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What should I do if my mom refuses to sign papers to have her assets in life insurance spent down in order to qualify for Medicaid?

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Do you have Power Of Attorney? Someone should have. This person can sign the papers for your mom. Otherwise, have a third party - financial person, spiritual leader, good friend - someone explain to her that this is the only way to keep her safe and that signing these papers is a legal matter that must be done.

Third party help is more effective in many issues, as it takes away the family dynamics.

Good luck,
Carol
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I asked if my sister, who is her guardian as of November 20, 2009, could sign and they said no, she has to personally sign a letter stating she wants to surrender the policy (have a check written for the cash value of the policy), which would cancel the policy in most cases (except for one for her funeral and another that may be irrevocable that the compnay is doing some research on). I can't even stop the automatic amounts coming out of her checking account without having her sign a written statement. I am planning to have her sit down with me and the social worker at the nursing home to explain to her what needs to be done for her to be on Medicaid when the social worker gets back from vacation.
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The social worker will know what to do if she needs to be placed in a nursing home as I was informed while starting the process for medicaide you have no choice or even if she is going to have medicaide for home care she has to give up her assests if a spouse in involved their life insurance is also cond sidered an assest for the one remaining at home it is not fair but medicaide do not care how poor they leave the remaining spouse they feel your savings and assests are for your old age and it is what it is the person get madicaide is now allowed to prepay their funeral which was not the case when my MIL was on mecicaide-but take if from me have the social worker or an elder lawyer paid for by your mother do the legwork for medicaide they will try to get you to do it and they can do it very easily while if you do it it is very hard and can be impossible since she probably did not keep papers necessary like 3 yrs of bank statements and if you refuse after she spends down they will do it very fast so they can get every penny out of her they did with my MIL without us lifting a finger they have all the resourses available a lawyer can do it in 5 hrs. and nursing homes have plenty of lawyers-while I was starting the process the social workers demanded so much for me to do -I had a meltdown and she took over-my husband died shortly after starting the process.
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Like carol stated if you have the Durable power of attorney and are listed in the insurance policies and even in some states you don not have to be, you can call the insurance company up and they will send you a form. You will need to make a copy of the Power of Attorney and either a notary or bank stamp on the paper work. When my mom first was placed in a nursing hom in New York, I was in Florida. I had to leave my job because I found out about the Alzheimers/Dementia and I wanted her with my. However she had a house in New York . This nursing home placed a lien on the house, and I was also advised that in a couple of years some states where going to look into insurance policies. I had to sell the house the nursing home was charging over $12,00.00 a month plus a deposit of $20,000.00. She wass there for almost two years. All her bank accounts were closed and I open a legal rep account after being sworn in by social security. The most important thing that needs to be done is to try and get any assets placed in a safe place doing everything legal. If there a safe depoist box check that out also. look for policies that may have stock attached.. It takes time you have to look all over. You can also apply the money from the insurance policy for pre paid funeral plan. One thing to remember that I did not know that these State social workers do not help like you think they will. watch out. Good luck. There are so many people going through things that you can not even think can happen. stay with this web site I have even after my dear mom just passed. patrica61
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Another idea is to convince your mom you want to buy the policy from her. Then she can feel that she's kept the policy in force, but it would no longer be a Medicaid asset once it's transferred to you (you would then become the owner, your mom the insured). In exchange, you give her cash, which can then be spent down (or, preferably, converted to a non-countable asset like a car or pre-paid funeral/burial, etc.). If you don't have the cash to pay her, you could borrow against your mom's cash value in the policy.
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There are a couple of possibilities.
First, make sure that she is indeed the owner of the policy.
Do you have a Power of Attorney that names you and gives you the power to conduct this transaction on her behalf?
If your mom's objection is that she will "lose the money", and depending on the amount of cash value in question, here is another idea: Via a 1035 tax-free exchange (presuming she has a gain in the policy) surrender the policy for a Medicaid compliant immediate annuity that will pay out during her life expectancy or less. This will provide a monthly check which will be included in her income but will allow her to qualify for Medicaid immediately.
It may also be possible, depending on the face amount, to gift this policy to an irrevocable life insurance trust. Most states limit the trust value to $6,000.
Don't forget that she is also allowed to keep $2,000 in cash and a burial fund of $2,500.
And lastly, again depending on the size of the policy, the proceeds could be gifted to a supplemental needs pooled trust which would, once she on Medicaid, permit the funds to be expended on her health, maintenance, and welfare.
If you are in Florida and would like more information please visit www.RalphRobbins.com
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Hmmmmmm. Wish I'd had the expert advice of Mr. Heiser when we had to spend down assets, and cashed 4 policies (mom's, dad's, mine and my sister's that dad owned for years). But can a transfer of assets be considered legal, without a lookback?

