Yes, there will be multiple problems with Medicaid.
Now Uncle needs to understand how Medicaid works. Although it is a joint federal & state program, Medicaid is administered or managed uniquely by each state. So how it runs in NY will be somewhat different than for PA. Medicaid since it is state run, requires that the recipient is a legal resident of the state (except in very unusual circumstances like due to a natural disaster). So Uncle will have to become a legal resident of PA. There will a lots of things needed to make this happen too (like have a PA address, bank account, have his SS and other retirement statements showing PA residency, perhaps PA tax filings, etc). As Medicaid is run by each state, the state could require several months or a year of full-time residency in the new state before they will qualify for Medicaid.
Yes, there will be an issue with the property. Under Medicaid rules, by & large, they can have their homestead as an exempt asset for Medicaid for the rest of their lifetime. His home in NY is getting that asset exemption right now for his NY Medicaid status. But once he moves to PA, the property becomes non-exempt as it is in another state so cannot be his homestead anymore. He will need to sell it and fully use the proceeds from the sale as a spend-down before PA Medicaid will pay a penny for his care.
The property is already noted in the NY Medicaid system. It would be safe to assume that all his NY Medicaid details will be provided to any inquiry by PA Medicaid. PA will find out about the property. And as all real property records are recorded by the local tax assessor / courthouse, it will be dovetailed to the state records and the exact amount of the sale or date of the gift recorded. If he gifts it, then usually the gifting amount will be whatever was the last tax assessor value on the property.
The amount of the sale or assessor value will be a "transfer penalty" for Medicaid. In very simplified example, if house $ 120,000.00 assessor value, then will have an 120K transfer penalty by Medicaid before Medicaid will pay for his care. Transfer penalties are day based and have a specific formula based on each states daily room & board reimbursement rate & when transfer / application done. Like for TX Medicaid, the r&b is about $ 145.00 a day, so 120K gifting would mean a transfer penalty of 827 days that he will be ineligible for Medicaid to pay for his stay @ the NH. Now he is qualified for Medicaid as he is now impoverished BUT he is ineligible for Medicaid payment to the NH due to the penalty. And that is a really, really, really long time to have to private pay for care. NH will get the transfer penalty letter too, and will fully expect someone to pay for his stay. There will be something in the admissions contract regarding this. Most of the time family will move them back to live with them for the penalty period as family just cannot private pay for the stay. So think hard about all this before he does something that will totally come back to bite you on the butt if you are the family who all this will fall too.
have Uncle spend some of his money and go with him to see an elder lawyer to find out how to best structure the move to another state. Good luck.
Now Uncle needs to understand how Medicaid works. Although it is a joint federal & state program, Medicaid is administered or managed uniquely by each state. So how it runs in NY will be somewhat different than for PA. Medicaid since it is state run, requires that the recipient is a legal resident of the state (except in very unusual circumstances like due to a natural disaster). So Uncle will have to become a legal resident of PA. There will a lots of things needed to make this happen too (like have a PA address, bank account, have his SS and other retirement statements showing PA residency, perhaps PA tax filings, etc). As Medicaid is run by each state, the state could require several months or a year of full-time residency in the new state before they will qualify for Medicaid.
Yes, there will be an issue with the property. Under Medicaid rules, by & large, they can have their homestead as an exempt asset for Medicaid for the rest of their lifetime. His home in NY is getting that asset exemption right now for his NY Medicaid status. But once he moves to PA, the property becomes non-exempt as it is in another state so cannot be his homestead anymore. He will need to sell it and fully use the proceeds from the sale as a spend-down before PA Medicaid will pay a penny for his care.
The property is already noted in the NY Medicaid system. It would be safe to assume that all his NY Medicaid details will be provided to any inquiry by PA Medicaid. PA will find out about the property. And as all real property records are recorded by the local tax assessor / courthouse, it will be dovetailed to the state records and the exact amount of the sale or date of the gift recorded. If he gifts it, then usually the gifting amount will be whatever was the last tax assessor value on the property.
The amount of the sale or assessor value will be a "transfer penalty" for Medicaid. In very simplified example, if house $ 120,000.00 assessor value, then will have an 120K transfer penalty by Medicaid before Medicaid will pay for his care. Transfer penalties are day based and have a specific formula based on each states daily room & board reimbursement rate & when transfer / application done. Like for TX Medicaid, the r&b is about $ 145.00 a day, so 120K gifting would mean a transfer penalty of 827 days that he will be ineligible for Medicaid to pay for his stay @ the NH. Now he is qualified for Medicaid as he is now impoverished BUT he is ineligible for Medicaid payment to the NH due to the penalty. And that is a really, really, really long time to have to private pay for care. NH will get the transfer penalty letter too, and will fully expect someone to pay for his stay. There will be something in the admissions contract regarding this. Most of the time family will move them back to live with them for the penalty period as family just cannot private pay for the stay. So think hard about all this before he does something that will totally come back to bite you on the butt if you are the family who all this will fall too.
have Uncle spend some of his money and go with him to see an elder lawyer to find out how to best structure the move to another state. Good luck.