What Do You Do When Medicaid Stops Covering Care?

What do you do when the cost of care is more than you could ever afford, when something unexpected happens and now the system that was helping you is about to stop that fear, that pressure of not knowing what comes next?Well, if you've ever felt overwhelmed trying to figure out how to care for someone you love, today we're going to walk through this together and I'm going to answer a heartfelt question from one of our listeners. Hello, friend, Ralph Estep Jr. Here.This is financially confident Christian, where every day my goal is to help you break that cycle of financial shame and, and live in confidence.And man, we got a tough question today from one of our listeners and that's all about what to do when Medicaid coverage is ending and you're facing overwhelming care costs. Let's get right into today's listener question. This actually comes from somebody named Jennifer. And Jennifer writes this. Ralph, this is Jennifer.My older brother James faced something unexpected this year. He had to stop his part time job and had a below the knee leg amputation at age 57. I'm going to pause for a second.I'm so sorry what you're going through, both James and Jennifer now. Right now he's in a skilled nursing and hopefully starting physical therapy soon. But here's the problem.Currently Medicaid is paying 100% for everything. But because his income and assets are over the Medicaid limit, he's going to lose his coverage on May 31.We're being told it could cost around $10,000 a month for the nursing home alone, not including his diabetic prescriptions, his inpatient hospital care and outpatient surgeries. Ralph, I honestly don't know what we're supposed to do next. What can he look into to replace this coverage once Medicaid stops paying?Now, Jennifer, this one hits a little close to home for me. And what I want to say to you at the beginning, what you and your brother are facing is incredibly heavy. It's tough.As a diabetic, I understand what happens with the amputations. This is all part of that diabetic situation. And I'm so sorry that you and your brother are going through this. But right now I know something.This isn't just financial. If it was just financial, I could probably give you an answer and we'd be great. But this isn't that. This is physical, this is emotional.And Jennifer, it's spiritual. And it makes sense that this feels overwhelming to you.But I want you to know you're not without options, but bigger than that, Jennifer, you're not walking through this alone. I am so happy to be able to help you today.And when that path feels uncertain, whatever's going on in your life, God is still there to guide you step by step. But right now, I want to walk through some practical things.Jennifer, you asked me for some practical advice, and I'm going to do my best to give it to you. So the first thing understand what's actually changing.What you said in your letter is right now Medicaid is covering everything, which is probably a pretty good thing because it sounds like your brother's been in a tough situation. And what's changing is eligibility. And that's simply because of the way Medicaid works.Medicaid looks at your income and your assets, and based on his income and assets, he no longer qualifies under those current limits. That's just a fact. There's not much we can do to argue that.So then the question becomes, though, is there a way to restructure so he can qualify again? Maybe there's a way to restructure.I'm going to talk to you a little bit about how to do that, but maybe that's the first step, is how do you restructure this so that he fits in those parameters again? Or maybe that's not going to work and you've got to start thinking about what other support systems can step in.But you got to understand from the beginning that shift is going to help you focus on the next right move. Well, here's my next right move for you. This is not an area that I have a ton of expertise in, but I know how to find people that can.So the next thing I want you to do is speak to a Medicaid planner or maybe even an elder law attorney. Now, you said Your brother is 57.He's not a real old guy, but he's definitely experiencing something that's going to be impactful with an amputation like that. The work I don't. You didn't mention what kind of work your brother does. It may very well be that he can't do the work he was doing before.But there are professionals who specialize in situations exactly like this. This may not be what you want to hear, but your brother's not the only one that's walked through this.But a Medicaid planner or an elder law attorney can help you figure out how to do this, because maybe there is a legally way to restructure his assets. Maybe an elder law attorney can say, well, if we do this, this and this. We can make this work. Maybe there are some spend down strategies.I work with clients all the time who are, maybe they have elderly parents who are going skilled nursing care. There is actually a way to spend down those assets. Maybe you've got to just simply determine if he can re qualify.Talk to that Medicaid planner and say, hey listen, we're in a bunch of problems here. Yeah, maybe my brother had income before and yes, maybe he has some assets, but right now he can't work. He's lost a good portion of his leg.I don't know what that looks like. What can you do to help us? But you got to go into protection mode. Try to protect as much as possible.Because the truth is these rules are complex, they're complicated things.But there are strategies and if you try to figure this out alone, and I'm so happy you reached out to me, when you try to figure this out on your own, it can cost you more in the long run. Here's another thing you can do right away. Ask the facility that he's at right now about any financial assistance options.Talk directly to the nursing facility. Hey, you know what, you can just ask them, hey, do you accept Medicaid pending?What I mean by that is maybe Medicaid's going to reconsider this because if your