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My 78 year old mother, with Dementia, lives in a Dementia care facility/nursing home that costs about $4900 per month. She is on Medicaid, so the majority of that is paid for by Medicaid and we pay the small difference out of her monthly stipend from Railroad Retirement each month. She does not get SS money, I am told that Railroad Retirement takes the place of SS (you can't get both, you choose the higher of the 2.) So she receives $1576 per month from RR ($18,912/year) - which is NOT taxed. And also receives a small pension from a former employer of $76.50 per month making her total "income" $1652.50 per month. She has zero assets. My question is - do we really have to file taxes for her? Doing so seems absurd as she usually gets a refund. Being on Medicaid, we have to make sure her bank account stays below $2000 per month in order for her to remain qualified, so the last thing we need is more money - of any amount being dumped into her account. Thank you.

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Always read the fine print. The 14050 "gross" income does not include Social Security unless...and more details follow. If the Railroad Retirement Benefits are treated like Social Security then the person gets an annual Form RRB-1099 and you use the Social Security Benefits Worksheet to determine if any of it is taxable if you even have to file at all. And in this particular case, probably no need to file.
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Adding to Barb.

Both my MIL and Mom brought in the same amount of money each month 1700. The IRS sent both of them letters saying that they no longer had to pay taxes. My MIL received more pension than Mom but less SS. SS is not taxable income unless you go over the cap set which is 30/35k a year, I think. So with my Mom and MIL they both made 20,400 a year, way under the cap.

You just have to find out if a RR pension is like SS in that its not taxable.
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This doesn't take a CPA to handle. It's basically a very simple issue that any legitimate tax preparer or AARP volunteer tax preparer could handle. And you either get SS or RR retirement benefits. I wouldn't bother trying to get through to IRS because it is now totally understaffed and under funded.
Retired IRS employee responding here.
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Following on and adding to Barb's advice, you start with the annual income then factor in the deductions and other costs that affect the taxable income, which is what you need to determine.

You're very articulate, and I suspect you could work your way through the often complex factors and calculations of preparing returns. But given the Medicaid and RR involvement, it would be good confirmation of whether or not she even needs to file if you have a good, qualified and knowledgeable CPA at least evaluate the situation. I would also concur that this is not an H&R Block project.

I've never been involved with Medicaid so I won't even try to consider how it affects someone's taxable status, which is the bottom line for filing or not.
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Curious, why is the Railroad pension not all going to her care? I would think its just like everyone else, all SS and any pension goes to her care with a small amount being allowed for personal needs. Is there not a cap in your State where she is only allowed a certain amount in assets?

Since this is a railroad pension and not SS, this is a question for a good tax CPA. Not a preparer like H&R block. For my Mom who brought in $1700 a month, she did not pay taxes because $1500 of the $1700 was SS. Her small pension, 2400 a year, was under the income limit.
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It is very unlikely she would have to file, but you should check this with a CPA or other tax entity, or make a call to IRS directly. You will be on hold forever, so hopefully you call very early and you have a speaker phone and good book handy. Don't leave legal questions up to a forum. Wishing you the best.
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According to the IRS, if her annual income is over $14,050, she needs to file a tax return.
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