Medicaid - is this right?

[Disney Doll]

Anyone with a relative who looks like they may be going into a nursing home needs to have the person transfer their assests into someone else's name a few years before otherwise, they will find themselves in the same situation posted in the OP.

Hence the reason that Medicaid has to be as diligent as vigilant as it does to make sure people aren't trying to scam them.

 

[PADISFAM]

You know, I know people always say that, and I have never understood why, other than the obvious fact of wanting to leave it to your children, which, while altruistic, may not be realistic. Why does it suck if the money someone worked for all their life was used to care for them in their declining years? What else should thei[/U]r $$ be used for? If they can't use it to enjoy themselves due to physical/medical limitations, then I would be happy that they had the financial wherewithal to be able to provide themselves with good care.

I have elderly parents. Their money is THEIR money. If every cent of their money has to be used to care for them, then so be it. THEIR money is not MY money. Yes, as parents I am sure they will hope they could leave me something, because that is what parents hope....that they can do things to make their children's lives easier. And certainly, when they pass away if there is any money left I will inherit it. But I have no expectation that their money is going to be my money, nor would I ever minimize their care or needs to save their money so I could someday inherit it.

Not to mention it is ALL of our taxes that pay for Medicaid & Medicare --- 2 &2 = 4 not 3.
If one has money one should pay for their care -- not pass it on to others -- that is exactly why they worked all those years for it -- so they would not be a burden--- a burden on family or society.

 

[KAMLEM]

Anyone with a relative who looks like they may be going into a nursing home needs to have the person transfer their assests into someone else's name a few years before otherwise, they will find themselves in the same situation posted in the OP.

That's right, they should do whatever they can to cheat the government. Heaven forbid they contribute something to their own living expenses. And how interesting that this is your first post. Hmmm.

She should really talk to a lawyer. It's not as black and white as a 7-year look back, the circumstances in every situation are different.

 

[PADISFAM]

who has one of those cool troll pics?

I want the one w/ the really BIG nose!

 

[vettechick99]

Thanks for the mention of SHIP. I found the GA number and gave it to them.

We all feel that absolutely the money should (and did!) go to the care of the grandma. While grandma was living with my friend's mom she paid for her entire care - food, dentures, healthcare, everything! When she had other expenses she couldn't afford alone, the siblings chipped in.

Just doesn't seem fair that now that the money that only partially reimbursed her now has to go to Medicaid to pay for...hmmm, 6 months of care? 6 months is all you get with $24k!!! What sense does this all make? Haven't we all been paying into the system so that we get these Medicaid benefits when we are older??

 

[NotUrsula]

Haven't we all been paying into the system so that we get these Medicaid benefits when we are older??

No, actually. The benefits you've been paying in for are for MediCARE, and that doesn't cover long-term nursing home care.

MedicAID is health care for the indigent, of any age. It makes sense that you should not be able to give away a whole bunch of money and then cry poverty to get free health care, but I personally think that sheltering a limited amount of cash as part of a "spend-down" is not morally wrong, because most state governments' idea of an acceptable monthly stipend is stuck in the 1960's. In my mother's case, it was $36/month. She lived in a nursing home for 9 years.

When you are single and end up in a nursing home on Medicaid, you are supposed to give them all of your assets, except a small cash holdback, in my mom's case, $2000. The only thing you are legally entitled to shelter is a pre-paid funeral plan. You also have to turn over your pensions and/or social security checks, and out of that they will let you have the above-mentioned stipend. The coverage provided by Medicaid covers nursing care, prescription medicines, and the institutional food provided in the meal service. Things it does NOT cover include toiletries, OTC medicines like an aspirin for a headache, clothing, shoes, haircuts, laundry charges, and additional foods, nor a telephone or a private television. We won't even talk about things like books, stationary, magnifying glasses, stamps, yarn for knitting, etc.

My mother was Irish, she only drank tea, but the nursing home she was in only provided coffee. She didn't want expensive tea, just ordinary Lipton tea bags; her habit ate up about $10/month of her $36. She also had some trouble toileting, so she needed to bleach her underwear; consequently it didn't last long, and needed to be replaced pretty often; she usually bought two new prs of basic underpants per month; that was another $10. Luckily my sister was able to do her laundry for her; if she had had to pay for it it would have been $5/week. She had to wear very sturdy shoes; they were not covered by Medicaid, and cost $80/pr. She needed a new pair every two years, as she wore them every single day.
Then there was deodorant, and foot powder, shampoo, soap, hair spray, denture cleaner, etc. She only owned two changes of street clothing in her final years; the only things she wore at the home were WalMart housedresses, because that was all she could afford. I bought her a suit to wear at my graduation -- she was buried in it, too.

