So, Your family has to reimburse Medicaid only if you die after you've been in a nursing home?

If Medicaid has paid for any expenses on your behalf -- a care center or in-home care -- then the state is entitled to/obligated to recover that money from your estate when you die. In practical terms, that means they can claim the proceeds from the sale of your house. There are exceptions. If your spouse or a disabled adult child is living in it, they do not force a sale.

If your Father-in-law is single, qualifying for Medicaid is straight-forward. If he is married, it becomes a little more complex, because the program wants to prevent the spouse from becoming impoverished. In either case, the the house would be subject to the state getting money when it is sold.

The family is not expected to reimburse Medicaid -- Medicaid would only take the proceeds of selling the assets that belonged to the recipient.

You may find it useful to consult an attorney specializing in Elder Law.

No, HE does not pay them, your estate pays them. Most people on Medicaid have little or nothing in their estate, except a jointly owned house. Medicaid will NOT take the house from him, he will be safe there. BUT if he decides to sell the house, your half will go to MERP (Medicaid Estate Recovery Program)

Medicare & Medicaid are totally different programs.

Medicare well almost all of us pay into via having FICA take out $$ from our paychecks & therefore we all can apply & get Medicare once we turn 65. Medicare is a general federal entitlement.

Medicaid is an "at-need" entitlement program that is a joint federal & state program but managed by each state uniquely. "At Need" means the applicant has shown the need for skilled medical care (as per MD orders) AND ALSO provided documentation to show that they are financially "at need" - which is basically impoverished (about 2K in monthly income & 2 K in non-exempt assets). Now there are some assets which are exempt such as the applicants homestead, a car and NCV insurance policies. But upon their death those exempt assets become non-exempt and a part of the now deceased estate. The state is required to try to do a recovery or "recoup" of any assets of the Medicaid recipient after death. This is done via MERP - Medicaid Estate Recovery Program. All states have MERP and many states have this function done by an outside contractor, who are very, very good at what they do. Now there are many exemptions, exclusions, hardships, etc under MERP but what exactly is totally dependent on your state's Medicaid program. Why? - because a lot of this is totally dependent on how your state laws for death, property rights, probate runs. Often family is living in the Medicaid recipients home and under Medicaid rules the home can have a claim or a lien placed against it as it is an asset of Medicaid recipient. Upon their death, the state will expect any proceeds from the sale of the home to be reimbursed to the state to off-set the $ that the state paid via Medicaid for the deceased care. The potential for the claim or the lien to be on the property allowed under state law gives MERP the leverage to ensure that the state is reimbursed. But again there are all sorts of exemptions, etc to MERP. Like if your state has a 2 year caregiver exemption, you can file for that, while another state may have a 1 year caregiver exemption.

It it totally up to family to find out just what needs to be done for MERP under your states program & file whatever & within your state's timeframe for compliance.

Also MERP is not limited to NH care paid by Medicaid. It can also be enforced for those receiving any community based care, mental health services, etc. MERP is set up for those receiving services via Medicaid who are over 55. Your state's DHHS site should have an exact list of what services is included.

Medicaid programs like WIC / child & maternal health are not in MERP's purview.