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Lanyajeanne Asked February 2020

Can you over pay the state on Title 19?

My father recently passed away and was living in a nursing home on title 19 in Connecticut for the last 3 years. I want to know if it is possible to over pay the state. They take his pension, and social security but they also got 250k for our house sale, 70k for my moms life insurance when she passed, they will get his like insurance of around 50k and an assortment of other things. I don’t have exact numbers of how much it has been for the last 3 years but I feel like he might have over payed and I can’t find any information on this.

igloo572 Feb 2020
Lanya, medicaid LTC NH reinbursement is set up for shared rooms. Sometimes a facility may have rooms that can not accommodate 2 beds so it’s a solo room & ok for Medicaid (my moms 2nd NH had these for all rooms adjacent to stairwells, my MILs old NH was in a historic district and most rooms were solo but w/Jack & Jill bathrooms). A few states allow for family to pay an upcharge to get a private room. LTC Medicaid rules are set by each state uniquely but under federal guidelines. It’s up to elders DPOA to find out & abdicate to do things.

& that begs the big ?, so just where is / was his DPOA in all this?
Someone needed to fill out his LTC Medicaid application & provide the stack of info for it & sign off on initial application & do questionnaire & documentation for renewal annually.
Someone needed to deal with placing his home on market, getting it cleared of stuff & sign off for the act of sale & deposit sale proceeds.
Someone needed to contact the insurance co to fill out & file for that 70k beneficiary payout for your moms policy (who I assume that predeceased your dad) & should file now as/for beneficiary for dads life insurance policy.
Someone signed off to allow the NH to be your dads representative payee on his SS (this had to have happened if as you wrote NH was getting his SS$ &/or other mo income) & by doing this NH (& NOT state) got the required income copay & put his smallish personal needs allowance into a Personal Needs Account Trust Fund for his use at the NH.
Things like this don’t just happen in a vacuum.
So who did this for your dad? that’s imo who you need to speak to...
OR
was dad competent & cognitive enough to do all this?
OR
was your dad a ward of the state?

if he was in a facility 3 years & sold his home & did rep payee action, there’s a papertrail on all this. So who did paperwork & filings for him??

Now regarding his life insurance policy, if he had your mom as his only beneficiary & did NOT have a secondary beneficiary listed, its -I’d guess- going to roll over to become an asset of his estate so subject to how. probate goes in your state. Most life insurance policies routinely have pages attached for secondary & tertiary beneficiaries. I suggest that you ASAP look to read the policy to see if that is the case. You do have the life insurance policy don’t you?
Lanyajeanne Feb 2020
I don’t think you could have written this in a more condescending voice if you tried.
Also I understand how the rooms work, he was in a fully shared room, Roomate and all I was never confused.
My sisters and I did all the paperwork we were his conservators. They didn’t force us to sell the house but we were forced to bc of the lack of income. And yes I have the life Insurance but it’s not typical life insurance, it’s Voya a very difficult company to work with that they got when they retired with the state. We had to subpoena them to pay out the first time.
igloo572 Feb 2020
Did he have a spend down to do BEFORE he got onto Medicaid?
if so, that spend down $ is not counted against the tally for MERP aka estate recovery as it’s spent beforehand.

So like if he had to cash in a whole life type of life insurance policy in order to be Medicaid eligible, that $ doesn’t count as it’s $ spent before LTC Medicaid eligibility. Ditto if he sold his home before going onto LTC Medicaid. The $ from whole life & house sale was used for spend down. Whether it was $30k or $300k that he had, it needed to get down to a max of $2k for LTC Medicaid individual eligibility. 2K max.

Could this be what happened?
It will change the math completely. It’s whatever assets after death that’s subject to recovery & against the Medicaid tally. Which based on Need2washhair info is $83660 yr X 3 years = $250,008.

Regarding after death payout of his life insurance policy, IF his estate is the beneficiary of the policy then it becomes an asset of his estate which is subject to recovery. There likely is a division of your state govt that only deals with life insurance policy for state as beneficiary. BUT if you or a sibling are named beneficiary then it passes outside of probate as an asset. It is not subject to recovery as it’s not his / his estates asset.

what “assortment of other things”? If they go onto LTC Medicaid, the rules are tight.... like max of 2k of nonexempt assets and a (1) car and a home with a homestead exemption & term life insurance policy (& these 3 have maximum allowed value which varies by state). That’s kinda it that’s allowed unless they have unusual situation like a family farm, or working ranch or mineral rights.
Lanyajeanne Feb 2020
So we never had an option to spend down any of the money like insurance pay out or the house. The state monitored our bank account and the checks went directly to them we never saw any of the money. And he had a shared room to answer the other person who asked it makes it cheaper. Also his insurance plan will most likely name my mother who passed.

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worriedinCali Feb 2020
The average cost of a nursing home in your state is just under $10k a month so roughly $120,000 a year. 3 years=$360,000 so I can see why medicaid estate recovery is taking a lot.

What you need to do is figure out how much his nursing home cost, how much his monthly income was and how much
medicaid paid towards his care.
needtowashhair Feb 2020
Medicaid rates, like medicare rates, are lower than what private pay or insurance pay would be. As of 2018, Connecticut medicaid paid $234.09 a day. So for a 30 day month, it's $7,022.70.
Riverdale Feb 2020
If you were to take all those figures together and find the sum what would be the monthly amount given that it seems it should be divided by 36 months if he resided in a facility for that period of time.

I can't answer your question exactly. Did your father reside in a private room? I know what it costs for my mother in AL. It is more expensive in the part of the state I am in. Generally it seems that NH care is at least several thousand more a month than AL.

JoAnn29 Feb 2020
So sorry this has not been answered. Maybe because no one has an answer. We are mostly lay people sharing our caregiving experiences. I think ur best bet would to talk to a CPA.

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