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I don't trust him and I don't think legally my mom is in a frame of mind to sign any legal documents. My mom feels like she has to secretly tell me what is going on. We have always been open about how to care for mom. I need advice on how Medicaid works because I believe he is keeping this from me for a reason just not sure what?

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If it was that simple everyone would be doing it. Medicaid will want to scrutinize their accounts for the previous 5 years looking for exactly this kind of transfer, beyond that some jurisdictions consider that marital assets such as the house are co-owned regardless of whose name is on the deed.
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If he’s doing this in the belief that it will be a method to avoid Medicaid look back regulations, he is beyond mistaken. And could be creating problems for her future Medicaid eligibility and for himself.

Do you think its for medicaid avoidance or could it be that he himself has some dementia & is acting on bad advice coupled with his own fears?

Medicaid does NOT require the community spouse (your stepfather) to themselves become impoverished. They can have their home (under a set value) and a (1) car as exempt assets, his monthly income is not a factor for her eligibility, plus he can have his own exempt assets (most states have this at 119k). He can possibly move assets above the 119k to a SPIA to pay him income. Only your mom will need to be at 2k in assets and have income below your states max for her Medicaid eligibility. If he should need some of her monthly income to enable him to continue to live as a community spouse he can request CSRA or MMNA waived from mom’s income to go to him rather than be paid to the NH. Community Spouse Resource Allowance/ Monthly Maintenance Needs Assessment..... think of these as kinda like old school alimony for the nonNH spouse. But how to best do any of these are imho not ever a DIY project. SPIAs in particular are very much speciality underwriting to be ok for Medicaid. Really imo they need to work with a NAELA or CELA level of elder law attorney to come up with a plan that will work for however Medicaid reviews LTC applications for your state. Not a DIY.

His transferring stuff now may actually be placing her into getting a transfer penalty when she finally applies for Medicaid. He’d have to do everything like now and not apply till Spring, 2024 to get past the 5 yr look back. That’s a l....o....n...g long time.

On another note, My late mom had Lewy and in many ways at the beginning and mid stages it was quite different than Alz was my experience. They stay lots more competent & cognitive and can continue to be pretty good at their ADLs. Which can be problematic for being found to be medically “at need” for skilled nursing care in a NH. Most states Medicaid LTC programs only will pay for NH level of care. If she cannot be evaluated to be “at need” medically for SNC then no Medicaid paid NH so either it’s private pay in AL or at a NH. It’s often a fine line to get Lewy to show “at need” medically for Medicaid. For my mom, she was in IL and it took abt 5 mos of seeing her gerontologist every 3-5 weeks to verifiably build up her health chart to show she was at need. She did the jump from IL to NH bypassing the AL phase. At the time, I didn’t realize just how unusual this was. For those living at home or in IL, they flat often do not have the fat medical chart to show need like someone hospitalized (MediCARE) then discharged to post hospitalization rehab (MediCARE benefit) at a NH with a rehab unit does. Most NH admits come via this process, so they come into NH with MediCARE paying at least till 20/21 days & if they aren’t “progressing” in rehab, they remain in the NH and transition to skilled nursing care (which is either private paid, LTC insurance or they file to be Medicaid Pending). Plus They have a nice fat medical chart that clearly shows “need”. And family kinda has that rehab period to pull together the documentation needed to file for &/or spend down till Medicaid eligible.

So so what’s your vibe..... he’s care for her but is fearful / panicking doing stuff without fully realizing he’s creating problems OR he’s moving on & away from his wife your mom??? To me your next step kinda needs to be determined by what his intent is.
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Kim2bake Jan 2019
Thank you so much for your advice. I'm hoping he is jyst making bad choices out of panic. My husband doesn't agree he thinks my step dad is wanting to put mom in a home and take off somewhere. I need to do some investigating and present him with the facts about Medicaid. I have had this conversation with him already but maybe he just didn't believe me I will get someone else to explain this time. Thank you for your knowledge I really appreciate it.
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This is Medicaid fraud. He would need to go to a lawyer to change the deed. If u find out who that is, make them aware of Moms condition. Same with DMV, contact them about the situation.

If he does this outside the five year look back, he will be OK. But if within, he can be held responsible for her care. He needs to talk to a lawyer versed in Medicaid. Medicaid does not take the house and car. SD will be considered the community spouse and will not be made impoverished. With my GFs parents Dad was in LTC. Mom remained in the home and had the car. They had 60k in the bank and that was split between them. Dads 30k had to be spent down to the 2k my state allows. When mother passed a few years later, she still had the 30k. So she had enough money to live.

Medicaid does not take the house. They put a lean on it which needs to be paid when and if the house sells.
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I'd get legal advice pronto to find out what is legal and proper. There are lookback periods, so, some things, may not likely help. Also, there are protections for spouses, so, I'd inquire about that.
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See an eldercare attorney--Medicaid is highly complex and laws vary from state-to-state. a lawful spouse has protections, but like I said Medicaid is highly complex. There are alternatives to nursing home care such as hospice. It's far better to keep off of Medicaid if at all possible.
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Medicaid won't take the house or cars as long as your mother and stepdad are living in them/using them. Medicaid will charge back to the estate what is owed after everyone has passed. You can google a lot of this information -- and there are several responses on this site (search at the top under Forum) that can get you started and start to allay fears. But, yes, above all, talk to a elder care attorney.
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This is illegal. Everyone tries this. There are specific laws that address this as no one wants to be "spent down." This is also taking advantage of system. They don't take anything. They access all income and assets and set up a budget and you can live in the house if it's an asset; they will have rights over it. Fraud it is and writing into a public forum is not a smart idea as they do watch. There's so much fraud in this area and so many people end up on medicaid and people wonder why we're in debt. If the guy thinks he's smart the IRS also looks and keeps tabs and is observant of this behavior as well. Also, it's not 5 years: they can look back 15 years if they suspect fraud.
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gdaughter Feb 2019
didn't realize they could look back 15 years...learn something every day...
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Your stepdad could be making a huge mess. What you're describing is illegal.

Insist that he consult with an elder law attorney. Some assets can be legally protected. For others, there is a 'look back' period. If any significant assets are transferred within that period, they will still be counted as belonging to the Medicaid recipient and will be recovered.
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gdaughter Feb 2019
It's not so much illegal as stupid, and looks bad when they do the look back, but my guess is, so long as they would be honest about what they did, they're just going to wind up paying for it somewhere along the line. If they don't apply for medicaid for X number of years into the future after this, the impact may be different. But I definitely agree to get to an elder law attorney ASAP before doing something that can't be changed. Medicaid shouldn't be so complicated but it is. I also think there is something that allows the spouse to keep the house so he may be doing something for nothing.
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Many people try this route to avoid paying the government for whatever.
Even Sen. Diane Feinstein tried it several years ago when her husband was near death. She got caught when he passed and had to pay a lot.
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Medicaid will catch them red handed. They'd best seek out an elder estate attorney.
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