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A friend of mine is in an assisted living home in Indiana that accepts her Medicaid Waiver. The facility takes her entire SS check and the family pays for the difference, which is several 100 dollars per month out of pocket and the family is unsure how much longer they can pay this extra amount to keep her in her assisted living home. One of the residents told my friend that she can ask for Social Security to help pay the difference so that she can stay put if/when the family cannot pay anymore. Does anyone know about this Social Security provision?

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It is up to the facility whether or not they will accept MediCAID or not if it is applied for. The family, unless quite wealthy, should not in my humble opinion be tapping into their own savings which they need for their kid's education, their own recreation if retired, and their OWN aging care. I think this is always a mistake.

If mother has lived so long that her resources are gone, and SS isn't enough for her care, then she spends down all her assets and applies for Medicaid. See an Elder Law Attorney and give them a list of assets and options.
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imajwru12 Apr 22, 2024
As I stated, she already has the Medicaid Waiver and is in a facility that accepts it. I am hoping to find out what (if any) provision there is that Social Security would increase her check to cover the Assisted Living rent. If anyone knows, I would like to know the name of that provision.
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Your mom is in Indiana? If so, try to apply for the Residential Care Assistance if she receives SSI.


Other then this, sadly, no. Whatever her benefits don't cover falls on another payment to make up the difference.

You dont mention the cost of the facility, so it is over $4k a month?

Has she applied for a Voucher and/or on the list?
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imajwru12 Apr 22, 2024
No, she is not on the section 8 voucher.... do you think Section 8 would help pay the difference? In order for that to even happen the facility would have to accept Section 8/subsidized housing. I dont think they do. I am not sure what the rent is....but its under $5000. Their out of pocket rent is somewhere around $300. Thank you for that suggestion of Residential care assistance, if this is a supplement to what the Waiver pays, it could be helpful. And yes, she lives in Shelby county in Indiana.
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I also have a friend with a medicaid waiver in Indiana. She is moving from one assisted living place to a different one.
I know the new place has them file for section 8 too.
I don't know any details but maybe something to look into.
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imajwru12 Apr 23, 2024
Can you find out the name of that assisted living that accepts Section 8? Thank you in advance.
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If Medicaid is paying for her care, then the AL has to except what is paid to them. Her SS is her contribution. Family should not be paying out of pocket unless its to help keep her in a single room. Medicaid does not pay for single rooms. Maybe the option would be, she needs to double up. They need to talk to the Administrator. She is only allowed so much SS which is based on her's or her husband's earnings. Maybe Medicaid could pay more?
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imajwru12 Apr 22, 2024
She is not in a nursing home. She is in an assisted living. All the apartments are single. There are no shared rooms. They take her entire SS check and family is paying the difference between what the Waiver pays, her SS contribution and what the room rents for. Hope that helps. I know her family has spoken to the administrator and in order for her stay, they have to pay the difference. Hence, our interest in finding out if SS would increase her monthly check to cover the extra expense. Thank you!
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No. Social Security will not pay AL or any other care facility. There may be some state programs and grants that can help with it though. Speak to the administrator at the AL. They can help put you in touch if there are such programs in your state.

