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My mom and I (she would be the community spouse) have started the process of the Medicaid paperwork. We met with a financial person at the NH who seems to handle this and she gave us the forms. This is ridiculous... people running for office drag their feet on showing tax returns but to get assistance paying for your actual health... you need five years of tax returns?!?!


Anyway, there will be a spend down period. Someone said my mom needs an accountant to avoid taxes if she takes money from his retirement account to pay the NH during spend down. My dad still hasn't given her POA.


So... any advice? Do we need accounts, lawyers, just the financial person at the NH... just patience and perseverance?

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I would not take what a NH employee tells you. Medicaid is a case by case thing. There is no way that a NH knows it all. There have been posters that have gone to two Lawyers for the elderly and get two different answers.

This is just and overview, like I said each case is separate. When a Community Spouse is involved, the assets are split. The CS gets the home and a car. This all depends on the Market Value of the house and assets. The Spouse will be able to pay their bills. One couple I know had 60k in the bank. That was split in half. His half having to be spent down. Not sure how the SSs and pensions were split. The wife retained the home and their car. She never seemed to be having any problems.

Five yrs worth of statements...I was lucky here, my Mom kept her statements for this long. The caseworker only pulled 4 a year out to look over. They are looking for any large amounts being taken out. You will need to know what were they for. As long as it was for the applicant, like a new roof, no problem. If a large amount was given to a child, lets say, that will have to be paid back or a penalty will be made.

You can make pre funeral arrangements for an applicant. If an insurance policy is owned by an employer or has no cash value, Medicaid won't touch them. Those having cash value will need to be cashed in.

My Moms application went smoothly because she really didn't have much. I was able to give Medicaid all the info they needed in a timely manner. Do as much as YOU can. Do not rely on the lawyer. In NJ you have 90 days to get everything together, spend down and get Dad in a NH. If not done, you have to reapply.

Just giving you an overview so u have an idea how it all will work.
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feelinglost8 Oct 29, 2019
Thanks! That was a really helpful overview! Figures that they randomly pull statements to look at, but make you produce it all.

Can I ask about pre-planning funerals and the life insurance? Does it mean, for funerals, that my mom should pre-plan hers now too? Is that allowed? And my dad doesn't actually have life insurance (which is a story in itself) but my mom does so would she report that?

And the lawyer/someone from the lawyer's office did say to do what we can to get everything in order and filled out and then they should be able to help with the rest.
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It’s great that you all are meeting with an attorney. Hopefully dad hasn’t actually filed an application as you want to wait to do that after atty has reviewed thier overall situation. Community spouse (CS) & NH spouse stuff is flat just complex & has to be done just right for however Medicaid reviews LTC applications for your state. Really not something you want an employee of the NH making decisions on ever...

If mom is youngish &/or relatively health spouse & likely to outlive dad for years, if not decades, planning her options on financials will be super important. Try to get a handle of what the housing / living / her health care costs are for last couple of years. As mom can file for a waiver of dad’s monthly income to go to her instead of his having to have almost all his $ paid to the NH. It’s done thru CSRA or MMNA- Community spouse resource allowance or monthly maintenance needs allowance- think of it as kinda like old school alimony. There have been dpoa who have posted on this site & had their moms do this; 1 had her mom getting almost all dads income but about $100 as she continued to live in her home, had herself small SS income and had significant medical & RX costs. The states each set a max on CSRA / MMNA but the atty should know just what for PA & how her costs get evaluated.

Mom does not herself need to become impoverished for dad to be eligible. Only dad has to meet the “at need” financial & medical standards for LTC Medicaid.
Make this your mantra. Good luck.
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Reply to igloo572
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Thanks all for your advice! We have just made an appointment with an elder care attorney who assured us that everyone calls in a panic and that they can help with everything. Feeling much less overwhelmed now, thanks to the attorney's office and all of you.
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Tothill Oct 29, 2019
Glad you will be getting professional advice.
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You need an NAELA certified attorney because this about Medicaid and 2 spouses. Without POA, how does your mom expect to pull money out of your dads retirement? There will Most likely be no way to avoid paying taxes plus withdrawal penalties if the money is taken out during the wrong time or exceeds the annual amount allowed to be withdrawn in a lump sump. If your dad won’t pull out the money himself, how does your mom plan to get the money?
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Reply to worriedinCali
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Are both your parents applying for Medicaid? Or just your mom? I think that spending an hour or 2 with a professional will be worth the money spent. Not sure but probably a tax attorney that is experienced with Medicaid issues. Your mom's case doesn't sound too complex, but I wouldn't bank on the advice of the NH financial person, unless they happen to be an actual tax attorney. Just make sure that in the interim, as this is ongoing, to document everything and keep receipts, etc. The govt will scrutinize all of it. It is a shame that your dad has no PoA...has anyone ever explained to him what it means to become a ward of the county through guardianship? Blessings!
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Reply to Geaton777
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You do need professional advice on how to proceed. I am not in the US, but here in Canada, if you take money out of your RRSP (retirement savings) it is taxable. It does not matter why it is coming out of the account.

From what I have read on this forum, each State has different rules, so at best you will get general advice here.

If Dad is still deemed mentally competent, he should be assigning POA, Healthcare Proxie etc asap. Mum should get her paperwork in order too asap. If Dad is not deemed competent, then it gets more complicated. I would be getting an Lawyer who is versed in Medicaid, and estate planning to prepare the documents.

It has been mentioned here many times that prepaying for a funeral is an eligible expense under the spend down. Perhaps now is the time for both your parents to do this too?
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