brother can't work or if he's in some kind of transitional plan, will they continue to let him stay there? I honestly don't think they're going to put him out on the street now. I don't know that for sure.Talk to the Medicaid planner, talk to the facility people. Maybe you can talk to them about any transitional programs they offer. Maybe they offer some financial hardship options.What I have seen talking with many clients over 30 years doing this kind of work. Some facilities, I say some will work with families during these transition. But don't assume there's no options.Ask the questions, be honest with them, be transparent with them. Say, listen, my brother's in a bad way. I'm trying to do everything I can, but I don't know what else to do. Which leads me to this.Explore additional coverage and support. There may be resources available depending on his situation. There's Medicare coverage for certain services.You mentioned Medicaid, but maybe Medicare. If he's got Social Security, maybe he needs to apply for Social Security disability benefits. If he does that, then maybe he qualifies for Medicare.There's a difference between Medicaid and Medicare. I'm not going to get into it today, but maybe he would qualify for that.Or maybe in your state there's some state specific assistance programs and also nonprofits or hospitals do offer financial aid. And this is where working with a social worker or a case manager can be incredibly helpful.Every single hospital, every health organization has folks that will come alongside of you and help you. Now listen, you may need to be persistent, you may need to kind of drag them kicking and screaming.But they often know what programs exist locally that most people don't even realize are available. So elicit that support from those people. But in the end, Jennifer, I want you to really focus on one step at a time.Because right now, when I reread your letter today, everything is hitting you at once. You've got the cost and the timeline, you love your brother, the uncertainty of all that. So don't try to solve everything today.You know, if you listen to the show, I always look at what's the next step. So pick that next step today. Maybe call and schedule with an elder law attorney or speak to the facility, connect with that case manager.But just do one thing because here's the thing I know about our Lord Provision often shows up just one step at a time. Which leads me to this. Invite God into the process.And Jennifer, you reached out to me, which tells me you're a listener to the show so you understand the connection between faith and finance. And like I said, Jennifer, this is not just a financial challenge.This is a moment in time where you need strength, you need wisdom, and yes, you need peace. And guess what? God is present in all of that. So reach up right now and pray for guidance. Pray for the right people to come alongside you.Pray for provision when right now, you don't think anything is possible. But I know we got a Lord that all things are possible. Because even here, right now, I truly believe this with all my heart.God is working in you and your brother's life. Even in this uncertainty, he is guiding you. But I want to encourage you, you don't have to figure this all out alone.So I don't really have a big win for you today.But here's one thing you could do, Jennifer, and if anybody else in the audience is facing these type of things, my wife faced this with her, her mother, my mother in law who has dementia. This is something I see a lot in my practice.But if you're dealing with this right now, schedule one conversation with a Medicaid planner, a case manager, or maybe that elder law attorney. That's it. Find the guidance. Because once you Find that right guidance. It can change everything about what's possible next. Well, let's go to the word.I found this verse in the book of James, chapter one, verse five. If any of you lacks wisdom, you should ask God, who gives generously to all without finding fault. Here's the best part. And it will be given to you.It will be. And here's why this fits today. And Jennifer, I know that you're feeling this right now. Even when you don't know what to do next.God asks you, invite you just say to God, listen, I don't know what to do next. And he's going to give you that wisdom for each step. Well, let's pray to God right now. Jennifer, again, thank you so much for your question.Heavenly Father, right now I just want to lift up Jennifer and her brother James. Lord, you see everything they're facing. You see those physical challenges, that financial pressure.And Lord, you see the uncertainty ahead in their minds. So right now, at this very moment, Lord, I ask that you provide them with wisdom for every decision they need to make.Lord, bring the right people into their path. People like advisors and professionals and helpers who can guide them well during this process.Lord, provide for their needs in ways they may not even expect and give them peace in the middle of this situation and strength for each and every day ahead. Lord, remind them they are not alone and that you are walking with them every single step of the way. And we thank you in Jesus name, Amen.Jennifer, you may not see the whole path, but I promise this, with the Lord at your side, you can take the next step.And right now, if you're walking through something like this and you want to share your situation or ask a question, you can leave me a voicemail at financiallyconfidentchristian.com/voicemail. We'll put a link in the show notes. It's simple. You just go to that website, click record, and that's it.I would love to hear what you're going through. Maybe there's a challenge, maybe there's a triumph.Maybe you just want to say, hey, Ralph, I just wanted to tell you I really like what you're doing here, but go to financiallyconfidentchristian.Com/Voicemail. Jennifer, again, thank you for your message today. I want to thank all of you for joining me today. Stay financially savvy.May God bless you and you have a truly great day today.