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My MIL was living in a home with holes in the floor, rats running all around, toilet not working etc. It was decided that she would sell her house and whatever she got for it would go towards us building a handicapped apartment onto our house for her. Her house sold last Sept. and building started in Oct. She has a 1000 square foot apartment that is 100% ADA compliant and it cost us $156,000 to build. She only received $94,000 for her home so she put that into the apartment. We paid for the extra. Now, she is not doing well and we see that she may end up in a nursing home sooner rather than later. I'm wondering if trying to take care of mom is going to end up really hurting us. If she ends up in a nursing home, are we responsible for paying her back the $94,000 that she put in if it happens before the 5 year look back period?

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We actually live in Europe and are leaving at the end of the week so I don't think we have time to see an attorney. I'll poke BIL who has a POA for her and see if he'll get involved.
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As we said before, we know nothing about about Medicare and Medicade. We just had everyone tell us that we will be in trouble if she needs to go into a nursing home. We did put her in a nursing home (a private room) after her surgery for an impacted intestine for a week while we finished her apartment. It was $6,000 a month. We live in a small town, and the nursing home is a Lutheran nursing home and costs aren't that bad. So, with that figure, we should be fine right? She has medicare but her pension should cover 2/3rd of the cost and her savings will last over 12 years so by the time she would go through all of that, the 5 year period will be long gone. Best case is she gets her issues fixed and it's a moot point, but she is still refusing to go to the doctor so I don't see that happening. Since we've told her social worker (social worker got involved per her doctor) to call APS if they feel it is needed, we should be okay?
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Royneberg- with MIL having 4k in monthly income...well that alone will keep her from being eligible for Medicaid. Most states have monthly income capped at $ 2,100 but some states are lower. 4k she is over.

And that plus her 300k in savings, she will not be eligible for medicaid for at last 2 maybe 2.5/3 years with NH costing 8k - 15k a mo.

NH Medicaid (Medicaid not Medicare) is limited to those who are "at need" both medically (needs skilled nursing care) & financially (basically impoverished with no more than 2k in nonexempt assets). She has 300k in non-exempt assets.

She could do a special needs trust to become Meducaid eligible but I'm pretty sue those require the beneficiary of the SNT to be the state. So if she keels over dead 6 mos from now, family will not get a penny as the state is beneficiary. Really with 300k, gather her paperwork together & ASAP see an elder law atty.
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Oh, I remember that post well. I understand. Medicaid and Medicare are two different things. Anyone who is a citizen of the US and over 65 can qualify for Medicare. Medicaid is intended for people who are below the poverty level.

I got a PM that the penalty doesn't decrease with time like I wrote above. I checked and that is correct. There is no reduction in penalty with time if it is in the 5-year look-back period. Medicaid is tough!
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RB, MediCARE doesn't pay for custodial care at Nursing Home. MediCAID is the entity that helps elders that have low income/low assets pay for care. Please find a good, experienced elder lawyer in your area that is familiar with MediCAID to make sure that you make good decisions on your MIL's assets, income, and future needs so that you don't end up with more financial issues.
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I am totally clueless when it comes to Medicare. MIL has over $300,000 in savings and has a pension of almost $4,000 a month. We're not putting her in a nursing home right now, just thinking of the future. If you've seen my other post on her, you can understand why we are concerned. I'm hoping that she doesn't need medicare to pay for this at this time with her income. Do you think what she has would get her by for sometime without having to use Medicare? Maybe even the 5 year period?
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5 years from the date of her Medicaid application.

The situation you & MIL are in is not uncommon. Commingling of assets. My suggestion is for you to gather all of her financials (income awards letters, house sale paperwork, tax assessor details on old house - could be some FMV issues lurking-, contractor contract & payment, her current bank statements, etc) and schedule a NAELA or CeLA level of experience elder law atty consultation to discuss how to best deal with her future Medicaid application.

The fact that she wrote a check directly to the contractor and not to you is
Iikely a very VERY good thing. I'd bet that you will be asked by the atty. to have to get an appraisal done on your home to get its new value with the addition. So try to find your old tax assessor statements to see how much of an "increase" the addition could pose.

Mil is now safe & secure and that is in & of itself priceless, so keep this in mind.

I'd bet you will need 3 -6 mos or so to get through paperwork on all this before Mil does her Medicaid application. Her monthly income can pay for in home caregivers either from an agency OR her atty. does a personal needs contract between mil & family. personally I'd go with getting an agency as it gives you a bit of a break & you have plenty of other things to deal with....plus show you & hubs are not all about her $.

About the transfer penalty, it's an equation roughly based on whatever your state pays for the daily room & boards rate at a NH by Medicaid. Rates vary by state as each state administers its Medicaid program uniquely but within overall federal guidelines. Many east coast states pay $300/400 a day. Southern states way way less. For my mom - who was in TX - it was about $ 155 a day. So a 94k penalty would mean 606 days of ineligibility; but if she had lived in a $ 350 reinbursement rate state only 269 days.

Good luck! if you would can you post an update as to what the plan is, thanks!
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jessie thanks for the information that medicaid uses a formula in it's look back penalties. idid not know that. I though you always had to come up with the full amount. Very helpful information for everyone.
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Medicaid uses a formula to calculate penalties, so that the penalty becomes less with the time when the money was spent. A gift made yesterday will be penalized more than a gift made 4 years ago. If there is a penalty, it may not be as much as the original amount she paid. If you apply for Medicaid for her, please let us know what happens. I know you didn't anticipate her decline when you added her apartment to your property, but these things happen.
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You are correct, it doesn't make a difference that she paid the contractor directly.

The five year lookback is five years prior to the application for Medicaid. So if she is applying for medicaid today, it would be five years back from today. To avoid the penalty you would need to wait for 5 years from when she spent the $94,000. If you can't wait, you can apply now, and accept the penalty (by paying out of your pocket the $94,000).

Angel
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Probably doesn't make a difference but she didn't pay us, she paid the contractor directly. Is it 5 years from when she sold her house, or 5 years from the final payment for the apartment?
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Unfortunately the answer to this is yes. Any improvements you do to your home, even if they are for her benefit, increase the value of your home and therefore are considered a gift and would trigger a penalty period for Medicaid if within the 5 year lookback period. I assume your mom gave you the $94,000 to put towards the addition. This would be the amount of the penalty.

Angel
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