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We kept my Mom's chevy astro van in her name, worth about 1400. Mom is on medicaid. Can I trade the van we kept in her name for a more useful vehicle. I would keep it at about the same value, but we really don't need a seven passenger van to conduct her business. Do we need to tell medicaid, or can we just trade the vehicle, register the new one in her name, and save the paperwork should they ask about it?

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According to Gabriel Heiser, yes, the home and car are exempt during your lifetime UNLESS you sell them or transfer title during your lifetime. Changing the title to joint ownership would trigger a gift penalty. PLEASE don't do it!!
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Here is the link to the article:https://www.agingcare.com/articles/medicaid-repayment-of-nursing-home-estate-recovery-150497.htm

Again, I do not think that a car is considered an "asset" that would effect eligibility for Medicaid. Could be a state by state thing as well, as the article suggests. Here in MD, a parent can gift a car to a child without tax issues or other implications involved. If the person who asked the question is an active caregiver to her mom, and continues to help, then the changing of type of car for her to use is still continuation of a type of care for her. Least, that is how I see it.
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"For example, you can title an automobile in joint names with a child. So the car would be titled as "Mary Smith and John Smith, JTWROS." John is Mary's son, and upon Mary's death, sole title to the car passes automatically to him outside of probate. "JTWROS" stands for "joint tenants with right of survivorship." (Be sure to check your state's motor vehicle titling rules to be sure this will work in your state!) Since one car of any value is exempt during Mary's lifetime, it's protected during her life and escapes estate recovery on her death."

It's taken from an article on this website regarding medicaid and nursing homes.
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NO you cannot trade it, but you can buy it from mom for fair market value and then she has to use that money for her care. She reports the income to Medicaid. So to keep her under the $2000 limit, pay her monthly, by a written agreement. For example, we sold grandma's car to her grandchild for $9000 and take payments of $200 per month for 45 months, and keep careful records.
Ask your grandma's social worker how this would affect her benefits.
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Abq - your mom or whomever is her DPOA needs to clearly ask her Medicaid caseworker as to IF a change of exempt assets requires a review of Medicaid eligibility. For Medicaid, a homestead & 1car are exempt assets by & large. But if there is a gain between the BBV of the cars, it could take mom over her allowable assets or income for that month so she could become ineligible.

Now if they are on NH medicaid, they are required to do a "SOC" or copay of all their monthly income less a small personal needs allowance (ranges from $35-90 a month), which really is just enough to pay for beauty shop, or phone or cable or some clothing. Because of this, all expenses related to the house or car, will need to be paid by family for either the rest of moms lifetime & through probate OR if sold before death, the $ used on their care. The rules on assets & income are very precise. I don't know if all states do this, but for my NH mom in TX, there is an annual renewal that must be done and you have to report or update with documentation all their assets & income and report any changes to continue eligibility.

Francis, gifting a car or a house is not allowed. Downsizing or new property purchase is ok for a community spouse but if there is a gain, it could possibly make the medicaid spouse ineligible. For other family, they could buy at FMV with $ paid to Medicaid receipent. But if it takes them over the allowed income & assets, no more Medicaid, till properly spent down.

Tax assessor tracks all sales & ownership on the local level & dovetails all to state. Eventually it will surface and a transfer penalty issued. Which means Medicaid will not pay till penalty period (which set by days) is over. During the penalty period, all Nh or other costs which would have been paid by Medicaid will be private pay. You the "new" owner could face reporting penalty as well.

Gifting bad idea once on medicaid or 5 years prior.
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I don't think that cars are considered "assets", and if you are her son/daughter, I think, you can have the car "gifted" into your name if she has a clear title. Then you can trade it from there.
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