Since my husband receives Social Security Disability, (not SSDI) is there a difference in the process if he would need to go to a Nursing Home? Would Medicaid be applied in the beginning or would all assets be depleted then Medicaid? I hope this question makes sense.
My understanding is that the household income, assets etc., are evaluated and any spend down of those calculated. That would be applied first, and then Medicare and Medicaid would pay--in that order. When the Medicare coverage is depleted the Medicaid would take over fully. We've been on SSD for years--last October his converted to regular SS. We've each got Medicare, and he qualified for a Medicaid Waiver (considers his income alone, to give him Medicaid with his Medicare). This has been a huge blessing.
Kadee, If your husband receives Social Security Disability makes no difference, When you start to apply for Long term care in a NH. You would go through the application process Of applying for Medicaid, they would look at your assets, etc. This has nothing to do with being Social Security Disabled. You would follow the same procedure as if he were not drawing disability as far as applying for Medicaid Long term care. It is different if you are just applying for Medicaid and still living at home. Long term care has different rules.
Medicare will only pay for a Nursing Home if the patient has been in the hospital for 3 days as an in patient and goes to the nursing home from the hospital or within 30 days of being discharged, AND is going for skilled care or rehabalitive care. Medicare will pay full for the first 20 days, and then a portion from day 21 etc. until it reaches a 100 day limit.
Most people do not qualify for the type of care Medicare requires in a Nursing home for the full 100 days so don't count on that. Once the patient no longer needs skilled care or has been rehabilitated to the max amount they can be then Medicare stops paying.
Jane, I have a question that maybe you can answer. My husband owned half of a farm with his brother. His brother is buying paying my husband's half on contract...in December, this contract is up, either we will need to re-new or my brother-in-law will need to pay the balance. The balance is a considerable amount of money. Since my husband has become so combative...even though I am trying to keep him at home as long as possible, I am losing the battle. I do have an appointment with an attorney next Thursday, if I would pay off my house with the money that my brother-in-law owes. Will that still be included as funds if I apply for Medicaid. I am hoping you will offer your take on this. Thank you in advance for any help.
Kadee, Let your brother in law pay off the balance and YOU pay off your house. Your house is under the non countable rule, some states allow the home to be valued at $500,000 other States allow the value to be $700,000 and many states do not set a value if the spouse is still living in the home. Also, it would be best if the home is in your name alone if placement happens. Please share with us what your Attorney tells you, it will help all of us. This is a learning experience for all of us. No one knows everything, we can all learn from each other. Please do share.
I would tend to be cautious if you re-new the contract, I am not sure how Medicaid would look at it, you would have to be sure you got the going interest rate and even then they might count it as a penalty. Let us know what the Attorney thinks on this.
My turn for a question - I figure we are about a year out to needing to go on Medicaid. I've been doing some reading but when/where do I start the process?
therrja, You will not want to start the process of applying for Medicaid until you have actually placed your husband in a NH or else he has been in an in patient facility for 30 days without a break, you cannot qualify for Medicaid long term care until that has taken place. Once the loved one has been in a hospital or NH for 30 days the process can start. Of course you can ask questions before but that 30 day rule is the trigger. If your loved one has EVER been in a facility for 30 days even if it has been years ago, that is when the assessment will start. Medicaid will ask you at the application time if the loved one has ever been in a facility for 30 days before.
As for the Elderlaw attorney, it is best to make that visit as soon into the beginning of this disease process as possible, at least to ask questions and know what plan you need to follow.
Thanks Jane, we meet the 30 days in a facility criteria - he was placed 2 1/2 years ago. We saw an eldercare attorney shortly after he was diagnosed and I did get a lot of the ducks lined up. He has progressed so fast that we are within the 5 year window that is always talked about.
Zibby, I agree, I think it is time to talk with the attorney again.