My sister and I own a home in IL in joint tenancy and there is no mortgage. She recently had a stroke and has dementia and also suffered a mild heart attack and is now in hospice care in a nursing home. She has an IRA and we also have several joint savings accounts. Can Medicare force us to liquidate her half of these assets before she can apply for Medicaid?

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Chuck - MediCARE doesn't care about income & assets. MediCARE is all about paying for hospitalization, physician & other health care provider costs and prescriptions. Medicare pays for hospice too. Medicare we all pay into via FICA when we are working and then from our SS once we retire. In general Medicare is geared to short -term care situations….for example, if you get discharged from a 3 day or more hospital stay to go to "rehab" @ a NH. Then Medicare pays for the first few weeks of the NH rehab stay. Medicare does an evaluation to see if you are "progressing" to keep Medicare paying. If not and you need to stay in the NH, then you have to either private pay for NH or have LTC insurance pay or apply for MedicAID. For the elderly or for those who have a major trauma, they do not progress sufficiently to qualify to stay on MediCARE for the 100 day possible benefit. I would speak to the social worker and the therapists @ the facility to see how Sis is doing on her "progress". The first 3 - 4 weeks are Medicare paid, so use this period of time to get the items needed and meet with the attorney to get whatever in order to apply for MedicAID for Sis.

MedicAID is run by the states under a federal guideline. (This is unlike MediCARE which is totally federal so the same in all states). Each state has it's own specific requirement for acceptance. For you all, you have been co-mingling your assets and income. This is totally sticky for Medicaid applications as you will have to prove who's $$ is who's. Personally I would not try this myself, I would go an see an elder care attorney & asap as she is already in a facility and each day is several hundred $ of care that needs to get paid eventually.

Her IRA will have to be cashed in as that is totally an asset and tied to her SS#. If you are her DPOA, you can start on this as it will take some time to do,.
For the joint accounts, the attorney will need to deal with this to have it work in your favor. You are not husband & wife so there is no "community spouse" protection for you on the funds (which is about $ 114K in liquid assets in most states). Medicaid may view all the assets as totally hers……this is why you need an elder law attorney. If the accounts read her SS# first for reporting, it is going to be viewed as all hers too I bet.

Now about the house, if it is in both of your names, then you should be OK. Now she will NOT have any income to pay her share on the property, so you will now have to pay 100% on everything (taxes, insurance, upkeep, etc.) Medicaid requires a co-pay of the applicant of all their monthly income to the facility less whatever small amount your state has as it's "personal needs allowance". So if Sis gets $ 1,200 a month in income and her state has a $ 60 a mo allowance, then the NH must be paid $ 1,140 of her income each month. $ 60 a month doesn't go very far if the house has significant costs. Thank goodness there isn't a mortgage! Please look at the costs on the house to see where you stand in it's affordability and think this through in the long-term view if you all are still kinda younger.

If she goes on Medicaid, the MERP (after death estate recovery) program will probably send you a letter (or whomever is indicated on the Medicaid application as the contact) regarding her after death assets. You then will have to file an exemption on the property since it's JT and maybe also other exemptions - the attorney will tell you what you need to be keeping track of. But I don't think the house should not be a issue over time as long as you can pay on everything on the house from now till she dies and then file the after death paperwork.

Good luck and get organized and see an attorney.
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Speak to an Elder Law attorney before doing anything. Liquid assets will need to be "spent down" before she is eligible for Medicaid. Use the search bar at the top left to find more info. Try "medicaid take house" and "Medicaid spend down."‎
This is the website that lists your "area agency on aging" websites. They can give you lots of information. I think they will help you even if you and Sis are under 65. Good luck!
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They may be able to force liquidation on the accounts but I think the home would be safe if you're both on the deed and you've lived in the home for at least a year.
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