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For example: When Medicaid application is approved, upon recipient's death...

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One thing to keep in mind is that although Medicaid is a joint federal & state program, each state administers their Medicaid programs uniquely. Due to this each state’s administrative code and laws coming into play on just what & how actions can happen on assets - like their home or if they have a life insurance that has estate as the beneficiary- of the Medicaid recipients both when alive & after they die

For those that go onto Medicaid after age 55, states are required now to have a defined system aka MERP or MERS to attempt recovery or a recoup of $ spent from the estate of the deceased. Some states do this internally by state workers usually within whatever is the Health& Human Services division or the states Atty Gen dept, so if your state moves glacially the notification and actions on the house could take till whenever. I know of someone in MS who is Executor for a SILs and it’s been 3 years and they cannot get a definite from the state employees on how to deal with.... they have stopped paying insurance & property taxes ($3500 annual), pulled the meters & it’s going blighted.

While other states have turned Recovery over to an outside contractor. The outside contractor approach is abt 1/3++ of the states, with HMS & PNG as the two biggest contractors in the US. Imho it’s similar to the debt collection playbook as to how done & the contractors get a % of the recovery. Contractor approach is much more on a time sensitive system with NOI (Notice of Intent) and a questionnaire sent out between 2 -4/6 mos after death. If no response to the NOI / questionnaire, the debt is assumed to be valid so lien could be placed. But family / heirs / Executor can via answers in the questionnaire file for exemptions, exclusions to what the contractor says is owed. And they can required validation of the debt, and in detail, just like you do to challenged any other debt collections. And then you can open probate and take it into that system.

But just how recovery can be done when it comes to property gets very much in the weeds as to your states laws. Some states are very pro-property rights (FL, TX) and a lien cannot be placed onto property while they are alive, so becomes an after death process & if family /heirs open probate then probate court & rules come into play. Other states allow the lien placed once on Medicaid. It’s is your states follows Tefra or is non-Tefra lines.

If an elder wants to keep their home by & large they can.
The rub will be that due to Medicaid copay requirements they will have no $ to pay any property costs. So it all falls to family or heirs to pay & from day 1 of Medicaid till whenever you get thru MERP or close probate. It becomes a wallet or purse issue and runs a risk of things not turning out like your expect. But if you want to honor your elders wishes and you can afford it and doing do makes sense for your situation and you kinda don’t mind risk, go for it.

I’v been on this forum for a while & what happens is family is all govmint not gonna take ma’s house but 6 mos later when insurance, taxes and blight Notice gets filed by county, family gets totally over the place and put it up for sale. If you do this imho you have to be in it for the l...o...n...g haul and have the purse & sense of humor to do it along with having a Estate atty who did a solid will & probate atty who understands MERP for your state. $$wise to me it’s like having a 2nd home but without ownership so runs risk. Most folks cannot afford a 2nd home. Really look at the costs before you tell your elder that you promise to always keep the old family homestead.
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One member said it took 3 yrs. By that time the house had been sold. The member hasn't come back to tell us what happen.

Me personally, it took 18 months but that was because I contacted Medicaid. Seems what should have happened was the paperwork goes to the NH. They are suppose to fill in the info of the person that represented Mom. Then Medicaid contacts me but this was not done.

Because I had Moms house for sale, after her death I requested information, from Moms caseworker, on what was owed so I knew how much I needed to get for the house. When it became evident that Moms house was not going to sell and a tax lean was on it but no Medicaid lean I contacted Medicaid. I told them if the house went to Sheriffs sale, they had no lean to recoup their money. I didn't want it coming back on me years later as the Executor. I was sent the paperwork, I filled it out, and have now received a letter saying a lean has been placed on the property.

I feel that when you know a person was on Medicaid and a lean does not show up on a title search, its up to the person selling the property to get the Medicaid info.
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lsugrad May 2019
So lien is after death.
Somehow my siblings convinced my Dad to pay off my Mother's mortgage, ($110,000). He's also paying for all yard/home maintenance, property taxes ($3000/yr), insurance ($300/mo), etc. My parents have been divorced since 1990, but over the years became friends. Dad is 84. All this being done to keep the property in the family. I'm not involved nor do i agree w this decision. This is Medicaid Fraud. I think an unoccupied home should be sold to pay for Mom's NH care. Thank you for your reply
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