Medicaid lookback

[Jeannie]

For years my mother would always say that my brother and I would 'be rich' when she died. We would tell her not to worry about us, we were financially stable. Fast forward to today where she is in a memory care facility, costing $15k per month. Luckily her savings have been able to cover that cost. Once her money runs out, most likely in the next two years, Medicaid supposedly will take over. I'd like to give her four toddler great-grandchildren a monetary Christmas gift from her. I was thinking of a $2,500 I bond for each child. This total is less than the cost of one month at her facility. I don't want this to jeopardize her Medicaid eligibility in the future, nor do I want to have to pay it back. My name is on my mother's checking and savings accounts and my brother's is on her investment accounts. Both of us have power of attorney. I don't want to do anything wrong, but not sure who can best advise us. My regular financial advisor? The lawyer who handled my own will? An elder law attorney?

 

[NotUrsula]

For years my mother would always say that my brother and I would 'be rich' when she died. We would tell her not to worry about us, we were financially stable. Fast forward to today where she is in a memory care facility, costing $15k per month. Luckily her savings have been able to cover that cost. Once her money runs out, most likely in the next two years, Medicaid supposedly will take over. I'd like to give her four toddler great-grandchildren a monetary Christmas gift from her. I was thinking of a $2,500 I bond for each child. This total is less than the cost of one month at her facility. I don't want this to jeopardize her Medicaid eligibility in the future, nor do I want to have to pay it back. My name is on my mother's checking and savings accounts and my brother's is on her investment accounts. Both of us have power of attorney. I don't want to do anything wrong, but not sure who can best advise us. My regular financial advisor? The lawyer who handled my own will? An elder law attorney?

I would consult an elder-law attorney before moving any assets, but having dealt with the lookback with my own mother, I would guess that it is too late to do this. Unless you are in California, the lookback is 5 years, and you expect her personal funds to run out long before that. Gifts to the applicant's minor *children* are an exception, but AFAIK, that does not apply to minor grandchildren.

This overview may help with some general info: https://www.medicaidplanningassistance.org/medicaid-look-back-period/

 

[RoseGold]

Def. not your "financial advisor." This is time for actual legal advice, and it's state specific. I would start with your lawyer. And I'm guessing you already know what the answer is.

 

[tvguy]

Yes you need to consult a legal expert, but it appears you are too late. They look back 5 years for all asset transfers according to this.
https://www.medicaidannuity.com/loo...UPThca03dhpFuqQuKXjU0aBqsAJKtU0oaAi8KEALw_wcB

 

[Pea-n-Me]

We had an elder law attorney and he told me that look back is forever, not just five years. I know everyone seems to think five years, but he said they can look back beyond that, too. Early planning is essential. I don’t know the answer to your question, but I would definitely consult an elder law attorney.

 

[izzy]

When we consulted with an elder care attorney about 10 years ago, the most you could gift was $1,000 if you were worried about the look back period. I can’t remember if that was per person or all together, though. Best bet is to talk with an attorney who specializes in this as the rules may have changed since then.

 

[barkley]

former medicaid eligibility supervisor here-

talk to an elder law attorney for the state SHE lives in. the look back is real, gifting money can mean it could still be counted as if she still had it when she would be otherwise eligible (so let's just say in december 2025 she would have been eligible, that money would still be considered under some state's provisions so however long that $10,500 would count against her she would be ineligible-depends on the spend down rules for that individual state).

p.s. keep records on every penny spent, it can be called upon to create a trail so it's better to have it, organized and ready (sooner you have paperwork/easier and faster for eligibility staff to process).

best wishes to you/your mom

 

[tasha99]

You'd be smart to see an attorney before doing this. As POA, you probably have a fiduciary duty to spend her money in ways that benefit her, not her great grandkids.

 

[QueenIsabella]

In your post, you say that "you" would like to give this money to the great-grandkids. It doesn't matter what "you" want to do--it's not your money. You must be a a good fiduciary of your mother's assets. In addition to the Medicaid clawback issue, there's a moral one, as well. I understand you wanting the kids to get a little something nice, but that's not your call to make. What you CAN do is remember this, and not put yourself in the same situation--use your own money to set up your grandchildren. Do it early enough on that Medicaid isn't an issue. Use this circumstance as your own wake-up call to do end-of-life planning--while your end of life is (hopefully!) still decades away.

