My mother in law annual income is about $2,000 over Medicaid requirements. She has zero access. Can she turn part or all of her money benefits over to Medicaid to receive the skilled nursing she needs? Her care is outpacing the family ability to help continue supporting her costs.

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Google Millers Trust, sounds like that would be a viable option for your MIL.
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Answers you’ve gotten are all correct for thier scenario. But to me, issue is more confusion over what is “income” & “assets”

Medicaid doesn’t exactly want her income or her assets.
what Medicaid requires is that monthly income is under whatever your state has at maximum- usually $2100 but varies by state. & income is paid to facility as her copay or SOC (share of cost) less small personal needs allowance. She doesn’t send $ to state Medicaid agency. It’s facility who gets monthly income.
requires nonexempt assets at/under 2K if widow w/no dependents. If over 2k she has to spend down before applies for LTC Medicaid

Income for Medicaid is determined by month. Not annually.
So she can NOT actually be “annual income.... 2k over”.
Math is being done incorrectly imho. & just what type of income it is will determine how it can possibly be dealt with for Medicaid.

So if it’s something that pays her $ once a year, she needs to have CPA type do amortization to level it out over 12 months. So hopefully once spread out has her under $2100 or whatever her state allows a mo. My mom had this from a super old fully paid up life insurance policy that actually paid a dividend which in the mo. paid took her over income max. But once divvied up by 12 was ok. Now it was required to plow back into the policy so was not actually in her SOC. Stuff like this happens, maybe a divided, or could be a royalty paid.
if your mom is flat over monthly income max, then either it’s Miller Trust or whatever her state does for a pooled income trust. They are different.

Miller maybe in 2/3 of states; only monthly income that meets “qualified” can do it, like SS income. Some pensions, retirement stuff can’t meet the strict “qualified or eligible”. So for those, it might just be the SS income that get placed into Miller, & the other monthly income goes the regular Medicaid copay route. Just how Miller runs depends on your states laws. Like some don’t do an overage build up & after death pay out to the state (as state is beneficiary). Some states (Ohio) have state done forms so it’s a DIY & notary to accomplish. Others you have to pay an attys. to set up & find a bank who participates.......
Pooled trusts, those I have no insight on. NYS does these. Seems like other upper east coast states also. Hopefully someone from NYS can share info on it!

medicaid staff in my experience tends not to give any info on all this as it’s viewed as giving legal or financial advice and not within the purview allowed of a Medicaid caseworker or staffer. We can on this forum as it’s folks sharing their experience or opinion, rotflmao.
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She can use it to purchase a pre-paid funeral. Medicaid doesn't penalize you for having one (up to a certain amount and it depends on the state). I would do this for sure if she hasn't taken care of this business yet. You can put a higher amount of funds towards this before going onto Medicaid. After she qualifies, the amount you can put towards a pre-paid funeral is very small. There are rules surrounding what they will allow the funds to actually pay for (like, travel related to the funeral is not allowed as a protected cost if you create a PPF after Medicaid) so please check with your county to know what those are for sure. I don't live in a Miller Trust state so not sure what that is or how that works.
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worriedinCali Dec 2019
She needs to set up a miller trust.
prepaying for a funeral won’t make her eligible for Medicaid. A miller trust is where excess income goes into a trust account that Medicaid is the beneficiary of and it goes to Medicaid when the person dies. OPs mom makes too much money for Medicaid so in order to qualify, her excess income will go in to a miller trust aka qualified income trust.
Yes she can, if she lives in a state that accepts a Miller Trust. A Miller Trust is a trust she sets up to lower her eligible income for medicaid. She deposits the excess income into that. It lowers her eligible income and thus she's under the limit. When she dies the Miller Trust is paid out to the government.
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