My great aunt (87) and I'm 40 and I'm a (HHA) who takes care of her for the last 9 month. My great aunt was denied Medicaid because of her income.They said that her less allowed deductions exceeds our standards by $1,639.80 per month but my great aunt can not take care of her self. She has arthritis through her hold body and she has hp. I help her with take a bath,feed her,ROM-active,medication reminders,skincare,nail,clean bedrooms,bathrooms,kitchen,laundry,grocery shopping and dress her on top of all that we live in WASHINGHTON DC we need some help!!!

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Robert - So is it the situation where you auntie has $ 1,639.80 over the maximum allowed for monthly income? She can spend down her assets, but she always has this pesky monthly income that is just too high for Medicaid. If this is the case, my suggestion is to look into seeing if she can get a Miller Trust done.

Miller is also called a Qualified Income Trust and you need an attorney to do it for you but it is totally legit and designed for the situation you are in. If her income is from a guaranteed source - like SS, federal or state retirements or other vested pension programs - she can get a Miller / QUIT done.

here's how it works: say mom gets $ 2,500 each month in income (1K in SS and $ 1,500 in federal retirement). Mom is in TX and their income limit is $ 2,100. So no matter what you do, mom is over by $ 400.00 to qualify for Medicaid. What Miller does is Miller as it is a trust now get's their income. The trust "owns" their income and pays the elder $ 2,100 so they are OK for the maximum income allowed and the extra 400 is "owned" by the trust. Now what happens with the $ 400 depends on how your state runs Medicaid. Some states allow it to build & then upon their death, the beneficiary of the trust is the state so all $ goes to the state. Other states have it so, that you get the max income allowed and then all the rest is also paid to the NH. Whatever the case, the state gets all the $ & the state pays for her care. So there is no build up in the trust. Totally legit for Medicaid too. The caseworkers can't tell you about it or suggest it as it is legal and they are not attorneys and cannot be dispensing legal.

Miller or QIT has to be done by an elder law attorney; you need to establish a bank account that is the trust and her checks go into; it needs to have a buffer amount in it - this you want to keep smallish, maybe $ 50 or $100.00 - just not to ever have to worry about having a negative balance. Some states have a bank of choice for Miller; other states don't. Really an experienced elder law guy will know how to structure all this for you.

BTW there was a poster on this site from FL who did Miller for her mom. Ran about $ 1,500 for legal costs (which your elder should pay for) and FL does the pay out all within the month approach. Now auntie will still have whatever her personal needs allowance is set aside for her every month @ the NH (like for my mom in Texas, this is $ 60 a month) but all the rest of her money goes to the NH to pay towards her care. Good luck in all this.
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