Toni:
I am not sure where to start with this but here goes: my mother is 78 yrs old and now lives with me full time. She receives about $1700/math from social security and has no savings and no other income. Most of her income is used to help pay for living expenses with me.
She has the beginning a stage of dementia/Alzheimer, so I feel the need to understand what I can put in place when she would need to be placed in a facility. The doctor said it could be 2 days, 2 months or 2 years before that happens.
I’ve read through Medicaid’s information on Long Term Care and wonder if she would qualify for Medicaid’s long-term care benefits? I am all for researching this myself but frankly do not understand which way to go at this point. I would rather be prepared than reactive when this time comes. Can you point me in the right direction for assistance in these matters? I really need direction and do not know which way to go….Thanks in advance, Shawn
Shawn:
There are different levels of Long Term Care/Nursing Home care services provided by Medicaid, which you can pick from for your mother’s care. To qualify for Medicaid with Medicare, one must be financially qualified, but to be eligible for Medicare with Medicaid’s Long Term Care services, one must also be medically qualified as well as financially.
Additional information on qualifying for Medicaid and to apply or obtain an application, please visit the DADS website at http://www.dads.state.tx.us/ltss/ or call 211 and ask for the local Medicaid office where you can talk with a representative and get your questions answered.
Each state considers 3 factors for Medicare with Medicaid’s Long Term/Nursing Home Care services:
- 1. Medical necessity for care: an individual that is unable to care for their self and requires assistance of daily living or ongoing supervision.
- 2. Income: In some states including Texas, in 2012 the monthly income cannot exceed $2,094 for Long Term Care assistance.
- 3. Assets/Resources-2012 “Countable Resources: limits which excludes the life insurance with $1,500 value, car and home. If assets are too much, then some seniors may have to “spend down” to $2,000 as an individual or $3,000 as a couple (when both couples are residents of a nursing home).
Since your mother’s Social Security check is $1,700 and it is below $2,094, then she may qualify for Medicaid’s Community Based Alternative (CBA). CBA provides home and community based services to people who are elderly or adults with disabilities and enrolled in Medicare Parts A and B. CBA is a cost effective alternative to living in a nursing home. CBA allows eligible people to receive services in their own homes, foster homes or assisted living settings. Here is how to contact your local Medicaid office by the internet at https://www.211texas.org/211/ or by dialing 211 and ask for the local Medicaid office.
If your mother does not qualify for Medicaid or CBA, then another alternative for financial help is the VA’s Aid and Attendant Benefit. With the Aid and Attendant benefit a Veteran or surviving spouse of a Veteran that needs additional care, may qualify for assistance and could receive $1,632 per month to a Veteran, $1055 per month for a Veteran’s surviving spouse or $1,949 per month for a couple together. This is a hidden secret that many Veterans do not know exists. There is over $20 Billion dollars available to Vets as a pension, so that the Vet or a spouse of a Vet that needs additional care at home or to help pay for assisted living facility or non-medical personal care at the home.
Qualifying for Medicaid or VA benefits are 2 ways of receiving affordable Long Term Care when you do not have a Long Term Care policy and need help paying for the care.
Toni King is an advocate/consultant for those “Confused about Medicare”. Email questions to toni@tonisays.com or call 281/830-3896. Visit Toni’s new website www.tonisays.com and be part of her new blog…Toni Says.
