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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.

Home›By Situation›The 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 should I do after a parent's first fall?

Treat it as a signal, not an accident -- a first fall is one of the strongest predictors of the next one. Get the cause investigated (medications, vision, inner-ear issues), fix the immediate environment, and ask CICOA Aging & In-Home Solutions about equipment-lending programs.

What should I do right after a dementia diagnosis?

Slow down -- very little has to be decided the first month. Get the specific diagnosis type, since Alzheimer's, vascular dementia, Lewy body and frontotemporal dementia progress differently, and put power of attorney and medical power of attorney paperwork in place now, while capacity is clear.

I live out of state. How do I manage my parent's care from a distance?

Build a plan that survives a bad-weather week when you cannot fly in. Recruit local eyes such as a Meals on Wheels driver or trusted neighbor, get medical power of attorney and HIPAA authorization in place, and establish one local point of contact, such as CICOA or a geriatric care manager.

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