Why is it always a goal to put aging loved ones on Medicaid?

Because my mom will be running out of money in less than 3 years , maybe add a year or so. I worked hard all my life. She did not work. She could have. My father could have taken better benefits, did not. I cannot afford $2500 a month to take care of my mother when she runs out of cash. I never even had a house payment that high.

I have not read any of the other comments . I think it might be so prevalent because of the cost of care in a facility. My sister was in a beautiful 3 step facility For 7 years .. It cost the better part of $650,000. And yes, I have the right amount of 0’s She was very fortunate, most of us do not have that amount of $$$ available to spend for elder care and Medicaid is a back up ..

You are very wise to question it! I do NOT recommend getting medicaid unless you absolutely need it. In order to keep it they want you to live in poverty. NO WAY! There are many changes that are going to be coming soon to insurance and how hospitals operate. The cost will come down and our coverage will improve. WAIT before making a decision that would limit you mom's happiness by taking AWAY everything she worked so hard for her entire life. I am praying for your mom's health and that soon we will also find answers to the many diseases out there. God Bless You! Very Smart observation!

It is a difficult question.  If you believe that legal Medicaid planning (gifting 5 years before a NH is needed) is immoral or unethical, do you think that gifting to legally avoid estate tax is immoral or unethical?   I would insist that no matter how my mom's money is titled, she get the best care, but I do not think the morality of Medicaid planning is so clear.

People who can afford to pay for care should do so. Medicaid should be reserved for those in legitimate need.

We spent my parents' retirement money on their care. The problem is that it's very, very expensive. If they had not had good pensions, we would not have been able to afford it, and that's what most people discover as they start pricing things like in-home care or assisted living. You would be surprised how quickly $8,000 plus medical expenses paid out on a monthly basis goes. In addition, if children are involved in the care of their parents, which is quite often necessary as home care workers need help and supervision and facilities are pitifully understaffed, parents generally want to leave their children something as well for all of their efforts, which are frankly, considerable. This is the beginning of her decline. Things may look a little different to you eight years down the road.

There are several views regarding Medicaid.
1. A couple has assets but spends freely, having every possible luxury, and save nothing. So they go into a nursing home later in life and Medicaid foots the bill.
2. A couple live frugally, doing without luxuries, and accumulate a sizable savings account. So they go into the same nursing home and use their savings to pay for their care.
3. A couple with considerable wealth sign over their assets to their children well before the five year look back period. So they go into the same nursing home and Medicaid foots the bill.
it seems that the couple that scrimped and saved lost out!

Using Medicaid to pay for nursing home care becomes a necessity for many for a stay that extends over many years, but should never be used as a dodge to pay one's fair share. This program is going broke!

I speak with experience. My husband has been a private-pay long-term resident for the past five years. He entered long-term care at age 59 due to frontotemporal degeneration. Some time next year, we will run out of money to pay 100% of his nursing home bills. He will still be able to pay about 50% of the bill. To extend his private-pay status, I will take out a mortage on my paid-up condo, which I should be able to pay off in five years. I also fully intend to pay Medicaid back every cent they pay for his care, even if I am into my ninth decade. Once I begin taking Social Security at age 68, I will voluntarily contribute about $10K annually to his care. That will decrease the amount I must reimburse Medicaid.

There are legal ways to shield assets. A competent elderlaw or estate planning attorney can help. Our attorney will convert what is left in my retirement accounts to a Medicaid-compliant annuity. The good news: I get to keep the money. The bad news: it's a fixed income stream.

You ARE reading the situation correctly. “Good” nursing homes have all manner of methods to resist taking Medicaid patients up front, though they claim to take Medicaid patients. What they mean is that they don’t eject then after a good stint of private pay exhausts their resources and they end up destitute and on Medicaid. We had the same attitude you do. Mom died in an excellent nursing home on private pay to the tune of $12,000 per month and her children, most of whom could have really used my deceased father’s inherited wealth, ended up with almost nothing split five ways. Most families are looking for ways to avoid paying for nursing home care. Whole cottage industries of so called “elder attorneys” exist for this very purpose.

Though it differs from state to state (and you have to check on the state where your mom lives) typically Medicaid only kicks in once you’ve exhausted all your assets and are down to your last $2000. You’re expected to use your own funds to care for yourself until then.