As Guardian/Conservator, I was able to do everything. All their assets were cashed in and paid for legitimate debts, and then dad qualified for Medicaid. Reliable guidance was difficult to come by at the time we were scrambling to help dad. Fortunately things worked out OK.

Question for Mr. Heiser, what about annuities that are joint, but only going to dad's nursing home. Hoping you can answer that one... Thank you.
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There are a couple of possibilities.
First, make sure that she is indeed the owner of the policy.
Do you have a Power of Attorney that names you and gives you the power to conduct this transaction on her behalf?
If your mom's objection is that she will "lose the money", and depending on the amount of cash value in question, here is another idea: Via a 1035 tax-free exchange (presuming she has a gain in the policy) surrender the policy for a Medicaid compliant immediate annuity that will pay out during her life expectancy or less. This will provide a monthly check which will be included in her income but will allow her to qualify for Medicaid immediately.
It may also be possible, depending on the face amount, to gift this policy to an irrevocable life insurance trust. Most states limit the trust value to $6,000.
Don't forget that she is also allowed to keep $2,000 in cash and a burial fund of $2,500.
And lastly, again depending on the size of the policy, the proceeds could be gifted to a supplemental needs pooled trust which would, once she on Medicaid, permit the funds to be expended on her health, maintenance, and welfare.
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Rsrobbins makes some good points! Swapping the policy for a Medicaid-compliant annuity can be a good choice, in the right circumstance.

I do note that in most states there is no official limit on the amount that may be protected in a pre-paid funeral/burial policy. So long as the money is permanently and irrevocably set aside for your funeral and burial, and is so used, then the state will permit it. Purchase of such a pre-paid policy is not a gift, so there's no penalty attached to such purchase.

I'm not sure I understand secretsister's question: how is the joint annuity titled and whom are the payments going to?
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Thank you. I was able to set aside approximately $11,000.00 for each in irrevokable funeral contracts.

Mr. Heiser, concerning the annuity question: dad is on Medicaid, and mom is not. She is a "community spouse," with house, but living in govt. subsidized housing. For some reason, the annuities all go to the nursing home payments, and none to her. But they are joint annuities. I want to know why mom doesn't get half? They were giving her a "house/heat/whatever allowance, but recently took away 1/2 the annuity money that was going to her for that, and increased dad's patient pay amount. I'm thinking I need to have a redetermination, or do something different with their annuities, etc. What do you suggest?
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Income is governed by the "name on the check" rule. If the terms of the annuity require payment to both spouses, then half would be countable as your dad's income. If you change that now, the state could deem that as a gift, but they may not; you'd have to check with a local attorney about that tricky point.

I'd be surprised if the joint annuity requires 100% to be paid to your dad. So that's the first step: find out what the annuity contract actually says.
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Thank you. They said joint, and is in both names. I will check into this further. I appreciate your thoughtful response!
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I did check each insurance policy thoroughly, mom allowed me to talk to the customer service reps and I talked with the Medicaid office and there is only one policy she has to cash in under the Medicaid rules and mom is now agreeable to doing that. At first having to do this made her upset again about being in the nursing home and started up some old arguments that we thought were resolved. Not a good idea to have to discuss financial matters with her because it gets her all stirred up again, but she does have to know what is going on and the facts about her financial status now, its just hard having to tell her.
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That's great your mom is willing to cash in the policy, but be careful of relying on any advice or suggestions from a state Medicaid case worker. First of all, they may not give correct advice, and second, it's like asking the IRS for good tax advice! It's not the IRS's job to save you money, nor the state Medicaid department to do the same. So if it's a substantial amount of money she's getting from the policy, give some thought to the best way to protect that money.
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Wow, i'm reading this and also wondering since we are in the middle of this. A medicaid social worker recently told me that we could sign the policy over to the funeral home which is what we have started to do. The funeral home agreed that they could do that and keep it in a special acct. The face value of the policy is 10,000, the prepaid funeral price is around 12,000, however this does not include the tombstone which we were told to get ahead of time and the funeral home would include it. If its done this way, when she passes the policy would be worth round 15,000, thus possibly leaving a small amount, which probably would need to be turned over to medicaid, but that would be fine with me. Did we get wrong information. And another thing...if we consulted an elder lawyer, can we use her assets to do this? The house is currently sold and settlement should be Jan 8th.
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Yes, you can definitely use the elder's assets to pay for the attorney's fee. There's only one state with a limit on that (Mississippi), and that's being challenged, of course.

