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My mom died July 15, 2018. I received a letter from Medicaid stating they are trying to recover the $32,000.00 they paid out on Mom for services. They want to know from her estate (which is me) all about her assets. Which were none obviously because she qualifies for Medicaid. She only had $6,000.00 in life Insurance which I paid for over the years and had to drop a lot because Medicaid said it was to much. She received her SS, which August payment will be returned to Medicare, she owned no homes, no cars, no anything. If she did she wouldn’t qualify for Medicaid.


She had no will, no assets, nothing. So what do they expect? I have on my credit card where I paid for her cremation and she is still in my living room and some of her ashes went back to be buried with her parents. She was poor in material things but rich in love. I loved her more than anything. Please help me to understand what they want. Thank you...it has been a very rough month.

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If no home to sell then no recovery. This is just standard with them. If the letter doesn't say anything about how you go about proving there is no money, call them and ask what proof they need to show there was no money to recover. Family is not responsible for the debt.
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Ahmijoy Aug 2018
JoAnn, this person’s post made me tear up. My mom and I were in the same situation. Thanks for your answer. I’m sure it made her feel better. We’re very lucky to have you here.
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joann if I could hug you I would ...thank you so much ..
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JoAnn29 Aug 2018
Welcome.
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Nothing particularly helpful to add, just wanted to say I’m very sorry for your loss. Losing a beloved mom is a special mind of pain and I wish you peace and comfort in place of the hassles you’re getting. My mom was also on Medicaid, she had a surviving spouse so situation on recovering assets is different, but you don’t deserve a cold, impersonal letter at this sad time, sorry you had to deal with that
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JoAnn29 Aug 2018
Yes, the were pretty quick. I had to request a letter so I could price the house to sell to cover the Medicaid lean. I am shutting the house down so they won't get a thing.
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Thank you ahmijoy I think we are very lucky to have jo ann,,I saw that letter and bawled ..I still cry over moms death it was very difficult to let her go but I had to ,,she fought to live believe me ..I stayed with her until the end ..I hugged and kissed her thanked her..we played her fav songs , prayed ..oh I loved her so much ..my heart belonged to Mom and she went without nothing ,,I miss her ..now I get this stupid letter and almost peed my pants ,,,thank you all for your love and concern and for helping me ,,,Mom lived with me so I go in her room and see her belongings and miss her so much ,,I talk to her all time anyway thank you
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Ahmijoy Aug 2018
Sending you many, many hugs, honey. My mom looks out for me from “up there”. So does my dad and grandma. Keep that in your mind. We’re never all alone. XOXO
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Unfortunately it is SOP (Standard Operating Procedure) to send out a letter to the family of a deceased person who received Medicaid assistance whether that person had any assets or not.  In some states, this SOP is even written as a LAW that the State's Medicaid Office MUST ATTEMPT TO RECOVER any assets that the deceased person had; otherwise the State Medicaid Office could be fined by the State Department of Health and Human Services for not doing their job in recovering assets from those who received benefits from Medicaid while they were alive.

I am sorry that you are having to experience this SOP.  All you can do is contact the State Medicaid Office and ask them what do you need to do to verify that your Mother had no assets.  Try not to dwell on it.  It is just "one of those items on the checklist" that need to be done when someone dies.   {{{HUGS}}}
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Hi ohmeowzer,

I'm so sorry about your mom. Did you receive a form to fill out or just a letter? I don't believe we needed to send any documentation besides my mom signing a form saying that he had no valuable assets or possessions. We provided documentation of his finances when he applied for Medicaid and was in the same boat as your mom (no assets -- no house, etc.) He was only on Medicaid for a few months. I think in those kinds of cases (where they already know the person was in poverty) it is a formality, and an opportunity for the govt. to let the "estate" know that they need to first reimburse Medicaid if there is anything left of value. Please try not to worry though it is even harder not to when you are already so sad. Hoping you feel a little better day by day. Hugs.
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I'm so sorry for your loss.

It does my heart good to read of the love you and your mom shared. What a beautiful, amazing legacy to leave your daughter.

