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My father is 90 and was living at home alone until last week when he broke his pelvis. He does not qualify for Medicare Part B because the hospital refused to admit him (was under observation only). He could not go home (per social services) so he went to a nursing facility, pending Medicaid approval. His income is about $700 over Medicaid limits so they are talking QIT. I understand the need for that. My question is: if he recovers enough to go back home (which is his wish), what happens with the QIT since it is irrevocable?

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Personally I'd hold off on doing the DIY QIT till you speak clearly with BOTH and elder law atty & dads MD. The atty for the reasons Barb mentioned.
The doctor to get a better idea of what the realistic long view is for dad. If he is not realistically going to be able to go home so doing irrevocable can seem to make sense....BUT if he doesn't go home what then for his home.?? If it gets sold, the proceeds all turn into income/assets that will again take him over Medicaid limits. Which morphs into yet another issue for medicaid as he won't qualify & has to spend-down plus if he does the Miller id bet his monthly income is tied up. Yeah nothing but FUN there. Atty can give you options as to how to deal with all this.

To me, it's either he's doing rehab & works rehab hard to go home and he/familycobbles together $ to private pay for 2 weeks of rehab (cause that enough time imo that either he's all in doing it and going home or it's LTC permanently in a facility). 90 isn't young but I've seen a lot of old roosters get past all sorts of adversities. You know your dad best, is he likely to do whatever even in pain to get up, do rehab & get onto walking?. My mom had rotor cuff surgery at 90 & did well continued living at her home; she was determined to get back doing stuff, big goal was being able to lift her arms to be able to set her hair & work clasps on necklaces (lol). But when years later she shattered her hip (pulling her wheelchair no less!), her dementia was such that although she be ok for surgery, her cognition was at the point that she couldn't do the rehab needed & so she stayed at the NH & went onto hospice. Really try to speak with dads docs to see what his likely situation is.

What seems to be the trend for QiTs (aka Miller Trust), is what OH is doing (a simplified DIY for the DPOA). Why? Well Medicaid income limits are around 2k and for a lot of folks, well if they worked or had investments last 15 years, their income is gong to be way over 2k ceiling. I ran across an article that abt 1/5 of new SS recipients are getting the max $ 3538 SS benefit. When the tsunami of baby boomers start hitting needing LTC a lot are going to be over the limits from the getgo. OH seems to actually be doing some proactive planning for their Medicaid programs. Their website is very informative. The DIY Miller to me is an example of this. Makes sense to do IF applicant does not have a spouse or a house & already spent down so no $ to pay for elder law atty. but desperately needs to be in LTC facility but the income overage is keeping them from qualifying for medicaid.

Help4dad - can you let us know what happens? We all learn from each other
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I would not sign for anything that is "irrevocable" without an attorney looking at it.

I have always been told that a QIT is not a do it yourself project.
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Thank you! I will find out. The NH Medicaid liaison just said that one would be required. I have a meeting with her on Thursday. The State of Ohio has a fill-in-the-blank form that I, OBO my dad, can fill out and take to the bank, have account set up, with ETF to the NH. Ohio has set up Automated Health Systems, OhioQIT@automated-health.com, to help current Medicaid recipients with this process. I have general POA and my sister has healthcare POA. I think I need to keep digging. Thanks very much for your input.
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Is an eldercare attorney doing the qualified income trust? This is a question for him/her, imo.
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