Either way the home sale will affect his Medicaid eligibility because even if its Medicaid health insurance, the proceeds will put him over the income limit. And if he’s receiving home & community based Medicaid, then there is an asset limit if $15k in NY.
Thank you so much for the answers, I really appreciate it. But as a follow up, if anyone can answer, if he decides to not want to be part of the Medicaid plan, will there still be any penalties that he will face?
Elaine, I’m confused, your initial post reads that he is on Medicaid. So is he on it? or is it that he’s on Medicaid (I’m guessing it’s community based Medicaid in NYS so Medicaid for him is abt being his 2nd health insurance to his Medicare) and that something has happened health wise that he’s likely to need LTC Medicaid? Or he’s being told he needs to go into a PACE day program in NYS, and needs to fill out an updated Medicaid application for it? So just what’s happening that he’s needing now to do something fresh with his Medicaid??? Medicaid is a huge with all sorts of programs from loaning breast pumps for new moms to paying room&board at a NH. The one constant in Medicaid is that you have to be “at need” both medically AND financially for the exact type of program you are trying to be eligible for. The “at need” varies. You can help him by carefully looking at just what he’s thinking he’s needing to apply to and you help him evaluate as to if it makes sense for him to do.
Please be aware that Medicaid is uniquely state run, everyone who posted this to you is totally accurate.
If he has an asset in NJ, it should have been disclosed for his NY application. Just how much of an issue that oversight is, & if penalties get placed, kinda depends on how much it would have affected his initial eligibility. Community based Medicaid has lots more wiggle room as you have to be low income & for some parts of NYC “low income” is pretty high. But LTC Medicaid (like in a NH) is very strict as to maximum monthly income and maximum exempt assets allowed. The issue for NJ house is that it’s not an exempt asset.... if he had a house with homestead exemption in Buffalo that’s an exempt asset, but NJ house isn’t. It should have been disclosed. Some states allow for an out of state property to be placed on the market with a MLS / Realtor listing and it’s ok for Medicaid as they anticipate it will sell & he can repay Medicaid for costs paid and he becomes private pay. That’s nice & straightforward. But what can happen if not disclosed & Medicaid finds out, is he becomes ineligible for Medicaid and Medicaid clawbacks payments paid to vendors..... yeah, horrors! so their pissed off and end up billing him and turning it over to collections when he doesn’t pay. Stuff like this snowballs. If he has cognitive issues, his dpoa will need to deal with all this and it’s likely a hot mess. If he’s talking to you about buying stocks from house sale $ and he’s in Medicaid, he’s not understanding the eligibility rules for Medicaid.
If he’s on NY LTC Medicaid, so his living in a facility, his Medicaid $ tally could be quite a sum. Once property issues surface, he’ll likely get a notice from Medicaid that his eligibility is being suspended and he’ll need to file an appeal in 30/60 days with documentation as to why the suspension is wrong. The facility will get a copy of the Notice so they will expect someone to assume his looming debt or sign off financially responsible so he can continue to live there. If not he’ll likely gets a 30 day notice to leave from the NH. If he doesn’t prove why he’s eligible at his appeal hearing, he’s off Medicaid. He’ll need to find new 2ndary health insurance plus deal with whatever bills due from Medicaid clawback.
if you haven’t been tight with your Uncle until now, you imho need to seriously look at his finances and how he is on competency before you get yourself entangled in all this. There’s a poster few weeks back who finds herself fighting 45k NH debt as her dad didn’t do some of the things needed for his Medicaid application and she signed off responsibility paperwork not understanding just what that meant; dad died after 5 mos. at the Nh & with no assets; NH turned the bill (in her name) over to debt collectors. She’s fighting it, but it’s incredibly stressful for her. You want to avoid having this happen to you.
Does he own a house in NY? If he does and claimed a house in NJ, he would have had to sell the house in NJ because Medicaid does not allow a recipient to own two homes. Those proceeds would have needed to be spent down before Medicaid took over. I think, even if he doesn't have a home in NY, he would have still would have had to sell the NJ home because it was not his main residence. So I am with igloo, bet the NJ house was not on his application.
Medicaid is a state run program, although it gets partial federal funding; Medicaid is based on residency and how you qualify depends on just which Medicaid program your applying to and eligibility is based on your assets and income levels as based on your state of residency and your medical care. It’s “at need” both financially AND medically.
So which state is he a resident of? If he applied for NY Medicaid, he needed to disclose that he owns an asset in another State. Did he do this? I’ll bet a case of Prosecco that he didn’t, & if he didn’t, I’d suggest that you or whomever is his DPOA ASAP find a elder law atty who practices in both NY & NJ to deal with his application and whats penalties may be lurking for him. Medicaid is very much about providing services for those “at need” for residents of thier state. The NJ property should have gotten flagged in his NY eligibility review.... that it wasn’t it’s either that he actively did not disclose it (so penalties placed) or that he was too incompetent to understand the Medicaid application (so dpoa did not do thier job or he needs guardianship). Whichever it’s us, it’s not a DIY project. He needs an experienced elder law atty.