However, you have to use your funds on only yourself, and cannot transfer/gifts assets or funds to anyone within the last 5 years in order to qualify. If you do, you will have to figure out how to “pay back” that amount before Medicaid starts (or pay a penalty.)

Because, depending on where you live and the level of care that you need, nursing homes and/or assisted-living can cost anywhere from $2000-$10,000 a month, you can see how quickly you can burn through your assets, and end up on Medicaid.

I am concerned and confused about these issues. i am an 86 year old retired teacher with a tragically mentally and physically ill and crippled 65 year old daughter. She is in an excellent assisted living facility because i could not be her caregiver. I want her to give me popwer of attorney so i can sell her home. i want to use the profit of at most $128, 000 to pay for ongoing excellent care for her. The money would pay for her excellent care for at most 5 years.Then, she could apply for medicaid. I am being urged by a lot of so called experts to have her apply for medicaid now. i have been called by 3 "group home managers" so called urging me to place my daughter with them. They sound very unintelligent and disorganized.My income is $3100 a month and my daughter's Social security income was dropped from $2400 a month to only $1225 a month at her husband's recent death.Obviously, i cannot pay for her care very long.However, I want her nearby and with excellent care for as long as possible.Why do so many people urge me to have her apply for medicaid now/ What can i do? Thanks

This month has been horrendous! All at once my husband got an infection (not Covid) & also lost all strength. One week of hospital and the rest of this month in Rehab. So far our insurance is paying, but we almost had to have private pay. Our appeal & his progress has kept him in Rehab via insurance. $350 a day would be impossible. He has an autoworker's pension, Social Security, almost no savings, and a long-term care insurance that currently requires 90 days before kicking in. I say currently as they're about to re-do the plan.
I'm the owner of this home (2d marriage for both of us), but he may be considered part owner, I'm not sure. I, too, get a pension from where I worked, Social Security, long-term care insurance, but I've saved like crazy including 2 annuities. I also normally am a freelance worker. (Covid currently has unemployment coverage for freelancers.) I'm concerned when I read the Spousal Impoverishment rules <https://www.medicaid.gov/medicaid/eligibility/spousal-impoverishment/index.html> . I'm not concerned about what either his or my kids might inherit, but have tried responsibly to plan for the financial "joys" of old age. I'm the one who talked him into the long-term care policy because I knew he had some health issues.
Yes, we'll pay privately (home health care?) while we can, but that doesn't look like it will continue to be enough? Does this mean I need to give up on my own continued work and savings? I'm glad there's at least some provision, but it sure doesn't speak well to those of us trying to be responsible.

I always have the same question. There are no doubt people who truly need it, sometimes through poor planning and sometimes not

But often, not ALWAYS its basically a scam to have taxpayers pay for ones care rather than oneself. I have seen plenty of examples in that in my own extended family.

There is absolutely No Other Reason But Money. People want their inheritance money and don't want it spent on Caregiving which is a bunch of poop.

My 96 yr old Dad worked and saved and had a nice nest egg that us 4 daughters thought we'd be divinding once he past but last year with his dementia worsening, he needed 24 7 Care.

Im the youngest and lives the closest so I've always done everything for my Dad as he aged like Dr's Appointments, Groceries, manage his money, pay his bills, ect. I am also the Executrix of his Will.

My Dad always wanted to stay in his own home and not go to a Senior Home and I promised him that would happen.

So, as of a year ago, I informed everyone that Dad would no longer be giving out money for Xmas and Birthdays and No Loans to anyone that he needed his money for Home Care.

I hired Cargivers and my Dad had 24 7 Care.

I had my son install Nest Cameras so I can check in and see and hear my Dad 24 7 and make sure the Caregivers are treating him right.

24 7 Home Care is very costly and hopefully his money doesn't run out.

Aflyer a year of 24 7 Care doing their shifts. I'm now thinking to make his money go farther, I'm going to look in to hiring a Live In which would be 1/3 of what is being paid for multiple Caregivers doing their shifts.

People should only concern themselves with what the Loved One wants, not be selfish and spend and or hide the loved ones assets so they can qualify for Medicaide which you could end up in a not so desirable place to lay til you die where they are just a bed to most and where they will feel sad, abandoned, lonely, scared and will lose their will to live.

