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A Supportive Podcast for those Dealing with a loved one with Memory Loss

MediCaid & You – All You Need to Know

MediCaid & You All You Need to Know

00:00:00 – 00:05:02

We’ve altered the horror stories telling us if we expect any help with paying for needed care. We need to be nearly destitute to qualify. For those of us who have worked hard all their lives saved and then Fallen ill this doesn’t seem to be Equitable. Thankfully it’s not entirely true navigating. The Maze of applying for Medicaid is a big critic challenge to say the least. It’s a challenge most people fail. However, knowing the required information before applying does give you a big head start. So that’s how do you know what documents together what information you need to have ready? It’s simple when you use the services of a Medicaid planning service stay tuned to learn why you should use a planning service. How do I go about finding one and all things Medicaid and you? This episode is brought to you by caregiver Chronicles and eight-week online course covering everything from diagnosis me through hospice. For more information use the link in the show notes. Welcome to fading memories a podcast with advice wisdom and Hope from caregivers who have lived the experience and survived to tell the tale think of us as your caregiver best friend. Welcome back to fading memories today with my name is Sylvia green, and she is going to be talking to us about a topic that I know nothing about. This is a good one to chat about all things Medicaid and I told her I remember to call Medicaid and Medi-Cal, so thank you for coming on and filling this on in on everything. We need to know about Medicaid. Thank you Jennifer for having me on excited. So you have a company that deals specifically in Medicaid services. So you want to start there or I’m not even sure where’s a good place to start definitely wage? Yeah. Yeah. So sensible senior planning. We are a Medicaid planning service and we assist individuals and seniors and their loved ones with the Medicaid planning process and the actual Medicaid application process. So as soon as heard the process can be quite challenging. Yes it is, you know, definitely a lot of documentation that’s required a lot of money that’s required so that you know, what documentation is required and you know what to do with assets what you can do what you should do. You know what your options are so dead it is it is a process that is very daunting, especially when you’re not a professional at it or like dealing with people like I just I don’t deal well with banks off. Service companies any of those regulated type things. It’s just I don’t know what it is. I have like a visceral reaction to minutes on hold and I’m just like losing my mind off that stuff up to my husband, which is much better. Yeah, so I know a lot of people get to a position where they’re taking care of a parent and the parent needs to go into a care home for one reason or another and they have some assets but not a lot or I know for example, there’s a gal in my support group who feels that her husband would benefit for a care home, but they can’t afford it and she obviously would like to continue living in her home. So these are kind of I’m sure things that you deal with every single day. I don’t know if that’s a good place to start the conversation is Lee. Definitely so there is a big misconception that if you know for someone to get onto Medicaid Medicaid is going to take off. All of their money and that’s not the case. The case is in order to be eligible for Medicaid. Of course the numbers that I’m going to throw out are different and every state but will say Most states need in order to be eligible for Medicaid your assets. So liquidated assets non-liquid assets, you know can’t exceed $2,000. Now, there are exceptions in many states you a lot of own a one car and you’re allowed to own a house if you’re anticipating to return so that’s you know, when everyone hears and you know again, it’s it’s well then Medicaid is going to take a lot of money. So I only have $8,000 left not like that. That’s just in order to be eligible when you look at a black and white that’s what’s needed. Now. There are I like to say when you look at a black and white because there are many many gray areas Medicaid understands that when there’s you know, a spouse someone who’s living at home and there’s someone who’s in a nursing home. They understand that the spouse that’s living at home. Wants to stay living at home and Medicaid once that so there’s a lot of ways especially when there’s a spouse involved.

