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Also her pensions as well as putting a lien on her home which I have also resided in for 5 years. I have been my Mother's caregiver for 5 years. Medicaid will be involved. I reside in Philadelphia, PA.

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Naughton, you can determine the state rules by seeing the following from a search for PA medicaid eligibility rules. Also search for community spouse if your dad is still alive.
http://www.dhs.pa.gov/citizens/healthcaremedicalassistance/medicalassistancegeneraleligibilityrequirements/
You can call the dept of aging to ask about your status and the value of the house.
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In some states, the home is maintained for the adult child who was the caregiver living in the home for at least the 2 years prior to application.

It would mean, they have to wait till you vacate the home (choosing to move or death).

A lien is nothing. Means nothing as long as you remain in the home.

If there is a mortgage on the home....then I would think twice about paying the mortgage while Medicaid is sitting on the lien to take it later. Unless the mortgage, taxes, maintenance is a lot less than renting...I would not pay off a mortgage for some agency to reap the benefit.
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TNaughton - Medicaid requires a co-pay or SOC (share of cost) to be done by the NH/SNF resident. The copay would be moms monthy income LESS whatever her state has for a personal needs allowance. Like for my mom, PNA was $60.00. PNA is for beauty or barber shop and some toiletrires or clothing replacement. If mom has a phone or cable, the PNA could be magically be the exact amount of the PNA. Once on medicaid in a facility, all mom will have is PNA $.

Now most states Medicaid program allow mom to continue to own & keep her home as an exempt asset. But mom will realistically have no $ to ever pay on any house costs once on Medicaid due to the SOC requirement. Family will need to pay all costs..... Property taxes, insurance, utilities, repairs, etc.

You should be able to get a caregiver exemption if you provided full time care and can provide either MD or SW documentation that care was needed. If your state allows for the exemption & transfer to be done in tandem with moms application, that may be the better way to approach this. If not, then you will need to do after death and deal with the caregiver exemption then along with documentation and then transfer however mom has the house as per her will. If there are multiple heirs for the house, I'm pretty sure that each heir will need to each have their own exemption in order for estate recovery otherwise their share is subject to estate recovery.

If moms income was the $ that was keeping the household afloat, so that on your own you cannot afford the house, your choices are limited. Often family continue to keep mom at home and try to get a community based Medicaid program where caregivers come several hours a week or get mom onto a PACE type of day program during the week. With family providing care all other times. Either would not have the total copay of her income like SNF medicaid would.

If you move mom back home, please please speak with an atty to get a personal care agreement so that mom pays you market rate for caregiving. All done above board with taxes paid. Save the $ so that you can hopefully afford the house after moms gone.

About the lien, all states Medicaid program are required to attempt a recovery of the $ Medicaid paid for her care from her estate after death. It's referred to as MERP & just how done very interdependent on your states laws. Some allow for a lein to be placed while they are alive; while others it becomes a lein placed after they die or a could be a claim against the estate if probate done. MERP has all sorts of exemptions and exclusions of which the caregiver exemption is just one. To me, if you can get it done now it's better as things change over time and perhaps trying to get a letter from moms old MD years & years from now may not be feasible.
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Medicaid does sometimes let a relative continue to live in the house for their lifetime but will then claim it to pay for Mom's expenses. In the meantime they will take all ofMom's SS & pensions to pay for her care.She will be allowed a small personal allowance to cover personal needs but it is very small.
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Sounds like crossed wires - it'll be Medicaid putting a lien on the house, won't it? Presumably the SNF has been attempting to explain the application process.

T Naughton, is this going to leave you up a gum tree when it comes to your own circumstances going forward? I'm not sure whom you can consult for advice on that - others will, though.
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Who is SNF? What right do they have to put a loan on your mom's house? That does not sound legal to me.
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I don't know about PA but in NC, if you are caregiver, the home can be given to you. That way you avoid having it included as an asset when it comes to Medicaid. But they will definitely use her SS benefits and pension before they contribute anything. Consult an Eldercare lawyer who can help you make the right decisions regarding Medicaid. I met with one for free who gave me great advice.
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