Gift Giving for Seniors to Qualify for Medicaid

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Let's take another look at how you can use Medicaid annuities. Say you're single and in the nursing home, and you have about $100,000 of "excess" assets. What can you do to qualify for Medicaid coverage of your nursing home expenses? You can certainly give everything away, but that would cause you to be ineligible for Medicaid for many months---the so-called "penalty period."

For example, if you gave away $100,000, to calculate the penalty period you must divide the amount of your gift by your state's "penalty divisor," which is based on the average cost of a nursing home in your state, and is usually set annually. So if your gift is $100,000, and the divisor is $5,000, then there's a penalty period of $100,000/$5,000 = 20 months.

If you indeed gave away the full $100,000 to, say, your children, you'd be faced with no Medicaid coverage of your nursing home expenses for 20 months, based on our assumptions above. Well, who is going to pay for you for that 20-month period? That's right, the kids! And it may well take the entire $100,000 you just gave them to cover your expenses for the penalty period, leaving the kids with nothing at the end! So much for that approach. Instead, you should consider the "half-a-loaf" approach. Here's how this works:

 
 

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  •  Comments 1 to 9 of 9 
 
 

winkpc

Give a Hug

Jan 13, 2010

Interesting, but I would like to know the scenario if both husband and wife are alive and one of them needs nursing home care. I used "spousal refusal" a fewyears back. Also, what was the law on reimbursement after death prior to 2/8/06?

 
 

N1K2R3

Give a Hug

Jan 18, 2010

As an Econ major, I must have been asleep the day that they taught Annuities. When I did wake up, someone told me that it was explained as follows: One gives up, lets say $100,000.00 to an insurance company that offers annuities. In return for your $100,000.00, you get a "stream of money", perhaps $600.00 a month directly deposited into your checking account. Well la dee dah! Who in their right mind would give up $100,000.00 for a measley $600.00 a month? I spend that on restaurants and clothing stores. Why would anyone do that? I guess that I am confused. Why wouldn't you put the $100,000.00 into the stock market in a safe, or perhaps not-so-safe mutual fund? What does "annuitized" mean? Does one "lose" the $100,000.00 at some point in time (old age, or death)? What if you want out? Let's say you downsize and CAN live on your S.S. money and your Pension Fund money. Well Gollee! My suggestion is Don't give up the ship. Put the lump sum in a Mutual Fund, a C.D. or a Bond Fund, or how 'bout a plain ole high yield Savings Account?

 
 

ladydi103

Give a Hug

Feb 3, 2010

My 78 year old aunt needs to replace her glasses. At one time we got them replaced. I am thinking medicad paid for her glasses rims and the glass part and medicare paid for check up for her eyes. Is this correct does someone know. Please help

 
 

2Weary

Give a Hug

May 12, 2010

I read this article with some hope..but now after researching a little it seems as if it has mainly become outdated and the strategies outlined in have become difficult or sinnce a 2006 law and that states are trying to make sure children pay for their parents in anticipation of aging babyboomers.

 
 

Mike3

Give a Hug

Jun 1, 2010

If I take care of my dad can he qualify for medicade if he buys an annuity and puts it in my moms name?

 
 

N1K2R3

Give a Hug

Jun 1, 2010

Go aks Mr. Heiser or another elder care financial expert. Eyeglasses are never covered by any plan unless the prescriber is an Opthamologist (MD). Then you may submit the statement to Medicare and subsequentially to the secondary provider.

 
 

annaga

Give a Hug

Dec 14, 2011

my 88 yr old mother receives $692.00 each month from a retirement pension and
$1500.00 a month from Social Security before A & B plans are paid for. Which put
her over the $2022.00 medicaid income limit for Georgia Medicaid. She needs to be in a nursing home.She also has no assets at all except for $ 7,000.00 which will
be gone soon because of having to pay night sitter for her while in a rehab facility
after surgery. Can anyone offer ideas to help with this problem

 
 

igloo572

Give a Hug

Dec 16, 2011

Anna - She can do a "Miller Trust" - lots of stuff on-line about what it is. it is also called a "Supplemental Needs Trust".

Basically it is used for situation just like hers - a lot of these are folks who get railroad retirement which is often very, very good (3 - 4K a month) but under what they need to be Medicaid compliant for their monthly asset to be in a NH. This is an easy problem to solve. One of my aunts had Miller done.

It needs to be drawn up by an attorney - really, truly. What I would look for is a NAELA certified one who is in the city/county where your mom lives or closest by.
I would not have just a regular attorney do this - they are kinda tricky and have specific requirement depending on each state Medicaid's rules and how the state does MERP (Medicaid Estate Recovery Program).

One thing you want is for the trust to be flexible - that means if the pension or annuity or SS can change (and they do) - the trust allows for the change without having to re-do the trust every time that happens. Again you need an attorney who does elder law to do this for her.

What Miller does is set up a trust account for whatever is excess every month from her SS and pension. If this month it is $ 201.79 cents, then the trust is bigger by $ 201.79 this month, and next month, etc. etc. When she dies, Miller goes to the state Medicaid program entirely. It is not part of her estate or goes through probate - you probably want to make double sure that is the case as you don't want to spend for probate costs if you don't need to.

You should pay for the attorney from the $ 7K that she has too. It is pretty standard stuff, if you have her documents together you can go and start it. Allow a couple of hours for intake and then take her to sign off whatever a few days later. If you do not have other legal done on her, then get this all done at the same time like a DPOA, MPOA, Guardianship in case of Incapacity, etc. done too. Good Luck.

 
 

igloo572

Give a Hug

Dec 16, 2011

Ana - another thing. You want to get whatever document that shows what she pays for health insurance too.

Most states allow for the payment of health insurance (Medicare is like $ 97 a month right now from her SS) to be deducted from the asset co-pay to the NH.
This is pretty straightforward.

The tricky part is if she is paying for a secondary insurance policy - like she has BCBS and the payment is coming from her pension or annuity and taken out automatically before she gets the monthly payment. I'm not sure if all states allow for that amount (and it can be a lot) to be excluded from the asset co-pay. Once she is on Medicaid, you could have her drop the secondary health insurance as Medicaid should pay for whatever Medicare doesn't BUT if it is a really good policy (like BCBS) and the state allows it NOT to be included in the co-pay amount, you might want to keep it. Yep, it's confusing.

 
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