Does Medicaid look back at the spending/borrowing from a reverse mortgage when qualifying in the spend down process? Or is it exempt? -

Does Medicaid look back at the spending/borrowing from a reverse mortgage when qualifying in the spend down process? Or is it exempt?

This question has been closed for answers. Ask a New Question.


Sharirose -
ask his MD if he can do Exelon pill rather than patch. It is less. The transdermal med's- any of the patch med's are transdermal's - are super expensive. Then if that can't work also ask if he can be on another dementia medication that is less expensive. My mom was on exelon as she has Lewy Body dementia and Exelon works well for that type of dementia. but if she had Alzheimers there are other med;s besides Exelon out there for them that also work just fine and cost less.
Also if you MD is writing the prescription so that any med;s must be dispensed as written with no substituions it will be significanlty more. Like I take synthoid every day (right thyroid removed) and the generic synthoid is like $ 10 a month but if my endocrinologist wrote it for Armour Thyroid it would be over $ 100 a month as that is not a generic and cannot be substituted at all. Exelon is a brand name so can charge more for that. Understand?

About the dreaded donut. You should have gotten a big book from Medicare earlier this year, in the back of it should be a listing of all the part D programs in your area. D is the drug / prescription part of Medicare. Find a couple of pharmacies that participate and go down there to speak with a pharmacist - the real pharmacist and not the pill filler person. Take all the medications needed in your household - you & your hubbies. They can probably tell you which Medicare drug program to switch too. They are not all the same. the big chains like Walgreen's, etc may not be the best ones. When my mom was in IL, there was a CVS close to the IL which most of the residents used. But it cost more, and she switched to the HEB pharmacy (HEB is a big grocery store chain in Texas and Northern Mexico) and her yearly cost were about 1/3 less.I'd call your local pharmacy and ask when is a good time that they are not busy and a pharmacist will be in to speak to and then drive over & do it. Good luck.
Helpful Answer (1)

I can't explain it, but it happened to us too. Our copays were very high for Exelon and Namenda, and the donut hole was worse. I finally applied for VA health benefits, which I had avoided due to years of hearing horror stories and the VA is 3 hours away. However, it has actually worked out well. The Exelon and Namenda had to get special approval and his VA neurologist probably had to submit some documentation, but it went through rather quickly and the copay is minimal. We were also able to drop the Rx coverage on his Medicare Advantage coverage. Don't know if that is an option for you, but if it is you should go for it.
Helpful Answer (1)

My spouse has Alzheimer's and needs the Exelon patch to maintain. Now we find we are in the medicare donut hole. He has medicare and Aetna as insurances but now we are paying an extreme amount for his prescription. This is puzzeling to me. I tried to read through the Medicare info but it puts me into a catatonic state. Does anyone out there know how to explain this in common terms? Thanks you are all so helpful. Glad you are out there. Luv sharirose78
Helpful Answer (0)

As far as I'm aware, Medicaid (at least in Washington state) does not count the monies against someone if they receive monthly payments--they do not consider it income. If someone takes a lump sum payment, however, the state of Washington's Medicaid program counts that lump sum as a resource, which will often put someone over resource limits for programs.
You will want to check with your state's Medicaid program for specific eligibility requirements for your state (maybe call your local office and ask to speak with a financial worker).
For more information on reverse mortgages, check out these resources:
National Reverse Mortgage Lender Association:
Fannie Mae:
Helpful Answer (1)

Medicaid will look back five years or more. Keep careful records, pay by check.
Helpful Answer (0)

The $ you get from the RM is usually considered assets and seems to be evaluated as any other assets for Medicaid.

You do need to be aware of the compliance issues with a RM and you have to be VERY careful if you do a RM and then need to go into AL or NH. Please go over the agreement to see what the policy reads especially on foreclosure.

If you do a RM there are 4 things that can be a problem for compliance and cause the RM to be due and payable in full:
1. FAILURE TO PAY - property taxes, homeowners / flood /wind &/or earthquake insurance. If you don't, the RM is out of compliance. You can get around this by instead of the homeowner selecting their own insurer, the insurance is folded into the RM and uses insurers that the RM selects, but this is going to be expensive......especially if the house was fully paid off and you had old, minimal insurance on it. Most RM also have the requirement of mortgage insurance too. But if the RM holder is going to need to go into a NH, under Medicaid they are expected to do a co-pay of almost all of their monthly assets (like SS or retirement) to the NH. So there will be no real $ to pay for taxes, insurance, plus whatever maintenance, yard etc needed on the property.
2. MOVING TO A NEW RESIDENCE- if reverse mortgage property stops being your primary, you are out of compliance with loan.
3. BEING OUT OF THE HOME FOR MORE THAN 1 YEAR - the loan will come due. Most policies have this.

4. ALLOWING THE PROPERTY TO DETERIORATE - being away for a while, like a trip or cruise is allowed but if the property gets run down while you are away, the loan could be called in. After Hurricane Katrina, some homeowners who had RM, got letters w/detailed questionnaire as to the status of the home, how it was being secured, status of repairs, utility information, if an insurance claim was done - this was all about calling in loans that were in areas with uncertainty. And Katrina was in 2005 before the real estate market tanked.

Please go over the RM agreement carefully. Good luck.
Helpful Answer (2)

This question has been closed for answers. Ask a New Question.