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I'm posting an answer for a change. Just before Mom passed on last week, I visited a very good, compassionate, and helpful eldercare lawyer because we had reached the end of a trust fund for her care and I thought it was time for the Miller Trust and the Medicaid application. Well, turns out we will not need to do it after all, and it cost $350.00 but I learned a few things about Medicaid spend-down and paying for care. I had thought my mom's funds from Dad's life insurance were exempt from spend-down but it turns out they are not. They are exempt from estate recovery ONLY if there is no living beneficiary. If I had known sooner, I could have done something more intelligent with the insurance funds, which of course are now frozen and awaiting all the paperwork for beneficiary distribution. etc, so I am in a short-term bad spot with some final expenses that weren't pre-paid. I should not have been such a cheapskate procrastinator and should have visited a lawyer as soon as I found out the one my parents had for their estate plan didn't know beans about Medicaid.

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As someone who has gone thru the Medicaid maze for my mom, MIL and a couple of aunts, I cannot agree with you more on having an elder care attorney work with you to get the paperwork set up so that it flows right for whatever state & county/parish the elderly is a legal resident of. Also your point of having one who understands Medicaid is well taken. Most estate planning & investments are all about putting money into vehicles to make money while for those trying to go onto Medicaid, it's all about getting rid of money - so you really have to have someone who truly understands that.

Even if there is no real $$ or estate, having the correctly done paperwork is just so critical. You simply can't do it yourself and downloading a form off the 'net or using those MPOA forms from the hospital just doesn't cut it.

Another plus for having an attorney involved is eventually when the elder dies, you will be going through probate and will need an attorney - to do it for you OR to advise you how to handle probate to your advantage. Most elder attorneys also handle probate or their associates do. Medicaid estate recovery (MERP) in most states is usually tied to probate. So good legal advise on probate is very important.
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Thanks for the warning story. If there is money or a home involved, it's generally best to get help from a good attorney to find out "what is next." Most assets belong to Medicaid in the end, unless the money was given away at least five years before the assets would run out if a parent is in a nursing facility. The idea is that we must pay for our own care for at least five years, if we have the money.
There may be ways around this, but even some attorney's give poor advice, so be very careful if you are trying to "protect" funds. No amount of money is worth taking the wrong steps with Medicaid.
Carol
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