Im sure they're are some nice places but even the nice places that look pretty and are made to sound so great is only for your observance and it's a different story behind closed doors.

The Loved ones should be able to live out their last years doing whatever they want.

Do to them what you would want done for yourself.

Tall to them, they know what they want. Make it happen for them.

Only if and when the money is gone should you seek Medicaide.

Best thing one can do for an aging Senior is let them live out their life in their own home where it's familiar to them.



Even

At the advice of her financial planner, my mother worked with an elder care attorney in California to create an Irrevocable Trust. The reason was to prevent my mother from being bankrupted by my father’s dementia. Also to reduce (or was it eliminate?) inheritance taxes for me, their only child.

My father passed two years ago after three months in memory care and one month for rehab after breaking his hip. This was paid for out of their savings. I helped my mother sell the house and move her to the lovely retirement community she couldn’t convince my father to move to. Her common refrain was “after your father passes, I will move to Rossmoor, and then I’ll be happy.“

The PA who ran in my dementia support group warned me that after my father passed I would notice the deficits in my mother. Boy did I. She had been mismanaging money for awhile. She had cancelled my Dad’s medigap insurance and had to pay out of pocket for his rehab after his hip replacement. When her financial planner told her not to worry about paying off her home equity loan until after the house was sold she stopped paying altogether, adding $20,000 to the bill. I wrote these off as hearing mistakes. The new hearing aid hasn’t helped.

I have had mixed feelings about this trust. If I were the state of California I would be trying to eliminate these trusts which allow families with an expendable $8,000 to bilk the state out of billions in estate taxes. However, when my mother spent $500 on a paper shredder because she is an important business person and had three months of $1,000 PG&E bills after she “adjusted” her thermostat, I am grateful that she does not have access to the money from the house sale. Scammers abound, and I am sure you’ve heard the stories of seniors giving their money to bad actors.

The deal with the trust is that I am not allowed to use the money to directly benefit her. But how I spend my money is my business. This requires me to move trust money to my account before putting it into hers when her expenditures exceed her bank account.

My thoughts on trusts are that while they are legal, they are not exactly ethical—a convenient loophole for people with money to hang on to their money. However, as my mother has been recently diagnosed with dementia, I will use trust money to take care for her when her savings run out. As memory care in her neighborhood runs $12,000 to $14,000 a month, this is a distinct possibility. If she outlives that, we will have no choice but to apply for Medicaid on her behalf as I my husband and I need to save our money for our possible care.

We spent every last penny of my mom's money on her 24/7 care at home, including selling her home and using that money. As we saw the "writing on the wall" with her decline in health, we tried our best to make sure all her money was spent exactly as it should have been so she wouldn't be penalized by Medicaid. It was my mom who was screaming and hollering that she wanted to buy new cars for my two kids, NOT me.

Their money runs out because they live so long with all the excellent care they get.

I went through this issue with my mom the last year before she died. My mom had funds that were quickly being spent down for in-home care and I faced the prospect of her going into a care home and eventually qualifying for Medicaid. She died before she went into a facility, so it all became a nonissue. However, I believe that a person's funds should be used to pay for their care, not to fund children's inheritance. I am heartened by the replies here that advocate that position. I talked with a Medicaid attorney while doing my research and asked why I would want to pay him to work toward speeding up the process to get my mom qualified. When he said, "to protect her assets for you", that was it. I was out of there. Again, my personal view, but government funds are supposed to be used to help the needy, not the greedy.

My husband has battled with ALZ for over 11 years. Every call I have made in the last five years to try to get assistance I state up front that we do not qualify for Medicare, and they always try to convince me to apply, I always refuse. We have savings and no debt. I private paid for home care for years, eventually I received VA benefits to cover four mornings a week, and this year he was put on hospice, so Medicare cover three mornings a week and home health needs. At this stage in his life it would be impossible to make the changes required to be Medicare qualified, and really I see that as a blessing. We have both worked very hard to be financially blessed. Our son is grown and his children are his responsibility. My only financial concern was somewhat selfish I suppose, I have many years to live and I know a nursing home would deplete our savings in only a few years. I own a small business, but it’s not enough to live on.

