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Lawyer was handling the application but once the application was approved, they dropped me like a stone without giving me the chance to ask questions. All along I've been required to forward copies of my mom's bank statements every month to the lawyer who was forwarding to the case worker (I assume). Now that the application is approved, do I need to forward the statements directly to the case worker or was that just for the application. I'll have to look through my paperwork. I don't even know if I have contact information for the case worker. I have invested so much time and money into getting this application approved, I don't want to mess it up now by missing something.

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Each state runs it’s Medicaid program uniquely. There is a caseworker assigned to your mom. Some states assign them by facility, others by zip code of the initial application. The NH should know who her caseworker is. Get that info as it will come in handy. I doubt they want monthly anything once she’s eligible. But that doesn’t mean you can toss stuff out...... more on this below.

For us & TX Medicaid, once approved, the state sent whomever is the contact person on file (usually the dpoa) all correspondence. You imho do NOT want this stuff going to mom at the NH; needs to come to you at your address. In the approval letter, there should be a to the penny figure that is your mom’s copay or SOC (share of cost) that is what she must pay to the NH each month from her monthly income. She will be allowed to keep a small personal needs allowance. PNA varies by state, like for TX it’s $60 a mo. So say mom got $1150 retirement plus $800
SS$, so $ 1,950 total for her mo. income. If PNA is $60, then her Medicaid required copay is $1,890 a mo to be paid by her to the NH.

Now your mom can continue to keep her SS as direct deposit to her old checking account and then you write a check to the NH for the copay & the PNA $ stays in her checking account & builds each month by the PNA amount.
OR
mom let’s the NH become her payee and the NH will put the PNA $ into a trust account in her name at the NH & you as her dpoa can go and withdraw from it, usually at the business office.
NH cannot require mom to have them become the payee. Although they will heavily impress that it must be done this way. Nonsense! Mom can chose not to. We did it this way and just had to make sure that NH got paid her SOC by the 5th of each month. For us, it was better as I live in another state and this way I could let the pna build and do a bigger buy of toiletries and clothing replacement every 3 mos or so as it fit my timeframe. Whichever way you choose, you must, MUST, make sure that each month, she never goes over $2k in assets. 2k seems to be the max asset limit for most state LTC Medicaid.

there will likely be an annual recertification or renewal of her eligibility. I didn’t know this happened and had boxed all up & into storage. It had a 14 day deadline and was postmarked days after the actual interior letter. That was a fun weekend..... For us, the renewal the first year came 1 month & a yr after mom was deemed eligible. It was a questionnaire that required some of the same info submitted initially (like her annual awards letters, funeral pre-need, life insurance) and the current months bank statement and prior 3 months as well. This is why it’s mucho importante that mom starts and ends each month under the 2k asset limit in her bank statements. If she’s over, it can jeapordize her eligibility.

When her second renewal came, I was totally ready with everything in a binder that I basically updated as mail came in.