 

[Praying Colonel]

We had an elder law attorney and he told me that look back is forever, not just five years. I know everyone seems to think five years, but he said they can look back beyond that, too. Early planning is essential. I don’t know the answer to your question, but I would definitely consult an elder law attorney.

Agreed 100%. Many attorneys will do free initial consultations.

 

[Jeannie]

In your post, you say that "you" would like to give this money to the great-grandkids. It doesn't matter what "you" want to do--it's not your money. You must be a a good fiduciary of your mother's assets. In addition to the Medicaid clawback issue, there's a moral one, as well. I understand you wanting the kids to get a little something nice, but that's not your call to make. What you CAN do is remember this, and not put yourself in the same situation--use your own money to set up your grandchildren. Do it early enough on that Medicaid isn't an issue. Use this circumstance as your own wake-up call to do end-of-life planning--while your end of life is (hopefully!) still decades away.

I understand what you're saying and I know well and good that it's not my money. It was more trying to do something that she would want - giving a generous gift to her great grandchildren. My mother was the daughter of immigrants. She dropped out of school at 16 to get a job to help support her younger siblings. She continued working as a young wife and mother. My father became quite ill when my mother was pregnant with my younger brother. She was eligible for public assistance but was too proud to accept it, instead moving in with her widowed mother and her mother's boarder. We all stayed there for two years. Ten years later she became a young widow with two school age children to support. We lived frugally and my mother scrimped and saved always. She was very proud to have been able to give her granddaughters money toward their wedding gowns and generous wedding gifts. She was able to save a large nest egg on her own. I am very grateful that she has the money to pay for her living situation now, but I know that it would absolutely kill her if she knew it was costing almost $200,000 a year. She hates where she is and is always asking how much it costs. (It's a very nice facility, she just wants to be back living with me where she lived for almost 20 years.) My thought was more along the lines of knowing my mother would rather give 'her babies' a gift then giving everything she worked so hard for to someone else.

This isn't about setting up my grandchildren. It's about my mother doing something for them before the state takes the rest of her money. I am not worried about setting up my grandchildren myself. This isn't our goal!

Reading this, I don't mean to sound snippy! I guess I'm just sad, and tired, and frustrated. We had to take a large amount of money out of my mother's investments to pay for a buy in for the first facility she went to. Because of that, she had to pay $40,000 in income taxes. Now I just got her Social Security statement for the upcoming year and her benefits are being cut by $600 a month because of the large withdrawal. She worked so hard and now her money is just disappearing so quickly.

 

[barkley]

Agreed 100%. Many attorneys will do free initial consultations.

in some states (and in some counties when they administer independently vs. as a whole state agency) a 'preemptive eligibility' appointment can be made for medicaid. the idea is to sit with an eligibility specialist who looks at the basics of a situation and explains where the person would stand if they applied on the day of the appointment. it can give a person a rough idea of where they stand at a given point in time. another spectacular resource is if you have elder ombudsman you can contact by phone-they know every resource for accurate and often free advice and guidance on everything medicare, medicaid, adult services.....just spectacular people to interact with.

 

[NotUrsula]

I understand what you're saying and I know well and good that it's not my money. It was more trying to do something that she would want - giving a generous gift to her great grandchildren. My mother was the daughter of immigrants. She dropped out of school at 16 to get a job to help support her younger siblings. She continued working as a young wife and mother. My father became quite ill when my mother was pregnant with my younger brother. She was eligible for public assistance but was too proud to accept it, instead moving in with her widowed mother and her mother's boarder. We all stayed there for two years. Ten years later she became a young widow with two school age children to support. We lived frugally and my mother scrimped and saved always. She was very proud to have been able to give her granddaughters money toward their wedding gowns and generous wedding gifts. She was able to save a large nest egg on her own. I am very grateful that she has the money to pay for her living situation now, but I know that it would absolutely kill her if she knew it was costing almost $200,000 a year. She hates where she is and is always asking how much it costs. (It's a very nice facility, she just wants to be back living with me where she lived for almost 20 years.) My thought was more along the lines of knowing my mother would rather give 'her babies' a gift then giving everything she worked so hard for to someone else.

This isn't about setting up my grandchildren. It's about my mother doing something for them before the state takes the rest of her money. I am not worried about setting up my grandchildren myself. This isn't our goal!

Reading this, I don't mean to sound snippy! I guess I'm just sad, and tired, and frustrated. We had to take a large amount of money out of my mother's investments to pay for a buy in for the first facility she went to. Because of that, she had to pay $40,000 in income taxes. Now I just got her Social Security statement for the upcoming year and her benefits are being cut by $600 a month because of the large withdrawal. She worked so hard and now her money is just disappearing so quickly.

