What is a Spend Down? with Kelley Smith
Kelley Smith at CarePartners Living discusses Medicaid qualifications. Let’s say that you have $100,000 in the bank. One qualification for Medicaid is having less than $2,000 in the bank, so you would need to spend the rest of that money in ways the state allows, with expenses analyzed for the most recent five years.
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*The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.
The following podcast is provided by care partners living and answers for elders radio, and welcome everyone to answers for elders radio. And we are here on a very special care partners living weekend with our wonderful Kelly Smith, and thank you so much for sponsoring today’s show, when you so excited whenever you’re here. Thank you. You know, one of the things I love about care partners is you guys have the largest floating Medicaid license in the state, which, ma’am, huge, and all of your communities really catered to seniors that you know you’ll always take care of them throughout their lives, which is really a nice assurance. But you know to get qualified for Medicaid. Kelly, I know that that’s the big misnomer. People don’t understand that and there’s phrases in our community called, quote unquote, a spend down right. I want love for us to take this first segment of the hour and talk about what is a spend out? What does that mean? What that means is Medicaid will only for an example, you’re a single person, Medicaid will only allow you to keep two thousand dollars in the bank. For Emergencies, HMM, and any income that you have, etc. All that’s going to be considered as part of your financial eligibility. First thing they look at is is physically medically right? Do you qualify for the Medicaid Program People Confuse Medicaid and Medicare and very different. Yeah, Medicare is obviously it’s your insurance over certain age, etcetera, etc. Medicaid pays for more home care, being in a skilled nursing or memory care or assisted living. Right. They don’t pay for independent living. You have to have a reason to be there and what they’re looking for are do you need help with activities of daily living? Seal here. People say Adl’s activities of daily living. You have to have I think, three or four of those. I think it’s three, and cooking and cleaning don’t count, Yepe, and so you had it has to do like bathing, Bingo. You need basis assist you know, helping with toileting, exactly, kind of stuff like daily living, the stuff that is is not necessarily safe for you to do on your own. Are you just can’t do it because of a physical limitation exactly. Mobility issues is a big one, because then you wind up with fall risk. So okay. So you’ve got a hundred thousand dollars in the bank and the state says you can only keep twozo of that. So you got to spend that down right. That’s what I spend down is to qualify for Medicaid. You have to spend that money down. What people need to understand those. You have to spend it the way the state wants you too. So so you can’t give it to your kids and then qualify for Medicaid. They do a five year look back. So they’re going to take a look at your accounts for the last five years. Did you own a home? Did you have a large amount of money that you paid off somebody else’s bills with? Because that can make you not qualify. That happened to me, by the way. Is it my mom? See, it happens and sometimes you don’t even realize it’s that big of a deal, and sometimes things happen that are beyond our control. Right mom might have heard about that Arabian prince soon needs some help with money, so he’s she said him a check because she’s got some dementia and you can find out about it. Until you know we’ve had it. We got a problem. So but the spendown is basically that spending down that money for care, and you can do it in an assisted living or memory care community. Say you look at the assets and what it’s going to cost for mom’s care and you think you know what that money is going to run out in about two years. That would be a two year spend down to get you qualified financially for Medicaid. Very good. And one of the things I think with a family member is when we talk about spend down is that’s where I am a really strong proponent of sit down with an elder lat tourney Bingo and understand what does that mean like? For example, this is this is what could have happened that we wouldn’t have been in the bad situation which we learned after the fact. My I was off work taking care of my mom, right. So I went a month without pay. My mother paid my bills for me, because you’re living paycheck to paycheck, right, because she needed me to be there. Guess what, I had to pay that money back. It didn’t matter that I was off because I was not, number one, a certified caregiver. I was not appointed by to be an official caregiver and she paid me, you know, paid for these bills right now. What should have happened is there should have been a separate situation set up, that there was a different types of vehicle, that I could have gotten my bills paid as a quote unquote, caregiver, temporary situation. But the paperwork was not in place to do that. But see how many people even think about that? Susanne, let’s be honest. But that’s what wouldn’t with families all that time? But wouldn’t all of us do that? I would do that. If I was disabled and my brother came over to take care of me from Mont You, I’d pay him. I wouldn’t let him not have his bills paid because he was helping. Right. So why our parents any different? They’re not. But what people don’t understand is that the state can come in and say, well, you didn’t get a guardian, you didn’t do this, you didn’t do that. Right, who thinks of that stuff, you know? So another lot turney with an elder law attorney. Understood in the Porram, it’s worth the time and the money because at least then you’re not going to make any mistakes, right and you’ve got somebody to back you up if you do exactly exactly. And so you know understanding to the parameters of being mindful of your parents assets. Now one of the things you know, I’m going to go back and say. You know, there’s difference between assets like a diamond ring, for example. State is not going to take away a diamond ring if you’re on a spendard. No, they’re not going to take if you have a silver bar or gold bar. SOLSHO considers products. They’re not assets. So this is financial understanding. Things