Medicaid and life insurance beneficiary. Is there any way mom can give her grandson his due without being penalized for Medicaid?

Your question should be read by everyone, as a reminder to regularly review the beneficiary designations they have listed on their bank accounts, insurance policies and financial accounts.

If you talk with an elder law attorney in your state, you can learn about options available to avoid the need for a nursing home admission, and plan for your mother's future Medicaid eligibility if the admission becomes necessary. Planning can protect your mother if you consider your mother's best interests in the context of the beneficiary designation that must be worked with.

If she or her sons executor has already submitted paperwork to insurer & $ is on the way to her, it will be her $ and her SS# will be tied to the distribution. So no way around it bring an asset for Medicaid.
Game over. She has 109k spend down to do & maybwant to look at a Medicaid compliant special needs trust to place the $ into.

If it hasn't happened, then in theory she waits and doesn’t submit paperwork. It’s not her $ unless & until it is paid to her. She doesn’t turn it down per se but doesn’t file to get..... it’s a subtle difference. She dies and the insurance pays her heirs as it’s becomes an asset of her estate. If grandson is her heir, then it goes to him and She will need to change her will to reflect that & how the asset exists for her estate. Now assets of an estate have to go to probate to be distributed and MERP can file a claim against the estate. She will need to have it so that this asset of her estate is placed into a Testamentary Trust as that can make it layers more difficult for MERP to acquire as it could be structured to exist till grandson is say 35 and cause it’s a Testamentary Trust remains under probate court till then although you as trustee can be managing the asset. Testamentary Trusts created from insurance policies are not usual, often wealthy have a TT/insurance policy for each grandkid indicated in the will to the point that there’s TT 1, TT2, etc and updates filed in probate perhaps annually with a trustee named who uses TT $ to manage trust for the benefit of heir or asset. Structuring any of this is NOT, again NOT a DIY! You need an estate attorney who has a probate atty that they work with and that both are savvy on Medicaid Estate Recovery. I’d start by contacting NAELA or CELA level of elder law attorney.

insurance companies deal with folks finding policies years if not decades later and if policy is valid it gets paid to the beneficiary heirs once paperwork submitted and validated.

An eldercare attorney needs to be consulted. Depending upon state law, there may be a way for her to not accept the benefit. She might be able to hire grandson to legitimately look after her property or finances and pay him a salary.

DeeAnna is correct. Mom could need Medicaid within five years and no gifts should be made.

Not really. You need to talk to Medicaid office or an Elder Care Attorney in Louisiana. Any money that your Mother gives to your nephew could be considered as a "GIFT" and will count against your Mom's application for Medicaid. In some states, the monetary gifts have had to be given back by the recipient(s) before Medicaid would take effect.

Also, Medicaid considers the $100,000 to be your Mom's money and it will need to spent on HER CARE only.