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I went to an Eldercare lawyer who wanted to charge me exorbitant fees to rewrite my healthcare papers as well as rewrite my will which he had just done two years prior. He said they needed to be updated. I know he was just trying to get more money! So my question is now that I know it will be 5 years or less until I have to place my husband in a NH, what papers should I be saving? Do I have to save ALL receipts for 5 years? (seems impossible to keep it organized.) Or exactly what should I be saving and what should I not be spending money on in order to be eligible for Medicaid? I do know that I cannot give money gifts to my grandchildren, and I assume my children also. That is about all he could tell me besides I COULD spend money on house repairs and improvements. He said I could even take a vacation and it would be OK? I am so confused about this. Can anyone help me?

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Wam…- if you are planning on staying at the house and probably will be able to continue to live there then under Medicaid rules you would be considered the "community spouse".. Now "community" does NOT refer to community property but to living in the community. For community spouse, you are NOT expected to impoverish yourself. You are allowed and expected to keep assets to enable you to do just that. I'm not sure of the exact amount but most states have the community spouse assets at $ 112K plus the standard assets exemption for a house and a car. So you should speak to someone how best - if you have to spend down assets to get you to 112K - to deal with this.

For couples, the car(s) are often a problem. Medicaid for NH allows for 1 (one) car. Most couples have 2 cars. If you gift the car to a grandkid, that triggers a Medicaid penalty issue. What seems to work best is for couples to take both cars, trade them in and then get 1 newer and more dependable car and pay in full for it.
If you still have a mortgage, often what is good is to take any excess $ and pay off the mortgage entirely. Although Medicaid does allow for their monthly income to be diverted to pay for maintenance for the community spouse if need be, the maintenance (MMNA) is usually pitifully low. If it's a May-December marriage, often the community spouse has to go to court to get the MMNA increased (kinda like going to court to get more alimony).

What is kinda critically important for couples is that Medicaid does a "snapshot" day on their finances in which whatever their assets are is set on & fixed to that specific day. The day can be the date of application or the date of admission, you need to find out what's what for your state's Medicaid program. So whatever you do financially needs to clear through your bank accounts before the snapshot day. If you are paying off a mortgage, this can take time and you need to get this cleared out & cancelled before the snapshot day. Often for couples, they need to keep them at home a couple of months to get everything done financially so that the community spouse can retain as much assets and spend-down and clear through before the "snapshot". Good luck and try to stay calm & organized.
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What a Miller Trust does is provide a way for those with just too too much income to qualify for Medicaid.

OK how Miller works is:
each state sets the exact "income" that Medicaid allows. Like for Texas when I applied for my mom, the income ceiling was $ 2,094.00. Now my mom's monthly income was $ 1,800 a month so she was under so no Miller.

But say my mom's monthly income instead was $ 3,500.00 as dad was a railroad retiree. RR retirement is extraordinarily high. Each month guaranteed $ 3,500, is quite a lot for living @ home but not enough to private pay for a NH. Now mom qualifies in all other ways for Medicaid, except that income is $ 1,406.00 too high every month. A Miller Trust is done to divert her income to the trust so that the trust gets the excess income of $ 1,406.00 and then mom gets $ 2,094.00. Presto! Voila! Mom now qualifies for Medicaid. The excess $ each month into the trust is the property of the state and upon mom's death reverts to the state 100%. There is no MERP action on it as the trust beneficary is the state .

Now for Miller the income has to be from a guaranteed source of funding but most larger pay retirements do that anyways. Miller does need to be established by an elder law attorney so that it is flexible (for changes in income) and adaptable for your state laws on trusts, banking, etc. You have to have it legally set up Miller. It's really not a DIY project imho.

Regarding legal fees if you are able to get a consultation from an elder law attorney and the main paperwork done (DPOA, MPOA, will or codicil to an old will, an AD) for under 1K that is a pretty good price. For my mom, we did this ages ago with an estate attorney (as elder law was not the speciality it is now) and it was a % of the estate (kinda like what probate attorneys do) and it was much more. Also if your state allows a "Guardianship in case of Incapacity" ask about doing that too.
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It sounds very much like you need a different lawyer or maybe you really need an estate planner instead, if you already have the basic paperwork in order and just 2 years old. There are possibilities or getting certian kinds of annuities, there is something called a Miller trust I have heard of and don't know a lot about, and the current look-back is five years so changing ownerships of things if that would help anything would need to happen soon. I found a good outift I felt I could trust who gave me an extremely helpful consultation for $350.00 here in Little Rock, and I picked them primarily on how well their website demonstrated knowledge and expertise in Arkansas Medicaid. Same would apply to estate planning or long-term care insurance professionals, they may be out to sell you their products, which may be good, bad, or indifferent. Its kind of like going to a mechanic, some are great and some are great at ripping you off; if you know a little about cars you can probably avoid most of the latter, and there are sites that will help you find the best, most honest and helpful. Good for you for looking ahead!!
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I live in Maryland also, Charlotte Hall is State Run facility, the VA if he qualifies will place him in either Fort Howard or Perry Point both of which are VA and Federal facilities. A friends husband has been at Charlotte Hall a month, he is retired military and 100% VA disabled, CHVH, a State facility takes just about all his pension except for $90, and a portion goes to his wife to pay bills etc. If you stop at CHVH they will give you the paperwork for financial & it explains everything you would need to know about the financial end of placing him there
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You can use your money on yourselves. You can take a cruise, but if you take your whole family and pay their way, that might raise questions. Medicaid is trying to prevent people from hiding their assets or giving things away just to get into the government program. It is my understanding that if you have always been giving money to your church monthly, you may continue to do so. Suddenly giving huge amounts you haven't before would raise a red flag.

I agree with pstegman, call your state department of aging for specific help in your state.
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Thank you. Now I have a place to start! I will print out this page.
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Dump the lawyer, for $450 and hour he could at least give you the right answers. Glad to see you're working with the VA. They should be very helpful in getting him VA to pay for the care.
Assets are cash, money in checking or savings accounts, credit union accounts, stocks, savings bonds, trusts, annuities, or any other money that you have saved or invested. Assets also include things like boats, trailers, real estate, and life insurance policies or other expensive items you may own. Medicaid does not count as assets the home you live in or personal property (e.g., clothing, furnishings, car). So make a list of those assets with account numbers and dollar value. Call your MD office of the aging for help 1-800-243-3425.
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Live in MD.
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I love in Maryland! Bill will eventually be in Veteran's home in Charlotte Hall, MD.
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The definition of “asset transfer” is very broad. It includes outright gifts and charitable donations, sales of assets for less than fair market value (which constitute a transfer of the amount by which compensation received falls short of asset value), and forgiveness of debt. (source is forbes)
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What state are you in? I will look up the rules for you.
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He also said that church contributions were acceptable!
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Thank you pstegman. That lawyer told me that, but he didn't give me anything on paper to refer to. He never offered to start me on that process. He just wanted to redo the will and Healthcare papers for $450 an hour for however long it took his secretary to do that! No definitive price was given! I just didn't trust him.
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Lawyers charge $150-$350 per hour to talk to you. You should save bank statements and tax returns. You should avoid using cash. Use a debit card as much as possible. NO gifts, NO charitable contributions. Home improvements are OK, get a new roof if you need one. Vacation, I don't know, sounds frivolous to me. medicare.gov has lots of answers
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