What is a Medicaid promissory note?

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I'd suggest you clearly speak with your legal about what type of note is possible.

If this is about a signifiant property or asset sale (like a business) & Medicaid, my understanding is that if it was done via a SCIN (self canceling installment note) rather than by a simple promissory note, the remaining balance (after death) is not in estate. Not subject to recovery due to the SCIN. Even if the entire principal amount is in note (so buyer is doing only annual interest & risk payments).

As long as the very tight requirements (like base AFR & mortality risk premium) to do a SCIN was properly done, SCIN stands is what I've heard. SCINs as standard issue generationally wealthy asset transfer technique has been around forever. I'm surprised that it isn't mentioned more for those dealing with medicaid & asset planning strategies.
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Medicaid requires loans issued by the recipient to have prevailing interest rates and a pay back schedule, in writing. Really not a good way to go if you are asking me.
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