I completely agree. I have used my mom’s savings for her care. I am grateful for the Medicaid safety net should she need it. I also was able to get her VA Benefits from my dad’s service when she was out of funds. Between those benefits and her social security, we are able to keep her in good care.

I don’t think that it’s usually a goal to move someone toward qualifying for long term care Medicaid if funds are available to pay for care.
I am a caregiver for a lady that saved all of her life for the “future”, in the meantime that saving caused her health to be neglected. She now has serious medical issues that require frequent procedures as well as assisted living. Her costs for her monthly insurance premiums and her monthly rent at assisted living total over $5,350 per month. Her savings are dwindling fast! If she had put some of that saved money toward taking better care of herself throughout her life, she might have been able to live in her apartment independently for years later on. For her, the “future” is now and she’ll be financially destitute within a year or so. Believe me, long term Medicaid will be necessary then but not something that either one of us ever wanted or maneuvered toward.

My husband has early onset Alzheimer’s. I’m using his 401k for his care - first memory care and now nursing home. In my mind, that’s what it is for - to give him the best quality of life I can.

To protect their children's inheritance. If you can afford $10k an month for nursing care for 2 years ($240,000.00) go for it. If you can't or your ailing parent can't then Medicaid forces that price down when they pay for it. It is ABSOLUTLEY RESPONSIBLE to your parents, your siblings and your grandchildren to plan for Medicaid.

A sin and a shame that elder care costs so awfully much - lots of pork, and big bucks to investors, I'll bet. The whole thing is a gamble!

I don't think it's. a goal to be on Medicaid for most people. If you have money, you have choices. The best nursing homes in my area will accept Medicaid but to get in you'd better show them $300k to $400k in assets- and the house doesn't count. Their Medicaid beds are for the residents who already spent the 100s of thousands of dollars renting a room.

People act like families investigating Medicaid are all gaming the system. Most people are just trying to responsibly manage their parents' estate- in my opinion. You really can't fault them for investigating the rules and acting according to them.

I don’t think it’s anyone’s goal. In the many cases like mine my mom doesn’t have the financial means to pay $8-10K per month for Alzheimer’s care. I’ve taken care of her for 6.5 years but now physically and even emotionally it’s more than I can handle. So therefore I’m trying to get her Medicaid. Hope this helps.

You've asked a very good question. The only reason to move assets is to hide them from Medicaid. The aging person does not benefit in anyway - the heirs do. I agree with you. They saved all their life for old age. Use it to pay for the best care you can get until it runs out. Then, use the Medicaid that is intended for people at or below the poverty limit. While money is available, why not pay for the best care you can afford? It belongs to the person needing the care.

I worked in welfare programs and retired with a state agency. With politics being front and center these days and comments being made about people wanting something for nothing - some of those same people forget (I sure didn't) that they called me at one time to ask "How do I hide my parent's money, property, house, etc" Or, what should I put on this application for a Medicaid nursing home bed about my mom's savings account". My answer was always the same - you tell the truth because once you use up her money, she will be eligible for the Medicaid bed. There was no way I was going to give advice to circumvent the system and lose my job. So what it comes down to, politically, is that there are some people who detest the thought that someone might get something for free UNLESS they are the recipient. Then the story is 'I worked all my life and paid taxes" No, you didn't earn a penny of your mom's money - she did. You just want to get your hands on something you did not earn.

My job was always a joke at a gathering of family/friends/etc. Someone had to mention what a welfare recipient looks like, however they would never identify their own Medicaid mom as being what a welfare recipient looks like. --They told me about all the cadillacs parked in our parking lot. 1)The car might have belonged to a working employee 2)large, older gas guzzling cars have been cheap to buy for years. 3) i work there and have yet to see a parking lot full of cadillacs. --Then there was the Food Stamps and depending on what race the person was who was talking, an opposite race would be mentioned saying it was all that particular color getting welfare. I got denied because I'm white, black, brown, etc. NOT. The rules are the same regardless of color. You're either eligible or not. -- And always knew someone getting thousands of dollars from welfare. Don't think so. People survive on welfare, they don't create huge savings accounts. And I happen to know the maximum amts for each program. Yes, a few cheat (and I worked in investigations) - but I saw far more people who could afford medical care/facility care for an aging parent trying to hide assets than I did cheating Food Stamp recipients. Some of them got away with it because they were lucky enough to move the money prior to the 5 year look back period.