Sounds like the advice you got is correct. Pre-paying a funeral/burial is a good way to quickly spend down without incurring a penalty-causing gift.
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The best money that you will spend for peace of mind and to get the answers that you will need in your specific situation is to contact a local qualified elder attorney. Every state is different when it comes to the bottom line. If the goal is to get medicaid qualified- there is a 5 year look back. Even if you transfer assets for care, you will come under the microscope and might make the person uneligible for medicaid. Before you move or tranfer any assets you should consult with an attorney in your state that knows the law. Most all states will allow attorney fees to be paid out of the elder's assests.
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Ummmm. Not so fast. Your mother is the owner of the policy. She bought it. She paid for it. She wanted it. Don't pull the rug out from under her, yet ask yourself why am I doing this? Do you not have the money to care for your mother in her remaining life and therefore become the beneficiary of this policy? If the answer is "No", then how do you expect to "buy" the policy from her? With what money? What cash would you give her? ..the cash value of the policy? That is very little, I would guess. It is certainly not enough to purchase a non-countable asset.
In my opinion, I would not try to take this policy away from your mother. Find some cash to care for her. It won't be long, believe me. You, as beneficiary, will get the money you so desire.
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Under Medicaid rules, only the cash value of a life insurance policy, to the extent the total face value of all policies exceeds $1,500, is countable for Medicaid eligibility purposes. So it may be possible simply to borrow against that cash value (usually it's a very low interest rate), which would get the countable value down low enough so that your mom can qualify for Medicaid. Obviously the borrowed money still has to be spent or otherwise dealt with, but this way your mom's policy remains in place.
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I understand, Mr. Heiser.
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Regarding a life insurance policy. If the person is ill and the state that you are in is going to change there rules on what happens to life insurance policies something has to be done before the person is on medicade. A policy has to be paid in full, and also you must be the one listed on the policy to get the money. You can set up a pre paid policy so that if someting happens to your loved one, that is one last thing to worry about. I was the durable power of attorney that is different than plain durable power of attorney in most states. everything was done legal. The papers were sent to me and I had to have a doctors note plus send in my legal papers. I received all the money. It was used to pay for mom full funeral cost before she even came to Florida. Mom was buried in New York in a veternans cementry in long island no cost to me to open the grave site but I also needed all my dad's military papers for the funeral director. I had no problem at the time of her death of which just happen. I am still awaiting additional monies from the vetenans. It is important to look over all important legal papers so you do not lose any benefits. You cash in only full paid polcies if the person is not completly on medicaid, ( you are not borrowing on the money the policy is paid in full) patrica61 Insurance polcies should be used for the burial of the loved one. Not to be used for anyting else.
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if you parent is a spouse of a veternan you do not pay for a tombstone. that is given to you. All miltary papers must be in your hands. There is also no charge fore opening the grave site. Some state have rules like New York if a pre plan is set up any money that is not used up goes to the government. Floirda does not have that. Both my husband and myself did our our pre plan so my children have less to worry about. Your house is sold however when I went for the final selling the nursing home placed a $71,000.00 leion the money and held on to my deposit for a year. All money was paid to them when I brought mom to Florida in Oct 2005. She passed away, and the nursing homes is pulling a fast one from 2006 to medicare and blue cross blue shield of a $74,000.00 try to get more money. They werre paid 100% when I left Oct 9, 2007 and borught mom to Florida. I do not beleive in medical social workerrs they did not help me at all. They were suppose to be watching mom, when I wass asked to get things in order and come back to New York, They did nothing, mom fell again and was back in rehad in a nursing home. patrica61