May God grant you grieving mercies. HUGS!
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Meowzer - The letter you got is probably a NOI / Notice of Intent (to file a claim or lien against an Estate). Look at the letter to see IF it actually came from the States Medicaid/ DHHS or (more likely) if it actually has been sent by the states outside contractor for MERP/ Medicaid Estate Recovery. There are 2 main outside contractors - HMS & PCG - and in my experience they very much function like a debt collectors & are very proactive. Contractors have an overall management / administration fee and get a % of the Recovery. HMS is the bigger player and has around 1/3+ of the states. This is just a part of what the parent HMS as a huge company does for health systems cost containment across the US.

Sometimes a letter with the debt Medicaid paid for the deceased is sent first & then a larger packet with a multi page questionnaire is sent after that within a few days later. Unless your mom died still owning her home OR had her term life insurance policy to have the beneficiary to be her Estate OR died with farm/ranch land OR somehow she inherited $, there will be no “estate”, no $, no assets upon her death. There can be no recovery as nothing to recover from.

To be on Medicaid they cannot have more than 2k in nonexempt assets to start with, so the likelihood is they died with under 2k in assets. The questionnaire is all about your (as her old DPOA or contact person in Medicaid files) providing the information with documentation to show why no a Recovery to be done as it’s not cost efficient to persue a federally required attempted Recovery action against your mom’s estate. All done so that MERP can close out your mom’s file. There will be a ? as to her bank balance on day of death, so you put that in and attach a copy of the bank statement. If bank account was POD to you, then that info is written in the questionnaire. Another will be about her life insurance, the amount and who beneficiary was. As long as the “estate” wasn’t the beneficiary of the insurance, it’s not an asset of her estate. There will be ?s on property, auto, inheritance, which you fill in as zero as she had none of these. Personally I’m of the opinion that you fill it out, attached whatever paperwork and make a xerox of all then mail it and supporting paperwork certified mail with the return registered receipt IF it will get it all closed out. So you stop getting collections letters and phone calls. There will be a tight submission date indicated on the letters, please try to get it in before then.

If your Recovery is actually done by state so done by state employees, it will likely be an initial questionnaire with no response back for months. If it’s the state, put in a line somewhere on the questionnaire, that unless you received a written response of the states concerns on specific assets within 30 days that you consider this matter closed by the mailed submission. Again you mail it certified with the return registered card. The duo from USPO is like $ 8.00 and considered legal.

It is NOT your debt.
It is a debt of your mothers, who is deceased.
Unless there are assets that can be an estate, there is no reason or requirement to open probate or do any other type of probate action - even if you mom had a valid will naming you as Executor.

About MERP, that was put into place by Geo. Bush era law the DRA / Deficit Recovery Act of 2005. DRA also put in to have Medicaid gifting / transfer penalty to be uniformly done by all states. Within DRAs MERP there are federal cost benefit/ cost effective requirements:
- value of the Estate has to be over 10k or
- assets of the deceased are under 3k or
- Medicaid's LTC bill under a set amount. I think this one varies by state (as each state manages thier medicaid uniquely) but it’s low like 5k.
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Thank you all for,the advice ,,I wrote him a letter and put a copy of mom’s funeral bill in the letter like they requested and told him she had nothing of value ..I didn’t send a copy of the bank statement but I will if I hear from them again wanting more info ,,,the only thing in her bank account is her social security that was August’s payment so they can take it back ,,I have to go,to the bank Friday with her death certificate to,show them that they have to return her social security then there will be $10.00 left ,,I was hoping social security would just take the payment back on their own but it looks like the bank will have to send it back ,,,ughhhhhh
that Medicaid letter I will look over igloo and see where it’s from I think merp is who sent it ,,,it’s so long to read and not a questionnaire..
i,have to work the next 3 days at the hospital and hopefully no letters from Medicaid or Medicare will come ..I’m afraid to go to the mailbox ,,,thank you all for your comments and prayers and hugs. I need all I can get ,,I miss Mom so much I cry myself to sleep ..it’s lonely without her and I always kissed her goodnight .,and good morning...and hugged her even when she was in a bad mood ,,at least she is with my sister who died 5 years ago suddenly of a heart attack ,,,I miss,them both. Anyway thank you all I couldn’t do it without you
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anonymous434963 Aug 2018
Dear one, Ohmeowzer, May God bless you with sweet reminders of your mom and sister that bring you joy and comfort!
You did the right thing with your reply. You do not need to fear anything. As some have said, it's just a formality that Medicaid has to follow up on. This is because Medicaid will pay for care even if a person owns a home, but once the person isn't going to go back to that house, the expectation is that the house will be sold to repay what they received from Medicaid. They will accept your explanation, and all will be well.
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I'm sorry for your loss. Not only is it difficult to cope with such a terrible loss, you will find out how greedy and dirty the government is. Medicaid has an estate recovery law. I'm no lawyer, but I tend to think this is a blanket form letter. In other words, anything that goes into probate will end up as Medicaid's property. If nothing is going into probate, they can't recover. If she still has a bank account--if your name is also on there it won't go to probate so they can't get that.
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anonymous434963 Aug 2018
Greedy and dirty? I find that comment somewhat offensive. Our tax money pays for care for those who need it without requiring them to live off their family or loved ones or to even sell their home. I don't consider it greedy or dirty to request information or to recover some of that payment from the estate of the person we generously provided care for.
It's a painful time for those who miss their loved one, but it's just another step in the finalizing of their financial affairs.
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It is just the way to try to recover monies spent. It really is just a formality.

