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My mother is in a nursing home and in the Medicaid application process(ohio). She has one house and one vehicle. My mother wants to sell the car to her grandson. Does it have to be sold at blue book value?

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Your question, mom's noble intentions and the inevitable answer breaks my heart.
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KBB has three different values, retail, private sale and trade-in. I think you would be safe with the lowest value (trade-in) on the look up.
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If an asset is sold below book value to a related party it will be seen as gifting and will affect Medicaid eligibility. All the databases are available for review over 5 years and this would show up on state tax records.
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