I think that it is perfectly normal and not a moral outrage for a working-class person to want to stash away a bit of money to use for things like buying a $6 Barbie doll for a grandchild's birthday. They did work hard all their lives, and while they understand that they are falling on the government's mercy, I don't think it is too much to ask to be allowed to keep a bit of dignity when you are too old and sick to work, in order to keep yourself clean and decently clothed, and maybe to buy a few very small indulgences once in a while. I'm crying sitting here typing this, remembering how humiliated my mother was that she couldn't afford to give my son a $10 christening gift. She didn't know how long she was going to live, you see -- how long she was going to have to make her money last.

I'll admit it. We held back about $4000 on my mother's behalf, and sneaked it into her bank account a few dollars at a time when she went below $2K, so that she could have the dignity of having a little money to spend when she wanted to. When she died after 9 years in the nursing home, she had $343 to her name. We used it toward the cost of putting a concrete slab under her grave marker, because Dad's was sinking into the ground without one.

The nursing home would have chewed through that $4K in 5 weeks; we made it last 6 years.

Living for 9 years on $9888 was very difficult. Living that long on $5888 would have been way beyond difficult. How many of you could keep your dignity on $55/month, even if you were given room and board? We tried to give my mother things, and did whenever an occasion came around, but most of the time she wouldn't accept them; she wanted to retain some measure of independence, if only on paper. If your children are poor, too, and raising their own kids, they won't be able to throw much your way.

One other thing about my mom; for the first seven years of that nine, she didn't really need to be in a full-service nursing home. She could have remained in her own home if she had been able to get a home health aide, but Medicare doesn't pay for that, either. I don't want to turn this into a political thread, but as long as my government is fine with wasting Medicaid dollars on providing me with full-time nursing home care when all I really need is someone to help me bathe and dress twice a day, then I'm fine with keeping back a nest egg of a few weeks' nursing home charges to make the rest of my life a little more dignified.

The high cost of nursing home care is guaranteed to bankrupt a working class person in no time flat; you just can't win -- even if you sell everything it took you 60 years to work for; it normally won't buy you more than a year or so of care in a decent place; two years at the outside.

A few years ago Georgetown did a paper on the question of whether large amounts of assets were really routinely being sheltered by those who got Medicaid nursing-home care; they found that the number of people who sheltered anything really substantial was tiny. http://ltc.georgetown.edu/pdfs/nursinghomecosts.pdf

 

[wall*e2008]

Ok this is my friend's mom's situation - so I told her I'd ask here because you guys know it all.

My friend's mom has always taken care of her mother ("grandma") since her father died. She has basically supported her financially and in every other way. When she got to the point that she could not take care of her in the home anymore, she placed her mother in a nursing home that medicaid pays for.

During that time, or maybe before, she sold her mother's house for her. It had once been in a decent neighborhood, but had since gone bad and had actually been inhabited by squaters for some time. So it was in bad shape all the way around. She sold it and was lucky to get much for it. The proceeds (less than $25k) went to paying a lot of overdue bills and the other children of grandma.

Grandma has since gotten a new case mgr and she says that my friend's mom needs to find that house money by tomorrow because it needs to go towards paying for grandma's nursing home. She doesn't care that grandma has been a financial burden to her, that it went to pay bills, and wants that money ASAP.

None of them knows the laws and coming up with that money would be a huge financial burden to them now. I told her to ask a lawyer, but there is some Medicaid gag law.

So any experience with this kind of situation?

That house was the grandmother's asset and it should have been used to pay the nursing home. The government does not pay for care while the children get an inheritance.

 

[wall*e2008]

Thanks for the mention of SHIP. I found the GA number and gave it to them.

We all feel that absolutely the money should (and did!) go to the care of the grandma. While grandma was living with my friend's mom she paid for her entire care - food, dentures, healthcare, everything! When she had other expenses she couldn't afford alone, the siblings chipped in.

