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Does moving an established Medicaid recipient from an assisted living facility to the home of their adult child affect their eligibility, if the move is within state (Florida)?

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Medicaid is huge # of different programs. Which 1 makes a difference.

Which type of Medicaid…. Is it Medicaid as health insurance so it’s her supplemental coverage to Original Medicare? or she is on a Medicare and Medicaid Advantage Plan for her health insurance?
And she is private paying for AL?
Or is it that she is on more than 1 Medicaid program so it’s Medicaid as health insurance AND Medicaid waiver program that is paying for her room & board costs at the AL as well?

Right now what happens to her monthly income, like Social Security $?
Is it required to almost all be paid to the AL except for maybe $50 or so? So that is all she has to give to the AL for their billing? And has she possibly made the AL her representative payee for SSA, so they get her SS$ directly?
OR is she or you private paying for the AL?
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Reply to igloo572
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Yes. Medicaid can't be taken from State to State.

Assisted living like long-term care or a private AL she was able to get a Medicaid voucher for? In my State Medicaid can only be gotten for ALs if the person has paid at least two years privately. You have to remain in that facility to get that Medicaid benefit.

You will need to talk to a Medicaid caseworker at your County Social Service office to see what Mom would qualify for in Fla. Homecare Medicaid is different than Long-term. The Insurance plan in her State may not be available in FLA. Then as Igloo pointed out, Traditional Medicare with a suppliment is quite different than a Medicare Advantage plan.
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Reply to JoAnn29
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I just re-read. The person is staying in the same State. By home do you mean a nursing home or to someones home. If you meaning just transferring from kne facility to another you do need to talk to the caseworker. If you mean to someones house, the criteria changes and you still needva caseworker.
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Reply to JoAnn29
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She is currently on Medicare with Medicaid Advantage, although she was originally on Medicaid with a Medicare supplement.

She pays a portion of her ALF through her social security, and Medicaid pays the rest directly. So the facility does not get her social security income directly.

She has United Health Care through Medicaid, so not sure but I think that she is part of the Medicaid waiver program because room and board are partially paid.

I have been working towards being able to speak with her case manager to get what answers I can, as opposed to scouring the internet. Thank you so much though.
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Reply to fs17dc
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That she is getting care in an AL covered by State Medicaid is wonderful. It is especially wonderful as most States do NOT - again do NOT - do this at all. Most only do the funding for those in a NH / SNF. Fabulous your mom and for you.

Usually if Medicaid is paying for AL, it is done on a waiver program with the $ coming from a diversion aka a “waiver” of some of the dedicated funding for LTC Medicaid NH / Skilled Nursing Care program. So as it’s a waiver of LTC Medicaid program, it requires her to do a Share of Cost of her monthly income (like her SSA $) as a copay to the facility. This is required by all those on LTC Medicaid unless they have a spouse. Now should her care plan get more involved and she moves into a NH, it too will have the SOC requirement of her income. Usually all they get to keep is whatever her state has as its personal needs allowance. Most States do $50 - $75. HOWEVER last year FL has their PNA at a whopping $160 that they can keep to use basically as they see fit as long as it is not used to pay any housing costs.

If you don’t know what the status is of your mom’s SOC and her PNA, I’d suggest that you try to sit with the billing office at the AL to review all this. The PNA is a fixed income deduction for those in a NH / SNF. But I’m not 100% sure that this is done for AL as the living situation is different. But find out, because if the PNA has been building up every month @ $160 in an at the AL trust account, you want to make sure you spend the $ as needed for your mom. And take the balance with her should she move out.

Now if your question is what happens financially if you move mom out of the AL and actually move her into you own home, it will be that her income will be retained by her totally. So she could in theory do a personal care agreement with you to pay a % of her income as rent or as room&board that is within your community’s rates. But her caregiving will fall to you to do and maybe mom can private pay for some in-home caregivers. To get her onto a community based Medicaid program so that Medicaid is paying for in home care, will mean she will have to apply for it. Different application for a different Medicaid program than the LTC program although some info overlaps.

That mom has not made the AL her representative payee for her SSA $ is really great because trying to switch it back is a beast (SSA does not recognize POA so it’s not simple). If you are to move her out, please pls look at her contract as it may have a 30 or 60 day notice. Mom needs to adhere to the contract and the AL can try to bill her if she breaks the contract by moving back home. If she were to move up in care to a NH, that’s allowed to be done with no contract issues.

Something that may have happened is that she got switched in her health insurance coverage to go onto a plan that is a Medicare and Medicaid managed care type of health insurance. Like the AL has all care contracted to be done by certain providers, clinics or hospital if needed. I bet that has happen as you wrote there was a change. Now that health insurance combo may not work if she returns back home. So it would mean she would need to change her health insurance coverage again. This can get complicated especially if she has lots of prescriptions to find a Part D that covers costs. Florida has a SHIP - State Health Insurance Assistance Program - which is staff by folks who help you navigate the Medicare system. Depending on where you are in FL there could be lots of choices or just a handful.

Moving her from AL back to your home has risks that her care needs will end up way WAAAAY more than you anticipated. Think carefully about all this & good luck in your decision making.
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Reply to igloo572
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