Wednesday, January 18, 2012

Finally poor enough to get some help

Let's not beat around the bush: you need to be poor to qualify for Medicaid.  But let's also be realistic--if you live long enough, yet are not the picture of health, chances are you'll be poor eventually.  When my parents had their home (damn the reverse mortgage, but it allowed them to stay there indefinitely), one car, Medicare health insureance, and a small but steady income, it was a tenable situation.  With the home, car, and income stream, they couldn't have qualified for Medicaid.  When Daddy had to leave the house, he didn't get any money because of the damn reverse mortgage.  Whether it's a retirement home, assisted living, nursing facility, or adult foster care home (and if you're good, someday I'll explain each of those in detail), the rent is more than his monthly income, so it didn't take long to blow through his limited savings and Mom's life insurance payoff.  But because he has so few expenses beyond rent and medical, after dropping his savings drastically,  he hasn't emptied the account quite as quickly as we anticipated.  They really don't want to even TALK to you until you are moments away from dropping below $2,000 in total assets.  The first time I called, she told me to call back a month later, because we were sure to get rejected at that point. 

Now we're there--the January payment for February's rent will drop him below 2K.  Then we get a bank statement and send it to our social worker, and she gets him signed up.  What does that mean?  We finally got a pretty good answer to that.

Last things first, he gets to hang onto about $160 pocket money a month.   This is for things like toothpaste ("That's a lot of toothpaste" my dad deadpanned when she mentioned that as an example), haircuts, magazines, and whatever other little toiletries or treats one needs.  The rest of his money he pays towards the rent.  But he earns less than his rent, so Medicaid covers the rest of it.  He also gets a Medicaid card to flash wherever he currently flashes his Medicare card.  This means Medicaid picks up the co-pays or whatever else isn't covered by Medicare.  (Wasn't it brilliant of them to name the two services almost the same thing?  Keeps things nice and bewildering.)  If he somehow ends up making a health-related payment out of pocket, he is supposed to give a receipt to Medicaid.  They deduct that amount of that month's portion of the rent he's responsible for, and cover that gap on their end.  So instead of just reimbursing him, they adjust the rent.  Sounds a little clunky to me, but who am I to question the mysterious workings of Government? 

This is one of those entitlement programs people keep bitching about, am I right?  Like my dad is so damn SPOILED and GREEDY for being old, sick, and broke.

I love Medicaid.  I love that they make sure you're out of money before they qualify you, because really, even an extra month or two of rent makes a difference when you multiply it by all the old people in the country.  I've hated the rigamorale we've gone through, but I respect the purpose.  I am deeply disturbed that it is so hard to find out about the program in the first place.  Without Aunt Margaret, I wonder how long it would have taken us to figure out how to do this.  We really thought one of us would have to take him in.   That's not just a matter of bad American daughters valuing their independent lifestyles over their aged parents.  None of us have first floor bedrooms or showers, none of us have wheelchair friendly houses, all of us work full time because we need the income, and he needs round-the-clock care available.  The only alternative we saw was all of us pitching in to cover his rent, and that would have been somewhere between tough and impossible.  So to have a program there to cover the basics gives all of us enormous peace of mind.  He's willing to live with just the basics.  Former world traveler who owned his own home since he was 23, he sits in a small room with a single bed and a couple pieces of borrowed furniture and is relieved he won't be asked to leave.

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