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gtepp031387 Asked April 2018

Will my mom become ineligible or face a penalty from MediCal if I sell her home?

My mom has MediCal, she is in not in a nursing home and lives at home. She lived with her boyfriend for about 20 years, he died and left her the house. We got a lawyer who had my mom quick claim the property to me and my brother, and put her on an occupancy for life. We are now trying to sell the house and move her in with my brother who can provide her with better care. I know MediCal has certain laws about such things, can someone help me in understanding if she will face an issue from them?

This is my understanding, but maybe I'm wrong.

1) Since the house she recieved was her primary residence it is an exempt property from MediCal.

2) There are no transfer penalties for transfering exempt property.

3) She gifted it to me and my brother, if we sell the property we will be the ones who make the profit, so she should not be disqualified for the 2,000 dollar limit.

4) Even if the house was ruled none exempt, becaues she inherited it (even though she lived there)...The penalty for MediCal would only be triggered if she entered a nursing care facility.

worriedinCali Apr 2018
Igloo-yes they were on IHSS for a long time, I came in to the family in 2002 and I believe they were already on IHSS at that time and their daughter was collecting a check as the caregiver but not actually putting in any hours and she actually was employed as a yard duty at a school. this is another reason I said I'd leave my opinion out of this. lots of shadiness and immoral/unethical things went on IMHO but thats beside the fact. Later on, one granddaughter was the IHSS caregiver. I can't recall the times and sequence of events but she did live there with her 2 young kids, I don't think this arrangement lasted more than a year. I'm pretty sure when they changed the deed to the house in order to shield it from medi-cal, my husbands grandfather was living alone at the house whilst suffering from dementia, his exwife (they divorced but stayed in the house in separate rooms) had went into a nursing home for rehab with the intention of going home but that never happened. the exwife of one of their sons was the caregiver for grandpa and then an outsider was brought in for a few months before he went to a nursing home. I just know that the deed to the house was changed so medi-cal couldn't take it but its entirely possible that there was no need for that to be done anyway. Yes we were fortunate but I will admit, I do not agree with some of things that went on. Its very convoluted & things were done to shield assets because both grandparents were on medi-cal.

gtepp031387 Apr 2018
oh also helpful note...The reason the lawyer had an occupancy for life drawn up is just in case mom left home, or got put into a nursing home. As long as a person intends to return home someday the property remains exempt...so make sure you hit that box when you go into a nursing home...do you intend to return home?...put a check on that shiz. Or have a life occupancy drawn up on it if she is moving out(not to a nursing home) but intends to keep the home.

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gtepp031387 Apr 2018
I talked to a lawyer, we worked it out. Ca by the way is the only state that did not accept DRA, at least in its entirety. Californias recovery laws for MediCal also changed as of Jan 1st 2017, as they where suied heavily for messed up practices. MediCal can only recoup on LTC services. Consiquently one only becomes ineligible for MediCal LTC for none exempt transfer. My mother is not on LTC. And as well the primary residence is an Exempt asset, so transfer of a home while it is your primary residence is asn exempt transfer.

igloo572 Apr 2018
MERP aka Estate Recovery came into play once a state adopted the Bush era DRA Deficit Reduction Act of 2005. All states have this requirement now. And all states have exemptions and exclusions as well as a cost-benefit requirement to MERP.

Worriedin Cali - wasn’t both your grandparents on CA IHHS program? So the grands were living in their home and had State of CA paid caregivers that were family, right? For several years & various family members did it, right? So the grands contributed part of their monthly income (if high enough) to the state to offset what state pays caregivers throughout their IHHS. If I’m not mistaken, I think IHHS requires the “ caregiver” to do this as their primary job & as IHHS pays slightly above state minimum wage & usually around 18-24 hrs a week, then they (the caregiver) themselves are considered “low income”. Being a low-income Heir is an exemption for Estate Recovery. I’d bet that this is the rationale State used to transfer the house to them & outside of any MERP. State has all the data on the grands and caregivers/heirs, & to the penny, so State can do the transfer and be ok for federal Estate Recovery rules. I bet that’s the scenario. To me, your beyond fortunate that your family could do this but it’s an outlier example of how MERP can be gotten around as most states do not have IHHS and most families don’t have generations of family around to be live-in caregivers for 2 different elders and have family who work for the state program to advise what can be done legitimately.

worriedinCali Apr 2018
Yes I know the law changed but there are still circumstances when Medi-cal will try to recover expenses through the estate and home. Its an exempt asset while you are living. This was done around 2014-2015 i believe and the reason is because medi-cal would have come for the house or asked the estate to pay up. My MIL was an eligibility worker with the department of social services at the time all of this happened (she was an EW for over 20 years until she retired in 2016) and she is the one who brought this to the family's attention and had the deed put in her brothers name otherwise medi-cal would have done something with the house. they had no will or trust and her dad had advanced dementia so he couldn't sign anything. IIRC this was done shortly before her mother passed in 2015? The law changed in January 2017.

anonymous439773 Apr 2018
This is only my opinion. If you have assets, pay for your care until the assets run out. Protecting an asset for your spouse, so they aren't impoverished is fine. Don't try to hang on to assets to leave an estate for your children.

