I greatly appreciate the wonderful work you do on this site and believe I owe our success to you. I followed the advice given here and applied for A & A in November 2015. We were approved and started receiving payments in April 2016. We sent our incompentency notice response in late March – have not yet had a scheduled appointment for fiduciary approval. My sister’s illness is progressing much faster than we expected. She had to be moved to skilled nursing much earlier than we expected. Even with social security and A&A she is running through her savings at an alarming rate. We expect to have to apply for Medicaid in August of this year. In KY because she gave some gifts to her daughters in 2013 she will have a penalty period of at least 6 months that she can not receive Medicaid even after she qualifies from assets and income. The family will have to make up the difference. From this site I know that her A&A payments will drop to $90 when she receives Medicaid. Here are my questions: Does A&A payments drop when we apply for Medicaid? Or do the payments drop when we actually start receiving Medicaid? Is it our responsibility to inform the VA or does Medicaid do it? I have some concern about the fiduciary process. Medicaid requires assets of less than $2000. The back pay from A&A will be more than $2000. If we determine that a larger check is a problem, can we eliminate this “back pay”? Thank you.