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Vegas - aren't guidelines for Medicaid for LTC/NH/skilled nursing care different than that for those on general Medicaid like on CHIP? If that is the case, then what Medicaid program Lwatts Dad is on will make a difference as to whether or not the tax refund is income. I was assuming - perhaps wrongly - that Dad was in a NH or an AL diversion program & on Medicaid……

For example, MERP - the Medicaid Estate Recovery Program in which Medicaid can by claim or lien attached the Medicaid recipient's home after their death - is only for those on NH Medicaid or on a elderly diversion program from your state's NH Medicaid funding. So young family getting Medicaid or Medicaid related benefits like through WIC or SNAP or TANF will never have any MERP placed on their home or on them. Only the elderly Medicaid have a MERP action.

The Earned Income Tax Credit is if you worked in the tax year, and didn't make much money. It's based on the money you get (income) and the # of children in your home. Most elderly aren't going to qualify for this type of tax credit. Really Lwatts should speak with their parent's caseworker so that there is no suspension from Medicaid later on that could be a problem.
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I'm pretty sure about this, but I think the tax refund is exempt income as far as the Medicaid is concerned. It's just a refund of some money that was already accounted for in the income eligibility calculations. I think that it is probably going to be exempt as an asset for up to a year under the law. It wouldn't hurt to keep track of how you spend it over the next year. Many families on Food Stamps and Medicaid get thousands of dollars back in tax refunds (primarily due to the refundable Earned Income Tax Credit). It's exempt as income and as an asset for a year. Many families count on this to get them by through the year until the next refund.
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It will depend on the amount of the refund from IRS.

Under Medicaid they are allowed to have a small amount of assets plus their monthly income (under whatever your state has set for the income ceiling). Like right now income limit for NH Medicaid in TX is $ 2,163.00 per month and asset maximum is $ 2,000.00. (My mom is in a NH in TX and on Medicaid.)

So find out what the asset maximum is and how much your Dad will be over the limit. Then before you contact the Medicaid office, I would look to see if there is anything that Dad needs that would be a good spend-down of the refund. Like using the refund to do a prepaid No Cash Value burial policy OR buying a new hearing aid or speciality walker. All this so you can figure out a way to use the money to get something for Dad rather than have to have him removed from Medicaid and then he has to reapply; or just private pay to the NH (if he is in a NH). If you go this route, you kinda have to have whatever paid for and moved out of Dad's bank account within the month, so that he is again impoverished by Medicaid for the next month, otherwise he's going to be ruled ineligible for Medicaid for another month.

You do have to report it to Dad's Medicaid caseworker as anything IRS is tied to Dad's SS # and will show up…..eventually. But imho you want to present a sound plan to the caseworker for spending the $$ that will work for Medicaid. Good luck
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