BarbBrooklyn Apr 2018
What year was that? The law changed a bunch of years ago.

worriedinCali Apr 2018
I'll keep my personal opinion on this to myself but I will share this as it may be helpful to some--gifting a house did not make my husbands grandparents ineligible for medi-cal. They were on medi-cal and receiving other entitlements from the state for years, when both had to go into a nursing home for round the clock care, medi-cal paid whatever medicare and their social security checks did not. Their home was eventually transferred into one of their childrens name because medi-cal could have made an estate claim after they had both passed or placed a lein on the house since there was no intention of either of them returning to the home. Transferring the deed had no affect on their medi-cal benefits.

gladimhere Apr 2018
You need to see an elder law attorney before you do anything. Gifting you and bro the house could make mom ineligible for Medicaid. And you do not want that to happen. What is something happens that she needs nursing home care but there is a penalty in the amount of the house value that will have to be repaid to Medicaid or you and bro pay out of pocket for mom's nursing home. That is a no brainer to me as I would never had been able to pay mom's $8,000.00 a month care bill.

Countrymouse Apr 2018
The medical insurance and health care industries are ripping off the consumer and the taxpayer, so you should too?

I don't disagree that there are scandalous billing practices going on. They happen throughout the health and social care sectors, all over the world. Over here, the public bodies responsible for running services tied hospitals up in 20 or 30 year contracts that delivered new buildings for a low capital cost but now permit the contractors to demand insane, exorbitant fees so that changing a light bulb, say, generates an invoice of £200 - 500% mark up on the light bulb, plus "engineer" time billed at however much per hour, minimum call-out charge applies. And, of course, Health & Safety and insurers' rules absolutely forbid a member of staff or visiting relative to get on a chair and change the dam' thing himself - so you have to wait three weeks for the Planned Preventive Maintenance Programme to "get around to it."

One might suspect corruption at the bottom of this. But when you meet the people in charge of the tendering process you realise that it's far more likely that stupidity and short-term populism were to blame.

As Sir Humphrey Appleby so correctly pointed out, it is not that these things go on that outrages the public, it is being told about it. The issues are political, universal and, as far as I can tell, eternal.

Meanwhile, it's a pity your mother's boyfriend didn't think his gift through, or that they didn't take advice together perhaps. "Too late, too late" the cry. Still! - take professional advice now, maybe there will be something useful that can be done - with a clear conscience 😊

BarbBrooklyn Apr 2018
What are you talking about?

Your father had a stroke and was uninsured? You son was uninsured as well?

gtepp031387 Apr 2018
You know what makes me grit my teeth? A fee for administration of an advil billed at 250 bucks. Or when my father stayed for a week in the hospital with a stroke and was charged 300k. A life savings gone in a week. Or when my son had an asthma attack and was given 1 hr of medicine followed by a night of observation for 25k. Im not trying to break their messed up rules im just trying to follow them for all I can, just like they do.

Countrymouse Apr 2018
This is making me grit my teeth a bit.

GTepp, I understand that you and your brother would very much like to be given a house. Wouldn't we all.

However.

Your mother's boyfriend on his death left your mother the house in which she lived. This was a substantial asset with a quantifiable financial value.

Your mother gave you and your brother the house, while maintaining the right to live in the property. Which would be fine, except that having given you and your brother property of - however much value - your mother is now claiming entitlement to state benefits on the grounds that she doesn't have any money.

She doesn't have any money because she's given it to you and your brother.

You see why MediCal might reasonably take a dim view of this arrangement?

