Planning for long-term care can turn a family’s world upside down. There are decisions about living arrangements, caregiving, medical needs and finances, sometimes all at once. When Medicaid eligibility enters the conversation, families may hear the phrase “spending down assets” and become so focused on paperwork and account balances that they overlook the equipment that could make daily life easier for the person receiving care.

At Rocking Mobility, we believe the right place to start is with the person. Whether someone is moving into assisted living, preparing for nursing-home care or hoping to remain at home with more support, it is worth asking what they will actually need to move, rest, transfer and manage daily routines more comfortably and safely.

What Does Medicaid “Asset Spend-Down” Mean?

Medicare and Medicaid are not the same program. Medicare is primarily health insurance for older adults and certain people with disabilities. Medicaid is a separate program with financial eligibility requirements, and some Medicaid programs help pay for long-term care.

For people applying for certain Medicaid long-term-care benefits, financial eligibility can depend in part on their countable assets. Families sometimes use “spend-down” to describe properly using assets above an applicable limit for the individual’s legitimate expenses and needs. This is different from Ohio’s former *income spend-down* program, which ended in 2016. Income eligibility and asset eligibility are separate questions, and the rules vary by the type of Medicaid coverage being sought.

The objective should never be to buy something simply to make an account balance smaller. It should be to meet genuine needs while following the rules that apply to the individual’s situation.

Start With Everyday Mobility and Comfort

A change in living arrangements often reveals practical needs that were easy to manage before. Someone may struggle to rise from a chair, maneuver a wheelchair through a smaller room, get in and out of bed or bathe comfortably. Families may also be thinking about a short recovery period, frequent medical appointments or equipment that will make the next stage of care easier to manage.

Depending on the person and setting, the conversation might include wheelchairs, walkers and rollators, lift chairs, hospital beds, bath safety products or other mobility equipment. These are not interchangeable solutions, and not every product belongs in every setting. The layout of the home or facility, the person’s physical abilities, caregiver involvement and facility requirements all matter.

This is one reason we encourage families to ask questions and, whenever practical, see and try equipment before purchasing it. A comfortable fit and realistic plan for how the equipment will be used matter more than an impressive list of features.

Can Equipment Purchases Be Part of Medicaid Asset Planning?

In some circumstances, yes — but not automatically. Spending a person’s money on legitimate goods or services for that person, at a reasonable market price, may be part of an appropriate asset-planning approach. Whether a particular equipment purchase is acceptable depends on the program, the timing, the individual’s circumstances and how the purchase is documented.

Ohio’s long-term-care Medicaid rules look closely at certain asset transfers, including gifts or transfers for less than fair market value during a five-year look-back period. A genuine purchase for the applicant’s own needs is not the same thing as giving assets away, but the details matter. Families should never assume that an expensive scooter, chair or bed automatically “counts” toward eligibility.

Before making a purchase for Medicaid-planning reasons, discuss it with an Ohio elder-law attorney, qualified Medicaid-planning professional or the appropriate eligibility agency. Keep itemized receipts and any relevant recommendations or documentation, and make sure everyone understands who the equipment is for and where it will be used.

Check What Insurance or Medicaid May Already Cover

Another important question is whether the person’s existing coverage might provide some of the equipment they need. Ohio Medicaid covers certain medically necessary durable medical equipment, subject to its coverage rules and, for some items, prior authorization. Coverage, available product choices and approval requirements vary.

Rocking Mobility is a cash-pay business and does not bill Medicare or Medicaid. We can help families compare equipment and understand purchasing options, but we cannot determine Medicaid eligibility or promise that a purchase will be accepted as part of an asset spend-down. It makes sense to check available benefits before deciding to purchase privately.

Assisted Living and Nursing-Home Care Are Not Identical

Families sometimes use “long-term care” as though it describes a single program, but the financial and practical arrangements can be quite different. Ohio’s Assisted Living Waiver, for example, can pay for covered care services for eligible individuals in participating facilities, while the resident remains responsible for room and board. Nursing-facility Medicaid and care at home involve different arrangements and requirements.

If someone is moving into a facility, ask what equipment the facility already provides, what residents may bring and whether there are space, safety or equipment-approval rules. A product that makes sense at home may not be appropriate in a particular room or care setting.

Four Questions to Ask Before You Buy

·      What does the person genuinely need for mobility, comfort or daily routines?

·      Is the product suitable for the home or facility, and who will help use or maintain it?

·      Could Medicare, Medicaid or another benefit provide the item under the person’s coverage?

·      Has the family’s Medicaid or elder-law adviser reviewed the proposed purchase and documentation?

Those questions help keep the focus on a useful purchase rather than a rushed one. Good financial planning and good mobility planning should work together, not compete with each other.

We Help With Mobility Decisions. Your Adviser Handles Eligibility.

At Rocking Mobility, we work with families throughout Northeast Ohio who are navigating recovery, assisted living, long-term care and changing mobility needs. Our role is to help you understand equipment options, compare products in our spacious showroom, and choose solutions that fit the person and the setting. Our sales, rental and repair experience can also help families think beyond the immediate purchase.

We are not a Medicaid eligibility or legal adviser, and we will not tell you that buying something from our store guarantees any benefit. But if your family is planning ahead, we would be glad to help with the equipment side of the conversation — so that the decisions being made on paper also make sense in everyday life.