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My mom is on hospice care and the social worker mentioned a while back about getting it for my mom. My mom has Medicare and a supplemental insurance and lives at home with me. I have a friend whose mother died a little over a year ago and Medicaid is making them pay back money spent on his mom's care. I don't want to get in a situation like that.

There are a lot of misconceptions about medicaid that are outdated. A lot has changed in medicaid since ACA. It is not only for the poor. With expanded medicaid, even if you are a billionaire you can qualify for medicaid. Granted you would have to be world's worse manager of money if you were a billionaire and still managed to qualify. Expanded medicaid is solely based on income. So you can have a billion dollars in your 0% interest rate savings account and still qualify for it. There is no recovery for expanded medicaid until you get benefits when you are over 55 AND it's along the lines of something like a nursing home. So as another poster said, MERP is really only for certain things such as nursing home long term care. If you are on medicaid using it as health insurance and don't end up in something like a nursing home, there is no recovery depending on your state. My state explicitly says that if it's not long term care, then there is no recovery.

https://www.medicaid.gov/medicaid/eligibility/estate-recovery/index.html
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igloo572 Mar 6, 2019
Need - the link you posted reads....
Quote: “State medicaid programs.... For individuals age 55 or older, states are required to seek recovery of payments from the individuals estate for nursing facility services, home and community based services, and related hospital and prescription drug services.”

The Feds require states have a system to attempt a recovery for those categories.

Estate Recovery aka MERP came into law in Bush 2005 era DRA. The planning done 2000-2005. Those were the go-go years of housing boom. Homes were cash ATMs. Old POS decades of delayed maintenance houses were selling for huge sums.... enough $ in theory for NH costs for a couple of years and $ left for heirs. MERP was going to be a plus for everybody... the states & heirs. Everybody got a payout, happiness all around! Not the reality now. Elders who want to keep their old POS decades of delayed maintenance home can and can still be eligible for LTC Medicaid. But now, imo, families spending a penny on it beyond whatever required (taxes, insurance, maintenance) for properties safety is probably of no benefit for family or heirs to ever do if there is little probability of ever selling it way way above Medicaid costs or having a very low value property.

in my experience it’s the property taxes & insurance that’s the biggest reasons why family walk away from dealing with parents home. When alive, the homestead exemption exists, even if their in a NH as they do a “right to return”. But once dead, property taxes skyrocket as no exemptions. No more homeowners either, it’s pricey vacant property insurance, which is basically a limited fire policy. Personally I think, what MERP means is actually finally getting true awareness by baby boomers both for dealing with our parents and our own future planning. Families and heirs are gonna take a hard look on walking away on dealing with their parents homes. Like what folks did on letting homes go into foreclosures. You run the #s on the costs to keep maw’s place & if there's no benefit then Property taxes don’t get paid, house goes blighted, etc. and it’s eventually the city / county or parishes problem but with a Medicaid lien atop it. Unless there’s a special circumstance, exemption or exclusions, family can opt to walk away from it.

Similar to if your parent does a Reverse Mortgage. There’s likely no $ benefit ever to heirs with RMs. Take the family photos and certified mail RM the keys. It’s their problem to work through.
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Recovery or recoup aka MERP can be done by Medicaid for any Medicaid program for those over 55. Community based programs, mental health programs or LTC in a NH or MC. If Medicaid pays the states are required to attempt a recovery of costs paid from assets of their estate. But there’s all sorts of exemption, exclusions as well as cost benefit determination as to whether it will happen. Plus how it happens - like if a lien can be placed on property or if it needs to be a claim against the estate - really is specific to your states laws on property and probate.

Community based medicaid may have pretty low actual costs as their still living at home so NO daily room & board fees like being in a NH racks up and it’s only paying whatever % MediCARE or her secondary insurance doesn’t pay - like for flu or pneumonia shots or twice a week participation at a PACE or other senior day care center.

Hospice is totally a MediCARE benefit. All hospice costs - staff that comes in, equipment rented and brought in, specialized nutritionals - should be covered by Medicare except maybe for a portion of drugs costs. MediCARE has an “extra help” benefit for those who cannot pay their drugs costs. Extra help seems to be a maze to get through. If your mom has a lot of meds that are very expensive, hospice may be encouraging Medicaid as it’s simpler billing and payment for them than dealing with Medicare “extra help” or her supplemental health insurance for her medications.
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Teresa914 Mar 2, 2019
The social worker hasn't mentioned it in awhile so maybe we aren't getting it. I really don't think we need it anyway.
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My mom has Medicare and Tricare. We're not having any problems paying anything. I was just concerned that if she went on Medicaid community that we'd have to pay that back after she passes. I have no idea what my friend paid for his mom's care. I just know that Medicaid is trying to take their property.
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Are you having trouble paying her supplimental? If not, then you don't need Medicaid. Medicare pays for her Hospice care so no worries there.

First, you only get Medicaid if you can't afford insurance or LTC. You are practically poor. If you have a home you are allowed to keep that. At time of passing, Medicaid will put a lean on the house, at time of sale, the lean will need to be satisfied. Hopefully your friend is not paying Medicaid out of their own pocket. If the parent has no money, no house, then Medicaid can't recoup the money. If your friend is paying out of pocket, then they need to prove there is no money left in parents estate.
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Yes, my friend's mother was in a nursing home for awhile, I think before I met them. They took her out and had her living with them until she died.
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Teresa;

Was your friend's mother in a nursing home? If so, she was getting "NH Medicaid"; for NH Medicaid there is a "recovery process" whereby the costs for the NH are charged back to the estate after the death of the person who was in the NH. Often what happens is that the person has a home, which doesn't need to be sold when they go into the NH, but after they die, if they have no spouse living in that home, the house is sold and the proceeds go to pay back Medicaid. ( I assume you DON'T mean that the friend is paying Medicaid with their own money).

You can check, but I don't believe that there is the same sort of "recovery process" for community Medicaid (where the person is NOT in a Nursing Home). Each state runs their own program, so you need to check.

Hope this helps a bit.
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