Just doesn't seem fair that now that the money that only partially reimbursed her now has to go to Medicaid to pay for...hmmm, 6 months of care? 6 months is all you get with $24k!!! What sense does this all make? Haven't we all been paying into the system so that we get these Medicaid benefits when we are older??

That is the way it works. If you want to protect your assets you get long term care insurance and you control how you assets are paid. If the LTC is enought to pay the entire bill, then you can have money for gifts etc. Many LTC policies allow in home care. Look into LTC insurance if you do not want this to happen to you.

 

[ZephyrHawk]

Just jumping in to reiterate what others have said, that house was the grandmother's. Since Medicaid pays for her to live, the house was really Medicaid's. Taking the proceeds was a bad idea. Similarly, transferring your assets before going on Medicaid is also wrong. You do that, you steal from all of us who pay taxes.

The fact that daughter paid for grandma for years is not the government's concern. Daughter was under no legal obligation to do so. She could have shunted grandma into a Medicaid facility way back when. Alternatively, she could have helped grandma sell her house way back when and used the proceeds to help grandma live.

Sure, everyone wants to be able to leave their kids something. I want a pony, too, doesn't mean I'll ever get one. My parents have told me I'm not getting any inheritance as they plan on spending it all. I've told them that 100% makes sense to me, but they'd best not look to me to take care of them when they're old. The best present they can give me is to not be a burden. You don't work all your life so you can have something extra at the end, you work all your life so you can make it to the end.

 

[bumbershoot]

That house was the grandmother's asset and it should have been used to pay the nursing home. The government does not pay for care while the children get an inheritance.

No one got an inheritance, read all the OP's posts here. Debts and bills were paid.

Just jumping in to reiterate what others have said, that house was the grandmother's. Since Medicaid pays for her to live, the house was really Medicaid's. Taking the proceeds was a bad idea. Similarly, transferring your assets before going on Medicaid is also wrong. You do that, you steal from all of us who pay taxes.

The fact that daughter paid for grandma for years is not the government's concern. Daughter was under no legal obligation to do so. She could have shunted grandma into a Medicaid facility way back when. Alternatively, she could have helped grandma sell her house way back when and used the proceeds to help grandma live.

The bolded part was EXACTLY what happened. This house wasn't sold yesterday. And no one took proceeds, they paid the woman's past bills and debts with it.

 

[DawnCt1]

Just wanted to be clear that money was not given away like an inheritence. It went to paying bills and repaying debts to the other siblings. My friend jokes she never saw dime one of that money.

Anyway, I would think that if she can prove that she spent that money on bills for grandma, that should count for something. I mean what if grandma had a hospital bill for $10k? Are they just supposed to absorb that cost and all that house money go to medicaid?

My friend's mom has a mountain of checks that proves that money was spent on grandma and her care. The CM said it didn't matter and that they want the money. It just doesn't seem right.

If there was a hospital bill that wasn't paid in full by Medicare or some other insurance and it was paid from the assets of Grandma and her house, they should get a receipt and submit that. That is an allowable bill/expense, just like her overdue electric/gas/oil bill would be if its in her name.

 

[DawnCt1]

Anyone with a relative who looks like they may be going into a nursing home needs to have the person transfer their assests into someone else's name a few years before otherwise, they will find themselves in the same situation posted in the OP.

They don't "need" to. That is defrauding the taxpayer.

 

[Pea-n-Me]

No one got an inheritance, read all the OP's posts here. Debts and bills were paid.

I could be wrong, but I think there are many, including myself, who read this as the children did get some of the money.

The proceeds (less than $25k) went to paying a lot of overdue bills and the other children of grandma.

 

[tonilea]

I could be wrong, but I think there are many, including myself, who read this as the children did get some of the money.

The way I understood it, from subsequent explaination, was that the grandmother had borrowed money from her children for living expenses and that money was repaid.

 

[golfgal]

What they look at is to see if the person has been quietly doling out proceeds to make their assests less. You have to keep receipts and good records of how you spend that money if your parent comes to live with you. You can also pay yourself a caretakers fee, but our lawyer helped determine that for us.

Your friend may need to get a lawyer involved since the nursing home is demandig payment. I had a lawyer when my dad had to go into a nursing home and I am so glad I did because I would have never been able to go it by myself. The social worker is the mouthpiece of the place, and I had a few run ins with the one at our home, but I just turned it over to my lawyer and he handled it. I know that my dad's skilled nursing ran about $7000 a month.