If you're concerned, call Medicaid and they will tell you the same thing. You are NOT responsible to repay that - and if you start, they'll never leave you alone.

Call Medicaid today.
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ItHappenedToMe Aug 2018
This is true - as it is for any collection - if you start paying, it's seen as an admission of responsibility. Totally agree - it's a formality.
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I do not have any advice. I just want to offer my condolences, I am so sorry for your pain. HUGS
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Tell them the truth - there is nothing. They did this with us, too. I'm sitting there going: "What estate? She didn't have one"
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I am so sorry you are having to go through all this on top of your loss. I have read similar posts on here and they say that the family is not responsible for their parents debts.

The letter that you received may be a formality, as already stated, but to put your mind at rest if this is not settled soon, please get in touch with a pro bono lawyer or Financial Aid. They are free. But, I am sure this can be sorted out.
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igloo572 Aug 2018
Best - I’ve found that pro bono clinics will usually not deal with anything probate other than reviewing a will or codicil to see if formatted properly for state laws and telling you where file pro se (if your state allows those). The glitch seems to be that as the debtor is deceased and in order for someone to have legal standing for matters of the deceased that is recognized by the court they need to be named in Letters Testamentary issued by probate court or be named in a Lineal Heirship Action filed in court. So you have have the $ to open probate to do these as a first step to have a docket to which one can file into. You have to have something with a PC case / docket # to file “standing” with. That has hard costs to do to start with. To me it’s why so often assets of the deceased fall to tax sale or end up as uncollected funds in State Treasury as family has no $ to do anything probate.

I’ve found that pro bono & law school clinics usually limit services to consumer issues (housing, rent to own disputes), child custody issues (as they can bring in CPS), juvenile justice.... stuff that more involves legal letter writing, research & filings at the courthouse (online filing). Not physically going to court. Probate judge expects you and your attorney to present themselves in person.

2 law schools in my city and both require 2Ls & 3Ls to do a set # of hours probono. 1 does it only through nonprofits & centered on juvenile justice. The other also does juvenile justice but has a bi-monthly walk in for consumer issues.
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I'm so sorry for your loss. If there is nothing for them to attach the bill to, then they will probably be out of luck.
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Depends on when she entered Medicaid. They could've have done spot check to determine if she really qualified for Medicaid(one car, one house, less than $2500 a month in income). They go back 7 years.
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Question??? What if there is Miller Trust with a niece as beneficiaries?
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igloo572 Aug 2018
My understanding is to have a trust as compliant for Medicaid the beneficiary has to be the state first and foremost. Only when the state has recouped its costs will any funds left over go to whomever else is named beneficiary in the subsequent order named in trust.

