Medicaid exemptions on liens (Estate Recovery) and property transfers.

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I found a letter at the government CMS site, dated 2011, that gives official and specific details regarding the transfer of real estate and property liens and estate recovery intended to recoup Medicaid payments for long term care.

It is full of good and current information but the following paragraph is important to many of the members of this forum who have moved in with their parent(s) to be caregivers and have no other home of their own:

"Per section 1917(b)(2) of the Act, Medicaid estate recovery may be made only when there is no surviving spouse (subject to the provisions in DOMA) and when there is no surviving child under age 21, or blind or disabled child of any age.

When estate recovery occurs pursuant to a lien, protections are afforded for siblings still lawfully residing in the home, as well as for sons or daughters who provided care to the parents and who continue to lawfully reside in the home."

I know you have to be able to prove that you lived there for, I (think) at least 2 years prior to applying for Medicaid long term care and that the care you provided kept your elder out of the nursing home for that time.

Hope this helps!


Another thing with MERP (Medicaid Estate Recovery/Recoup Program/Policy) is that MERP is very much interdependent on your state's laws regarding death, property laws and probate. So there is no one way to do things or footprint to follow. Each state does it differently.

For my mom's Medicaid application, MERP is done as a 1/2 page boxed statement within her overall Medicaid application. It is an Acknowledgment of Policy. When I do her annual recertification, the same form is again in that paperwork. Both require either the applicant or their representative to sign off that they understand. I would imagine that most do not read it or pay any attention to it or to most else on the Medicaid application as everybody is in a rush to get momma in the NH.

MERP is in essence a legal process that goes through probate to occur. (So if you structure things so no probate needed (like a trust) then NO MERP can happen.) The system is set up for MERP to be dealt with as a lein or claim against the estate and settle in probate. This is when your state laws make a big butt difference. I am all about MERP as my mom - who is in a NH & on Medicaid - still has her home, which sits empty and will stay that way till she dies. So dealing with MERP is in my future as we will have significant expenses on the house (taxes, insurance, maintenance, etc) which are MERP exemptions. She's in TX and TX is a level of claim state for probate. I've been executrix twice ages ago and spent more hours in probate courts that I ever thought (even had to go to NM to deal with stuff as 1 aunt had sections which ran from TX into NM - your state is easy probate like TX is also,yeah!). But back to state law, it makes a TX is a level of claim state. MERP is a class 7 claim and all other classes are paid first & foremost. So MERP is low in TX because of that. Still happens but low. Now if you don't know that and get the dreaded MERP letter, most folks immediately think "we have to sell the house". Instead of doing the documentation to try to get exemptions done and then working the probate system to your best advantage. Probate in TX can go up to 4 years & really that gives you time to negotiate things if you are so inclined and have your wits about you. But before you even get to probate court, MERP has to review your situation to see if it is cost-effective to go after. But you have to let MERP know in writing and with documentation of your exemptions within whatever timeframe MERP exemption review is set in your state;& let them know you are planning on going full probate IF NEED BE and expect Class 1 - 6 claims against the estate. If you don't, the assumption is that the house can be sold for whatever is the assessor value with no interest from family or other heirs.

Now not everybody goes through probate or responds to the MERP letter and that is often when MERP comes as a surprise to family when many months later they are trying to do something with "momma's house" and can't as there is a claim or lein on it. MERP has been until the last couple of years been pretty low recovery rate done by state employees. But now there are big national contractors doing this for many states that really approach MERP as debt collectors. Should be interesting.......
so somebody did live there with mom before she went in the nursing home?

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