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» LymeNet Flash » Questions and Discussion » General Support » MIL - need advice

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Author Topic: MIL - need advice
linky123
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It looks like my MIL will probably be outliving her savings in the next couple of years.

She now lives in a retirement community in another state, but has health issues and will need full-time care that a nursing home provides.

What happens when the money runs out? Would medicaid provide the funds for her to live in a nursing home.

I believe this was the case in our state a few years ago when I was caring for elderly relatives, but not sure if all this has changed with Obamacare.

Not sure what our options are.

[ 12-01-2014, 12:35 PM: Message edited by: linky123 ]

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'Come to me, all you who are weary and burdened, and I will give you rest.' Matthew 11:28

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Lymetoo
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Does she have Social Security?

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--Lymetutu--
Opinions, not medical advice!

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linky123
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As a widow, she gets the benefit allowable for that from her deceased spouse.

It's not near enough to cover her expenses.

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'Come to me, all you who are weary and burdened, and I will give you rest.' Matthew 11:28

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steve1906
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Here's one site to look at.

http://www.longtermcarelink.net/eldercare/long_term_care.htm

Steve

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Everything I say is just my opinion!

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linky123
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Thanks for the info, Steve.

It looks like a person has to be destitute to have medicaid pay for all of long term care.

I wonder if her SS benefit would disqualify her.

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'Come to me, all you who are weary and burdened, and I will give you rest.' Matthew 11:28

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Keebler
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No, a SS benefit would not disqualify her but make her eligible, in a way, if there is zero other income & no real resources to tap,

*** Depending upon the SS monthly income ***

they might qualify for their state's medicaid program (even if also for Medicare dual coverage).

In such a case, as it is now in many place (though not all),

all the person's SS benefit (whether from disability, a spouse benefit or retirement) would be paid directly to the care home. Every dime.

In such a case, a person would not have money for any personal items so family is even more important then to help with clothes, necessities and personal care items - or any special foods they may enjoy.

One of my aunts was in such a home for many years due to severe mental illness. I remember, each time she needed some new shoes or clothes my father would get a note from the group home with a request, sizes, etc.

I have an acquaintance in such a care center after a stroke and she does not have even money to buy herself a beverage. Still, she has a shared room and roof over her head and stuff that sort of looks like food.

There are only certain places that would accept those under their state medicaid policy, though. And, as with all things medicaid, not every state is exactly the same in requirements or services.

She may be in control of all this, or not. Hopefully, there is some group in her area - adult community centers - the AARP advocates - state ombudspersons - workshops and educational opportunities, etc. to find out more.

The state's medicaid site may also have detail.

Some states are developing plans to allow ill / seniors to stay in their homes as long as possible. Always the best option, IMO.

The grim reality is that many will find themselves at the lower end of the line, and very few living situations even accept medicaid clients. The nicer ones are usually connected to those who can pay, or have better long term care insurance coverage.
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[ 12-01-2014, 08:18 PM: Message edited by: Keebler ]

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Lymetoo
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Yes, I thought I had heard that the nursing care place will take their checks and write off the rest. But I have no details or other info.

Was hoping to hear more about that possibility.

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--Lymetutu--
Opinions, not medical advice!

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Keebler
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Oh, Medicare and state medicaid is not part of the Affordable Care Act. It's totally separate.

I may have assumed she is covered by Medicare. Medicare, itself, has zero long term care coverage. That falls to the state medicaid to cover for those at the very low income level.

Some Medicare HMOs do have long term care coverage, although any HMO plan is private insurance, in reality, they just manage the person's Medicare, in all effects.

And, if the payments for the HMO can longer be made, that coverage ends and would revert back to Medicare for medical and then whatever else could be done for the long term care if that is required.

If she does not have as her primary medical insurance Medicare, anyone covered by a policy under the ACA, well, that's a private insurance policy with a private business. Each one varies.

If she has obtained private insurance through the ACA, then she would find out what that covers. But coverage will last only as long as the payments for the policy can continue.

Also, whatever state in which she is a resident is the state where inquires should start, unless she is planning to move to another state at some time. If so, information should be gathered from both states, just in the preliminary research process.

If planning to move, she would have to FIRST establish residency in the new state before any kind of coverage with any state plans for which she may (later) qualify.

Still, you say she still has savings and her SS income. To prevent finding herself with the least favorable option, perhaps someone who is close to her - non-judging and very good personality match -

could help her sort out other options available. It pains me that a care home seems the most likely option - for anyone. I think we've really lost it here in the way ill and elderly are cared for institutional settings.

She may know folks she could design her own living set up with. I know there are few creative situations happening here and there. We all have to start thinking outside of the institutional options as if we have no other choices.

We have to create those choices, in community. I'd rather go live off in the woods in a tent if it came down to having to go into a care center. Just walk me out onto an ice floe and leave me with some of the world's finest chocolate.

My guess is there are arrangements that fall somewhere in between. But they are just not very apparent, practical or even possible for so many.
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[ 12-01-2014, 09:11 PM: Message edited by: Keebler ]

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