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I am in the process of advance planning. The NOLO website states that the state can recover medicaid funds my mother would receive by putting a lien on the house that we co-own or state it's rights if the house is in trust or in a will. In order to keep this from happening, I would need to show proof that for 2 years before her application to Medicaid that I have provided care that delayed her institutionalization. (And I would have to live in the house with her - which I do). Currently, our deed shows that we are tenants in common...something we did not pay attention to 5 years ago when we bought the house. We plan to change the deed to joint tenants with right of survivorship. But, I also want to have all the correct records I need in place to show Medicaid I am entitled to keep the house.

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Really you need to work with an experienced eider law attorney to plan this out.

I would NOT change house title / ownership till you have met with one.

Keep in mind that Medicaid is administered by the states under an overall federal guideline so each state can do its compliance differently as it is dependent on your state laws. More & more states are having MERP done by outside contractors who approach it much like a debt collector with tight time frames on compliance. For example, TX has outsourced to HMS & for the caregiver exemption you have to provide a letter on MD or SW on letterhead with their state registration # with the specific caregiving required for a specific timeframe. This could be easy but could be difficult (like mom lives another decade so getting an after death letter not simple as providers not around anymore).

Really seek legal in your state to see how best to approach medicaid planning
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I agree with igloo. Each state is allowed to implement Medicaid according to minimum federal guidelines. I was not aware that MERP is already being outsourced - knew it was inevitable; but not a pretty thought. There is a great deal of emphasis being placed on this discussion right now (Medicaid vs LTC) so whoever the outsourcing MERP vendor is - they will be looking at requirements harshly.

Please do not transfer property or change title prior to consulting with an attorney. Depending on your state - MERP has a Look Back period of UP TO 60 mos. for asset transfers. And transfers can have lasting impacts on future capital gains tax when/if you should sell etc., and could present as a double whammy if your MERP appeal is unsuccessful.

As igloo suggested; get a physician's DATED statement indicating that your parent required 24/7 care and that you are the primary caregiver. If you haven't already, save all medical records from SNF's, hospitals etc showing the parent was released to your care at time of release. If you did haven't saved copies - see if you can have copies sent to you.

Hopefully, things will work out for you so that you won't need to go the Medicaid route. Good luck.
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