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Mom is 90 years old and lives in assisted living. She has given me her POA. She has enough money to live in her AL for 5 more years. She wants to spend her money and enjoy her life while she can so that when and if she has to go to a nursing home, Medicaid will pick up the payments. What concerns should we have if Mom wants to take a trip or two? Does Medicaid look into family vacations as a violation of their rules when applying for aid? Does anyone have any good references for us to read re: what is considered "off limits" regarding policy? We want to do the right thing and honor mom's wishes, but not get her into trouble with the law. Thanks.

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I will assume that Mom has 300k and this is based on 5k a month for AL. As her care increases so does the cost of the AL. She could decline all of a sudden and need a NH. ALs do not do skilled nursing. So what would have lasted 5 years now lasts maybe 3 at the most. Because with 2 people sharing a room, a NH could cost 10k a month. Private room even more. So now you are under the 5 year look back. Any large withdrawals are going to be looked at and backup provided.

No problem if Mom wants to go on vacation but u may want to pay your own way.
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RobbiesMom Feb 2020
Thanks JoAnn29. She isn't wanting to do anything extravagant. Maybe rent a small cottage in St. Augustine and have her two daughters with her. She and Dad (Dad passed away last year) lived in St. Augustine for many years. We don't want to trick Medicaid or anything. Just trying to figure out if she would get in trouble if she rented a cottage for a week in her own name; with her own money.
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I would call your state Medicaid office and ask them. This is a federal program overseen by the state, each state has a little different guidelines.
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first of all, having her spend her money so that Medicaid can pay for her nursing home in 5 years is probably not the best way to approach this. If she needs a nursing home in one year, or 2 years, she will have to spend her assets for her care. If she took family with her on a trip, that would be gifting. If she buys a new couch, it is her money. If she buys you a new couch, that is gifting. If she went on a trip and took a caregiver, that would be her money but there would likely need to be a caregiver contract on place to prove this is really her caregiver. If she does spend her money and needs Medicaid to pay for her care, it is really not that simple. There are long waiting lists for Medicaid beds in some facilities. Medicaid does not pay for private rooms and her choice of facility may be limited.
Medicaid knows all the tricks. The look back is usually 5 years. She is 90. She could need this money for her care next week. If she uses the money for a family trip, it may have to be paid back. It is a nice fantasy to all go on one last trip together but the reality is, she may need that money sooner rather than later.
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RobbiesMom Feb 2020
Thanks dogparkmomma. Good advise. We don't want to trick Medicaid. Just trying to see if Mom can get her trip down memory lane in Florida and figuring out what the right thing to do is. Perhaps we (her daughters) should pay for the trip ourselves so there's no misunderstanding with Medicaid.
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Thanks DollyMe. I thought I would need to talk to a Medicaid lawyer or something. Talking directly to Medicaid... What a great idea! Will find out who that is in Georgia. We are knew to all this. Dad just passed away in November and we just got through navigating hospitals, POAs, rehabilitation centers, assisted living facilities, memory care facilities, selling the family home, etc. I think our brains are fried right now.
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mollymoose Feb 2020
I’m in GA. If you need an elder care attorney I can tell you who ripped us off, charged us $2500 and he wouldn’t do any work or return our calls. He’s very prominent in his town. We also found a great elder care attorney who gave us honest advice (we were praying he was honest, after being ripped off like we were. I was loosing sleep!) and that firm ended up being spot on, without charging us thousands of dollars. You can PM if you’d like.

My mom did go on vacation to FL with 24/7 caregivers that had to be paid the entire time. Mom paid all expenses. We knew she was about to enter a nursing home & this would be the last time she get to go anywhere.
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Your mom take you on vacation. She’s allowed to live her life and spend her money as she normally would even if she might need Medicaid in the next 5 years.
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Medicaid does not care how she spends her own money as long as she benefits. So if she travels to Florida, and rents a cottage, she needs to keep the receipts for if she later has to prove what she spent her money on. If she has enough for 5 years in AL, she could end up with 3 years in a skilled facility if she declines past what the facility can help her with. But on the other hand, she could, like any of us, die in 3 months; so maybe it is a nice idea to go take a trip. You would not have to pay for lodging; I don't think Medicare would ask that but she probably maybe should not pay for everyone's plane tickets. On the other hand, it is her money she should spend it and then if the worst happens, maybe you have to pay it back. But she has a lot of money to go thru before you have to explain anything to medicaid. If I was calling Medicaid, I would be asking what type of documentation they might look for, if it comes to that.
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Go on vacation with your mom and sister.

None of us knows what tomorrow holds, enjoy the time while you can.

From what I have seen here there are several posters that can help you work the system to get her approved if needed.
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