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Mother is ninety years old and still in the house she purchased sixty years ago in New York. Because she was an Educator her pension and SSA (Medicare) make it appear she makes a lot of money when, in-fact, it all goes to house necessities, basic living and maintenance emergencies. Therefore our Social Worker advocate got her qualified using the "pooled income trust". I'm still unsure how it works, even though I have read about it and she has explained it to me. So I am asking the Aging Care community for any advice, experiences or pitfalls you have gone through. I am mom's oldest and currently staying with her until the home attendant is solidly in-place. We already have a person in-mind who mom likes, but are open to interview one or two more candidates. ThanQ!

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The link below to Russo Law is very helpful, as this is specific to those residing in New York state. Note that in many states a pooled trust also accepts contributions of assets--not just income--and in some states is limited to those contributions made before the Medicaid applicant turns age 65. If the individual does not have a lot of excess assets, it can be a perfect solution. If the individual has a lot of excess assets, then a private trust may offer more options and flexibility.
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Also, with pooled income trusts that excess money will go back to Medicaid when the beneficiary dies.
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Just wanted to bump this up so others will see it and respond. I don't have any knowledge of a Pooled Trust but intend to do some research just to see what it is and how it works.
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Gabriel, thanks for the contribution and distinction between high and lower levels of assets. It seems there are a lot of issues to consider and weigh before accepting a Medicaid pooled trust arrangement. I was hoping one of the experts would offer an opinion on this thread.

Igloo, you make some good points about unexpected expenses that may arise while subject to a pooled trust arrangement.

The aspect that troubles me just as much though is the potential for fraud on the part of management agencies. Medicare has been plagued by so much medical fraud just from the extended health care field.

It's such a large and extended operation that I would think it would be difficult to monitor already, but with the temptation of accessing trusts, the potential might I think exist for abuse.

Still, it reflects that Medicare is attempting to provide assistance to those with some assets, perhaps too many to qualify otherwise but insufficient to provide longer term care.
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My mother is in a "pooled" or community trust. Each month I write a check for $627.00 and mail that along with the deposit slip to the trust. I then fill out disbursement forms for the bills to be paid from the trust. I also make a copy of the bill. You can either fax the copies of the bills and disbursement forms to the trust, or mail them. It takes about 2 weeks for the trust to process the bills. There is a fee for the trust the same as a bank fee. Also, the trust will send you a statement each month. You should sign up as well, so that this a joint trust account. This will help in the event of your mother being unable to fill out the forms. My mother has a reverse mortgage so this was her only option for payment of home care. For single people Medicaid caps income at $809.00, anything over that goes into the pooled or community trust. From there your mother's bills are paid from the trust up to the amount available. While I was waiting for Medicaid to approve the application, the home care agency, wanted me to pay them the excess income. Don't go that route. The agency will get paid from Medicaid, and your mother will have her money for her bills. I haven't had a problem with it. I am a joint beneficiary on her account, so I usually take care of task for my mother. The only downside is that those bills paid by the trust are always going to be paid late. You can try contacting those companies to advise them that their bills will be late. Maybe they can change the due date for you. I've had no problem when calling the customer service number with questions about payments. They were very nice, and very helpful. You will receive a binder with all the information you need, along with deposit slips and disbursement forms. If you need more disbursement forms, just call the customer service number and they will send you more. If you have a joint checking or savings account with your mother, make sure that Medicaid knows that some of the money going into the account is yours. My sister and mother have a joint checking account, so even though my sister supplied a copy of her paycheck to prove that the additional money deposit was my sister's paycheck, Medicaid denied the application due to excess income. It took 7 longs months before Medicaid acknowledged my sister's income. I spent 7 months taking care of my mother at home with minimal help from family members. She was on a ventilator at that time. When the aide finally started, my mother went to the hospital and the doctors determined she no longer needed the ventilator. Be very careful with Medicaid, as any error on your forms will invalidate the application. Also, you need to refile the application each year. Good luck with everything.
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Hi,

I'm a RN who works in long term care. Yes, a pooled income trust is a way for a Medicaid benificiary to still use their income and receive long term care at the same time. As stated before, if anybody makes over 809 a month they will not qualify for Medicaid, because Medicaid is based on income unlike Medicare which is awarded to people who have worked at least 10 years and reach 65, develop chronic renal failure or are on disability for two years. Through what program is your mom receiving long term care? Is she in a MLTC, MAP, PACE, a waiver program or is coming directly from your local county? Thanks
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Hi,

I can explain the acronyms at another time. But, to the other question. Yes, Medicaid is mandated to recover assets only if that person becomes permanently institutionalized, such as, permanent nursing home placement. After the beneficiary dies any property or accounts in her name can be subject to recovery but if these are joint accounts this does not apply. Always speak with an elder lawyer before placing a parent into long term institutional care.
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What is Lady Bird? I know she was Predident Johnson's wife...
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Amada - Medicaid is an "at need" entitlement and you have to be at need both financially & medically. Basically financially your impoverished - for TX it's 2k in assets and $ 2,163 in income allowed. A home & a car are exempt assets. Once they die these become non exempt assets for MERP (Medicaid estate recovery) and subject to a Class 7 claim for Texas probate. There are all sorts of exemptions and exclusions to MERP and class 1 - 6 claims for probate as well.

Lady bird deeds are a way to transfer a home after death outside of probate. BTW it has nothing to do with lady bird johnson either. LBD 's are done in only 5 or 6 states. They have to be written just right to be valid. Not a DIY project IMHO.

One issue with keeping an elders home whether your planning on using the ladybird deed to avoid probate or not, is that once they go onto Medicaid, they have to do a copay of all their income to the facility. They have no $ anymore. All costs on the home - taxes, insurance, maintenance,etc - will have to be paid for by family from now till their death and the through probate or after death legal process. Elder could live another 6 mos or 6 years and you better be able to pay for everything house for whatever time frame. It's kinda like having a 2nd or 3rd home but without any guarantee of ownership so runs a risk. Most cannot afford a 2nd home or like risk, so the house gets sold.
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Well the state in Question is New York State , however thank you all near and far. Mum's house is long-since paid for and not in her name anymore, by the ways...Thank you for the "lady bird" clarification, lol
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