Really before you even go down this path, gather up all their financials (including life insurance) and paperwork on all real property ownership, then do a “face sheet” on them and schedule an appt with an elder law atty. Personally I’d go CELA or NAELA atty. if they have anything beyond SS, Fed/State retirements, term life and a fully owned house that needs to be dealt with.
Face sheet is a 1 or maybe 2 page listing of all the important details on them, like dob, dates on all marriages, divorces, all kids even if some deceased, real property listing, last statement value on assets.
Try to get on this soon cause IF a assumed to be totally good for QiT income source is actually not guaranteed/ not eligible, there is going to need to be a spend down or horror-of-horrors a surrender done with the asset instead. That kind of stuff inevitably takes t..i...m...e.
Please realize that a QIT / Miller once done makes state beneficiary. If the income source will have beyond death funding, you / DPOA / executor need to know how to deal with that scenario and think of who would do and at what cost.
Also please try to keep in mind that although oodles of emphasis on $$ & Medicaid, they have to “at need” BOTH medically AND financially for Medicaid. Just being old, iffy on ADLs, needing medication management not enough to show “need”. Many states only cover if skilled nursing care is required or have very limited waiver programs for community based or AL with waiting lists. CA, based on posts on this site, has shifted entry to LTC Medicaid to require a discharge to a LTC facility from a hospitalization; it’s just time before other states follow CA or something else even more restrictive. From a health policy & planning viewpoint, it completely makes sense
One of the experts on this site, Gabriel Heiser, has a really excellent book that gives an overview of how all the interlocking aspects of Medicaid (& Medicare) work for families that’s understandable, “Medicaid Secrets”. On Amazon and at libraries too.
The powers given under the Power of Attorney are defined by the document itself, and the applicable state laws. You should read the POA carefully, and then the related statutes. In general, a POA is usually able to enter into financial transactions that are in the principal's best interest. Beyond that, you will need to consult with a qualified elder law or estate planning attorney.
By QIT your referring to what is also called a Miller Trust, right?
So your elder is needing to reduce their monthly income be eligible for Medicaid to pay for their NH, right? & all assets have been properly spent down? If so the QIT/Miller will need to be done in tandem with thier medicaid application. And how that happens will depend on how your states Medicaid program is administered & your states laws. You as thier dpoa need to clearly find out from Medicaid how to approach how Miller & Medicaid application gets done for your state.
Some states have a QIT packet that needs to be filled out and submitted that places the assets into an irrevocable trust ownership to the state and provides info for the banking institution as how to do. Other states expect the applicant to have an their own atty review the assets to ensure they are “qualified” for a Miller and draw up the QIT documents which dpoa takes to the bank. I think some states have preferred banks for QiTs like some banks are SBA preferred lenders.
Not all retirements or income sources can meet QIT criteria. Are you solid on this?
Really to me it would be very worthwhile to get all of your Parents info and meet with an atty before doing the Medicaid application and QIT.
Face sheet is a 1 or maybe 2 page listing of all the important details on them, like dob, dates on all marriages, divorces, all kids even if some deceased, real property listing, last statement value on assets.
Try to get on this soon cause IF a assumed to be totally good for QiT income source is actually not guaranteed/ not eligible, there is going to need to be a spend down or horror-of-horrors a surrender done with the asset instead. That kind of stuff inevitably takes t..i...m...e.
Please realize that a QIT / Miller once done makes state beneficiary. If the income source will have beyond death funding, you / DPOA / executor need to know how to deal with that scenario and think of who would do and at what cost.
Also please try to keep in mind that although oodles of emphasis on $$ & Medicaid, they have to “at need” BOTH medically AND financially for Medicaid. Just being old, iffy on ADLs, needing medication management not enough to show “need”. Many states only cover if skilled nursing care is required or have very limited waiver programs for community based or AL with waiting lists. CA, based on posts on this site, has shifted entry to LTC Medicaid to require a discharge to a LTC facility from a hospitalization; it’s just time before other states follow CA or something else even more restrictive. From a health policy & planning viewpoint, it completely makes sense
One of the experts on this site, Gabriel Heiser, has a really excellent book that gives an overview of how all the interlocking aspects of Medicaid (& Medicare) work for families that’s understandable, “Medicaid Secrets”. On Amazon and at libraries too.
So your elder is needing to reduce their monthly income be eligible for Medicaid to pay for their NH, right? & all assets have been properly spent down?
If so the QIT/Miller will need to be done in tandem with thier medicaid application. And how that happens will depend on how your states Medicaid program is administered & your states laws. You as thier dpoa need to clearly find out from Medicaid how to approach how Miller & Medicaid application gets done for your state.
Some states have a QIT packet that needs to be filled out and submitted that places the assets into an irrevocable trust ownership to the state and provides info for the banking institution as how to do. Other states expect the applicant to have an their own atty review the assets to ensure they are “qualified” for a Miller and draw up the QIT documents which dpoa takes to the bank. I think some states have preferred banks for QiTs like some banks are SBA preferred lenders.
Not all retirements or income sources can meet QIT criteria. Are you solid on this?
Really to me it would be very worthwhile to get all of your Parents info and meet with an atty before doing the Medicaid application and QIT.