I don't know, but I suspect one year is not going to get you and your brother off the hook. Your mother DID own that property, it was bequeathed to her, and not to you or your brother; and now she needs the value of it to fund her own health care. Sell the house, you and your brother give her back her money, spend it until she runs out, then apply for MediCal. Maybe your lawyer knows a way round that. Maybe he knows even knows an ethical way round it. I'd love to hear it.

gtepp031387 Apr 2018
So me and my brother did get court ordered to be exectors of the estates, also the quick claim deed was verified by the county assessor....if that helps

igloo572 Apr 2018
Also you really do NOT want anything to happen to disqualify mom from her existing Medicaid eligibility.
If she’s 57 and has been on Medicaid for a while, that means she more than likely entered Medicaid BEfORE California signed off on Bush era DRA / Deficit Reduction Act. My understanding is that Anyone who was on Medicaid before DRA cannot be subject to MERP / Estate Recovery or any other DRA new “at need” program requirements as it was not required to be done & acknowledged by Medicaid applicants till after DRA done. So Medicaid cannot try to recoup costs paid on her from the house she owned after she dies. Ask the attorney about this.

igloo572 Apr 2018
Mom needs atty with CA mediCal expertise.& who works with Real Estate atty & asap.

Reasons are: Home is an exempt asset for Medicaid as long as she continues to own it. Whether it’s community based Medicaid (sounds like she’s that presently) or LTC in a facility Medicaid. But if she sells the house the proceeds from the sale are INCOME for the month of the sale and then become ASSETS for months thereafter. It will affect her Medicaid eligibility as its “at need” program for finances.

Mom supposedly owns the home as she inherited it. There should be documentation filed at the CH from probate court with judges orders or other PC seal to allow the transfer. (Like a Muniment of Title done to transfer house). If not, it will be a serious problem for selling it eventually. 
If the house was over CA property value limit for Medicaid at time of transfer, she would be ineligible for Medicaid. Probably in her Medicaid application any changes are required to be reported within 60-90 days. Most states have property value around 575k. It’s critical to know exact house value & if tax assessor value is whack the atty will have suggestions as to how perhaps adjust value for Medicaid exempt asset determination. Property value is what determines the amount gifted (if she signed it over to you) and transfer penalty period for Medicaid. 

If you do not have the chain / PPINs on filings for the property, you need to get these ASAP. Most countries in most states have all this as a cheap download per filed document. Like Warranty Deed $7.50; Covenant $3.00. If you have to actually go to CH, go around 9:30/10am (courts in session) and take lots of small bills to pay in cash. Also get a copy of current tax assessor valuation and 2 years past, try to get these on line as well. If you need to go to Assessor, it will be a separate office from chancery court or property records office..... take more cash.  

I’m guessing atty did it as a QCD is cheap, simple, cheap filing. 
Did this atty explain the difference between types of Deeds? 
QCD does NOT GUARANTEE ownership. Only a Warranty Deed does that. QCD transfers what the person “thinks” is their ownership, it doesn’t have to be correct or even valid. To me the only way a QCD can work is if it is done by judges orders like in a divorce or a distribution list for probate. Hopefully you have judges orders for QCD? 
Also Selling a QCD property may require more steps & more costs for seller. 
Then atop these Deed issues there’s seems to be some sort of Life Estate (“occupancy for life”). What kind of LE exactly is will be super important cause if it’s moms 100% asset until she dies or gifts it, its very different than it’s % shared ownership with her, you & bro and she will have to do a Remainder Interest workup for medicaid. Remainder filing is super precise & imo not ever a DiY & why real estate atty is needed. 

I would try to get with a elder law atty (NAELA or CELA) very soon once you get at CH documents. All real property filings are in your states database. It’s just keystrokes for the state to do a annual cross check to her name, her SS#. The info will surface. You want your attorney to be proactive in this for your mom. Good  luck.

SnoopyLove Apr 2018
I think you need to consult an elder law attorney with experience with Medicaid.

MrsWright37 Apr 2018
This isn't making sense. If she never owned the home then why did she have to sign a "quit claim deed" to you and your brother.

gtepp031387 Apr 2018
also she never really owned the home, thats what the whole life estate thing was about. She took the home only so much as she took the right to live there, and passed the deed to me and my brother. The lawyer we had at the time said this was the best thing to do

gtepp031387 Apr 2018
My mom is willing to sign away the occupancy agreement. She understands the need to have the money to take care of her, and can not afford the taxes on the home. She has been on MediCal for 20 years or so, but she is only 57. She got it becaues she is disabled. The quick claim deed was turned into the assessor about a year ago.

SnoopyLove Apr 2018
When did she go on Medi-Cal, when did she inherit the home, and when did the quit claim occur?

I am not knowledgeable about this but my limited understanding is that the time frame matters. Hopefully more folks with info about how Medicaid works in California will chime in.

MrsWright37 Apr 2018
I'm not a lawyer, but if your mom has a life estate (what you referred to as "occupancy for life"), I believe that prevents you from selling the house while she's alive. She has a right to live in that house for as long as she lives. No one would buy the house from you because your mother has the right to live there and the new owners could not stop her. She has a right to live in that house for the rest of her life.

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