You may come to the time when your loved one has to be in a care  home, and they do not have the financial resources. This is not just for elderly people, it can also apply to other vulnerable individuals.  In this situation, people in the U.S. may turn to Medicaid, otherwise known as Medical Assistance (“MA”).  This is not to be confused with “Medicare”, the U.S. government healthcare plan for anyone 65 and older. Medicare may cover a short term stay in a care home, but it does not cover long term care.

As happened with my family, we had to place my dad in a nursing home due to his advanced dementia.   He had limited assets, and I knew if he lived long enough, we would have to eventually apply for MA. (He needed it the last five months of his life; the cost at that time was $7,000 a month to stay in memory care.)  Important things you should know:

• If you or a loved one may need to qualify for Medicaid one day, there is a five year “look-back” period. You will need paperwork regarding house sales, vehicles, and nearly every other expenditure.    Come up with a good system to track every dollar, including what is spent on health care.  Also needed are birth, marriage, and divorce certificates, military service paperwork, home and vehicle sales, immigration documents if applicable, and more.  Keep all such documents in a central location.
• The person qualifying has to “spend down” their assets. At the time my dad qualified, he could have no more than $3,000 in assets, including life insurance. One way to offset future costs is to purchase a funeral plan.  If done correctly, this money does not count against one’s assets. When my parents’ house was sold, we immediately appx. $6,000 each in funeral plans for each of them, which did cover their deaths and basic funerals.  (This did not count burial, as they were buried for free at Fort Snelling, as my dad was a veteran.)  It is not cheap to die!
• We then had to pay back to the state all his leftover assets (less than $2,000) to make up for receiving MA.
• I recommend seeking the help of an elder care attorney to understand how this all works. The laws may vary from state to state, are complicated, and it is difficult  to find specific information.

I wrote this in the book “Dancing With Lewy: A Father Daughter Dance Before and After Lewy Body Dementia Came to Live With Us”:

“In September 2011, Dad ran out of money. Of course, I knew this was coming, so I was prepared. (Thanks to my mother and her bookkeeping, I still had the records from when I initially applied for MA assistance years ago when they did not qualify.) Finally Dad was approved, and the government paid his nursing home bills of over $6,000 a month.

When my parents sold the house in July of 2006, they gave each of us four daughters $1,000….For five years, I wondered what would happen if my parents ended up needing MA, as the government has a five year “look-back” period. Would we have to declare that they “gifted” us this money? I asked my oldest son who works for the county. He said yes, we would have to declare any significant funds they gave away within the last five years.

The date he began receiving Medical Assistance was in September 2011. The five-year period ended July 2011.

Coincidence? Luck? No, I don’t think so. I believe God was protecting my parents, just as he had promised, and he was also looking out for us sisters, as this $1,000 was basically our entire Inheritance.”

Here is a link to a brochure explaining more about MA.

https://www.medicare.gov/publications/#results&keyword=11409

As your loved one ages, keep in mind the five year look-back period.  Any significant gifts given away during that time may have to be repaid. Financial and other related records will be needed for that five-year look back period.  Again, you could seek the advice of an elder-care attorney to learn more about how MA works, and what may be applicable to your situation.

Information about “Dancing With Lewy” and links to caregiving resources may be found on https://nancyrpoland.com.