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Continued Medicaid eligibility. What can I spend down my monthly income on to bring my cash balance down to 2000 or less? Can I give nieces and nephew birthday presents and if so how much? Can I buy a tombstone for my plot in the cemetery? If so how much? I live very frugally and do not have many expenses..rent, food, transportation are my main expenses but do not consume all of my monthly income. Thank you for any and all replies.

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Other posters have experience with this more than I do. From what I have read the money must be spent on you. There are stipulations what your funds can be spent on. I don’t think you can gift money to relatives.

Best wishes to you.
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The money must be spent on you, not gifted to others. You can provide for your funeral, headstone and such. If you have funds, they can be used for your care before Medicaid kicks in, self pay. If you go into a nursing home, I can guarantee that all your funds will be gobbled up quickly, it is very expensive.
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Any gifts you make within the 5 years period before going on Medicaid will cause you to not qualify until your medical needs are first paid for in the same dollar amount that you gifted away.

this is done so that seniors with real amounts of money are forced to use it to pay their for own care before Medicaid. Every so often someone comes here looking for help on how to hide money and assets from Medicaid.

in the case of just the typical small gifts from grandma...sadly that is caught up in this too. But, the rule is applied equally at least.
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mstrbill Feb 2020
Typical small gifts from Grandma ARE NOT caught up in this. At least where I live and the information I have received from others and caseworkers. Medicaid is looking for large asset transfers and withdrawals. Like in the thousands or tens of thousands.
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Do you have a pre-need funeral trust set up? That is a legitimate use of your accumulated assets.

Do you need dental work, even just more frequent cleanings? An extra pair of glasses? Prescription sunglasses? A new winter coat? Better boots? A couple of new shirts? Some kitchen gadgets that will make cooking easier?
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Please don't believe you can't give your family birthday or Christmas presents. For that 5 year look back, Medicaid is generally going to look at large asset transfers and withdrawals. You can go on vacation, you can go out to dinner, you can buy things you need, and yes, you can buy presents. Medicaid will look for unusual large withdrawals that stand out and question them. You can buy all your funeral arrangements. If you have any doubt, consult an attorney. There are some who do a free consultation.
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Spend money on anything for your benefit. No gifting of money.

Use your money for facility rents until you are spent down.
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BarbBrooklyn's suggestion of a pre-paid funeral is a great one: pre-Medicaid you can preserve thousands for this purpose and cover expenses like travel that relates to your funeral, food, gravestone, funeral home costs, etc. Post-Medicaid the allowed amount for a pre-paid funeral decreases significantly, down to about $1500 (may differ for each state) for only certain expenses. Regarding birthday and holiday gifts: don't write checks directly to your LOs (give them cash or material things from bought from stores). Do things for yourself while you still can, like traveling and things that bring you better health and joy. Blessings to you!
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I doubt if you are watching your pennies if your "gifts" total much. If nieces and nephews are now adults and earning their own money, I may just send a card with a gift card in it. Which is what I do with 26 yr old grandson and 30 yr old nephew. (Nephew has a neurological problem. His maturity age is 19)

As said Medicaid looks for any large amounts.
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You mention monthly income and if that’s correct and you want Medicaid health insurance, everyone here has misread your post. This isn’t about the the 5 year lookback and long term care. If your monthly income is over the limit for Medicaid then you CANNOT spend the excess income as you please, you cannot give the money away. You spend it down on your health care. It’s called a medically needy pathway. You can spend down your excess income on medication, insurance premiums, medical supplies, etc.
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You could set up a Miller Trust and designate a monthly amount that would be transferred each month from your checking account to the Trust. Any funds in the trust at your death would then go to Medicaid.
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you can pre pay your funeral. as I understand it you can do any improvements to your house. You can not give money away in large amounts. monthly income is what they look for
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Consult with an elder law attorney. That will be money well spent. They will guide you through the confusing path and help protect your assets. It is really tough for a lay person to do this on their own.
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In Pennsylvania I have had 2 lawyers agree that you can give gifts totaling up tp $500 monthly without a problem. I don’t think I totally understand your question though.
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I wonder why such information isn't published plainly for people in each state to read. I realize situations can be difficult and require professional help, such as from a lawyer, but many questions should be able to be answered quite simply without the need for a lawyer. Perhaps it IS done this way in some states--if so, the others should follow the example.
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worriedinCali Feb 2020
Every state has this information online. Many counties also have links on their websites.
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BUY A NEW CAR!
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Before you gift anything to anyone - call your Medicaid worker to see if it will penalize you.

You can buy anything you need to stay in your home. Your car, car repairs/maint, the tombstone should be ok and put it on a payment plan so you have X dollars coming out of your income each month to help stay under the $2K. Do you need any equipment, a new recliner with a lift (again, do payment plan to help lower income each month), a new mattress/adjustable bed, etc.
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Here's a link that might help you: https://www.elderlawanswers.com/spending-down-assets-to-qualify-for-medicaid-12003
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Cancelled
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Spend money on pre paid funeral.
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