Senior Care Stories

One of our readers has submitted  a guest column regarding his experiences with Medicare. The names have been withheld by request.

My mother was never very affluent. So when it came time for her to move into an assisted living facility for the treatment of Alzheimer’s disease, she was not financially prepared for it. Eventually, we had to turn to state Medicaid for assistance, but we were very surprised at the restrictions imposed on her finances.

In our state, at the time my mother applied for assistance, a person could have no more than $1500 to her name in cash and assets. Since my mother had more, we (believe it or not) had to sell off all her assets and give the excess to the state government for use in paying for Medicaid. The excess, and any income she had, including Social Security, was to be used first to cover costs before state help kicked in.

We were lucky in that her living facility had staff who were very helpful in navigating the state’s legal system. Other facilities may not be as prepared. But we realized while it was happening that my mother was essentially becoming a ward of the state—not that we expected her to recover, but in effect she no longer had an independent future.

In retrospect, we could have tried to have her “gift” the excess assets to her relatives (up to the federal tax-exempt limit) before applying for Medicaid, but even that strategy is difficult, since in our state, Medicaid looks back three years to figure net worth, to ensure the person is cognizant enough to understand what she is giving away. Who can say three years before Alzheimer’s care is needed that it is inevitable?

Think carefully about your parent’s future. It’s much better to be prepared for the possibility of having to use state Medicaid than to have to deal with it suddenly, as we did. If a long-term care insurance policy is an option, you should investigate it.

Keep in mind that Medicaid, although a national program, is also governed by individual state law and the requirements and services vary from state to state, sometimes greatly. But the best advice, if you anticipate that your parent might need it in the next few years, is to learn as much as you can about the program where you live, and prepare your parent’s finances so s/he gets the most help for the least impact.