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Can we pay the last 2 years of long term care for him and then apply for medicaid? When will the 5 year look up begin?

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Igloo572, thank you for the info about family paying for care. I had been worrying about that with my ex-Mom-in-law as couple times a year I will send her a nice check for her birthday and Christmas. She's not in a nursing home, yet.
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Freq - medicaid looks at the applicants finances to determine eligibility. If family gives $ regularly to their elder, it will cause a glitch in the Medicaid application as it will show up as a deposit & throw off what their actual income is.

At a NH, Medicaid does not allow for family to pay for an private room upgrade. From what I've gathered this is something that families often want to do but Medicaid does not allow this.....Medicaid requires shared rooms whenever possible. Now family can pay for an outside sitter or companion IF the facility will allow for this. Most won't as there's a whole liability issue. My late MILs old NH in New Orleans had several ladies who had regular " sitters" who had been their sitter before their move to theNH. The NH basically looked the other way on all this but did charge the resident for their meals.
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Medicaid although a federal & state joint program is administered uniquely by each state within some department in state government. So exactly how it will b done will vary. But in general, the date of the Medicaid application is when the 5 year look back starts. So any gifting or transfers of assets within that 5 yr window can be subject to a transfer penalty. Medicaid applications will require a paper trail of their bank statements, IRS stuff, awards letters, real property ownership, life insurance policies, etc. so there will be easily found out reporting on assets and income.

Now add into all this is that the transfer penalty is done by a formula based on just what your state has as its medicaid daily room & board reinbursement rate. Like for TX, medicaid is within THHS but done by TXDADS division and for TX the daily r&b is roughly $155.00 a day (btw this is really really low). But many east coast states have their r&b pegged at $300 a day. So a 50k transfer penalty is going to take almost double the # of days to work through than a higher paying east coast state. The penalty has a formula that is based on days rather than the $ amount too.

Before you get yourself too deep n all this, really, please, please, please take a clear look at the costs on the facility over time. Many places easily run over 10k a month and you will have to sign off most likely a legally binding contract to be financially responsible for all charges. Going private pay can often have all sorts of add on fees so the base rate of say 1ok a month can go to 12/14k with incidentals factored in. Private pay usually doesn't not have the set pricing that Medicaid requirs of a faculty. Comprende?

As a mom of a college freshman, I totally understand the pinch of college costs. Omg the whole meal plans is a scam! But unless you have oodles of your own $, you are going to have to make a full family meetng & decision on how to deal with uncles $ and his needs. The kids can get a stafford and can do work study and you all can do financial aid for them. Really you may want to get your taxes done ASAP in January to get on doing the fafsa and getting fnancial aid & perhaps being able to return some of uncles $ for his care.

5 (2021) years is a long time and things can change for everbody in this scenario but one thing that won't change is that the costs of his care will never ever get cheaper or decrease in need.
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so it will start at the end of us paying is last 2 years?
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The 5 year look back by Medicaid begins when a person applies for Medicaid. I can understand why you want to pay for his care so that his niece and nephew's college cost won't be counted as "gifts" from his assets.

Medicaid will advise you what the rules are for your State, and what you would need to do.

Hopefully Igloo, who is a writer on these forums, will come in to give advice as she is very familiar with issues like this. Not sure how Medicaid handles other family members paying for long-term-care.
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