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Hi all, I absolutely know I need to contact an attorney in regards to this question. I actually did contact an attorney - they're just taking forever to get back to me and I'm getting anxious. I'll share their response when they hopefully respond.


My question is about your general, personal experiences with Medicaid (I know the rules vary by state): in short, are you allowed to use the cost of services such as home health aides to spend down assets and qualify for Medicaid?


My mother is dying of brain cancer and I am bringing her home for hospice. Although home hospice provides services, they are not sufficient to care for a person as severely disabled as my mother and I can't do this on my own.


I love my mother dearly, but she didn't plan for retirement and didn't save money, so she has limited savings and I'm not yet able to place her in a nursing home or an institutional hospice - that would take time and the institutional hospices around here have wait lists (and are also expensive). She is poor and I don't expect to receive any inheritance, but not poor enough to qualify for Medicaid. Because of her brain cancer, she could live for as long as 3 months (or less). Who knows.


But yes, I wanted to know if you are able to use the cost of home health aides to spend down your assets and qualify for Medicaid. I know you can create a contract to pay a family caregiver (I'm the only one around), but I need professional help and don't think that's the best way to go. I know the rules vary by state, but I'm just trying to get an idea because the stinking lawyer won't get back to me and I'm a nervous wreck.


I didn't think I'd have to bring my Mom home for hospice so soon, but she is suffering miserably in her sub-acute rehab center, not improving physically, practically blind, and sitting in her own urine and feces since she can't walk to the bathroom. I tried to transfer her to another sub-acute rehab, but at least 10 places rejected her. I can't let her stay at that place; it's breaking my heart.


I am not ruling out nursing homes; I just can't get her placed in time. It hurts so much to see my mother suffer like this; I need to bring her home and hire personal caregivers in addition to hospice so that she can have some peace and comfort.


It will be hard for me, but it's hard enough knowing that she's in the dump she's in. I can't take the thought of leaving her in there, it's unbearable. Thank you, apologies for the panicked and anxious post.

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Yes, home health aid is a legitimate spend down.

Based on the situation, you don't want to try and implement a contract for you. You need to be her daughter and spend quality time with her and let a caregiver deal with caregiving.

I am so sorry you and your mom are going through this.

Great big warm hug!
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Even home health aids must be legit, with formal caregiving agreements. Taxes, etc withheld or monies paid to them will be co soldered a gift by Medicaid and mom will then be ineligible.
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gladimhere Feb 2022
Considered a gift. Darn auto correct!
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Yes. Money paid for her care is absolutely an acceptable way to spend down her assets. Do everything you do in an aboveboard and legal manner so as not to jeopardize her application for benefits.
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Yes, my cousin just did it. His Mom had 30k in assets that he prepaid her funeral with and hired aides in hopes to get Medicaid in home care. Things happened and he had to place her in LTC.

You can hire an agency for an aide. They take care of the payroll.
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