We're in MN, where they use an elderly waiver program that kicks in when assets drop to Medicaid levels. Even if income is higher than the federal limit, there's simply a monthly spend-down of income, then the waiver/Medicaid kicks in to cover the remaining AL or Memory Care costs.
In choosing a facility for my 82yo mother-in-law with moderate-stage Alzheimer's, price almost seems moot. She has enough to pay privately for about 2.5 years. Each place we're considering has a 1-2 year private pay requirement, then they guarantee they'll continue to house the patient using elderly waiver/Medicaid after that.
We anticipate she will outlive her assets at a private pay level and then switch to the waiver/Medicaid and remain at the same facility. With that in mind, is there any downside to simply opting for the best (most expensive) option?
I can't identify a reason to make her finances stretch out a matter of months longer before government aid steps in, but I'm used to being frugal while managing finances for her (and for my recently deceased father-in-law) so it feels very counterintuitive to opt for the higher-cost option.
Am I missing something? Any advice or thoughts welcome.
Note, I said at least two years and haven't met their guota. There is no guarentee by the time Dad runs out of money, they will be able to take him. ALs and MCs are private businesses. They don't make money off of Medicaid so they don't allow that many residents to be on it.
One reason NOT to choose the most expensive living situation is that while your mother is private-pay, she can choose to pay for a private room. On Medicaid, she will normally be in a double room. I'd rather be in a less-than-perfect private room for as long as possible than use up these funds, need Medicaid sooner, and be in a double room!
Most places who accept the Minnesota Elderly Waiver require two years of private pay first. Then the *county*, not the state, picks up the payments in excess of what the resident can afford, and you get to stay in your assisted living or memory care.
It is not Medicaid - terms were getting mixed up here. I have looked into this closely at several different assisted livings in three different counties here in Minnesota.
I have never heard of what Geaton talked about with the Elderly Waiver paying for home care. It may, but I was dealing with this this for my elderly mother (who was able to self-pay in a rural county assisted living until she passed away), and my disabled sister who required an assisted living and had just barely enough money to meet the Elderly Waiver requirements at a very comfortable private assisted living near us in Hennepin County.
Assisted Livings are very forthright and knowledgeable about the question of “What happens when the money runs out?”
The MN Medicaid Elder Waiver is for in-home care, not facility AL or MC care (no AL or MC). Medicaid will pay for facility LTC when one qualifies both medically and financially.
Medicaid is financial assistance for medical care. It does not pay for custodial (room and board) care. This is why it doesn't pay for AL or MC as those are only custodial. One's SS income then covers the custodial portion of the LTC.
One has to be assessed as needing LT or NH level care. This is done by either the doctor or the facility admins. Then the person needs to qualify financially. If your LO exceeds the monthly income threshold for Medicaid, they or their PoA can create a QIT, which is a special trust where excess funds go in order to qualify for Medicaid. Then, when the recipient passes, the money in the trust goes to Medicaid (along with other recovery from any remaining assets, like a home).
So, make sure the facility you ultimately choose for your Mom accepts Medicaid and has a continuum of care (IL, AL, MC, LTC, hospice services). Then talk to a Medicaid Planner for MN, along with a certified elder law attorney or estate planner so you are never blindsided by anything.
Presbyterian Homes is faith-based, non-profit and more affordable, They see caregiving as a mission, not a business. Or, join Nextdoor.com and post an ISO Recommendations for local elder care facilities. You will get great input from non-anonymous people in your community.