The awards letters are especially important. These are the trifold mailings that like SS, federal retirement, other pensions mail out like in Oct or Nov of this year, that indicate to the penny what they will be paying mom starting January, 2020. Medicaid uses this info to recalculate what her copay or SOC is starting Jan for her (or you as dpoa) to pay the NH from her checking account. If your mom was just approved, likely renewal goes out next September. But you may get a awards letter questionnaire in December. My experience is that the state sent letters have a tight schedule for submission. Like 14 or 21 days, so you kinda need to continue to stay organized with her paperwork. I had 3 binders for each year - banking, medical (like those mailings CMS sends out that list for MediCARE who was paid & the code & amount) and then 1 for everything else. Medicaid didn’t send out any statement or summary as to what they paid ever.
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NancyK123 Aug 2019
Thank you so much for your knowledge. So going forward, I'll just make sure to keep every single scrap of paper in an organized way and keep an eye out for correspondence. I'll make sure all her correspondence is coming to me and not the NH. Thanks again. Much appreciated.
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Congratulations! One hurdle jumped successfully. Igloo is the resident expert on Medicaid here has given you excellent info. I’m in NY so our Medicaid process may be different than in De. but on the acceptance paperwork there should be a case number and a caseworker name and phone number on it up near the top. Do you have it or does the lawyer? If so you need to get it in case you want to ask them anything. It also documents her share of cost showing how much she gets to keep each month for her personal needs account at the NH. I did not have to send anything else in to her but I saved all bills and statements because in about 10 months they will send you a reapplication to fill out with up to date information. The reapp is much easier than the initial application but you have to make sure you get that form and turn it in on time. Don’t let any paperwork go to the nursing home or you may miss something. You’ll need to keep track of her balance in her personal needs account at the NH as well since the NH will deduct hair appts etc automatically from that account.
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NancyK123 Aug 2019
Thank you so much. I'm like a deer in headlights right now. Its calming to know there are people that I can ask. It doesn't sound so scary when you and Igloo say it. I do have a copy of that letter. So I guess I get a little rest until that reapplication letter comes. I'll be ready. Thanks again.
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My Mom an I just saw an Elder Care Attorney. NIGHTMARE. For my Dad. He is getting where we can not physically care for him. Well we have done everything WRONG last 5yrs. Big time penalized. Then lawyer said in Tx, after one is approved an in NH there is a trial yr which Medicaid looks deeper into financial history. ANYTHING we forgot or missed to bring to attention they could find an automatically penalize an no longer eligible an Dad would be kicked out(due to no money to pay NH to keep him there) an any months prior would have to be paid back to NH!! Unreal. An I have been their caregiver 7 yrs. I didnt or couldnt work due to their care. So my husband an I suffered financially an my 2 sons last 7yrs. So my Mom decided to start paying me for caregiving. We thought since it was a check an we wrote " for caregiving an dates on memo" it was ok. Ir proof! NOT OK IT TURNS OUT. GIFTING. So every check she gave me so we could pay our bills counted as gifting. Then Mom has been withdrawing cash each month ( old people like to havecash on hand. She wasnt doing out of spite an we didnt know it was NOT ok) or I withdrew like 500$ or 400$. Then went on for yrs. An we did not know its not good for me to be " joint-owner" on their acct. We did it that way an bank agreed rt move back in 2015. They had alot of money an we didnt think Dad would last an wanted someone to be able to close acct an take or move money!! Well now due to his care an their decline I had to put them in independent living (cheaper than assisted living) for 2 yrs at 3,500$ a month plus secondaries, meds, Insulin (1600$ for 3 months both on fast acting an long acting)some groceries, etc..so the money went fast. Finally had it at the Independent place. Making them sick fr food, an smoking allowed inside an both on oxygen, etc...so moved to handicapp apartment to conserve money. So all those withdrawls an all those checks to me for not much, off an on during 5 yrs look back , an my sacrifices are just slammed into ground. We litterally have been avoiding NH. Both 84. Now prob a immense penalty for either!! I just dont kniw what to do. My husband an I are broke. Our house is to small. I have 2 sons at home. Patents have 35,000$ left. Dad not doing that great an Mom so tired an own health issues but at least tries to be compliant with dr orders an can care for herself except bath. Dad cannot do anything for himself except chg depends (barely)& we hired a professional caregiver in Nov to releave me of some things because I have health probs now an bad back. Im 50. An depression/anxiety an ADD . But now letting her go an I will have to go over again an do everything. Neither drive. An Home Health Agency was an has been for 7yrs, coming 3x a day an giving diabetic shots an assessment once wk. Now thats stopping due to Medicare wont pay for in home diabetic shots anymore. Its a total mess an nightmare an lawyer wants 10,000$ an that doesnt guarantee penalties will be less either. It means he will try real hard to get it down . If 10,000$ gone that leaves really 20,000$. An their secondary is extremely important because of so many tests or dr appts. Home INR machine etc... im so depressed. They cant move in with us. My sister has 2 bedrooms not used but in another state an hr an 20 away. Uprooting them an all new dr's an a smaller town so not many specialists. I cant just dump them under a bridge!!
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newbiewife Aug 2019
Lynn, I'd suggest you start a new thread so people will be able to see and respond to your situation. You could just have a new heading and copy and paste the text you have here into that new discussion. Best of luck!
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We live in NYS and did the Mediciad approval as well. The other positive responses were great. Let me reemphasize that keeping all records and receipts in organized manner is key. Have a paper trail for everything and use checks and reasons for all bills and cash withdrawals.

