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No, elder does not have to sell. An individual homeowner elder applying for LTC Medicaid (custodial care in a facility) by & large for most States can continue to keep home is their name. Medicaid allows for 1 car & a home and both need to be under whatever value State has set as max value. Usually based on last tax collector bill. Abt 650K.
LTC Medicaid has a copay or SOC aka share of cost required of almost all of elders monthly income (like SS) paid to the NH. That homeowner elder will have zero $ realistically to pay a penny on that property still titled in their name. They cannot transfer home or do anything that involves changes to title with no $ paid, as that is “gifting” for Medicaid and will place a transfer penalty & ineligibility onto elder’s application. Ditto for keeping a car.
if elder wants to keep home, then someone else will have to pay all property costs. Taxes, insurance, utilities, repairs, whatever will have to get paid by POA, potential heirs, Santa, whomever. But it won’t be elder in the NH on LTC Medicaid paying. And they need to pay for undetermined period of time. Could be 6 months or 6 years… it’s not like grandma has an expiration date. So could be quite a tidy sum.

Plus estate recovery / MERP will have to make an attempt to recoup costs paid. There are exemptions & exclusions to MERP. There are legal protections that go outside of recovery, like LE, Trusts, Lady Bird Deeds. But no matter what there will be costs that have to, HAVE TO, be paid on the place all the while they are alive & in a care facility and then after they die.

Before your elder blithely goes along this path, if you are the POA, or the erstwhile heir as per a will, I’d suggest that you take a hard look at past 2-3 years of property costs. So can you on your own 100&1% afford to do this and do this for possibly years? You good on risk? like if it doesn’t work out, you can walk away on the property if need be? If it doesn’t make sense to do it - for whatever reason - try to get the elder to sell the place before ever filing for LTC Medicaid.

Keeping the house & transferring title after elders death can be done. It will not be simple & may be couple of years or could be a decade. I’m on the same wavelength as JoAnn in that you have to be very objective on all this. If keeping the place for whatever reason works for you and you can afford what’s necessary at a minimum and can tolerate dealing with the place or find it amusing, go for it!

it’s somewhat like having 2nd home but without the protections of ownership. For most of us, having a 2nd home is flat not financially feasible. But if it is and you’re ok on risk, go for it!
If there are multiple siblings / potential heirs, this likely gets in the weeds as someone (or better yet their spouse) will have less than zero desire in spending or doing anything related to moms house. & you can’t make them & you cannot change moms will to do a Codicil to exclude them by this point in time.
Helpful Answer (14)
Reply to igloo572
MyNameIsTrouble Jun 1, 2023
Igloo knows! In general, the information Igloo posts is must know info. Great advice here.
9th time I have said "Welcome to Forum" today. So many new members! But the warm welcome remains as genuine as first I said it.

RIZHAO, a person is allowed to keep a home and a car and still apply for Medicaid coverage for LTC. Know, however, that this taxpayer program does what we typically call "clawback": A goofy way of saying that when an elder dies a lien is often placed on a home so that any sale will have funds directed to payback Medicaid taxpayer money expenditures.

It's complicated, so your best information will come from your state (each is different) regarding this practice, or from Medicaid information online; best of all consult an elder law attorney.

Wish you good luck. We have a forum member named Igloo who has spot on advice about these things; you can look up her post responses by typing her name up into the magnifying search glass next to your avatar. Bet you will fine helpful information there.
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Reply to AlvaDeer

I dont know the answer, others here do

But my opinion is if they are not required to sell home, they should be required,. unless a spouse or significant other still needs to live in it

I am always puzzled when people look into strategies to pay down assets, or whatever, so they can get freebies from the government while protecting assets.

If you have assets, those assets should be used to pay for care, until said assets are gone then I am all in favor of state stepping in.
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Reply to Karsten
catglass Jun 2, 2023
This type of mindset is why living in this country has become a nightmare. We pay some of the highest taxes in the world at the federal, state, and local levels. Yet, very few of us benefit from those expenditures at. all.

Yes some people can qualify for Medicaid, which is far better than Medicare. The rest of us--who have more than starvation wages or benefits--are left to fend for ourselves. Our medical system is collapsing. Just finding a doctor that accepts Medicare is a tremendous effort. Mental Health care? Ha!

We are, I think, one of the only nations that makes almost no provisions for adequate elder care. Heck, we can't provide medical care for anyone!

Most of our citizens read at a 7th grade level. Medical personnel are leaving the profession in droves due to frustration and exhaustion. Most doctors pay on their student loans for the rest of their lives.

Sure. Put the elderly in "nursing homes" starting at $5,000 per month. I'm sure they will get excellent care until they die of Covid or expire due to neglect. And when they do, take their home and all of their assets. We wouldn't want their spouse or children to get anything, would we? It's much better to provide for the Pharmaceutical Companies and Medical-Corporate Complex. They need it desperately.
Rizhao, welcome.
Medicaid is state specific. Regs vary from state to state.