that you have that like money and the bank that they look at, and I just wanted to clarify that. You guys think, because how many times do families do dad passes away or mom passes away, Dad’s got dementia, the kids are going through her jewelry and things and I really wish I could keep this. HMM, yeah, you can, you can, you sure can. There the state’s not going to take away everything that meant anything to you and your family. But, however, you don’t get to give that house right the brother that lived next door that took care of mom. It doesn’t work like that either. So so we are talking again to Kelly Smith, who is a vice president of sales and marketing for care partners living and Kelly, your guys are amazing to help seniors in just taking care of them throughout their lives. You know, with your met a floating de acaid license. And tell us a little bit about where your communities are located. Well, where you were from Marysville down to lacy. We got a brand new baby down there. And Renton, I know it’s gorgeous. Find what I over the moon stop in if you’re down there and in rent and see the cottages of renting, to hop in and say hi to amy and Jennifer. They’re doing an amazing job. And Care Partners, you know, the thing that’s everybody talks about, even Daphne, and last week he was talking about your amazing concept with the cottages and with four memory care those with Alzheimer’s. And you know that’s a big issue with people with our Alzheimer’s because expanded care, your assets are going to run out quicker. How do you expect families to financially be able to sustain this? Think about it. Average memory care cost is anywhere between, you know, six and nine thousand dollars. A month, depending on the care level and depending on where you live. I talked to higher yeah, I talk to a really good a good friend of mine, Worse Jail Shimer’s Association, yesterday and she was saying that care for her grandparents was twelve thousand exactly. My Mom’s was ten, almost ten. Well, think about that. That’s a hundred and twenty thousand dollars a year. That’s a lot of that’s a lot of money. And okay, good. So you do that, you do that for a few years and then what exactly exactly? So that there in lies the wonderful service that care partners living is and you know, certainly we want to talk about you know. So, as you’re spending down right your resources as a caregiver, one of the things I was recommend especially to keep clanks clean, is I always say, if your caregiving a senior loved one and you’re in the middle of a carrot spend down, you need to keep very solid records for every dime you spend out of that account. And so and you know, just being held accountable because in many cases there’s going to be some questions in trying to qualify your loved one for Medicaid. And that’s some things that I always recommend. Number One, get a separate caregiving account. Amen. But there’s another reason for that to that people don’t realize. Yes, yes, it also holds everybody accountable. Yes, you have that one crazy relative that comes back there and goes you spend all mom’s money. Well, no, no, I didn’t hear. So here it is. But you that there’s another reason. When you go to apply for Medicaid, mom only has five hundred a month and you’ve been spending three hundred a month on her medications. Correct. You need to be able to show the state that so that they don’t Ding you guys for that when it comes down to her participation in the Medicaid program the the other situation that happens little daytoday. Things a mom needs new, new, new clothes and you go to nordstorm and you spend five hundred dollars for mom or dad on, you know, new clothes, and you come home and they write you would check for five hundred dollars. You better have that receipt available. That’s why the caregiving account I, in my opinion, is the best way to do that. It is all in one place. Exactly. You can just set up a separate check in account that has an as record and then you keep all the receipts in an envelope and more to me, that is the best way to handle that, especially when you know that your parents assets aren’t going to last more than, you know, a couple of years exactly. Well, the other thing, too, to keep in mind with folks is that it, yeah, the separate account is good and if you’re really worried about it, if you have a feuding family, get a guardianship. Yeah, get a paye service. Those people exist to they’re not horribly expensive and they can also keep things very clean, because now you’ve got someone else it’s paying the bills, it’s taking care of things that they they can be accountable for that. MMM, well, I can’t. Can’t agree with you more on, you know, just this whole piece, and I will tell you it’s not easy to qualify your loved one. So do yourself a favorite upfront. Take the time to just save the receipts, to make sure that you have all your documentation in order. And if you’re, you know, handling things in a caregiving situation, Um, you know, make sure that you have you, you don’t keep those records and if you’re not good with money or if you need, you know, oversight. The great thing about having a separate account is you can use online banking really easy, with somebody that can help coach you. You know, maybe you have another relative that is is involved in this situation that says, okay, we have five thousand a month to spend and mom’s care is going to cost right now three thousand a month. That’s low, but let’s just say that’s it. Now we’re going to look at okay, how do we best negotiate the rest and have, you know, bring in a teammate that can help you, and that way it also keeps your own separate finances separate, exactly different. We’ve all made mistakes. Every single one of us who’s ever cared for somebody we love has made horrible mistakes, as we have. Used to let my grandfather gamble because it was his favorite thing in the whole world. So a thousand dollars a week and he blew through at night. Didn’t care, there you, because it was his money, and my idea was when he died, there shouldn’t have been ane left. Yeah, however, he got to be smart about it. Yep. Thank you so much, Kelly and Kelly will be back right after this. Everyone. The preceding podcast, which provided by care partners living and answers for elders. Radio to contact care partners living co to care partners livingcom
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Originally published July 28, 2019