Navigating Elder’s Home and the Medicaid Jungle: Meme’s Story Part 10

Good morning, afternoon, evening, or whatever time you’re reading this. If you are just tuning in, I am writing about my paternal grandmother’s mental decline with dementia in order to raise awareness about the disease and its effect on the person and caregivers. You can find the other nine parts here.

I haven’t written about my grandmother’s journey with Lewy Body Dementia in some time. Right now, her mood seems to be better. She knows who everyone is, but still doesn’t quite understand where she is in the nursing home. She also keeps asking for money to “buy herself a coke or something.” While we tell her that we can get her whatever she wants and that valuables like cash aren’t allowed in patients’ rooms, she soon forgets this.

Right now, my father is struggling as my father and mother are currently both on social security. A fixed income means that they cannot afford to keep up the bills on two homes (theirs and my grandmother's). He’s been able to write her checks and pay pills for her with her checkbook (good news about having a POA). But, money from her bank account is slowly dwindling with the payment of bills and for her stay in a nursing home. Right now, with her Medicare plan, it is about $1600 a month. (Without Medicare costs, some nursing home payments can reach almost $6,000 a month). My father has even received bills as high as $21,000 even though her Medicaid status was still pending. Of course, neither I nor my parents can afford that amount. o.O

Upon the advice of the American Council on Aging: “Some nursing homes may ask the resident’s family to pay for the full cost of care while the elder’s Medicaid application is pending. It is highly advised that the family does not make this financial commitment. If the family covers the cost of care in the interim, they very likely will not be repaid once the application has been approved.”

The plan my family has is for me and my sisters to begin living in her home in order to pay for her bills. I myself have been attempting to clean up her home. Sometimes, this feels like I’m intruding. Sorting through closets, and gathering up her important papers. I have let her know what I’ve been doing. Sometimes it’s like a treasure hunt. I’ve found a Nazi flag my great uncle took as a trophy from an SS jeep in WWII. I’ve found war stamp booklets, napkins from my parents’ wedding, and even my father’s prom pictures from 1973. (He looked pretty good in his sky blue tuxedo with white ruffles XD). I promised my grandmother that I would take care of her home if anything were to happen to her health. I also know that this is a temporary situation.

Most likely, the nursing home and Medicaid will end up needing to recover the money she borrowed. This means the nursing home and Medicaid offices have the first claim on the value of a home when sold. The rest is distributed according to the deceased wishes dictated in a written will. But, getting my grandmother Medicaid is a whole mess in itself. My grandmother has applied to Medicaid many times, only to be denied. Medicaid is a government program that provides health insurance for those with limited income, while medicare is an insurance program for elders 65 and older. My father has to keep calling the bank for more bank statements to be submitted. The last time she was denied a few weeks ago, she was barely below the “threshold” for income ($2,000 in Arkansas). She was also denied because she had “too many resources.” When she only has her car, home, and social security checks…And so the fight with the Medicaid office begins again…

My knowledge of Medicaid Estate Recovery is quite limited. So please talk with someone who knows elder law before making any decisions. Some lawyers will offer free consultations. (My father was unfortunately told after his first consultation that he “couldn’t afford” them.) Other resources and research that I have found, will be listed below. Basically, if you do receive Medicaid for long-term care services, DHS will file a claim on your estate upon your death. This means that your home is an asset and may be the only way for Medicaid to recover the money.

Sometimes, they won’t pursue the claim, and sometimes they will. For example, the claim can be waived if: recovery will cause undue financial hardship on loved ones (for my father, it will) or the office determines that recovery of this debt is not “cost-effective.” (I have absolutely no idea what that means).

HOWEVER, if a son/daughter or caretaker was living these last two years before their parent entered the nursing home, the recovery is waived. The same applies if the house is put in a child’s name or ownership. My grandmother could have put the home in my father’s name two years ago, but sadly did not.

For an “undue hardship” claim, you have to file for a waiver. Medicaid Recovery can only file a claim on your home AFTER your death, and if the house is sold or goes into probate. Probate is a court proceeding where a judge authenticates a will (please it’s better if you have one for your loved ones) and distributes the properties or assets.

Her home is placed in a trust which automatically bypasses probate courts. My father becomes the beneficiary of that trust as her last living child. However, this only occurs after the Medicaid recovery claims (if they chose to file one, are paid).

Whew! A lot to take in and for my family to deal with right now. I can only hope that perhaps an “undue hardship” claim can be filed. (But, working with the government is always messy).

Part 11 can be found here.

In the meantime, I’m still working on my Meme’s Angels Team for the Walk to End Alzheimer’s Event held in Jonesboro, Arkansas on October 15th, 2022. Please consider donating to our team page. I’m also selling bracelets for $5.00 each, with the money going toward the Alzheimer’s Association. You can find the Etsy listing here. I will be adding more awareness paintings and autumn stuff soon!

If your business would like to sponsor the Alzheimer’s Walk in Jonesboro, Arkansas, please contact Noelle Richardson at (501) 265–0027 or at nrichardson@alz.org.

Helpful Resources:

24/7 Alzheimer’s Association Helpline: 800.272.3900

American Council on Aging, “Medicaid Pending, Nursing Home Care and the Application Process, February 14, 2022, accessed September 2, 2022, https://www.medicaidplanningassistance.org/medicaid-pending/.

Terry Turner, “Medicare vs. Medicaid,” RetireGuide.com, May 8, 2020, accessed September 2, 2022, https://www.retireguide.com/medicare/compare/medicare-vs-medicaid/#:~:text=Medicare%20is%20an%20insurance%20program%2C%20while%20Medicaid%20is,income.%20Medicaid%20serves%20low-income%20Americans%20of%20all%20ages.

“What is Probate and How to Avoid It,” Trust&Will.com, accessed September 2, 2022, https://trustandwill.com/learn/what-is-probate.

“Your Guide to Medicaid Estate Recovery in Arkansas,” Arkansas Department of Human Services, https://humanservices.arkansas.gov/wp-content/uploads/Your_Guide_to_Medicaid_Estate_Recovery_in_Arkansas.pdf.