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If you do not have a pre paid funeral plan use the insurance policy money to set one up as soon as possible. Not everrything the medicaid social wrokers tell is correct. I found that out the hard way. I di find all moms insurance polices that were paid in full I was the only one listed and was the Durable power of attorney, legal rep, heath epoxy, caregiver and only one on the will. That was done before she got bad with the illness. and wass moved to Florida from New York. I just had to bury my mom, she passed away Oct 5,2009 and was placed with my dad in New York at the veternans cementary. No money was due. Therre was less stress on me, every thing was done by the funeral director of which I knew for years from New York. patrica61
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I'm going to share you my story about insurance. I will keep it short. Last year I wanted to put mom on medicaid but because she had an insurance policy over the legal amount, she was ineligable. I had used up almost of her funds to pay for her care- and now had to dip into my savings for her daily care. For many months my nights were sleepless and filled with tears. And then I remembered reading an article that there are people who buy insurance policies. For several nights I thought about how to find a buyer even though I know that they would give much less than the value of the policy- but I needed the money for her care. After many more tears and sleepless nights I called up the insurance company. It turned out that with proper documentation (POA, a letter from hospice, and a letter from the doctor) they released half of the insurance funds. This allowed me to continue moms care for a while. Yes, I was a beneficiary and so were my siblings (two totally not ever involved siblings when it came to moms care but loved to talk about the money that they would get when she passed). When they find out that the insurance payout is going to be much less than what they were hoping for- this will be a new discussion.
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For Mr Heiser...we made an appt with the elder lawyer here in NJ...Dec 22nd. I feel really good about this...too much red tape and the home will get all the assets anyway, so why not make sure that everything will be done correctly, leaving us less stress. These last four months have been stressful enough with a fall, than heart problems and she seems to be getting worse instead of better. Knowing that she is well cared for is the most important thing to us..and knowing that things are done right to prevent her from being "kicked to the curb" so to speak is our goal. For anyone who spoke regarding veterans benefits, I was told about this from the funeral director (also someone we are familiar with and trust) but she is not entitled to these benefits because her 1st husband remarried after their divorce many many years ago.
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I guess I'm a little confused: Why does one need medicaid?
Why not just put away about 20K for funeral expenses and be done with it? When the time comes, your beneficiary will take out the money and pay for the funeral...something wrong with this? Mr. Heiser?
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Yes, one can certainly pre-pay for funeral and burial expenses, buy a new or better car, pay off the mortgage (if any), buy more tangible personal property (household items, musical instruments, etc.), and do other such relatively small purchases/conversions, to reduce one's Medicaid-countable assets. I always recommend looking at the simplest techniques first, before getting into any complex planning. Often it's enough to solve the problem.

It's when there is, say, $100,000 or more and/or a home to protect, that it starts to get tricky and worth hiring an elder law attorney to save you money.
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Yes regarding benefits there can be only one spouse that would be the one that was married to the vet either male or female until the veet death. And the other person can not remarry. That is true. But if you have all the miltary papers can either mom or dad did not divorce or remarry and were married had the time of the otherrs death. You can get help from the VA. The veternans also if buried in the VA cementary there is NO COST to open the grave and a new tombstone is place. That is what I did with no problem with anything. I used all the insurance polices that wee set up in only my name and I was the power of attorney and set up the pre paid benefit. That was done becasue the law wass going to change about nursining homes and medicade and for my own peace of mind. It wass less stressful when my mom just passed away in my arms a few weeks ago at the assisting living. patrica61
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Ok, Mr. Heiser, I'm definitely in that latter category. I still don't understand where the cut-off is.
Norene
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Norene,
You have- actually we all have been givin great advice and guidanece. The next logical step is to take everything that you learned and to contact a local elder attorney that will be able to specifically guide you in your own personal situation. Each state is different and as caregivers we are too. Take it to the next level- pick up the phone or go onto the internet and find a local elder attorney. I only wish that I had this infromation before- but you have it now.
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