00:05:02 – 00:10:01

There are a lot of ways to Dave assets turning assets into income. So where you can take some of the assets and put them into a specific Medicaid compliant annuity and turn it into an income and that way the spouse is living at home still has the financial resources for that, you know, and of course there are the ways as well that individuals can preserve some of their assets and spend down there is gifting when you’re working with a professional you are able to do some gifting where you can gift away money and then long story store and you then use some of money that’s in an annuity or an income that that you pay out for the penalty. So basically what I’m trying to get at is it is complex. There’s a lot of great areas and there’s a lot really to learn so trying to take away that fear that off. In order to be on Medicaid, I’m going to have to also move into nursing home or we’re going to have no money. I mean those choices, right? Right. Exactly. Exactly. It’s a realistic fear, but it’s not the be-all end-all. So now I think I’m correct in stating that Medicaid does not pay for like a long-term memory care residence type Community off. Those are different than nursing homes. Are you referring to like a assisted living facility A Memory Care Assisted Living? Yes, so that’s state-specific. There are some yes. Yes, there are many states actually more and more states are starting to pick up on that we’re Medicaid or another government program similar to Medicaid pay for assisted living facilities. The big issue is is that the payout of Medicaid is significantly less than private pay so not many assist. Living facilities have accept Medicaid and a lot of assisted living facilities that do accept Medicaid. They only have maybe five or ten beds that are set aside for accepting Medicaid office in the waitlist can be really long. I think it’s changed a little bit cuz a lot of people have pulled their loved ones out of those kind of communities and I’m assuming a private like my mom was at home a private corporate run Assisted Living Memory Care community and my first instinct cuz I’m Ms. Practical would be like, okay. Well, you take the Medicaid money and then pay the rest that probably doesn’t work that way either. No, it doesn’t because you yep, you can’t be approved for Medicaid unless if you reach certain requirements, so Medicaid won’t do that exactly home seems like that would be a good option. But I’m sure there’s a hundred reasons why that’s not the case besides that with my bankrupt the system. That’s what I was going to say probably comes down to the dollars, you know comes down to the dog. Ours that is very very likely. So besides the fact that we should all plan ahead knock on wood and have long-term care insurance which can be pricey. When a start getting it in your you know, you’re more advanced years, which I think I’m getting there what other things should people know about Medicaid and you know, maybe if they deserve love when they can still keep them at home, but they’re like, yeah, I’m thinking down the road. What should they start maybe contemplating and start doing? So what I would recommend is the first thing that young I would recommend is don’t do too much Googling don’t go on Reddit too much don’t go on Facebook pages. There’s a lot of false information and a lot of information that will definitely provoke anxiety and fair. So what I would say is what should be done immediately is really is talk to a professional. So either speak with a Medicaid planner, you know and a dog Sure, you can find just from looking online us, you know, sensible senior planning. We service across fifty states. So can always reach out to us will give the information towards the end or you can speak with an elder law attorney. I will specify though that in speaking with an algal our attorney. One of the things is if you do have concerns about Medicaid and you anticipate your loved one or you needing that in the future wage, make sure that the elder law attorney is knowledgeable with Medicaid planning so often, you know individuals go to all the law attorneys and and if it’s great. I work very very closely with many elder law attorneys, but there are many that aren’t familiar with Medicaid planning. So the advice that they’re giving you can be wonderful but it may not be the advice that you’re specifically looking for. If you have you know, you’re anticipating meeting Medicaid in the in the future. You’re not someone that has two three four million dollars. So that’s really what I would recommend. I know I’ve been asked a lot what the difference Says between a Medicaid planner and it’s an attorney and I will you know just to make a clear again.