If he’s had an home he could have sold and used for care or for living costs, it’s going to surface when it sells & pose issues for his truly being “at need”. All property transfers get recorded and it will surface eventually to intrastate databases.
He cannot just sell that NJ home and place house sale $ into another type of asset for himself. NY Medicaid is for those “at need”. The house and it’s sale $ is an asset of his that must be disclosed in his Medicaid application and renewals.
Yes he will lose his eligibility. Even if he re-invests in stocks he will lose his eligibility. Medicaid isn’t for those with money & assets. He could sell the house and purchase another house but that’s about it, if he wants to stay on Medicaid.
Cannot answer the penalty thing. For Medicaid, the penalty is usually you being dropped from the program if you no longer fit the criteria.
So is he on it?
or
is it that he’s on Medicaid (I’m guessing it’s community based Medicaid in NYS so Medicaid for him is abt being his 2nd health insurance to his Medicare) and that something has happened health wise that he’s likely to need LTC Medicaid? Or he’s being told he needs to go into a PACE day program in NYS, and needs to fill out an updated Medicaid application for it? So just what’s happening that he’s needing now to do something fresh with his Medicaid???
Medicaid is a huge with all sorts of programs from loaning breast pumps for new moms to paying room&board at a NH. The one constant in Medicaid is that you have to be “at need” both medically AND financially for the exact type of program you are trying to be eligible for. The “at need” varies. You can help him by carefully looking at just what he’s thinking he’s needing to apply to and you help him evaluate as to if it makes sense for him to do.
Please be aware that Medicaid is uniquely state run, everyone who posted this to you is totally accurate.
If he has an asset in NJ, it should have been disclosed for his NY application. Just how much of an issue that oversight is, & if penalties get placed, kinda depends on how much it would have affected his initial eligibility. Community based Medicaid has lots more wiggle room as you have to be low income & for some parts of NYC “low income” is pretty high. But LTC Medicaid (like in a NH) is very strict as to maximum monthly income and maximum exempt assets allowed. The issue for NJ house is that it’s not an exempt asset.... if he had a house with homestead exemption in Buffalo that’s an exempt asset, but NJ house isn’t.
It should have been disclosed. Some states allow for an out of state property to be placed on the market with a MLS / Realtor listing and it’s ok for Medicaid as they anticipate it will sell & he can repay Medicaid for costs paid and he becomes private pay. That’s nice & straightforward.
But what can happen if not disclosed & Medicaid finds out, is he becomes ineligible for Medicaid and Medicaid clawbacks payments paid to vendors..... yeah, horrors! so their pissed off and end up billing him and turning it over to collections when he doesn’t pay. Stuff like this snowballs. If he has cognitive issues, his dpoa will need to deal with all this and it’s likely a hot mess. If he’s talking to you about buying stocks from house sale $ and he’s in Medicaid, he’s not understanding the eligibility rules for Medicaid.
If he’s on NY LTC Medicaid, so his living in a facility, his Medicaid $ tally could be quite a sum. Once property issues surface, he’ll likely get a notice from Medicaid that his eligibility is being suspended and he’ll need to file an appeal in 30/60 days with documentation as to why the suspension is wrong. The facility will get a copy of the Notice so they will expect someone to assume his looming debt or sign off financially responsible so he can continue to live there. If not he’ll likely gets a 30 day notice to leave from the NH. If he doesn’t prove why he’s eligible at his appeal hearing, he’s off Medicaid. He’ll need to find new 2ndary health insurance plus deal with whatever bills due from Medicaid clawback.
if you haven’t been tight with your Uncle until now, you imho need to seriously look at his finances and how he is on competency before you get yourself entangled in all this. There’s a poster few weeks back who finds herself fighting 45k NH debt as her dad didn’t do some of the things needed for his Medicaid application and she signed off responsibility paperwork not understanding just what that meant; dad died after 5 mos. at the Nh & with no assets; NH turned the bill (in her name) over to debt collectors. She’s fighting it, but it’s incredibly stressful for her. You want to avoid having this happen to you.
So which state is he a resident of?
If he applied for NY Medicaid, he needed to disclose that he owns an asset in another State. Did he do this?
I’ll bet a case of Prosecco that he didn’t, & if he didn’t, I’d suggest that you or whomever is his DPOA ASAP find a elder law atty who practices in both NY & NJ to deal with his application and whats penalties may be lurking for him. Medicaid is very much about providing services for those “at need” for residents of thier state. The NJ property should have gotten flagged in his NY eligibility review.... that it wasn’t it’s either that he actively did not disclose it (so penalties placed) or that he was too incompetent to understand the Medicaid application (so dpoa did not do thier job or he needs guardianship). Whichever it’s us, it’s not a DIY project. He needs an experienced elder law atty.
If he’s had an home he could have sold and used for care or for living costs, it’s going to surface when it sells & pose issues for his truly being “at need”. All property transfers get recorded and it will surface eventually to intrastate databases.
He cannot just sell that NJ home and place house sale $ into another type of asset for himself. NY Medicaid is for those “at need”. The house and it’s sale $ is an asset of his that must be disclosed in his Medicaid application and renewals.