About The Care Ledger

Why this exists

The number that decides how many months Medicaid will not pay sits in a state policy manual nobody hands to families. This is why we went and got it.

I kept watching the same thing happen to people who had done nothing wrong.

A mother helps a daughter with a mortgage. A father signs the house over to the son who moved back home to care for him. Someone pays a grandchild's tuition because they can, and because they want to see the good it does while they are still here. Ordinary things. The kind of thing families are supposed to do for each other.

Then a fall, or a stroke, and a hospital discharge planner says the word Medicaid, and five years of bank statements get pulled into the open in a single afternoon. The application gets approved — and the letter says Medicaid will not pay for the next eleven months.

Nobody told them. There was no warning when the gift was made, no notice in the mail, no line on any form. The rule only shows up at the worst possible moment, when the money is gone and someone is already living in the nursing home.

I have watched families lose months of care that way. Not because they were hiding anything — because the number their state divides by was sitting in a policy manual nobody outside a county office reads, and no one ever handed them the page.

So we went and got the pages

Every figure on this site comes from the state's own document. We link to it, every time, so you can see it with your own eyes and take it to a caseworker. When we cannot find a state's figure, we say so plainly instead of printing a number we cannot stand behind — and we show you the rule we did find, so you at least know what to ask.

We checked the big sites while building this. More than one of them publishes figures that do not match the state's own manual. One of them prints a single number for a state that does not have one. That is how this gets decided for families: on a number somebody guessed.

It is free, and there is no catch

This Site Is Free, With No Strings Attached.

No account to read anything. No paywall on the part that matters. No "talk to a specialist" button that sells your phone number to somebody paying for leads. We do not take referral fees from nursing homes, insurers, annuity salesmen, or attorneys.

If you sign up for email, you get exactly what you asked for and nothing else — one message when a state you picked changes its figure. One click unsubscribes and we delete the address.

What this is not

It is not legal advice. We can tell you the number and show you the document. We cannot tell you what to do about your own family.
It is not a substitute for asking. Caseworkers apply exceptions you may qualify for. Every state has a hardship process. Ask for both, by name.
It is not always going to be right. States change these figures quietly and sometimes apply them differently than their own manual says. If you find something wrong here, tell us and we will fix it and say that we did.

If this saves one family eleven months

That is the whole point. A penalty is not a fine you can appeal away — it is months where the bill lands on a family that already gave the money away. Knowing about it a year earlier changes what people do. Knowing about it the week of a hospital discharge changes almost nothing.

So: use it, print it, take it to the county office, send it to the sister who is handling everything. It costs nothing, and it was built for exactly that.

How to reach us

Write to contact@thecareledger.org. A person reads it.

The message we most want is the one telling us we got something wrong. If a figure here does not match what your state or your caseworker says, send it — we will check it against the state's own document and, if we were wrong, fix it and say so on the what changed page. We would rather be corrected in public than be quietly wrong.

We cannot tell you what to do about your own family, and we will not try. For that, ask your state's long-term care ombudsman, your Area Agency on Aging, a legal aid office, or your state bar's lawyer referral service. None of them pay us and we do not send them your name.