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The money is running out

Spend-down, Medicaid waiver waitlists, and why waiting makes this harder.

Quick answer

Spend-down, Medicaid waiver waitlists, and why waiting makes this harder.

HomeBy SituationThe money is running out

This is the situation families delay talking about longest, and delay is the one thing that reliably makes it worse.

Short answer

Spend-down, Medicaid waiver waitlists, and why waiting makes this harder.

What to do, in order

  1. Work out the actual runway. Current balance, monthly burn including care-level charges, and expected increases.
  2. Contact the Area Agency on Aging about waiver waiting lists now. Indiana's PathWays Waiver has carried a waitlist historically -- ask CICOA where an application would currently stand before assuming there is time to wait.
  3. Find out whether the current community holds a waiver provider agreement. Ask directly, and ask how many current residents actually use it.
  4. Check for benefits already on the table. VA Aid and Attendance is heavily under-claimed; unreimbursed care costs reduce countable income.
  5. Talk to an elder law attorney before moving money. Transfers carry look-back consequences.

Questions families ask

What does a long-term care ombudsman actually do?

An ombudsman advocates for a resident free of charge, and only with the resident's consent. They can attend a care conference with a family but do not license, inspect, or fine a facility -- that is the state health department's job, not the ombudsman's.

Can an ombudsman file a complaint even if my parent doesn't want to?

No. Consent matters: if a parent has capacity and does not want a complaint pursued, that decision stands, even where family disagrees with it. The ombudsman represents the resident's wishes, not the family's.

Is the ombudsman the same as filing a state licensing complaint?

No, they're two different systems. The ombudsman advocates for an individual resident; the Indiana Department of Health investigates regulatory complaints and can take enforcement action against a facility's license. Using one does not preclude using the other.

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