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The Medicare and Medicaid fall short of actually getting her into an ALF and she cant really care for herself. She has vascular dementia, is on oxygen, and is diabetic.

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Medicare does not pay for an AL. ALs are private pay. In my state, the only time Medicaid pays for an AL is if you have private paid for at least two years. If you cannot private pay, LTC (NH) is ur only option with Medicaid paying for her care.

Any assets MIL has will have to be spent down to the Medicaid cap your state allows. Mine allows 2k. She is allowed a house and a car. Problem there is none of her money can be used for upkeep. Her SS and any pension will go to her care with Medicaid picking up the balance. If her income is over the cap, there is a Miller Trust that can be set up. Its called something different in some states.

Medicare is a health insurance. It only pays for rehab when in the hospital for a certain amt of days. 100% first 20 days, 50% 21 to 100. After that its private pay unless u have Medicaid.

If MIL has Medicaid as her suppliment, you will have to apply for LTC.
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Auroreandream May 2019
Hey thanks for the reply. She doesn't have any assets, no house, no car. She has Medicaid and we did apply for Humana Long Term Care and we got a letter that she was eligible. Do I just find an ALF and see if they take her?
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If your MIL is also in Florida, and cannot afford to self-pay, she would need a Medicaid waiver in order to go to an assisted living on . Last I heard, there is a wait list for a waiver. Medicare isn’t a factor because they won’t pay for assisted living.
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Have you considered a skilled nursing facility for her? With her health problems, she may be better off there than in assisted living and it might be easier to get Medicaid.
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I think you may not understand what Humana LTC is. It does not pay for the cost of an AL or LTC. It coordinates services so you get the most out of your Health insurance. Its part of the Medicaid ur Mom is receiving.

You still need to be able to private pay for an AL. If Mom can't afford that, you need to apply to Medicaid for Longterm care, a Nursing Home,

Longterm care insurance to cover the cost of an AL, is bought way before your Moms age. You cannot purchase it, then go right into an AL. Premiums need to be paid over a period of time.
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