Mom is receiving unexpectedly retroactive lump sum from SSI. Will she lose Medicaid?

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Mom is receiving unexpectedly retroactive lump sum from SSI. Will she lose Medicaid?

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Mom is getting a retroactive lump sum from SSI survivor benefits of $16,000. She is currently in an assisted living facility on a Medicaid waiver. What will the consequences be?

My stepdad died in May of 2022. My mom is on SSI and currently living in an assisted living facility on a Medicaid waiver. She found out she qualified for survivor's benefits when talking to social security about another issue. She did the necessary paperwork and was approved. Her income is going from $943/month to $1,500. This is great because before she would only be left with 50 dollars after paying the facility. However, she is also getting a retroactive lump sum of $16,000 that she wasn't expecting. She says she'll be ineligible for Medicaid because of this and is panicking because she is supposed to have a surgery next month to deal with a large abdominal hernia. She has no idea what to do with this money. Will she have to use it to pay out of pocket for the surgery? She is assuming the facility she is in will end up with all of it otherwise and then she will once again qualify for Medicaid. Of course, she would like to keep it if possible and she knows it's unlikely but neither of us understand how any of this works. Does anyone know if she would have to spend it down somehow or could it be put it some kind of trust? She has no other assets and very little furniture in her room. My wife and I were both laid off a couple of weeks ago so haven't been able to help her much. Does anyone have any advice or could possibly point me in the right direction? Thanks.

Financial Planning Medicaid Medicaid Spend Down

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I'm sure someone will reply who knows more about this than me, but my guess is that she will end up having to surrender the money to the facility (or the state) as they are now paying for her care.

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Just a bit of an update. This is turning into an even bigger mess now. She now has 2 different letters from Social Security that she has received the last couple of days. Each one says she will be getting a different amount per month. One is saying she gets her original monthly check amount, and the other is saying she will get my stepfather's retirement check. We know she definitely isn't entitled to both. The different Social Security departments are obviously not communicating with each other. Not only that, several employees working in the office at the assisted living facility have told her they can only charge the amount of her original check minus the $50. In effect, they're saying she will get to keep the difference between my stepfather's check and her check every month Even after rent is paid. Even several of the office staff have also tried to tell her to just take the $16000 out because, quote, "they are so disorganized they'll never figure it out anyway" They don't seem to know what they're talking about, or maybe do, and are telling her to do something that is, if I'm being generous, just very bad advice if not completely illegal. There is a program here called Lifespan, which is an ADRC (Aging and Disability Resource Center), that she is trying to get in touch with so she can send the $16000 dollars back at this point, if necessary.

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Each state's Medicaid regulations are different, but I would bet there are ways to prevent her from becoming ineligible. My brother in law is in a nursing home on LTC Medicaid. My husband was POA, and three brothers jointly owned a piece of property. When they decided to sell it, my husband checked with a Medicaid caseworker about how to handle his brother's share, which was about $15,000 I think. We were concerned that he might have to self-pay for several months to spend down and then have to reapply for Medicaid. Instead, the caseworker said he could just pay back Medicaid in a lump sum for $$ they had already spent on his behalf and thereby get his assets down to the allowable level without any break in Medicaid eligibility or the need to reapply.

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I always found Social Security to be very helpful, at least by the time I could talk to someone. Call them and see what they say about this, but most likely the 16,000 will go to medicaid for the care she already received and she can stay on medicaid. Hope this works out. It's so confusing.

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SS has nothing to do with Medicaid. She already got the wrong info from them. She does not profit from this. Medicaid will require it be used to offset the cost of her care.

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So Medicaid is paying to Moms care in an AL? And Moms SS is being used to offset her care with $50 going to her personal needs? I am sorry to say but that extra money she will receive every month will go to offset her care in the AL and what Medicaid pays towards her care will be adjusted accordingly. She will still only get $50 a month for her personal needs because that is what the State allows. The amount is not based on how much SS they have. The 16k, maybe Medicaid will credit it against what they have already paid out for Moms care like newbie said. But Medicaid may stop till she spends down that 16k. Thats between Medicaid and Mom. Your Mom would have been better off not filing for more SS because there is no way she would profit from it if Medicaid is paying for her care.

If her husband was a Vet enlisted in time of war, she maybe entitled to the $90 that Aids and Attendance gives for personal needs. She can't receive A&A because she has Medicaid.

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First Condolences to you for your stepdad's passing.🙏🏾

Second mom won't get the money all at once. By law, It will be in 3 installments 6 months apart based on 3 times what the maximum monthly SSI is. In this case it is 943 x3 or $2829. Her first 2 payments will be this. The last payment is what is left over, which would be $16,000-$5658=$10342

She has 6 months to spend these overpays before they count against her SSI. She can use this money anyway she sees fit.

If she wants and SS agrees, she can get more of this back pay sooner, but only in certain circumstances. Her being in this facility may fit, but I'm not 100% sure of this.

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I'm sorry, I know it probably doesn't make much difference, but I need to correct something. My stepfather was collecting social security retirement benefits not SSI. He was the breadwinner for them. My mother was collecting SSI because she never worked

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That's okay.

ssa.gov is the website you can check out. The way this works should be there

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Mom is receiving unexpectedly retroactive lump sum from SSI. Will she lose Medicaid?

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