Christine - a ? for you? Is there an actual Miller Trust done?
Or is it that Miller has been brought up by others as a way to deal with excess $ and still qualify for Medicaid?
If it’s the latter, you need to first see IF your state allows for a Miller. Not all do. Then IF your state allows for Miller, most have it that all income is paid into the Miller then the exact maximum allowed for income under Medicaid paid to the person and all the rest of the $ is also paid to the facility. So there’s no $ building up in the Miller.It all gets paid to the NH. It seems there are a few states that have the excess build and stay in the Miller trust account held by participating bank then when they die the $ escheats to the state. State totally in control of it both when alive and after death. States can do this with annuities too.
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When someone passes Medicaid will try to recoup what they paid out. When a individual applies for Medicaid one house and one car is a protected asset. The individual can choose to keep one home and one car and still qualify for Medicaid. If they choose to sell their home then the proceeds have to been used to benefit the individual applying for Medicaid. If they choose to keep their home when they pass and Medicaid sends the letter that letter the family would have to sell their loved ones home and pay Medicaid what they spent out. There are exceptions to this, if the individual was married and the spouse lives in the home then this would not apply, if there is a disabled child this may not apply.

If she does not have any assets then you have nothing to worry about, the family is NOT responsible to pay her bills.
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Kalliekaykat Aug 2018
I think 29 states have Filial Reaponsibility Laws where children can be on the hook for their parents’ medical debts. Thankfully, Texas isn’t one of those states.
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Please contact an Aging and Disability Resource Center or might be called An Office On Aging, near you with your documents. This is an agency that will help you interpret information and even make appeals if necessary. God Bless!
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To avoid all this, I went to a lawyer, for low income people and we paid nothing, (Legal Aid Services) and had things titled in such a way where they could not take the home away from me if my mother died. What CJWilson said is true, but I am not a spouse, I am a daughter, so I went and had that checked out, so that I would be okay.
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igloo572 Aug 2018
You’ve been your mom’s live in caregiver for a while now, aren’t you? Then you can qualify for the caregiver exemption from any recovery action. There’s all sorts of exemptions besides caregiver, like low income heir, handicapped or disabled heir. FL is pretty pro property rights type of state for heirs. Your fortunate.
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This raises a number of questions for me. Please get expert advice. Each State is unique. I live in a very unique State. I thought the "look back" was 5 years. Has it changed? Why didn't Medicaid look back before they started paying. That was what I would expect. If they missed the $32000, that would be their mistake. In my State the nearest child is responsible for paying back if the parent can not. Scary!
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igloo572 Aug 2018
Great grandma - the 32k is what the States Medicaid program spent on Ohmeowzers mom. Her mom died last month and Medicaids Estate Recovery (MERP) system is trying to find out IF meowzers mom died with any assets so she would have an Estate that could have a recovery action attempted on.
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I love the name - Ohmeowzer!
Sorry to hear about the Medicaid issue - Caregivers have enough stress without these types of headaches.
But, in regard to your issue with Medicaid here's my suggestion
- First off, they are just doing their job and what they want is a response from you - My suggestion - don't ignore their claim. 
That being said, based on the information you've listed here it will probably be resolved in your favor. But I would suggest the following:  get some legal advice. 
Please note:  I am not an attorney, but here is a list I
got from a workshop I attended of items  you might gather and/or have on hand for future reference - make note whether she did or didn't have these
†##SUGGESTED Itemized list of assets
(e.g., bank accounts, contents of safe-deposit boxes, vehicles, real estate), including current value and the individuals listed as owners, account holders and beneficiaries. † Copies of all estate planning
documents, including wills, trusts and powers of attorney.
† Copies of all real estate deeds.
† Copies of recent income tax returns.
† Life insurance policies, including their cash values.
† Long-term care insurance policies or benefits booklets.
† Health insurance policies or benefits booklets.
† List of names, addresses and telephone
numbers of those involved in decision making,including family members, domestic partners and caregivers,
as well as financial planners and/or accountants
Prepare to meet with your lawyer
(an Elder law attorney)  by gathering
all of the documents related to the assets of the person living with dementia.
##
The information was very helpful to me -Again, I'm not giving legal advice, I'm just sharing information shared with me when I had to go thru similar issues and if your situation is like mine was when my mom passed, away, I had to go back to work as I had tapped out my own retirement savings etc taking care of her so I was definitely not in any position to repay any services she had received from agencies.

So, my suggestion: Don't ignore the letter! - Get your records organized for a response as quickly as
possible.  

In terms of getting any legal advice, I would first check with organizations like your local Office On Aging,
The Alzheimers Assoc (if that was her issue) Even local Senior Centers often have a list of referral services for these types of issues. In other words you want to check with as many agencies as possible to get their input to help you with your response. They are experts in these types of issues and can help or refer you to find the right sources of help. 

