How can I protect my family’s assets, without disqualifying mom from Medicaid?

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Q: How can I protect my family’s assets, but not disqualify my elderly mother from Medicaid benefits?

A: A thorough answer will depend on the age and health of your mother, the state she resides in, the amount of her income and assets, and how soon she might need to apply for Medicaid.

However, rest assured that indeed there are many techniques for protecting your mother's assets while qualifying her for Medicaid. If you have at least five years to plan, then use of an irrevocable trust could be a good option. Once the trust is created (you will need an attorney to prepare this for you), your mother transfers most of her assets into the trust. After five years, none of the trust assets can be counted when your mother applies for Medicaid.

If you think your mother may not be able to wait that long before needing nursing home care, then a combination of an outright gift to her children and a purchase of a "Medicaid annuity" can protect roughly half of her assets. This technique can be done immediately, even if the parent is already in a nursing home.

A Medicaid annuity is a special type of annuity that is irrevocable, non-transferable, immediate, and fixed to equal monthly payments. With the right type of annuity, it is non-countable as an asset for Medicaid purposes, and the purchase is not considered a gift that might otherwise cause a disqualification period.


K. Gabriel Heiser is an elder law attorney and author of "How to Protect Your Family's Assets from Devastating Nursing Home Costs: Medicaid Secrets." Read his full biography

 
 

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SecretSister

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Dec 10, 2009

Sure would like to learn about more of the above. Thank you.

 
 

195Austin

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Mar 2, 2010

Thank you for this info no one ever told me about this and I have been to two elder lawyers, beware of elder lawyers who give semiares with free dinners who promise you the moon and once they have a big chunck of your money they are too busy to talk to you esp. if you live in the NE-just a thought if it sounds too good to be true------

 
 

Sharon B. Yes you can. However, once she begins receiving benefits and if she is no longer living under your roof you will most likely not be providing more than half of her maintenance and support and you will no longer be able to make such claim.

 
 

weeziegoodyear

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Mar 30, 2011

What fee does an Elder lawyer charge?

 
 

japinke

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Apr 4, 2011

I recently met with an Elder Care Attorney and was told that the Federal Government has outlawed placing assets into an annuity. Also was told that I need to set up an LLC in my sons name (maximum of $25,000) and that he will have to pay income tax on this amount. With regards to gifts to children..won't they also be required to pay taxes on this amount? I am my husbands only caretaker and have been trying to figure out what to do with our assests so Medicaid will not take all of our money if my husband should have to be placed in a nursing home. Does anyone have some answers????

 
 

scrapblu1

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Oct 19, 2011

My father in law is in a nursing home and on medicaid. I was told that everything Medicaid pays out, when that person passes, will be required to be paid back from everything that person owns. Is this true? We live in his house and have no intentions on selling when he does pass, but am concerned that the state will take it for re-embersement for his care. Does anyone know? Please help

 
 

Ralph Robbins

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Oct 19, 2011

weeziegoodyear -
Answer: A lot!!

 
 

Ralph Robbins

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Oct 19, 2011

japinke -

The issue, as you know, is the gifting of assets OVER the Medicaid limits to qualify for benefits. Gifts made without receiving fair market value in return during the 5 years prior to application may be counted as current assets for eligibility purposes. The question for you really is should you pre-plan or wait for "crisis planning". Depending on your circumstances either may be appropriate.
My experience has been that unless you have substantial assets pre-planning does not make a lot of sense because you will have to give up control of the money and there are still, and probably always will be, plenty of crisis strategies to use when and if he time comes.

Some techniques are state specific so knowing what state you reside will be helpful. For instance, transfers between spouses are not penalized and many states still permit the spouse to retain $109,500 in cash assets in addition to the house, car, and personal effects. Also, in some states the $109,500 is in addition to the value of IRA's or other qualified plans as long as they are in distribution. Some states have tighter rules with respect to the above.

Therefore the very first technique at application for Medicaid would be to transfer from one spouse to the other the permitted amount.

I cannot imagine why you would set up an LLC for Medicaid planning purposes but I don't claim to know everything...just most things ;).

He may have been referring to Personal Care Agreement where your son would be paid a lump sum in advance for full satisfaction of an employment contract where he would be paid for caring for you and/or your husband. This does not require an LLC. Funds so paid to your son would indeed be taxable to him under this arrangement.

With respect to annuities the attorney is partially correct. As of 2/7/06 the use of annuities in Medicaid planning has been restricted. If you are pre-planning the use of an annuity (we are talking about IMMEDIATE annuities, not DEFERRED annuities) does not make much sense. However, at crisis they may make sense for the community spouse who has more than the amount permitted. The excess amount would be placed in a short term immediate annuity (less than 3 years). As a result the cash is turned into an income stream to the community spouse (most states permit unlimited income to the spouse) and the full amount is paid to the spouse in a relatively short period of time. There are some caveats so don't try this without proper advice.

The state will not "take" a house for reimbursement for care until the demise of the second spouse and then (in most states) only if the house is subject to probate. To protect the house, make it probate proof. How this is accomplished will again depend on the state in which you live.

My advice: Do nothing now except what you are doing....exploring.

Is your husband a veteran who needs home care? If so, look into the VA Aid and Attendance Improved Pension.

Good luck!

 
 

Ralph Robbins

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Oct 19, 2011

scrapblu1 -

If your father in law (FIL) is in a nursing home it is doubtful he owns much more than the house so that is really the only asset we are talking about, correct?

The answer to your question will depend on the state in which you live.
For example, some states only will attempt recovery from "probate assets"; i.e., those assets that pass by will. Others will attempt recovery from all assets.

Some states permit what is known as an "enhanced life estate deed". This deed arrangement permits the transfer of the home now but with the elder retaining a "life estate" in the property. The life estate permits the elder to do whatever they would like with the property as if they owned it rent it, sell it, burn it down) while alive. At their demise the property is free and clear to the other named in the deed.

Another solution available in some states is to create a revocable living trust and title the property in the name of the trust. The problem is that if you do this in some states the property will lose its "homestead" status and then be considered a countable asset for Medicaid eligibility purposes. Also, if the state does go after assets other than probate assets the trust arrangement will be of no value.

Lastly, if you lived in the home for more than two years and you and/or your spouse were primary caregiver to your FIL the property may be able to be transferred to you currently with no Medicaid penalty.

Good luck!

 
 

TimeLost

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Dec 8, 2011

This is an example of nihilism at best.... Let me paraphrase... I want to keep my mother's money for me and her, not have to her responsible for paying bills that are solely due to her life condition and get others (the people of the United States to pay) This attitude is a symptom of what is wrong with America today. Medicaid was for people who were down and out without the ability to pay... NOT a general medical plan to pay for expenses of well off people.. This is disgusting the lawyer should be ashamed of recommending "legal" but morally reprehensible behavior to milk the over-burdened nearly bankrupt system. "ask what your country will do for you not what you can do for your country" to fracture a famous phrase.. This is an obscenity

 
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