give $3000.00 to the same person and then again in another 3 months the same than the dept of social services would more than likely question this and possible count this as a period of ineligiblity. But same birthday, graduation gifts are a part of being grandma. As for life happens, it really does, I work for a Skilled NH and let me tell you money only goes so far and at the tune of $6800 per month for only room and board not any medical items it goes fast and AL facilities seem like they start out with a smaller amount then with all the ADL's needed it all adds up. Medicaid is a life saver for families who are not able to keep loved ones at home money or not.

My father in law has only SS & Vets benefit per month, about $2,000.00. He also has a Reverse Mortgage, owns a Condo, is joint owner of another Condo in Fla. He is 90 with dementia & we are in the legal process of getting Guardianship. His girlfriend, who is in Joint Ownership of Fla Condo also has Joint Accounts with him in Fla and has been taking large monies from Rev Mortgage and putting it into their joint accounts in Fla. She tells him what to do and sign and he does it. We have had many explosions with her over this and she tells us "not to tell her what to do with her money". Its not her money, it belongs to my father in law. If we had to apply for Medicaid...would he be eligible? How does this "LOOK BACK 5 YEARS" work and what do they look for?

I talked to a lawyer about that a month ago. He said "No monetary gifts to grandchildren at all!" However he did say it was ok to make gifts so I am trying to be creative and sew some gifts this year.

I should have added that I live in Maryland. No monetary gifts at all.