00:10:01 – 00:15:02

I work very very closely with many attorneys or contracted with some attorneys. What we do a little bit different than it was that we have that, you know, the resources from a legal standpoint when needed we also have other resources. So we you know have the health and life insurance. We have a way to specialize in helping Lee life insurance. So in that case we are able to do annuities we are often, you know, when you’re going legal, you’re not really looking at that route. We do have an individual who is a sense to do a funeral homes and all 50 states as well. So we have that route at all. So we kind of are able to take a very comprehensive look and our recommendations are dead, you know comes from different angles and what suits each individual case. That’s one thing that’s different than going to an elder law attorney. The other thing of course is pricing our pricing comes home. No, nowhere near a little attorneys. They of course because of their background and their education the price is definitely significantly higher than going to a Medicaid planner. And that’s another reason why another difference I should say between a Medicaid planner and elder law attorney. That makes sense cuz I’ve always heard while you should go to a an elder elder law attorney. It’s not so easy to say wage and I wasn’t super familiar with businesses like yours because my parents had plenty of assets to take care of my mom. We had plenty of assets to take care of her and she lived much longer than she did. So, you know, this is why I don’t know anything about it cuz I did not have to go through this process. So maybe can we like walk through and a typical process is not something that exists but like the basic, you know, I’m a spouse and my 80s my my other spouse needs to be moved someplace. I can’t continue age. Do it, you know my health and physical and mental health is breaking down. They need to they need to go to a nursing home or someplace anywhere or do they have to specifically go to a nursing home or does Medicaid pay for in-home care to get so in some states Medicaid does pay for long-term care and long-term care Medicaid pays for in-home Medicaid. It’s in some states. It’s considered. It’s called like a different waiver program just the names fluctuate but provide similar Services. The biggest differences though is that Medicaid won’t typically coverage for hours of bad home care because then right everyone would be home with 24-hour many people would be home with twenty four hour care if it was it’s covered. So they’ll provide a couple of hours but not 24 hours typical not like eight nine eight hours. It really depends on the clients need and what Medicaid chooses to cover for them. There is no guarantee. It is gray areas dead. Exactly a lot of gray areas. Well, what would happen is if we do get a cold we do also offer a senior care referral program. So we do work closely with nursing homes and we are able to assist in getting someone a log into a nursing home as well. But what usually happens is when we get that call. We have a free consultation. So either will do it during that call if the individual has sometime or we’ll schedule another phone call that usually takes about 30 minutes we go over. I like to say we go over definitely family Dynamics cuz that’s important to get a background. You know, we go over a certain age and we go over income. We also reveal which usually goes back to family Dynamics to see if there was gifting that was done or if there was any any fraudulent activity you refresh often that could be done someone’s been living at home and they hired caregivers the caregivers may have done some fraudulent or whatever else but it’s important for us to know that for one playing for Medicaid A phone number. That we will you once we go over the consultation. We will discuss see if we think our services sensible senior planning is a good fit for the client or if we would recommend them going else where we then usually will review, you know have a medicated process works with them and we’ll discuss options that they have if required for us to speak with an attorney. We will get the Dodge Journey involved at that point as well depending on the complexity of the case. They you know, we tell them the options then of course, we quote a Fame and once they decided definitely want to go ahead and use our services they’ll sign a very basic contract and a release of authorization information so that we have access to speak to the County Assistance Office on their behalf. So that gets off you say, okay. We want to use this they sign the paperwork. They send that back from the air its assigned to a case worker and that will be the one and only caseworker that will be working with them until there’s an actual approval. So from beginning to end we will go if there’s a denial or you know, if we have to do an appeal.