I know exactly how you feel, but the problem is that this is Medicaid, the medical coverage of last resort for America's poor. I know it's hard to think of your mother as poor after all that hard work, but when her money runs out, that is unfortunately what she will be, and if you and your brother cannot afford to pay for her care and must ask the government for help; this is the only help available. (Note that if your late father served in the US military on active duty in wartime, she *might* be eligible for some benefits from the VA; ask your attorney about that if so.)

My MIL had a very similar life to your mother, including being widowed young, and she, too, planned carefully to have enough to live on for decades after her retirement, but all of her calculations were based on staying in her own home. After 18 months in residential care, I saw my MIL literally *will* herself to die after we had to explain to her that her savings would not finance a private room for much longer, and that she would have to downgrade to a shared room before eventually moving again to a facility that would accept Medicaid. (She was still fairly sharp, but her physical ability was declining (she kept having TIAs), and our home did not have space to safely accomodate her needs.)) She told my husband that she would die before she would let a nursing home company take her home when it was all she had left to show for her and his Dad's combined 40-something years of hard work and frugality, and the only thing she had left to leave to her family. Within 4 months she did die, mostly by cutting down her food and liquid consumption to almost nothing. At the time of her death she had spent down her cash assets to less than $30K; the house was the final item of value in her estate, other than her engagement ring, which she left to DD (it really wasn't worth all that much, either, only a few hundred dollars, mostly for the platinum.)

The cost of institutional residential elder care in the US is backbreaking; every working-class person over age 75 that I know in this country remarks repeatedly that their fondest wish is a quick sudden death, and it's all for just this reason. I'm really sorry about the situation you are dealing with; it's heartbreaking to see people who have spent a lifetime clawing their way out of poverty fall back into it again as soon as they develop a chronic health problem that requires skilled nursing assistance.

 

[jo-jo]

I understand what you're saying and I know well and good that it's not my money. It was more trying to do something that she would want - giving a generous gift to her great grandchildren. My mother was the daughter of immigrants. She dropped out of school at 16 to get a job to help support her younger siblings. She continued working as a young wife and mother. My father became quite ill when my mother was pregnant with my younger brother. She was eligible for public assistance but was too proud to accept it, instead moving in with her widowed mother and her mother's boarder. We all stayed there for two years. Ten years later she became a young widow with two school age children to support. We lived frugally and my mother scrimped and saved always. She was very proud to have been able to give her granddaughters money toward their wedding gowns and generous wedding gifts. She was able to save a large nest egg on her own. I am very grateful that she has the money to pay for her living situation now, but I know that it would absolutely kill her if she knew it was costing almost $200,000 a year. She hates where she is and is always asking how much it costs. (It's a very nice facility, she just wants to be back living with me where she lived for almost 20 years.) My thought was more along the lines of knowing my mother would rather give 'her babies' a gift then giving everything she worked so hard for to someone else.

This isn't about setting up my grandchildren. It's about my mother doing something for them before the state takes the rest of her money. I am not worried about setting up my grandchildren myself. This isn't our goal!

Reading this, I don't mean to sound snippy! I guess I'm just sad, and tired, and frustrated. We had to take a large amount of money out of my mother's investments to pay for a buy in for the first facility she went to. Because of that, she had to pay $40,000 in income taxes. Now I just got her Social Security statement for the upcoming year and her benefits are being cut by $600 a month because of the large withdrawal. She worked so hard and now her money is just disappearing so quickly.

Did SS see her withdraw as income? I don’t understand why her checks would be cut?

 

[Skippy918]

I hope your mom doesn’t live in a state with filial law. My friend’s mom did and when her mom ran out of money, my friend was stuck with the bill. When the mom’s husband died, he left everything to his kids and not his wife. So she failed the lookback test.

anyway, if she does live somewhere with filial law, you and your siblings will be financially responsible before Medicaid foots the bill.

 

[570traveler]

Definitely get an elder law attorney now. We dealt with this for my mom. The attorney was able to help us immensely. They know what’s permitted and can let you know if you can “gift” any money. In our state it’s a set total amount each month that may be gifted. I felt the same way. My dad worked hard and to see all that money gone so quickly was both sad and eye opening.

 

[LuvOrlando]

Sorry you have this trouble OP but I think you are one family out of millions dealing with this, I do not think you should have to give anything back at all & hope the rules change, but for now you probably do need an attorney.