In NYS there is five year look back rule and Medicaid looks at everything suspiciously. Organize, put it in a binder and call your social worker with any questions. I was so fortunate that our elder attorney was amazing and also responds to my emails promptly.
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Mhillwt Aug 2019
5 yr lookback only for institutional ie not community medicaid
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Good luck. I went through the Medicaid application for my Mother.
What a nightmare! At one point I had to get 5 years of bank statements and turn them in to them. Oh my gosh. It is very scary and stressful.
I did everything on my own. When I tried reaching out to Medicaid
I got very little help which was very frustrating, I am sooooo glad that
is all behind me now and I feel for anyone having to go through the
process. Good luck.
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elaineSC Aug 2019
I went through this too with my Mom and you are so right. It is extremely stressful. When you call the Medicaid office, you really get an intake person and they forward your questions to somebody else who may or may not call you back.
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GREAT QUESTION & equally eye opening answers! We, My Mom & myself are still waiting for Moms acceptance of Medicaid...God willing, so this is a question I too wondered about!
Now I’ve got my own questions to ask as My Mom is still living with me.
Thanks & GodSpeed.
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igloo572 Aug 2019
Dora, if your mom is living with you, then she is probably not applying for LTC facility Medicaid (like in a NH). She’s applying for some sort of community based Medicaid program. Could be IHHS (in home health services), could be just becoming a “dual” (medicaid is her secondary insurer to Medicare), could be her going onto PACE. Which program is super important to know as each has its own specific “need” that she will have to be documented to show to be “at need” for.

Medicaid is a huge HUGE program run by each state uniquely but under overall federal guidelines. Medicaid is everything from those Happy Teeth vans that kids enrolled in Medicaid CHIP visit, breast pumps loaned out to new moms on Medicaid via WIC, to paying for room & board costs in a skilled nursing care facility via LTC Medicaid. Again each specific program has its own both medical and financial “at need” criteria.

So which medicaid did she apply for? Really you want to know exactly which program and what the exact details are.

My experience is that for LTC NH Medicaid, they have to already be a resident of a NH, so living in the NH at the time of filing the LTC Medicaid application. LTC NH Medicaid has tightest “at need” criteria imo. Like they basically are financially impoverished with most states having that amount at a maximum $2,000 in nonexempt assets and their medical chart documentation clearly showing need for skilled nursing care.
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After approval, there is an Annual redetermination by the DHS. You or your mother will be contacted by them. Call the local DHS or go to the office and find out the case worker assigned to your mother’s case. They will be happy to answer your questions.
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Call your local medicaid office and ask the question. You don't want to drop the ball on this in case it might deny her. They can tell you what happens from here forward.
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Good last question for the attorney who set it up for you.
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You needed to ask questions along the way I have a MediMedicaid adjuster that I am paying and I only have to supervise one year of bank statements doing it every month was probably just with the attorney wanted I would Not worry about it they’ll let you know if they need anything else but once it’s approved you’re done
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My bad. Once a year re evaluation
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Ask the attorney and Medicaid for all details for the future. And follow up a verbal question by writing them to confirm your questions, etc. And save all documents and expenses, etc. SO YOU HAVE THEM IF YOU NEED THEM. Be safe, not sorry. Document everything and protect yourself.
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You should go with Igloo's on point post.
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Medicaid follows up once a year. At that time a form will be sent. In my nephews situation he needs to send in payroll stubs for a month, savings/checking last statements. annuity and SS info, and even though it can't be counted, his Special Needs Trust statement. So, you don't have to worry, u will be contacted.
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