00:15:02 – 00:20:02

We do all of that until there’s an actual Medicaid approval if it’s a choice where you know the case scenario that you had given me is kind of it’s not so much Medicaid planning. It’s more going towards the Medicaid application process. So that’s why I’m kind of going very towards they are talking job application like we’re there until approval but what we would do is, you know, really work on advocating for the spouse that’s living at home that’s going to still be living at home. What we would do is really Advocate that off of the others. The other spouse is going into a nursing home his income gets rerouted to harm that she can keep most of the assets in Most states that usually is around they can usually around $120,000 in assets. So we want to try and Advocates that she can keep that and that’s not including a house or a car. So we take care of all that we do all that advocating we assist in game. All necessary paperwork 5-year bank statements 401 k i r a social security proof of social security income everything we assist we do all of that with the family package and then we submit a Medicaid we fill out the Medicaid application and we submit it through the whole process. We would be in touch of course with the family and then if the individuals in a nursing home or looking to go into a nursing home with the nursing home as well though in my area. There are not very many nursing homes. And most of the ones that take Medicaid buy the cow in California are generally a place that you would want your loved one. They’re they’re not great. That’s the it’s from what I understand again. My mom was in a lovely facility. They took excellent care of her, you know, my dad did pretty good planning ahead. Their house was paid for that was a huge benefit. It was under the prop thirteen taxes, which people that are outside of California probably like, huh? They they basically kept the property taxes wage. Fifty years later for them what my parents paid in property taxes for the years what I was paying for the month my dad would complain and I’d be like a few months. I’m like, I can’t I can’t like you can’t wrap my head around this complaint here buddy. Yeah, and so we rented out her home to a really nice family and that covered at least it covered about half of her expenses her social security was another 25% and then my dad’s Investments the financial planner put in the other $1,500 a month to you know, so she had plenty of money which was lovely cuz then we didn’t have to worry about running out of money at a time when she needed more and more care. So there was a question I had was first off you when you’re talking about all this paperwork that you have to collect and gather. My mental image was here’s money do that for me. So that is the thing off. Cannot do just that’s my husband’s job. He was in banking for twenty years now. He’s a real estate broker. So Stacks and stacks and stacks of paperwork is his life and Stacks and stacks of paperwork with me feel like screaming and running out the door. Definitely Yang Yang in our relationship there. So, oh the question I was going to ask you pop back on my head. Thank goodness. I’ve heard that it’s really a typical you go through this whole giant process which again too much paperwork for my sanity and then you get rejected like it’s it’s almost like that’s the first step all this work and they’re like, yeah, no go away. Is that typical when they’re you work with you guys or another company similar to yours or if you guys kind of dialed it in so that that doesn’t happen as often or is that just a myth? I don’t know. Yes. The good thing is is that we you know us working with many Medicaid offices. We have very good relationship with them off. What we do is also we like to say we tie we get the entire application completed. We submit all of the paperwork prior to them asking for it. We submit paperwork that we anticipate the masking would be like to tie the paperwork up a nice bow. We send it off to them and it’s you know, it’s really spoon-fed to them. So they like it it’s you know, it’s pleasurable for them. They feel like they were working with someone who’s responsible and who knows what they’re doing and we definitely find that they’re not very nitty-gritty that often. I want to say all the time, but often they’re not very nitty-gritty 8, we don’t typically get Thousand Miles what would happen is is that they come back and they asked for a lot of information, but that’s what that’s usually what happens to most people and and working like nursing homes when you’re going through the nursing home. That’s usually what’s happening out of people you’re not approved because we need all this information. So you just now have to start Gathering all that information when we go and we gather all that information prior. So the process is just smooth that makes sense dead. Yes back in the day when my family and I had the one hour photo lab and portrait studio.

00:20:02 – 00:25:07

We did a lot of immigration photos and they had we had a little clearer and it was basically a guide to make sure that the head the head size had to be a certain size from top to bottom and left. Right and all of the one ear had was very complicated. Sometimes they send those pictures back and you know, the client would come back and say they rejected these make me some new ones and it’s like this person not have their Wheaties today because this fits the I mean this is exactly what they asked for is so frustrating. Yeah, and sometimes you know, everybody’s head is different, you know, some of them really long face so it would be too long and not wide enough and I’m like, what am I supposed to do is Miss the guys fact, it’s just like right right. It was dealing with a government is just insane since we’re talking about paperwork and trying to keep the insanity to a minimum what should people with them? Know that they’re going to have to maybe start going through this process. What can they do in the maybe before they call somebody like you guys what should they be prepared to gather I guess is probably a good thing cuz you said five years of banking Bank information and my first instinct is oh, but I also know that it’s all online and my husband has access to it all. I mean I have access to it, but he knows how to find it faster speeds right? It’s like, you know, my first reaction is LG is no and then I’m like, okay now I’ll be fine. So maybe if people are aware of what will be likely expected they can you know, maybe if you wrap your head around it’s not such a giant scary process. So the 5-year being State. Oh, so I’ll get to five evenings after what I would say is additionally what you should definitely have is know the individual that you’re applying for and their spouse know what the income is in some states if your income is too high you you won’t be qualified for Medicaid and log You set up what’s called a qualified income trust. So you want to know what the income is and you want to know any assets so assets include 401 k i r a checking savings life insurance policies any properties cars house any of that you want to know about and the third thing I would say is you really want to educate and not gain weight, but you really want to find out if there was any gifting that was done. Even if it’s just $100 200 don’t be afraid but just know about it. So you want to find out about any gifting that was done and the way that you can if if you know, let’s say your loved one who you’re working on your power of attorney, but you don’t know all that information. Then what you would want to do is get 6 months bank statements. They usually if you give six months bank statements, either you can look through it or give it to Medicaid plan or they usually at that point can find out what are notable assets that Medicaid will find out about or what are what is the name? The the other thing the one other thing that I did believe out which that you would want to find out as well as about taxes of taxes has been done or if there was any debt that’s owed back. Yes. See all that. This is the creative part of me that says ich no hubby. You do all this stuff. Right? Exactly. My mom. He did do a lot of that just cuz it’s it’s his thing. Yeah, we did our trust recently and I knew the the attorney very well, you know, I trusted him which I guess that could be dangerous but it’s like I know how long conversations that everything was the way I wanted it. So I didn’t have to read all of that legalese, but the husband did write at least monster and there was things there was something I was talking to somebody the other day for the podcast and they said something and when we were done he popped his head in and he goes, oh by the way, yeah all that’s in our trust like there is Awesome song. I know I get almost well. He must have heard the little thought bubble. Go over my head going. I better double-check that so right right. That’s that’s how we that’s how we roll in this household wage what other things should people be aware of like I said, since I’m like completely clueless. I don’t even really have good questions to ask. I feel yeah. No definitely that’s really good question. I think you know the the talk a little bit about because I know I get calls a lot of asking about this about three things. Number one. I want to talk a little bit of a alluded to that before the income tax income trust also known as the Miller trust. So in many states Medicaid looks at your income, so the income is usually around in those States income usually can’t be more than $23.49 in some states 2199 in other states. So I would say around the low mm Mark if your income does exceed that you woke. Eligible for Medicaid unless you would set up what’s called a qualified income trust also known as a Miller trust and what that does is it takes your over resource money so money where they you are.

