Regarding the 5-year look-back when applying for Medicaid, what types of expenditures are questionable?

CharK60, first thing to do, stop co-mingling Mom's funds and purchases with yours. This can turn into a quagmire. Thankfully you saved receipts.

Medicaid will look at all the financials to see what Mom has been spending, and they may see "income" when in fact you had been reimbursing Mom whenever you used her debit card. The receipts will come in handy to prove otherwise.

Medicaid will question money used to purchase gifts or money given as gifts. I don't know what is the limit that Medicaid uses, each State has their own rules and regulations.

I would purchase things on my credit card for Mom, she had none. I would reimburse myself keeping all the receipts. On the statements that I gave Medicaid had the checks on them. No way they didn't know how Moms money was spent. I think what they look for is large amounts. If it was to upgrade her home, no big deal but giving you money to upgrade your home maybe questioned. Birthday gifts within reason and tithing should be OK. From now on, if in spend down, her money will have to only be used on her. No gifts, no tithing just for her her personally. No taxes no utilities.

An Elder Law Attorney in your state can help you further improve your bookkeeping system, and show you how to justify all of the expenses needed to provide good care, including payment for your work.

The specific advice you obtain from an Attorney who understands the application process will benefit you and your family in the future, and provide peace of mind now.

Thanks for your response. She won’t be in “spend down” until they make her sell her house. That is her only asset and it’s paid off. Her income is good but not in excess.
We live very frugally. We don’t even have a vehicle but that is taking its toll on me. I do as many repairs as I can manage but that’s not saying much as I’m not strong enough to make the work last.
Its a vicious cycle and now I’m worried about her long term care when she’s not in that bad of shape. We’re getting by. What more can we ask for?

Charlotte

When I did the paperwork for Massachusetts I was told to document any expenditures over $1,000. I reviewed my parents credit card statements and bank records for anything over $1,000.

You may want to step back and look at the bigger picture...... By & large Medicaid does not require an applicant to sell her home. If she wants to sell it she can, but the $ from the sale has to go to a “spend down” for her care or her needs and get to no more than 2k in non exempt assets for an individuals LTC Medicaid for most states.

House can remain an exempt asset for her lifetime. BUT upon death reverts to an asset of her Estate, which is subject to Medicaids Estate Recovery policy (MERP). However MERP has all sorts of exemptions, exclusions.

The crux if they want to keep their home but go into LTC NH Medicaid is that Medicaid requires a copay or SOC (share of cost) of almost all her monthly income to be paid to the facility each month. So mom still has her home in her name with hopefully a homestead exemption, but has no real $ to pay any property costs. You or other family will need to pay all property costs- taxes, insurance, upkeep - from day 1 of medicaid till beyond death as you or whomever her Executor will need to deal with MERP & possibly probate as well.

If you live with mom and her income & assets are currently being needed to keep the household afloat, and you totally on your own cannot pay the required costs of the house, having her go into a NH & onto Medicaid will be a crisis situation for you.

Is this the situation?

I am not sure when you started with the "5 year look back' but I am proud of you that you have enough sense to start it. Keep all receipts, But Checks with Memos on them are also very helpful.
As long as you are not taking huge lumps out, I would not worry so much. nd if it is getting close to the time when your Loved one has to go in, Time it where there are No huge gifts that are given out.

It shouldn't be too difficult to get a credit card in mom's name. She has a bank and income, and the card doesn't need to have a high limit. It may be a bit of a bother, but do use that card for everything for her. When the bill comes in, then look at the expenditures and make a note on the bill as to what it was for: clothes, food, shoes, Dr. visit, etc.

An Elder Care attorney will be an expense BUT it is very worthwhile as you will now have advice from a legal expert in the area of income, expenses, and care for the elderly.

If you want to track expenses for her, just buy a simple spiral notebook and set it up like a checkbook with date, item, expenditure, for both checking and credit card. You will have plenty of space to write in explanations. Do a page a month and attach the specific receipt. If you are ever asked about expenses you will be able to find it easily.

Hi, a lot of information you have to dig for. with MERP every state is different but in texas if you are single, and have lived in same home for atleast one year or are disabled yourself or you have put house into living estate all should be fine! always spend a few dollars and find a good elder attorney!!! God Bless!

As far as birthday gifts and Christmas gifts...for me I was told that I could not "buy" a gift for myself and charge it to my Husband even if it was something that he actually would have done.
(slightly different I was his Guardian" and all purchases had to be "approved" by the court and I was told that 2 items I had purchased I had to repay the money into his account)
So I would be cautious about any gifts for any member of the family. Just know that they may be looked at and you may have to repay the money.
An elder Law attorney would be your best and safest bet in this quagmire.

Your mother, the Medicaid applicant, will be allowed to own $2,000 in countable assets. You may want to hire an elder law attorney to ensure that the 5 year look back doesn"t have any glitches, especially since you've already comingled monies.

I was lucky. My mother’s assets were sufficient for her nursing home care. I was very careful to use her funds strictly for her needs. I was also very careful because I knew that my brother was the other heir. I never wanted him to think that I was “helping myself” to her assets. I paid for all of her expenses by check. Eventually, I did get a debit card for her account because sometimes I had to order things on-line or even pay cash for things she needed. This included buying new clothes for her. She was in a nursing home. But, she was always well dressed in her life and I wanted to continue that. Plus it always cheered her up to have new outfits. In addition, I did not want her to look shabby in case someone came to visit her - including family members. I made sure she always had what she needed. However, I was careful NOT TO COMINGLE OUR ASSETS. Her accounts were with one bank. Mine were in s separate bank. There were zero transfers of assets from her accounts to mine. There were times when I paid for things out of my pocket. I tried to keep that to a minimum. My advice to you is to keep her income and expenses separate from yours as much as you possibly can.

I just went through this with my father and i only had to provide 8 months of clean bank statements. You cannot have any of that transferring from account to account or writing checks to one another. They will question this. For Medicaid, you cannot contribute to her monies or what i mean is add any money to her bank account, or give her money by cash, gift cards or anything.
Make sure her account is very clean and just shows her Social Security and her actual bills.
If she lives with you, then you have to figure out how she contributes to the household bills by percentage.
If you need more information please email me @ easawyer1969@gmail.com

Has anyone ever herd of Community Medicaid?