She may have to be moved to somewhere more affordable. Too bad. Social Security isn't paying for that.
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SS payment is based solely on what the person worked their whole life for and paid into the trust fund. Medicaid is run at the state level, if she's on Medicaid already speak with either the facility or a representative of Medicaid to make up the difference.
This is where limitations on her assets comes into play.
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If it's waver In Ohio, you get on waiver and they take everything but 50 bucks. And it's in the Ohio revised code. State law you're out of luck like me. I've contacted my national congressional senate representative Brown. And Landsman (aide Jason) and they told me I'm out of Luck you just gotta suffer and it's like a camp in a war. In the facilities There's no appeals. You'll succeed the first couple of times complaining. Then they won't pay attention to you. It's a racket. Mine went to chapter 11 and the owner had one in Dayton, Ohio, Florida and Tennesse they ripped you off. And the government's empowering enabling them. There's no hope that's why people used to keep us at home until we died. Because this kind of thing will happen. Their turnover is worst than fast food places. Different people each week. In fact, the assignments are each shift has a different nurse and nurses aid, and they rotate, and they act like road runners. Cause they want to be detached. They don't want to be attached to you and they're trained and. Tutorialized like that I never knew about this kind of stuff until they threw me in it because of my LAFEDEMIA. There's a senior's committee in Congress in the senate that just started. I communicated with them and every other regulatory agency. And staff laugh and joke constantly because they can't deal. And they don't pay attention to you. Wonder why this country is in the shape its in. . And you know the message going on in DC. And they laugh and joke constantly. Because they can't deal with the bed. Ridden, people that they have to change a couple of times a day. And they let those poor people just lay there and suffer. Don't see any visitors come in to see em. It's a crime. It's crime against humanity against Americans domestic crime.
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The family should leave their mother where she is and pony up the difference. PERIOD! She likely made many sacrifices for her children. Certainly between them they can afford a few hundred $ a month. Tell them to get extra part time job. Don't put her in a worse place.
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Your state law probably has it set up that they confiscate. Both medicare and medicaid, and all your income they call it medicaid Waiver, and then the state gives the facility everything but 50 bucks.
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I imagine you are talking about SSI, which is supplemental income for the poor. I am assuming her social security benefit is small and she has no assets. There are requirements one must meet, make an appointment for her with Social Security to find out what the application process is.
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I'm sorry to see your friend in this situation that appears to be single room AL. May require a transfer to a shared room facility with a Medicaid license.
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SS income is solely based on how long your mother work when she was still able to work. You have to work at least 10 years to get SS check. The more years you work, the more SS money you get. So, there’s no way SS will increase her SS check. Hope this help. Try Adult Family Home. They’re more affordable than assisted living, is what my friends are telling me. Good luck.
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As someone already mentioned, Social Security has nothing to do with long term care payment. It is a set amount based on wages earned during employment. Talking to an elder law attorney is the best way to get accurate advice. Also, talking to the case manager who handles the Medicaid waiver might be helpful. Don't try to deal with this alone or rely on others' advice. I did, and it was a mess until I got professional assistance. It can make all the difference.
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imajwru12 Apr 28, 2024
Correct, SS does not pay for LTC directly. I was asking about a supplement that she could apply for that would be a supplement to her SS that could be used to pay for her LTC at the AL. I realize that SS does not directly pay a facility for their services. It would come to her and then she can use the supplement to pay for her AL.
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There seems to be a lot of misconception concerning Medicare. Medicare is a health insurance. It pays nothing towards LTC. It pays for up to 100 days of rehab IF NEEDED. 20 days 100%, 21 to 100 days 50%. They will pay for "in home" but that too is not permanent and not f/t care. They pay for intermediate care, which is not f/t care. So when trying to get LTC paid Medicare is not even in the equation.

In my State Medicaid will not pay for an AL until you have paid privately for at least two years. Then the AL has to except Medicaid and if so, not meet their quota. My Moms AL only allowed 14% of residents to be on Medicaid.

There is a reason why family is paying extra. From my understanding, once a person is getting Medicaid family cannot be asked to contribute to a recipients care. The recipient gives up their SS payment and any pension they receive as their contribution.

There is a reason why this family is paying xtra. There is something they want their LO to have that Medicaid won't cover. Again, I think its having a single room. They need to find out what they are paying for and then determine if their LO needs that service.
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JoAnn29 Apr 26, 2024
Sorry, did not see the duplicate and now can't delete.
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There seems to be a lot of misconception concerning Medicare. Medicare is a health insurance. It pays nothing towards LTC. It pays for up to 100 days of rehab IF NEEDED. 20 days 100%, 21 to 100 days 50%. They will pay for "in home" but that too is not permanent and not f/t care. They pay for intermediate care, which is not f/t care. So when trying to get LTC paid Medicare is not even in the equation.

In my State Medicaid will not pay for an AL until you have paid privately for at least two years. Then the AL has to except Medicaid and if so, not meet their quota. My Moms AL only allowed 14% of residents to be on Medicaid.

There is a reason why family is paying extra. From my understanding, once a person is getting Medicaid family cannot be asked to contribute to a recipients care. The recipient gives up their SS payment and any pension they receive as their contribution.

