Applying for Medicaid

After establish a pooled income trust and seeing that my mother's assets (those not in a trust), were now within the Medicaid requirements, I began the application process. I consider myself a fairly intelligent and capable person. I have a Masters Degree. I've run my own business for close to 15 years. I manage my own finances and my mothers. I'm familiar with negotiating paperwork and I'm excellent at multi-tasking. The Medicaid application was daunting but I was determined. Over a period of about 2 months I put together the laundry list of documentation requested on the application. I'm also working, in school, have a child, and manage my mother's life as well, so time is limited. I sent the thick packet, with cover letter, to Medicaid via certified mail. I felt I had gone above and beyond, including copies of the trust and other information that wasn't required but might help clarify the entire financial picture. About a week letter I got a response from Medicaid saying that I was missing numerous items and had until the end of the week to send the missing information or the case would be closed and I'd have to start from scratch. I called the worker, whose name was listed on the form, and pleaded my case, explaining it wasn't enough time to gather the missing documents. The Medicaid worker was very nice and gave me another week. I sent another packet, thicker than the first, via certified mail. After more back and forth I ended up sending two more envelopes to Medicaid and my mother was approved with a "spend down". This was when I learned that Long Term Care Insurance reimbursement was counted as income. They added $3400 / month for this reimbursement. At this point I have followed up and explained that they only reimburse up to $100/day so it is impossible to be reimbursed more than that. They calculated this number based on reimbursements I had received the prior month. Because it is based on time sheets, and there is a delay in reimbursement, one month might be less and another more. I'm hoping they will bring this number down to $3000. Initially I was shocked that they considered this income but now I've adjusted and am trying to find a way to handle this. I've learned that, sadly, many people actually cancel their policies in order to qualify for Medicaid. I could deposit his money into the Pooled Income Trust although it would be tricky because reimbursements come in piece meal during the month. The problem is I can't pay the independent aides I hired with the Trust. The Trust will only pay an agency. Agencies charge about $25 an hour (often paying the aides $10 or less/hour) so if I did switch to an agency I'd be getting 4 hours for the same $100 instead of 8, and very likely losing the trusted aides I hired because I doubt they'd be willing to take that cut to their income.
The idea was that Medicaid would eventually pay for the home care and not just 8 hours but what my mother really needed 24/7. This was my idea anyway. Medicaid explained that I'd have to sign on with a managed long term care company who would handle the home care. There are over a dozen of these companies covering Nassau county so I checked some ratings on the Medicaid site and called the number.