My husband is looking for answers. His grandmother owned 2.5 acres and a brick house most of her adult life. Since 2018 we have lived on 1 of the 2.5 acres in our mobile home and help her out when she needs it with repairs, money, etc. She has gotten older and couldn’t take care of the large brick home anymore or the expenses that come with owning an older home and things messing up, plus her portion of the land taxes so she gifted him the house in March of 2024. We took out a 70k home equity loan on the house for extreme repairs to the electric, termite damage, remodel because it was in rough shape, and to buy her a tiny home to live in on the property that she could maintain easier. We rented out our mobile home to lose the note and moved into the house to remodel and live in. We just found out today (June 21, 2025) that she has had Medicaid since 2020. We were always told she only had Medicare and she said she never reported it because she didn’t want to lose Medicaid. What do we do??? I’m genuinely at a loss. We just had renters sign a one year lease on our other home, we moved her into a tiny home, we are 70k deep into a home equity loan to get this house safe and livable and have already spent dang near every dollar and then this gets dropped on us. If she doesn’t report it, do we? Will MERP come after the house if she dies and my husband legally owns it? Will this make her lose benefits? There is no option to pay back the loan immediately and give it back. If we had 70k to spend on all of this we would have never took out a loan in the first place.
if so can you post an update as to that is its status?
2020 timing is likely due to Covid. When Covid hit, Federal $ for dealing with the PHE/public health emergency. CMS / Centers for Medicare & Medicaid guidelines allowed flexibility on eligibility & “continuous enrollment”. State Medicaid got serious $ for this. Health insurance companies that did Medicare gap & Advantage really put the move on having enrollees switch (imo dumped) to Medicaid. Probably what happened to GMa. PHE ended 5/11/23 w/up to a 2 year “wind-down” process. For States that took 2 yr winddown, enrollees getting notifications this year. It was continuous enrollment so GMa did not have to do anything. May need to reapply…. hopefully not.
Dont be kicking yourself on not knowing because for those on Medicaid as health insurance as well as other Medicaid programs there usually isn’t a trail of bills or “statement of services” sent to person enrolled. Providers bill Medicaid & get paid; Medicaid recipient does not see a bill. Only get a bill if provider not paid.
Gma is a “dual”: on Medicare & Medicaid for health insurance. She is probably (& hopefully) on Original Medicare w/Medicaid as her secondary / gap policy. If not Original Medicare then on a Medicare Advantage Plan for “duals” (fwiw I hate em). Find out as you do want to make sure whomever seen for care takes her health insurance. If rural TX, may not be choices.
If you & hubs have gotten a HELOC in your names, banks are pretty good about making sure all courthouse recordings, all paperwork shows you 2 are owners. What this means is GMa living in that tiny house is a tenant. She’s a tenant much like the ones renting the mobile home. I have a suggestion for you….. have Gma pay rent. The mobile home folks are paying rent. Needs to be rental income, property depreciation, costs etc IRS tax filings done. If not in your wheelhouse, find a tax person to shepherd how you need to keep documents & they do the tax filings. After couple of years, you DIY it.
Why GMa should pay rent: as transferred ownership 3/24, if she needs to be in a NH, she will not be eligible for LTC Medicaid bc she “gifted” her asset (home & land). GMa or y’all would have to private pay NH @ 7K-15K A MONTH! Why? well LTC Medicaid will place a transfer penalty on her. She cannot get away from this till April, 2029. That is a long time. 1 serious fall she is toast on living independently. That rent $ you set aside for that very very likely eventuality.
It is imo mucho importante to find & keep 2023 tax assessor/ collector bill. It will show the property value as of her gifting. That would be the figure you want used if there should be a transfer penalty. Ya need to have this as otherwise you probably will find Medicaid defaults to current value. You are doing all sorts of upgrades, an ADU, leasing a parcel; going to have an increase in value.
How Medicaid transfer penalty works: GMa XMAS 2023 gifts you her 345k assessor value home. She moves into IL apt. June 2025 she has a bad accident, hospitalized, then rehab patient @ a NH. In July it’s determined she needs 24/7 care. She stays at this NH to become a custodial care resident. July 15, 2025 files for LTC Medicaid as cannot private pay 10K mo. Gifting found and Transfer penalty placed due to gifting. Her State LTC Medicaid pays NHs a custodial care day rate of $275 day. Her transfer penalty is 1,255 days. So over 3 years of ineligiblity starting date she filed on 7/15/25. It’s a very serious crisis.
And why i suggest GMa pays rent as that $ will be set aside to pay for her care if - IF - something happens to before April, 2029. Work w an atty to set up all this, review everyone’s legal & review that lease as well. Good luck & stay organized!
Federal Minimum:
Federal law requires states to recover the costs of nursing facility care, home and community-based services (HCBS), and related hospital and prescription drug services.
State Options:
Many states also recover for additional benefits, including those received by individuals aged 55 and older. This can include Medicaid premiums for managed care plans."
From the above, your State could recover the cost of her healthcare cost. Really, her home is an asset that could have been sold to cover those costs. And because Mom just turned over her house in 2024, that maybe questioned. It changes the status of her Medicaid. Mom has to renew every year. She must show she owns a home and the next year she doesn't? Where did that home go, did she sell it, if so she can afford to pay for healthcare. Gifted it? I think you need to talk to an elder lawyer. She's also changed her address, Medicaid needs to be aware of this especially if she has changed Counties. In my State, each county handles their own medicaid. You apply for services in the county you live in.
Good Luck and please come back and update us. We learn from others experences.
I'm not sure what it is she didn't report because of fear of losing Medicaid: the fact that she gifted her home? If she's on Medicaid for medical (insurance) coverage, not LTC, I don't believe gifting the home would impact that or cause her to lose it. If she had sold or rented the home and did not declare income, that could cause here to lose Medicaid at least temporarily if her asset or income level was too high for financial eligibility.
https://www.hhs.texas.gov/regulations/legal-information/your-guide-medicaid-estate-recovery-program
A big issue has been that the contact info from 2020 is no longer valid. The eligibility was continuous so any change in address, in phone, in email addy had no need to be updated to stay on Medicaid. Lots (1.4M) falling through the cracks.
Medicaid has a 5 year 'look back' period to prevent the applicant from transferring assets to meet Medicaid income thresholds.
Tranferring an asset, like a house- would void
I'm not trying to alarm you , but I think you should look into this further, with your own research or an expert in Medicaid.
Good luck!