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Family member has been in NH for 2 yrs on private pay spend down now makes him eligible for Medicaid. If he goes on Medicaid but decidea to leave to live with a family member will he get control of his pension back?
I understand once on Medicaid nursing home gets his check as well as SS disability.

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Thank you all for the information.

I guess we are hoping that one day our brother could move to an assisted living with private pay shortfall funded by family, if needed.

he is mobile disabled so needs help with daily essentials, but needs no medical attention as he is otherwise healthy.
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To be in a NH means the person usually needs 24/7 care meaning it would be hard for the person to be cared by others. It would mean the family member would need to set up 24/7 care or give up their life to care for the person.

If the NH was allowed to be payee for SS and pension both would need to be notified that the NH is no longer the payee and the checks need to revert back to the person. No problem if NH not payee. Depends on how your share is being paid.
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Are you asking if Medicaid can pursue reimbursement for past care or are you asking about present/future care?

If I understand the question, your relative is interested in doing the opposite of the more common situation where someone privately pays for care in what they hope is a nicer NH, in the expectation of being able to stay once they go on Medicaid.

Your relative has been doing something like staying in a $8,000 NH, and paying privately with their $2,000 SSDI, $2,000 pension, and $4,000 from personal savings? Now that the savings are gone, they want to get qualified for Medicaid, use it for a while, then leave to live with a family member?

My guesses:
Leave before Medicaid kicks in, no problem.
Leave after Medicaid, but no longer need it, maybe get some control back?
Leave after Medicaid, still need it at home, Medicaid makes sure provider(s) collect from person's income first, so not likely to get control.

I am not a lawyer. If you want expert advice you can rely on, hire an expert.

If you are the family member they'd like to live with, why do you think it will be better now that their savings are gone? Are their needs becoming less?

I would be very wary of not being able to get them back into the same NH, or any NH without having to go through the whole admission process over again.
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Not as long as he is on Medicaid. His income is paying for his care.
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He has been self pay in the NH , he has run out of money and will have to go on Medicaid.

what happens in the future if he were to decide to leave the NH and go to other living arrangement - does he get Control of his pension and SS ?
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He is in a nursing home and on medicaid. Leaving nursing home for another on self pay? I don't understand. To be in NH on Medicaid usually requires a period of self pay before home will accept Medicaid for payment. Were there assets that were not originally reported to Medicaid?
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It may depend on the NH and their requirements but since he has been self pay for so long the arrangement may not change. Medicaid will just pay their portion of the bill (cost minus his portion which is his pension and ss minus his spending allotment). Some NH arrangements sign over the benefits to them or an account for the patient help by the NH and they administer the monies rather than bill. Either way if he moves out of the NH they should stop collecting all payments, I’m not sure what it does to LTC Medicaid qualification but it isn’t likely he will get the same benefit amount living home rather than in a facility. He or his proxy might want to look into this very closely and make sure they have a full understanding of what doing this does to both his current and future qualifications and benefits.
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Joehowie58 Aug 2020
Thank you
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