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JTsMom
03-22-2007, 05:09 PM
Hoping someone might be familiar with this stuff...

This is re my grandparents:

Grandparents have just under 100K in the bank, don't have any other assests. If Grandfather were to go on Medicaid, go into a nursing home paid for by Medicaid, then dies, what would happen to that money? What if Grandmother died first?

Hope that makes sense. I found this, but the copyright is 97-99, so who knows if it has changed.

http://www.eldernet.com/lawover.htm

""Estate recovery" refers to state laws that allow the state Medicaid agency to file a claim against the estate of an individual who received benefits during his or her lifetime. The amount of such a claim is the amount spent on that individual’s care by the program.

In light of the extremely low asset limit for Medicaid eligibility, the only assets of value that a Medicaid recipient may have at death are those that were not counted for purposes of Medicaid eligibility. Of all such assets, a personal residence usually is the only one of significant value. Thus, as a practical matter estate recovery concerns the treatment of the personal residence after death.

In order to assist with recovery against the personal residence, many states impose a lien on the property while the recipient is alive. Each state has its own procedure for liens. To learn more about whether your state has such a policy and what it may be, check with your local agency. If you don’t have contact information for your state, find it at the State Medicaid Toll-Free Lines page of the Health Care Financing Administration website.Federal law requires states to pursue estate recovery in all institutionalized cases, and it allows estate recovery in community cases as well. OBRA-93 expanded the scope of estate recovery to include non-probate property at the state’s option, such as life estates, jointly-held interests and property in trust. To date, however, only a handful of states have sought to expand estate recovery beyond the probate estate. Of these, only one or two have successfully done so. To find out the status of estate recovery in your state, check with your local agency. If you don’t have contact information for your state, find it at the State Medicaid Toll-Free Lines page of the Health Care Financing Administration website."


Judging from that, I'd assume the state would take any money that had been spent on his care IF Grandma died first, BUT, since the $ is in a joint account, would it be the same if he died first? I don't understand this stuff at all.





This is such a long story, but I'm trying to help my mom figure some of this out. She called an attorney specializing in elder law, and he refused to let her know what fees would be involved to answer this ONE question. Nice, huh?

Any help would be much appreciated. Oh, and they live in FL btw, if that matters.

schums
03-22-2007, 06:22 PM
In MI and PA, the deal is that you have to "spend down" your assets to the upper limit for Medicaid, then the Medicaid kicks in and pays your bills. So if the upper limit is $10,000 in assets (have no idea what it really is) then the patient (or his suplimentary insurance) is 100% responsible until they've spend $90,000. In the case of joint assets (like the bank account), the gov. can take at least 50% of the cash and might be able to take it all (not sure). Houses used to be exempt, thinking that the patient might need to go home one day (like from a nursing home). Now I think it's exempt only if there is a spouse still actively living in the home.

I'd definitely find a local source to make sure this is how it works in FL. Check with the local community "senior center". A lot of time they have an attorney that comes in on a regular basis to answer these types of questions. At the very least, they might be able to recommend an attorney who isn't a a$$!

HTH,
Sarah
Mom to Alex (3/2002) and Catherine (8/2003)

Momof3Labs
03-22-2007, 08:32 PM
There are ways to protect some or most of those assets and allow your grandfather to go on Medicaid, but you really need an attorney who specializes in it to walk you through it (if one attorney is ornery, try another - elder law attorneys are a dime a dozen in FL). Otherwise, the PP is correct that those assets (minus the house) MUST first be used to pay for his care before Medicaid will take over.

o_mom
03-23-2007, 07:00 AM
Generally they will have to spend down the assets to even qualify for Medicaid. If they give it away or move it Medicaid will look back for a certain period and try an recover those assets.

You really need to hire an attorney (though not the one she already called, obviously). This is not something that you can do on your own. We have been through estate planning for both sets of my grandparents and my parents in the last several years and the strategy for each was very different because they all had different needs and were at different times of their life.

ShanaMama
03-23-2007, 07:27 AM
Since Medicaid is a state (not federal) program, the rules vary from state to state & even from county to county. Generally, the person would need to spend down their $$ as PP said. In NJ & NY the asset limit is as low as $2-4K. HOWEVER, if the person who needs Medicaid in an nursing home has a spouse in the community they are allowed to keep more $ and the residence. (If not, they'd have to sell the home & spend that $ too.)
I'm not exactly clear why he wants to get on Mcaid. Is it for now or to pay for the nursing home? IME, if a person came into a NH with that much $$ he'd have to pay privately until he came closer to the asset limit that Medicaid determines. Then an attorney or the NH could help the family with the application process. I'm only familiar with nursing home issues, but IME Medicaid wouldn't even look at someone who has that much $. Keep in mind that annuities & life insurance policies are considered assets & would need to be sold if possible. There are legal things that can be done to 'use up' the $, but you must have the appropriate paper trail or you can really get screwed. The laws are quite complicated, & changing all the time, so I second the motion for getting an elder attorney who specializes in Medicaid financial planning.

I work in NH billing & help people with the application & approval process. Currently I do nursing homes in NY & NJ so that's my main familiarity, but I did FL a few years ago. Disclaimer is that I obviously am not giving you legal or financial advice blah blah blah. Just a friend trying to share my background knowledge.
Feel free to pm me if I can help you more.

Moneypenny
03-23-2007, 08:36 AM
As PPs have said, it varies state to state. I know in our state the medicaid limit was $2,500 of assets (this was a couple of years ago when my grandparents were dealing with this). Since my grandpa was going into a nursing home and my grandma was not, she was allowed to keep one house. The problem is that even if you get rid of all your assets down to the limit, they look back at assets for a period of time (I believe it was 3 years in our case), so you have to spend down your assets and then wait out the time period before you can qualify for medicaid. In the case of my grandparents, my grandma died first. They had thought ahead to put the house in just my grandma's name and the money from the sale of it went to her children, not my grandpa. My grandpa just died in January and his $2,500 was immediately taken by the state - we couldn't even use it toward funeral expenses.

Susan
mama to my cutie pie, Avery
http://www.gynosaur.com/assets/ribbons/ribbon_sapphire_24m.gif[/img][/url]

JTsMom
03-23-2007, 09:44 AM
You guys are going to thunk this is crazy, but someone- can't remember who, but I think it was a coordinator at one of the nh's- told my mom that they could have up to something like $98,000 as a couple, and still qualify! Huge discepancy between that and the #'s you all are giving. She is definitely going to have to find another attorney.

Thanks for all of your replies.

o_mom
03-23-2007, 10:36 AM
For a couple it may be different, but if the money is in a joint account it may be all considered his or at least half his. Here is one page I found - so the spouse can have money, but what is considered 'his' needs to be low:

http://www.virtuallawoffice.com/Medicaid3.html

There are all sorts of ways to do it - trusts, life estates, LLCs, annuities, pre-paid funeral expenses, etc. It all depends on the situation.

AARP is usually a good source of info, so you may contact them if anyone is a member (it's like $10/yr, so someone can join) and ask for a referral.

JTsMom
03-23-2007, 11:21 AM
That's good info to know. Thank you! And great suggestion to try aarp!