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She is 85 and has only had Medicaid in the past 5 years or so . I’ve just recently learned that when she passes, that Medicaid could take her home. My mother worked and paid for our medical insurance when I was growing up, and she’s never been sick much. Now she has dementia and I am taking care of her when the nurse isn’t there. She still lives at home and a nurse comes in to help out during the day. Is there anyway we can avoid her house being taken over by Medicaid when she passes? Mama May outlive me, but I don’t want her home that she worked so hard for just to be taken away.

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Cleo, what exactly happens 4 moms home is interdependent on how State of NC does MERP (medicaid estate recovery program), deals w property rights, probate law & administrative code for Medicaid programs. The examples Stacy posted are indicative of just how much they can vary.

If mom went onto Medicaid after your state adopted Bush era DRA (Deficit Reduction Act of 2005), then State is required to attempt a recovery of costs paid by state from her after death assets. For some low income elders, they could have been on community based Medicaid for decades & before DRA so no MERP. For assets, whether recovery is limited to assets that could comprise an estate in probate OR can also include non-probate assets (like assets held in a Trust) depends on your state. Another factor is whether your state allows for a lien to be placed proactively or whether it can only happen as an after death action.

Under MERP there are exclusions, exemptions & a cost benefit analysis that factor in. Exemption you hear abt the most is for a caregiver; but you will need to provide to the state (or it’s outside contractor for MERP) whatever documentation to clearly establish you were a FT caregiver for a set period of time & why mom needed a caregiver (like on letterhead correspondence form moms old SW or MD as to her needs assessment that you provided). But there r other exemptions, like low income heir, aged sibling heir, property part of an existing business / farm / ranch. Exclusions are items that can be deducted from MERP tally, like some allow taxes, insurance, some maintenance deducted for a vacant property. Some allow for Lady Bird Deeds & Testamentary Trusts. But whatever angle you look at, it’s on you, DPOA, other heirs, &/or executor to keep what documentation needed on all this and do whatever filings that need to happen, hire whatever legal needed.

I’ve been on this forum a long time & what seems to be biggest hurdle for family is not being able to deal with costs - both $ & time - of having your elder continue to own the home as an exempt asset for an indeterminate period of time once they go onto LTC Medicaid (so are in a facility).
Right now as your mom is still in her home, she’s on community based Medicaid & ok on keeping her income to pay for her costs of living. Hopefully mom has enough SS & other retirement, savings. MERP is lurking in out there, but unless she dies, it’s not yet a biggie for you.
BUT
& this is super important imho- should she go into a NH, under Medicaid rules she is required to basically pay almost all her mo income to NH as her copay; then add that to apply for LTC Medicaid for most states the max in nonexempt assets is 2k. Mom will have no $. Mom can continue own home as exempt asset but no $ to pay taxes, utilities, yard, etc. It will fall to family to do & pay for whatever on a property they do not own for an unknown period of time and because of MERP run risk of not ever owning. So could you on your own pay for & do whatever needed for at least 3 yrs? If there are other heirs besides you, are you ok on their benefitting from things you do or pay for on moms place without getting reimbursed for years & years?

It’s like having costs & responsibility on 2nd home but w/out ownership.
It can be done, but you ime have to have a wallet, a sense of humor & ok on risk. If house if left empty, it will be easier to deal with.

What seems to happen is family all gung-ho first 6-10 mo then forgetabtit. Even if they have pretty solid exemptions, they flat cannot afford house. Pls please look at moms checkbook to see exactly what is needed to “own” the place. Can u easily afford this for years? Are u ok on risk? If not, and your mom is looking like needing a facility in her near future, I’d suggest you try to sell the home at FMV. The $ from sale she uses to private pay. Private pay will give her lots more options.
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gladimhere Apr 21, 2021
Is there such a thing as quick claim deed?
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Alva Deer has a good answer. After all the taxpayer program that helped your mom needs to pay serious attention to recovery of monies so that it can help others down the line.
Keep in mind that we Americans do not fund the kind of healthcare systems that some European nations fund through taxes.
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Reply to rovana
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Medicaid is complicated but it depends on the value of the home and amount of care. To simplify it, think of it as the first $15,000 is exempt from recovery.

So, NC allows a lady bird deed to transfer the home to a beneficiary so there is no recovery on the home. In Michigan, we are allowed to do lady bird deeds at anytime even after the person is on Medicaid. I do not know of any other state that allows this but I also do not know the rules in other states. You should check with an attorney on what is allowed.
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Reply to Stacy0122
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I understand that your Mom worked so hard to get her home. However, as such, it is her ASSET, and our assets stand to take care of us in age. It is somewhat a miracle that we have a program that will give us medical care and assistance on the taxpayer's dime while we still have an asset (home) but that is the case. Whatever the rules are in your own state, upon sale of the home the program will be paid back in terms of what they assess. You will, upon death of your Mom, receive notification and requests regarding the remainder of her estate in terms of home, car, etc. You can check now on the rules for your own state by accessing them. Wishing you the best.
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Reply to AlvaDeer
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I just can't stop myself from this! The word is "lien", not "lean".
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Reply to SeniorStruggles
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MJ1929 Apr 21, 2021
LOL. I was gritting my teeth, too.
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Perhaps think of it as the value of the house is being used to provide the care Mum needs now.

It is not being taken from her estate, the equity has a lien against it to provide her care while living.
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Reply to Tothill
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Cleopatra, this link may help explain:

https://www.elderlawfirm.com/north-carolina-medicaid-estate-recovery/

Since Medicaid is a joint Federal/State program, the rules vary from state to state.
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Reply to BarbBrooklyn
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I am not sure- I thought they only did a lean on the house if they had LONG term Medicaid (nursing home )
maybe i am wrong.
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Reply to tboudreaux1982
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tboudreaux1982 Apr 21, 2021
LIEN - gosh I am so sorry !
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Do you live with your mom? Also, i know you can protect homes with irrevocable trusts but not sure if you can do that while she is already on medicaid...usually there is a 5 yr lookback for nursing and 2 yrs for community...there is a legal aid group in ny that might be able to help you if you live in NY but im sure there are others in differant states   https://www.nylag.org/


https://www.elderlawanswers.com/medicaids-power-to-recoup-benefits-paid-estate-recovery-and-liens-12018.
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Reply to Mhillwt
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Think of it this way...the home becomes something like a reverse mortgage. Later, then it is put on the market, Medicaid will claw back on the share of debt
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Reply to MACinCT
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No, they don't take the home but a lean will be put on it. If someone has been living there, they probably can remain but if they leave, sell or die, the lean will need to be satisfied. If no one living there the house can be sold to satisfy the loan and the remainder of the proceeds go to the beneficiaries. Each State is different in how they recoup the money they put out on care.
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Reply to JoAnn29
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Medicaid will not "take" the home. They actually place a lien on the home in the amount of the care they have paid for.
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Reply to gladimhere
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Mhillwt Apr 21, 2021
but basically the estate has to pay back all medicaid expenses (up to full value of home)
and it could surpass the value of the home in which case its like the home is taken
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