I just recently went on SSDI (not the income related part) because I was worried about all the horrifying hospital bills people were reporting during Covid and to help absorb expensive tests that I can't contribute towards because I haven't been able to work for a few years. I put my time in and qualify so it's my right to be covered by or so I thought. Now that I have been on SSDI I was notified that in a few months I have no choice but to pick up the hospital portion which opens a Pandoras box. It seems that it is out of my hands whether private or Medicare land as first or secondary coverage, this is based on the number of employees at the spouses company in the event of a hospitalization because I can't opt out of it. Well this would be fine if Medicare was medical insurance but as I read into the process it seems like Medicare is nothing at all like insurance in the way it functions out in the world and how I understood it to behave. Instead, Medicare actually acts like a sort of reverse mortgage loan which means that if the Medicare is drawn on for my care I or my family could end up needing to pay it back, even if I had private insurance. So now I am trying to figure out what else it is I don't know.

This feels exactly like I felt when my kids were starting college and I thought financial aid was actual aid, which it is not, it too is a loan. I wish someone somewhere would just call things what they are. Medicare is not insurance, it is a reverse mortgage type loan and financial aid isn't aid at all is a loan - what is up with this misnaming nonsense? How can Americans plan our lives properly if most of us have no idea how all this stuff works? It is mind numbing - we can do better and I hope newer generations improve on this mess because the punitive vibe is not in keeping with what most of us want, it's just such an outdated mindset from the 40's or something.

 

[mom2rtk]

Sorry you have this trouble OP but I think you are one family out of millions dealing with this, I do not think you should have to give anything back at all & hope the rules change.

I just recently went on SSDI (not the income related part) because I was worried about all the horrifying hospital bills people were reporting during Covid and to help absorb expensive tests that I can't contribute towards because I haven't been able to work for a few years. I put my time in and qualify so it's my right to be covered by or so I thought. Now that I have been on SSDI I was notified that in a few months I have no choice but to pick up the hospital portion which opens a Pandoras box. It seems that it is out of my hands whether private or Medicare land as first or secondary coverage, this is based on the number of employees at the spouses company in the event of a hospitalization because I can't opt out of it. Well this would be fine if Medicare was medical insurance but as I read into the process it seems like Medicare is nothing at all like insurance in the way it functions out in the world and how I understood it to behave. Instead, Medicare actually acts like a sort of reverse mortgage loan which means that if the Medicare is drawn on for my care I or my family could end up needing to pay it back, even if I had private insurance. So now I am trying to figure out what else it is I don't know.

This feels exactly like I felt when my kids were starting college and I thought financial aid was actual aid, which it is not, it too is a loan. I wish someone somewhere would just call things what they are. Medicare is not insurance, it is a reverse mortgage type loan and financial aid isn't aid at all is a loan - what is up with this misnaming nonsense? How can Americans plan our lives properly if most of us have no idea how all this stuff works? It is mind numbing - we can do better and I hope newer generations improve on this mess because the punitive vibe is not in keeping with what most of us want, it's just such an outdated mindset from the 40's or something.

I have no idea about the Medicare stuff. But for college financial aid, I always thought it was all laid out pretty clearly. There loans that need to be paid back. There can be grants that don't have to be paid back. And there are scholarships that don't need to be paid back (depending on how it's laid out and whether the student continues to meet the terms of the award).

 

[LuvOrlando]

I have no idea about the Medicare stuff. But for college financial aid, I always thought it was all laid out pretty clearly. There loans that need to be paid back. There can be grants that don't have to be paid back. And there are scholarships that don't need to be paid back (depending on how it's laid out and whether the student continues to meet the terms of the award).

For families who have been through the process I think the parents do understand, so you are probably right in certain circles but I do not come from money so I actually had very little understanding of the whole ball of wax until the kids were in high school. My circles growing up were very different. Now, I always knew our kids wouldn't get income related help but what I didn't get was that not a single kid we know got through college without giant loans. Now, that's not too say it doesn't happen, I believe it does and that there are unicorns, but it just doesn't happen to any of the sort of normal people I have ever known.

The Financial Aid Dept should really be called a Loan Services Department, that would snap it into focus for everyone real quick

 

[Pink Partridge]

I'd like to give her four toddler great-grandchildren a monetary Christmas gift from her. I was thinking of a $2,500 I bond for each child.

I would not give her money away to anyone at this point.