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Medicaid says they were in a nursing home but they werent because they were at home except that last month of life when he was in the hospital and last 3 days when hospice stepped in.

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This is for Florida...
According to federal and state law, the money that the Florida Medicaid program pays on behalf of a Medicaid recipient is a debt owed back to the state. Upon the death of the Medicaid recipient, the Medicaid program files a claim against the decedent’s estate in order to seek reimbursement for the amount owed.

The debt includes all payments made by Medicaid for services or goods when the recipient was age 55 years or over.
Assets that are not exempt are used to pay the expenses of administration and other obligations of the decedent's estate in the following order. First, there are the expenses of administering the estate such as filing fees and attorney fees. Second, the estate may pay for funeral and burial expenses (not to exceed $6,000). After these are paid, the Medicaid claim must be satisfied before any lower-class creditors or heirs receive any non-exempt assets or money.
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By applying & accepting Medicaid, the state can seek any & all reimbursement for whatever amounts Medicaid paid. To be on Medicaid, they basically are impoverished and really their only asset could be their home & a car. Now if there is a home, you need to look into what exemptions, exclusions, etc could be filed for. If there is a surviving spouse, that is an exemption to MERP.

For children, they have to qualify for one of the many other exemptions or exclusions to however MERP is set up for your state. Just because the deceased parents will left the house to them (so they are the heir), is not an exemption in & of itself. If they were the caregiver for 1 -3 years and can document properly their full-time caregiving was needed, then that is an exemption they could file. What flies for exemptions, etc depend on how MERP is set up in each state as each state manages or administers Medicaid under their own unique way interdependent on how their state law views property, death, probate, etc.

But whatever the case, family will need to file for these (along with whatever documentation needed to prove the exemption, etc.) within the timeframe based on what is indicated in the "letter of intent" sent either by the state or by the MERP contractor for the state. Some states have the info on the existence of a community spouse aka surviving spouse within the Medicaid database so the letter doesn't happen. Other states send the letter of intent across the board to whomever is listed as the contact person for the Medicaid recipient.

For even more fun in all this, for some states who have contracted MERP out, the timeframe for doing this is based on when the state makes the MERP contractor aware of the death. That is when the clock starts for the letter of intent to go out. So it may be months later, not necessarily a few weeks after death. There have been a couple of posts on this site from family who find there is a MERP claim or lien on the parents home a year or more after death.
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Donna, Medicaid will not touch the house while the spouse is still living there. If an adult child lives there they would have to prove hardship in order to stay in the house, according to Kansas. They cannot sell the house and expect to keep the proceeds for inheritance.
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What if there is a spouse or child of the patient who live there? Does the govt still have the right to take away the house?
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Angels - have you actually received a notice of a claim or lien against the estate? or is this just a "what if" type of question?

The notice is called a "letter of intent" and sent out with specific details as to the deceased & Medicaid amount recoverable. If you got one of these, can you post that and how it reads? thanks.

BTW Medicaid's MERP - Medicaid Estate Recovery Program - covers reinbursement for a wide variety of programs. When they applied for & accepted Medicaid, the details on MERP were in the application. You do not have to sign off on acceptance either as your participation in Medicaid is an acknowledgement of the terms of the program. In addition to NH, it also pertains to some mental health services, some community based care or services and lots of other things that Medicaid paid for those 55 and over. The state (or their contractors) can go after the estate of anyone who got Medicaid paid for services. The details as to just what will be on your states Medicaid website along with what exemptions, exclusions or hardship may be allowed under your state's program.
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Think about this next time you're in the voting booth. If we elect politicians who recognize that our current health care industry is based upon bankrupting hardworking Americans and are working to change it, our kids might live in a country where they can feel secure that the future they're building for themselves can't be shattered by a chronic illness or accident. The Affordable Healthcare Act is just the first step. There's a long way to go.
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Medicaid is for impoverished people, so if a person has assets (like a house), but otherwise qualifies for Medicaid, part of accepting Medicaid is putting a lien against those assets so that Medicaid can recover some of the money spent on a person's care after that person has died.
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Unfortunately, yes. The Medicaid Estate Recovery Program will attempt to get back any monies paid to the person over their lifetime, after their final bills are paid. It doesn't really matter if they were at home, in the hospital, or in a nursing home. So sad.
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If there is a surviving spouse? Any survving children? Whose name is the house in? Theses are some of the things that would make a difference. pamstegman is right but before I surrendered the assets I would check with a good lawyer.
Best to you as you go thru this, it is not easy and sometime costly.
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Was the patient without health insurance? Were they old enough for Medicare? Were they on Medicaid (medical care for the disabled or poor)?
If they are on Medicare, most of the hospital bill (80%) should have been paid. Most seniors pay for a supplement insurance coverage to cover fees not paid by medicare.
I would check with an accountant and an elder lawyer to make sure why Medicaid is involved? If they had health insurance outside of Medicaid, it should be footing the bill.
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Medicaid Estate Recovery is a program which allows KHPA to recover medical care costs from the estate of recipients who, prior to their death:
• Were 55 year of age or older; OR
• Resided in a nursing facility placement
Note that it says either scenario. So the Executor of the Estate is charged with paying the bill from the estate of the recipient.
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