00:25:07 – 00:30:28

Your income is too high. You’re over income. I should say limit is too high take some of that money and it puts it into this qualified income trusts which a family member or a friend. Someone has to be the beneficiary of that and the money essentially sits there. It can be used for some things. Every state again is a little bit different but it can be used like healthcare. Some things can be used for home. But the money the over resource money sets there there’s so that’s if you’re over income so know again, if you here I get so many times I won’t be approved for Medicaid cuz I’m over income. It’s a simple trust that needs to be set up and it costs all of that $500. You probably can find an attorney to do it for you can find a Medicaid planner that can do it. We do it $500. The other thing is where I had Could amount was the Medicaid compliant annuity. So I want everyone, you know to be aware that this exists. I was made aware that there are many Medicaid planners that but don’t necessarily realize that this exists and a lot of times people are spending down in a nursing home. But a Medicaid compliant annuity specifically for a spousal case can be very helpful, but in other scenarios as well, that’s where you set up where your assets because of income now and there’s ways again that that that and every situation is different but there’s ways than that way to that instead of just spending down and paying the nursing home privately. You can actually preserve some of the assets the third thing that I want everyone to know about. I see this way too often is funeral homes. So often, you know, I speak to people and say well, do you have Funeral Home set up there? Like Yeah, we actually just did it about two months ago cuz you know things weren’t looking good. And I you know first question I say is it a revocable and they don’t even know what that is the funeral home doesn’t even know what that is. So you said yep. Funeral funeral trust or you pay for a burial arrangements and a funeral home and it is not irrevocable has to be specifically irrevocable life and it is consent considered an asset and now you can be over resource because of that. So you want to make sure it’s irrevocable. There’s many ways to do that. You can either do it directly through your funeral home. Again. We have the resources where you’re able to go ahead and sign up for like what’s in a irrevocable and funeral insurance policy. So to say it’s like a funeral trust you buy back into that and you can use it at any funeral home. So, you know, definitely again I say make sure it’s a revocable and speak to professionals about that. So those are three points that I think just met many times. I’ve been I’ve been getting a lot of phone calls of people anxious or you know, they’ve been told one thing they’re not sure so those are just three points that I definitely want to make known that exists out there. We made a good point. Iran don’t Google. Yes. Yes. I’ve never done that. So I don’t I’m sure it’s like going into med MD right to do that or WebMD and I you know, the I’ve seen this question on the Facebook support pages and I’m going to read him closer now that I’m informed. Yeah, I can tell people save yourself the headaches just find and what is it the Medicaid Place planner planner. There we go Medicaid just yeah. I want to make sure I have the right right turn off and I’ll tell I know a good one if you if you guys need a reference cuz I know a lot of those pages don’t like promotion of any kind, right and its just oh my God so crazy and like I said earlier my first instinct was here’s money you take care of it because I know how insane this kind of just just talking to you about it makes me yes, and it makes yep. Happy that we have our ducks in a row. Hopefully we’re doing what my dad did so but maybe we should do the long-term care insurance too. Because you know, my grandmother’s almost a hundred and three so it’s oh wow. Yeah, you know, that’s that’s a many more year. What does that 49 more years for me? That’s a long time. So that’s probably the next thing we’ve talked about looking into that and I did do podcast episode on long-term care insurance, which I figured people would be like, oh boring not listening to that. That was very popular episode. So that’s great. So this one will be to what else is there anything else like a an array assurances? What else? What else would you tell somebody? That’s like me going. What I would say is is again, it’s a lot of fear and anxiety that takes people over with you have the proper guidance and the proper support people will get to see that it’s not as complicated as it’s made out to be and it’s and it’s it’s not it shouldn’t be that complicated dead. So if you have the right guidance and the right support, everything will go smoothly essentially would end up saving a lot of you know, a lot of time and a lot of headache to support and if you’re taking birth family with Alzheimer’s or dementia, you have enough challenges and things to take care of you don’t need to be digging through paperwork while they’re trying to get your attention or they’re needing something to exactly you know, I just feel like this is this is a very important service for people to take advantage of you know, just just saving your sanity.

