My question is the facility said he had to pay 2 years private pay before they would consider Medicaid. That’s fine he’s at the 2 year mark his needs are increasing. We are pretty sure he will get the Medicaid. We are using an attorney. Should we tell the facility before he’s approved he’s going on Medicaid or wait until he’s approved? If there’s an overlap and the family needs to pay a month or two it’s fine. I’m just worried we will do something to jeopardize his assisted living arrangement. How do you find out exactly how many beds are Medicaid and if there are one's available anyway other than asking the facility? Anyone been through this? Thanks!
As Ahmijoy posted states have different laws. Some states Medicaid won’t pay for AL is my understanding. There is a financial as well as a medical qualification for NHs to accept Medicaid.
So your states rules have to be considered. Since your ALF made the provision of two years private pay prior to Medicaid that sounds like they accept Medicaid and that your state pays ALF but a visit with an experienced attorney would be where I would start.
That being said, I’d suggest that dad be evaluated as to his needs and you do an assets & income sheet on dad as this EOM. A new needs assessment done beCause IF he’s kinda on the cusp of possibly being “at need” for skilled nursing care, then you may want have him go into a NH and apply for Medicaid LTC NH program. The big plus in this is that the reality is that if he lives long enough he will eventually need a NH and doing it now means he won’t have to move again. The AL may have a sister NH facility that could take him & make this all easier and he could have a couple of months to transition to NH and have his medical chart show to be needing skilled care if needed. If he was to be able to private pay for a couple of mos at the NH before applying for Medicaid, it could be a plus.
The asset / income sheet tells you by when he’s eligible for Medicaid. I’d be frank with the AL as to when that’s to be.
Out of curiosity, what is the atty doing? Individual LTC NH Medicaid is pretty straightforward and specific; it’s 2k in assets & under the monthly income maximum. So they spend down till they hit the mark and the application is done at the NH with NH submitting the application in tandem with thier bill to the he Medicaid caseworker for their facility. Dpoa does have to find & get together all the supporting documentation needed, like life insurance policies, burial polices, old property sales & banking statements info if within 5 years. To me, it can be a DIY. Did dad have $$ moved into a special needs trust or property trusts done or a Miller trust done cause his income is too high?.... or were there gifting issues? in the past that could pose problems so an attorney is needed to shepherd his application?