It sucks that you work your whole life for stuff and then if you have to go into a nursing home the state takes it all.

The easy solution to the problem (too late for Vettechick's friend) but for the rest of us is to get Long Term Care insurance. It covers the cost of your care for in-home, assisted living and nursing home care. If you are in a partnership state then any monies paid out by a Long Term Care policy can be what you can hold back and not have to surrender if you end up on Medicaid in a nursing home (if the policy pays $500,000 you can protect $500,000 in assets).

 

[bumcat]

Ok this is my friend's mom's situation - so I told her I'd ask here because you guys know it all.

My friend's mom has always taken care of her mother ("grandma") since her father died. She has basically supported her financially and in every other way. When she got to the point that she could not take care of her in the home anymore, she placed her mother in a nursing home that medicaid pays for.

During that time, or maybe before, she sold her mother's house for her. It had once been in a decent neighborhood, but had since gone bad and had actually been inhabited by squaters for some time. So it was in bad shape all the way around. She sold it and was lucky to get much for it. The proceeds (less than $25k) went to paying a lot of overdue bills and the other children of grandma.

Grandma has since gotten a new case mgr and she says that my friend's mom needs to find that house money by tomorrow because it needs to go towards paying for grandma's nursing home. She doesn't care that grandma has been a financial burden to her, that it went to pay bills, and wants that money ASAP.

None of them knows the laws and coming up with that money would be a huge financial burden to them now. I told her to ask a lawyer, but there is some Medicaid gag law.

So any experience with this kind of situation?

Did grandma sign the admission/financial agreement or did a family member? Whoever signed is fully responsible but they can still discharge her no matter who signed.
I use to work (28 yrs) for a co. that owned nursing homes (quite a few were in Ga. and other states).
If grandma signed the financial/admission they can only go after grandma financially. They can not go after family members if they did not sign the financial/admission agreement.
The co. I worked for use to write the balance off all the time. It was more important to keep the patient for future $$ than to have to fill a bed over and over. Not saying it is right but that is what they did and I"m sure still do.
You do have to wait a certain amount of years after selling houses etc before you can be in a nursing home under Medicaid.
CM should have told grandma/family that the money needed to be paid before accepting grandma in the nursing home.
Is it possible that the family member signed stating they would pay xx amount per month to go towards this amount? If so they should be paying it.

 

[CPT Tripss]

No one got an inheritance, read all the OP's posts here. Debts and bills were paid.



The bolded part was EXACTLY what happened. This house wasn't sold yesterday. And no one took proceeds, they paid the woman's past bills and debts with it.

If there was a hospital bill that wasn't paid in full by Medicare or some other insurance and it was paid from the assets of Grandma and her house, they should get a receipt and submit that. That is an allowable bill/expense, just like her overdue electric/gas/oil bill would be if its in her name.

If OP can demonstrate that bills and living expenses were paid with Grandma's money, then that amount of the "look back" should be waived. Repaying "loans" from family members is much more sticky and not likely to pass muster.

Although OP doesn't indicate one way or the other, an FYI for readers. If you are in a similar situation and a house sale to a relative is contemplated, be sure to get a professional appraisal and sell at that amount so it is clear there was no gifting.

 

[CPT Tripss]

Anyone with a relative who looks like they may be going into a nursing home needs to have the person transfer their assests into someone else's name a few years before otherwise, they will find themselves in the same situation posted in the OP.

No, they just need to spend the person's money for the benefit of the person.
Regardless of one's position on government involvement in paying for health (or long-term) care, fraud and stealing from one's fellow citizens is wrong.

Hence the reason that Medicaid has to be as diligent as vigilant as it does to make sure people aren't trying to scam them.

Not to mention it is ALL of our taxes that pay for Medicaid & Medicare --- 2 &2 = 4 not 3.
If one has money one should pay for their care -- not pass it on to others -- that is exactly why they worked all those years for it -- so they would not be a burden--- a burden on family or society.

They don't "need" to. That is defrauding the taxpayer.

 

[LKHomemail]

These are the kind of questions that you need to see an attorney for and those conversations need to be in person (not phone or email). Estate Planning is one of several topics you need to become familar with. Good Luck to you.