In most states, Medicaid places a lien on a house which needs to be satisfied when the person who owns the home dies.

In truth, most folks who owns homes are best off selling their home to fund their care in old age.

Of course, if there is a spouse living at home, it is best to see an Elder Law attorney to allow the spouse to remain in the home.
Helpful Answer (6)
Reply to BarbBrooklyn

My moms house was already up for sale when she started Medicaid. It did not sell till after her death. There was an OP a while back that her State was requiring the house be sold if there was no surviving spouse.

If the person ur talking about needs Medicaid, then they have no money. Social Security and an pension they receive is required to help pay for their care. This means no money to upkeep the house. So who is going to pay the bills? In my situation, I wasn't. Medicaid will want to know about anyone living there. If a spouse they become the Community Spouse so remain in the home, allowed 1 car and get some or all of the monthly income to live on. A Caregiver family member living with the recipient in the recipent's home maybe able to stay if they can show they can upkeep the house. There are all kinds of rules and each state is different. I would sit down with Medicaid caseworker and see what your State laws are.

A lien on a house is not placed until the death of the recipient. Again, at that time who can live in the house is determined. The family or representative are responsible for selling the house. Medicaid is not in the reality business. I was just about to just leave Moms house to rot when it sold, primarily for the land. Medicaid would not have cared. It would have eventually went to Sheriffs sale for taxes and Medicaid would have gotten what was left of the proceeds after the tax lien was met.
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Reply to JoAnn29

One part that is missing in the first 5 responders is when ther person vacated the house for a nursing home is that the social security payment check figures into his care. He only gets a small allowance from it for personal needs. From that point, who pays taxes and maintenence of the house? If the house sits until the Medicaid clawback then there is another list for other liens. Think about the town and companies that will not get paid back. It falls back on us taxpayers and consumers.
It is best to sell the house if the person lives alone. Surely there may be a profit from which the Medicaid application will need to start again after spending. However if the person passes early and there are still funds left over then the beneficiaries may receive something.
Helpful Answer (3)
Reply to MACinCT

There are too many unknown factors in your question to appropriately answer the question (what age is the person, are they married/have a spouse, is the home deeded to both spouses and/or are any others named on the deed, is the individual blind, is the person already on Medicaid medical coverage and now applying for Medicaid "long term nursing home coverage" -- different than regular Medicaid for general medical coverage, what if any asset transfers of any type have happened in the past 5 years?)

It would be best to get with a licensed elder care attorney in your State. There may be ways to put some assets into specific types of irrevocable trusts (aka "special needs trust" -- perhaps if younger and blind -- or other structures) but there are a myriad of rules and limitations that MUST be met to qualify for any such structures. If married, there are "spousal impoverishment" rules that protect the spouse who will remain in the family home.

If there are no adults to stand up and act as the individual POA and medical agent to handle all the affairs, a State Guardian could be appointed and in such cases sometimes if there is no spouse, the State-appointed guardian (usually lawyers who handle this; elder care lawyers) they will ready the house to be sold and sell it. The proceeds then are spent down and other things are paid off (mortgage if one exists, outstanding expenses/utilities, expense to get the house ready for sale -- hauling away unusable stuff; painting, cleaning, and fixing things in the home, etc.). Other things of use/value -- car, furniture, other belongings -- can/will also be sold -- all assets are liquidated and the funds thereafter spent down to pay privately for long term nursing home. Those funds also pay the State Guardian a court approved fee for their work to handle all of this and these fees are ongoing as long as the person lives and there are things to handle: Medicaid or other paper work, taxes to file, the asset pool to manage, interacting with the nursing home staff or care team as needed, etc.

If the person passes before the funds are totally spend down; heirs may thereafter in inherit the residual. To close their estate (process through the legal steps, including the filing of their last taxes) this may take a full year or 18 months after the person passes. Meaning any heirs should not expect any payout of funds immediately.

If the person spends down all their assets -- they have little in the way of assets to spend down OR they lived a long time in the nursing home thereby consuming (spending down) the vast majority of their assets-- then Medicaid long term care coverage kicks in. In this later case, basically there are no assets to dispense to heirs after the person passes.
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Reply to Sohenc

No and yes. Once they die Medicaid can make a claim against the assets. That is where an estate lawyer come in to set up a trust to stop that from happening.
Helpful Answer (2)
Reply to Sample
Hothouseflower Jun 15, 2023
Unless the irrevocable trust was set up prior to the 5 year look back period, Medicaid will put a lien on the house and recoup what Medicaid paid upon the sale of the house after the person’s death.
Check with a local lawyer who specializes in elder law or family law to get the answer.
Helpful Answer (2)
Reply to Taarna

Medicaid places a lien on the house and will recoup the money spent upon the death of the parent.
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Reply to Hothouseflower

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