00:30:28 – 00:34:28

I’m sure is worth the fee because I I keep thinking fifty states fifty different rules different. I’m like you guys probably should get as much money as a turkey. It’s right. Well and I did also want to say the feed to pay for Medicaid planning actually is a Medicaid allowable expense. So meaning if you’re a family that is I should have said this many more times very much sooner, but if you’re a family member and you know, yep. Working with your loved one. You don’t have to worry you’re not going to you unless if there are no assets for your loved one. You’re not going to be paying for the fee Medicaid allows for you to take some money out of your life. Someone’s account to pay for this service. So this sounds like a no-brainer unless you’re right no money just to call a Medicaid planner call. You guys save yourself the freaking out anxiety stress. I know with me there would be tears and I’m assuming in the long run it saves time to yes, you you guys know what you’re doing versus getting off to say bad advice on the Facebook pages, but maybe incomplete advice as a proper way of putting it exactly you never know where those the person who’s answering you and they always say what the responses I’ve seem to always state-specific but and then they throw in their two cents worth. So right after you’ve read those just forget everything called Medicaid planner. I don’t I don’t see any reason why you wouldn’t change. And I’m really glad we had this conversation because man that just that one piece of information to me was worth the whole the whole chat good good good. So am I thank you so much Jennifer. You’re welcome. And I will make sure that your contact information is in the show notes. So people can call you since now they feel like they know you write good thing and it’s not Google and Medicaid planner and find one that’s in your home town. Maybe exactly exactly now, I’m pretty confident that even though this was a shorter than average episode that this information is some of the most important thing that you’re going to get from me this month this year. Not sure I try to provide lots of good information and that’s why I brought to you Sylvia and her Medicaid experience. You’re definitely going to want to share this with other caregivers other family members and friends and I truly hope that you do that. I also table Hope that you are enjoying the email newsletters with additional information and little catch-ups recipes and usually some cute dog photos. So make sure if you’re not subscribed to do that via the website next week. We have another great episode from dr. Elena on medications common in older adults. And as always I’ll be in your ears again next Tuesday. While I’ve got your attention, let me tell you about the modules in the eight-week online course from caregiver Chronicles. It starts out with what is a caregiver then educating yourself off on the diagnosis caring for a sick loved one and observing your loved one’s religious beliefs how to live a healthy lifestyle as a caregiver navigating the medical professionals understanding medication super important legal matters also important the decision-maker insurance Community Resources durable medical equipment, when a caregiver is needed finding a caregiver placement in a Skilled Nursing Facility or Memory, Care residence family Dynamics challenges and conflicts learning how to navigate that is probably worth the entire fee. Then there’s Home Health hospice been planning for your loved ones transition. Be sure to check out their weekly live. Dr. Yvette anything the link for that is also in the show notes.