Medicaid

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Mary2

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Lost a loved one
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04/2021
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Synapticure, the telehealth neurology company Brian Wallach started had speak with an insurance consultant today. She named a federal initiative whereby the federal government was having the states have their Medicaid plans include home care for patients who are at risk for being institutionalized. I know one of my careworkers provides care to Medicaid patients in the home.

She says that with some Medicaid Estate planning it might be possible to get PALS on a Medicaid program that provides careworkers. I wish I remembered the name of this federal initiative.

Anyway she is going to look into GA's program for us. She says it is possible to transfer assets to a spouse. I just looked this up and this does not trigger any type of look back period before services can begin. The community spouse as this spouse is called is allowed to have about 120K I think the number is. I may be wrong...someone can correct me....but I think with IRAs only the RMDs count and not the principal of an IRA as an asset. I will let you know if I am wrong. I just googled it and Googled it and Google agreed with me.

I don't know much else at this point. I am posting this in case it helps another family. So many of us have money tied up in IRAs I thought it was worth mentioning.

It is possible that we qualify for a Medicaid caregiver program and that some other family here does as well.
 
Medicaid waiver? Or something newer? Waiver programs have been around for quite a long time and vary from state to state.

Did she discuss clawback after you both are gone? I don’t know if it applies to whatever this is and some states like NY seem to get around this but I believe in MA anyway for seniors the state goes after the estate for their medicaid costs. There was an exception only for a child who lived in the house the deceased owned AND had provided care for at least two years that kept them home. This is true in PA too because I know someone who needed a doctor’s letter she had provided the care I don’t think the clawback happens if you get medicaid and are under a certain age I think 50 something
 
She didn't mention clawback or estate recovery provisions. The best I can do is see what she finds. I am not even sure I am being billed for her services. I have a couple of attorneys I could call and maybe will do this.
 
I found this page. Both the estate recovery and waiver links look like they might be of interest to you Elderly
 
I am "dual eligible" (I qualify for Medicare AND Medicaid). Our family is below the poverty line. Both adults were laid off right before COVID. At our age it is difficult to get rehired for what we were doing.

I own our house. I live in a town with low property values. No mortgage.

They have not asked about the value of the house or the TIAA retirement investment (which is not huge because we spent so many years in school and/or out of the country that we got a late start preparing for retirement).

I will be starting Medicaid long-term care in approx. mid-February. I will start with a small number of hours per week and as I progress it will increase somewhat.

I spoke with the expert in this area in my county and she didn't warn me about any long-term repercussions. The only one I know about is that a child with a disability under IDEA, if the family signs a certain Medicaid paper that allows the school to have Medicaid pay for the special education services, then the lifetime maximum benefit might kick in at some point. The way to avoid this is by not signing that paper. I forget what it's called.

New but related topic: I found out recently that Synapticure has a special thing for low income patients. I met with the insurance person there over zoom and she asked me the approximate value of the house and the retirement investment. She asked some other financial questions, like emergency fund in the bank, current balance, credit card debt, etc. She said that she has to put those numbers on a form, but they won't prevent me from qualifying.

I don't know if other states have what we have in NY, each county has an office for the aging. In NY, I would suggest that people start there. If the person is younger than 65 and qualifies for Medicare due to disability, I think that office may still be able to provide information.

The other place that could be quite helpful in NY is the county office for disabilities and independence. They are usually called "name-of-place-or-area Independence Center." I'm not sure exactly whom to ask to speak to within those organizations.

Note that small counties' offices of both types may not be as helpful. But one is allowed to call an office from another county.
 
Mupstateny. I would advise to also read the law in addition to speaking with experts. Medicaid can seize the asset of a deceased person after their death in the state of NY. Some states prevent this, ca and tx. This is not a subject I know much about, but I do know the state wants to be repaid through the assets of the deceased. And, the law is very complicated.
Medicaid Estate Recovery Program.

 
I will look into that, thanks.
 
Mupstateny. I am so sorry you have to think about all this stuff at once. ALS is cruel disease. I hope you can also focus on your own wellbeing. Hugs.
 
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