I actually overheard a lady whose mom was in the nursing home having a conversation with her friend. The friend asked how much it cost a month to be in a nursing home. The woman replied, we don't pay anything. I made my mom destitute so she would get a free Medicaid bed. We moved all her money over 5 years ago while she was still living at home. I thought to myself - what a wonderful daughter you are to make your own mother a pauper.

I failed to mention in an earlier post the existence of continuing care communities, especially those that are “life care” designated and can’t throw residents out if their funds dry up. Of course, these communities do an upfront review of prospective residents’ financial assets and health issues before being admitted. When I lived in Maryland, I started touring these communities while healthy and in my sixties. Seniors often sell their homes and use the profits to buy into these communities. Had lots of fun touring, hearing the sales pitch for each and enjoying a free meal or two. One of the things I learned was at least one company managing these communities, Erickson Senior Living properties, reimburses 90% of unused funds to residents if they die or choose to move out. Some folks move into these communities and perhaps after a short period, they leave or die and all invested funds are lost. Not so with Erickson. They have several properties in MD and I think maybe Delaware and PA. Worth looking into Erickson. Of course, if you spend a decade or more in one of these communities and within that period move from independent to assisted living and then skilled nursing care, your initial funds are gone, but they were used to help pay for essential care. Plus, one can’t be kicked out if funds dry up. For those who can afford something like this, it can be a good plan. I would think there are other senior communities with this type of financial arrangement where there’s reimbursement of unused funds The time to look into how these communities work, ask questions, and review each community’s financial status is before they’re needed.

I agree totally! I have been saving all my working life planning on using the money for retirement. If any is left when I die it goes to charity. My family is all well able to take care of themselves without my money.

My mother fretted that she wanted to stay in her house so it could be sold and the money divided between her children. It took a lot to convince her we didn’t need the money and her funds should be used on her care and comfort.

In my opinion the only people who should be using Medicaid are those who have outlived their assets, as my mother soon will, or those who haven’t been able to save enough to support their retirement.

Medicaid is a government program designed for people who are truly indigent, no money, no assets, and can’t live on Social Security. It is funded with tax money so in the end we are all paying to support the program.

If you have the money to pay for home help, Assisted Living, etc they that money should be used for that purpose. When it runs out then Medicaid is appropriate.

Do your homework too, most AL facilities do not accept Medicaid waivers unless the person has been a resident for at least 2 years. And while nursing homes are required to allocate a number of beds for Medicaid beds they might be the smallest or shared rooms. Medicaid residents are not profitable.

Based on my experience I think you have an accurate assessment.

However in the real world with people living sooo much longer all of these entities you mentioned promote moving your loved one (and making the appropriate estate planning to permit it) is to prevent all of their assets from being spent on medical care.

I agree with you. If your Mother has the resources you should spend it on her care. By you using her money it keeps you and her in control of where she goes, what care is provided etc.

I have a friend whose parents were wealthy, they lived until their late 90s. This friend (their daughter) used this money to allow them to spend the last 20 years of their life in a VERY nice facility with high quality care. In that whole time she never was told "sorry medicare/aid does not cover tha" When her last parent (her Mother) died there was about $100k left. Had she/they gone the route of getting the parents on medicare say 15 years sooner there would of been about $2mil left for her and her sister. BUT her parents would of spent the last 20 or so years of their life in a very different facility, different level of care, etc, etc. It depends on the financial resources of the parents/family and how much control one wants to have over their elderly years. Her parents could have died 2 years into it and she would have gotten the money. Her parents could have lived into their 100s and she would have had to eventually transistion them into a medicaid funded lifestyle.

One things for sure GET EDUCATED NOW on how all this works, the rules of medicaid, the IRS etc. There are rules with time constraints like 2 years of caregiving etc,etc,etc. The time to figure this out IS NOT when Mom/Dad are impossible to deal with ort are phisically or mentally incapable to deal with.

Find an accountant and an attorney well versed in elder/Senior issues