There is a reason why this family is paying xtra. There is something they want their LO to have that Medicaid won't cover. Again, I think its having a single room. They need to find out what they are paying for and then determine if their LO needs that service.
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imajwru12 Apr 27, 2024
Medicaid Waiver is different than regular Medicaid. Its a completely separate application than applying for Medicaid. And not all AL facilities have to accept it. All 1 bedroom apartments are the same price and all residents have access to the same services. They dont offer studios or 2 bedrooms, either. I am reading from several that the facility should not be asking the family to pay the difference between the Waiver+SS and the rent they are asking. I am going to check with the medicaid waiver folks here in Indiana to see if thats true for Indiana. If it IS true the family should be getting a REALLY big check back. Thank you for your comment.
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As has been said, Social security will not increase payments because you want to stay in a certain locale. It's my understanding the HUD may make payments for the rental in some ALs (rental only, not services). Have your friend's family check out : https://www.hud.gov/ and search for the offices under Indiana. They can then check the website or give them a call to get more info and specifics.
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imajwru12 Apr 27, 2024
I finally called SS and was told if the SS check is less than $943 then the person can apply for SS Supplement and if they qualify they would receive additional funds on top of their regular SS check. Family is going to explore this. If this works out then the additional monies will pay for the additional rent and not out of the family's pocket (they are getting tapped out and she needs to stay in the AL facility). Hoping for the best.
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I don’t know of any provision with Social Security that will help pay the difference or increase the amount they pay in to the facility. Social Security payments are based on earnings. The Area Agency on Aging in Indiana directed me to Medicaid waiver when I needed to get my brother into AL. He only had social security and the waiver picked up the balance. He ended up in a nursing home where social security went to the facility and basic Medicaid paid the rest. It sounds like the financial resources will be changing so contacting the waiver office would be the next step to report a change in financial circumstances so the waiver payment can be adjusted. The Area Agency on Aging may know of other financial resources to assist but start with contacting the waiver program about adjusting that payment. An elder law attorney may be of great assistance.
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imajwru12 Apr 27, 2024
Well, I finally decided to contact SS... it was an hour wait for them to call me back....I was told that if the SS check is less than $943 then a person can apply for Social Security Supplement. He gave an example of someone receiving $500 from SS could possibly receive another $500 with the supplement on top of their regular SS payment. So, I let the family know this and they are going to explore get the SS Supplement.
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imajwru12: The individual's social security dollar figure does not increase because they want stay in assisted living.
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imajwru12 Apr 30, 2024
In looking into SS benefits there ARE additional benefits that SS provides such as SSI and OSS. But you are correct, the SS monthly amount would not change based on financial needs but it CAN be supplemented with SSI and OSS.
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Better to find a place that accepts SSI and Medicaid
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imajwru12 Apr 29, 2024
I found another option of income called OSS that is also a supplemental income from SS that can be used for AL. I have suggested to the family they apply for SSI and OSS for the resident.
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No, social security does not pay for long term care of any type. They do pay for some home care, if it is medical in nature, but not for housekeeping, meal prep or personal care assistance.
If she has a Medicaid Waiver in place, that should pay for long term care of any type as long as the facility accepts it. Some do not. It sounds as though her facility does not, because other than her PPA (patient pay amount) the Medicaid Waiver (the amount the state pays) would pay the rest. Maybe you could petition Medicaid to recalculate her PPA. That would relieve some of her personal burden. I have never heard of the patient paying anything more than their Social Security each month. The family can't be required to pay anything. Having a Medicaid Waiver should pay all or the largest portion of the cost. If this is not the case, I might suggest speaking to the facility. They should not be charging you anything over & above what Medicaid or you mom pays.
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imajwru12 May 14, 2024
That is what I did and FSSA and the Department on Aging are going to do a sweep of the facility and get the money returned. They have been collecting additional rent of over $400 per month for about 2 years. Family will be getting back a rather large check from the AL facility.
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Regardless of what people say here,

You / friend needs to contact social security and Medicaid Office.
Look on-line, too. Although perhaps also go to the soc sec office.
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Reply to TouchMatters
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Finally found the ultimate answer...first of all wanted to clarify to all that while Medicaid does not pay for AL, the Medicaid Waiver does. I keep getting replies that AL is not a covered benefit within the Medicaid system---and it is.

And 2nd......after asking the Medicaid Waiver department if there were any additional resources to help pay the difference between SS/Medicaid Waiver and the rent the AL was/is charging......we found out from FSSA that the AL facility IS NOT ALLOWED TO ASK FOR MORE RENT and....they ALSO MUST LEAVE THE RESIDENT WITH APPROX. $50 IN SPENDING MONEY. Therefore, FSSA and the Department of Disability/Aging is going after this AL facility and the facility will have to give back all the additional rent money to the families for overcharging. In addition, the AL facility was not allowed to charge for their COMMUNITY FEE and DEPOSIT from a person with a Medicaid Waiver. So, the family will be getting back all those fees as well!!! They will probably be receiving back over $10,000 in rent and fees. I should say too the investigation by the department is going to be anonymous. However, the resident is being moved to a nursing home as her health is deteriorating.
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Geaton777 May 14, 2024
The amounts differ by state. Here in MN my MIL on Medicaid in a LTC facility is left with about $120 per month. The waiver programs also probably vary by state, since Medicaid (even though a federal program) is contolled by each state individually.

Did your friend have a private room? In MN Medicaid only covers a shared room (in LTC) to my knowledge.
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