Good Luck and God Bless!
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elaineSC Aug 2018
She just needs to go to DHHS in person. The representative you see in person will help. I tried this by phone and you get a front line intake person but if you drive on down to the nearest DHHS office, the rep will tell her exactly what they need and have a list. My Mom is in the nursing home. I learned this is the best way.
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There isn't anything to give them, Just say sorry but your s**t out of luck. Next thing go to an attorney with the letter just in case they want try to collect from anyone in the family. They might try to send a threateningly letter to a family member, just tell them to ignore them.
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This is standard operating procedure. It is done just in case there are any funds that were not known about at the time of filing for Medicaid that could have been used to cover her costs. It seems unlikely but there are instances where money was tucked away and was unknown to family and only comes to light after a death.
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Tell them the same thing you said here---she had no assets at all. If you think she did, feel free to do the research yourself----I am not going to do your job for free.
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Medicaid is kind of a loan. If there are any assets left at death, providing there is no surviving spouse, minor, or disabled children, then Medicaid will try to get what's left.
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There is no court case yet, but discuss with Center on Aging referred Attorney if you can file Paupers Papers with the court. Perhaps it is worth leaving a credit card, or any legal matter. Ask about filing Paupers Papers on her behalf. Sounds like you are Executor,
If it goes to court, you have them ready! It is a court form that is easy to complete.
On date mm/dd/year, ( mother's name), is a Pauper ( Owes More than she has)
List of assetts & their value that date.
List of expenses and debts on that date.
Balance is less than. $0.00
Bingo....use this with anyone chasing old debts, debt collector, and Medicaid.
Also, you said you paid premiums on Life Insurance Policy...Ask Elder Law Attorney if you need to produce those payment records
. Does this mean you owned the policy in your state? If so, not an Estate Assett.
Also $1,500 is allowed as an exclusion to cover funeral expenses. You likely paid much more, but that is limit they allow to set aside for funeral costs.
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There is no court case yet, but discuss with Center on Aging referred Attorney if you can file Paupers Papers with the court. Perhaps it is worth leaving a credit card, or any legal matter. Ask about filing Paupers Papers on her behalf. Sounds like you are Executor,
If it goes to court, you have them ready! It is a court form that is easy to complete. Pauper papers, when accepted by the court, mean you, nor your attorney, at least not a probono Attorney, have to pay filing fees...for answer...for appearance...supeona...continuance...they charge for pretty much every piece of paper of form you must or might put in the record, even official form that you appeared in court. Adds up fast!

Last note my father, an attorney, taught me.
Get what you have...papers...list of what you don't have ( value $0)
Put it on a spreadsheet. Person working your case wants it off their desk to. Make their job easier!
Ex:
Bank balance,: $150
Life Insurance: $XXX, less $ ___ to cover funeral expenses..see line __
Car: None. $0
Home: None $0
_ note year sold! Clawback can go 5 years. State date of sale. If under 5 years, Buyers Name, Relationship to Mother.. they are looking to see if sold for less than market rate to a relative)
Pension: Company, $__
Annuities: None
Money Market: None
Stocks & Bonds:
Etc.

Add a page with address and contact information for any changes to Assets in past 5 years.

If anything was cashed out, list how used
- costs to prepare house for sale
- moving costs (to NH)
- Rx, OTC and supplies for Medical Care.
- Utility bills..till house sold.
You get the idea. Hope this helps.


On date mm/dd/year, ( mother's name), is a Pauper ( Owes More than she has)
List of assetts & their value that date.
List of expenses and debts on that date.
Balance is less than. $0.00
Bingo....use this with anyone chasing old debts, debt collector, and Medicaid.
Also, you said you paid premiums on Life Insurance Policy...Ask Elder Law Attorney if you need to produce those payment records
. Does this mean you owned the policy in your state? If so, not an Estate Assett.
Also $1,500 is allowed as an exclusion to cover funeral expenses. You likely paid much more, but that is limit they allow to set aside for funeral costs.
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You may do yourself a big favor by hiring an elder law attorney.
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I wish you the best through the rough times. Unfortunately I’m not much help and looking for the same answer too from someone who experienced similar situations or those that have rationale ideas.
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