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Imo there will be consequences, but they will not surface immediately. And that, Jlo, will be the problem.....

Theres a whole host of Medicaid programs & eligibility varies by state.
Medicaid is HUGE, like from those happy teeth vans that go to elementary schools via CHIP, to breast pumps via WIC, to LTC in a NH.

But imo you really, really, need to keep in mind that they all must be within the overall federal guidelines as how administered. Medicaid is a joint federal & state program. And since Bush era DRA 2005 (deficit reduction act) was signed into federal law, all states now must have an Estate Recovery system (MERP or MERS) to attempt a recovery or recoup of $ spent by Medicaid on those who go onto Medicaid programs after age 55.

My understanding is that due to DRA, Estate Recovery not limited to LTC NH type of Medicaid, unless your state has explicitly removed recovery due to conflicts in preexisting state laws. (Like property in Lady Bird deed in those states that do them, or property in lien resistent testamentary trust ). Estate recovery can be attempted on costs paid for any type of continuous or sequential Medicaid, like mental health services or in-home health care or even a PACE program, if your state allows for that degree of recovery action.

DRA passed in 2005 and each state has eventually placed it into its Medicaid administration & state administrative code by now. So a property sold or transferred by someone on Medicaid after age 55 can have attempted recovery on the value of the asset. Your mom’s still alive, so it’s not MERP that will be an issue but rather her continued eligibility for Medicaid.

What I’m guessing will happen for community based Medicaid, is 2 things, & stick with me on this cause it’s mucho importante imo:
- first, a renewal for community based Medicaid will go to your mom eventually. Some states do this annually, others maybe every 2-3 yrs. In the renewal will be ?s regarding her income & assets. She will have to disclose sale or transfer of her home whether she was paid for it or gifted it. Renewals have signature required & some sort of box with info on penalty for non disclosure. House has a value (usually the amount determined by tax assessor) that is an exempt asset & not counted for Medicaid as long as it’s hers but the day she signs it over that value becomes income for the month of transfer & a nonexempt asset the month after that. Even if she gifts it, there’s $ value. As income or asset, house value likely takes her over fixed limit her state has for being low-income enough for community based Medicaid. It’s gotta be disclosed on the renewal.
It would have to be a super low value property (real POS & almost worthless) as per assessor or appraisal not to affect her Medicaid income/ asset limit imo. If mom just did renewal, might not surface for a bit.
BUT....
- second, when you sell or transfer property, to be legal it has to be recorded or filed at courthouse. Info at courthouse, dovetails into states database. It’s just a few keystrokes for Medicaid to find. Some states do compliance runs by name & address routinely. Whatever the case, it’s gonna surface. Medicaid can suspend eligibility. Some states Medicaid will clawback eligibility on you & therefore on stuff paid, so docs, clinics may come after your mom to collect. You don’t want to go there....

My state, Louisiana, started compliance search this year for anyone on Medicaid or TANF & cross referencing to FICA; kicked like 30% off. Even if it was a temporary job, it showed they worked & made $ above what’s allowed. Remember when you apply for Medicaid, application has a required disclosure on you to do if your income or assets or status changes.

Lady Bird deeds work cause elder owns the home till they die. It’s only after death that it transfers & transfers outside of MERP.
If she went on Medicaid before age 55, no MERP.
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Since the person is on community
medicaid and NOT long term Medicaid, the rules are different. It is income that determines eligibility. There will Not be a penalty period or any issues unless long term care is needed in the next 5 years
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Penalty will be enforced by Medicaid, this is an asset of the recipient, to be used for that persons well being. Medicaid will want their money back. They are very good at securing funds. You cannot transfer assets once on Medicaid, too late to even consider this tactic. Even before entering the system, the 5 year look back would apply.

Medicaid is one of the best run arms of our government, although administered by the state, the federal government umbrella overseas everything.
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worriedinCali Sep 11, 2019
The person is on community medicaid, they are not on LTC so the rules are actually different DollyBeauty. It is income and resources that determines their eligibility not their assets.
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Jlo0226, since the homeowner is on Medicaid and lives at home, I am not sure how Medicaid collects reimbursements. If the homeowner moves into a Nursing Home, then Medicaid can place a lien on the house.

With or without Medicaid, changing a Deed to let's say a grown child isn't the best thing to do. It all has to do with IRS Capital Gains when the time comes for the grown child sell the property.

Changing a Deed, the grown children's tax basis on the house will be from when YOU bought the house. And if the house has gain in value over the years, the grown child may have an IRS Capital Gains tax to pay.

If a grown child receives said house through inheritance, then the tax basis is the date the of the owner's death. Thus the IRS Capital Gains would be much less.

Would the new person on the Deed be living in the house? If not, then the house becomes an "Investment" property and that's a whole other ball game when it comes to IRS taxes.
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North Carolina allows ladybird deeds that transfer outside probate. However this is a very specific type of transfer and you should consult a lawyer so it’s done correctly. You cannot just transfer property once on Medicaid.
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igloo572 Sep 12, 2019
Yes but Lady Bird cannot be done till after death.

LBD can work but elder still owns it. It’s still in their name, but paying taxes at elders rate & with homestead exemption. If the mom is on community Medicaid, she probably still has enough monthly income $ to pay costs, like insurance, taxes, maintenance. If she dies next week then the Lady Bird is ideal.

But if the mom should eventually have increased needs & goes onto LTC facility Medicaid, her income has to get paid to the NH. That Lady Bird house is still there in her name but family has to pay all on it and till past mom’s death as it’s going to take a bit of time to clear the paperwork.

Family may not be interested in paying till whenever on the place. If multiple siblings on the future deed & only 1 wants house...... that sibling has to pay it all and then share the ownership as per the deed. There has been someone on this forum, who had this very situation. Mom did LBD to her 2 daughters abt 3 yrs before going into NH. In a NH abt a year, house empty. Sissy #1 paid all property costs & her hubs helped with maintenance. Her sister paid zero on house, but got her 50% when it finally sold after mom died and the LB deed recorded. They also used an atty to do all, including dealing with a detailed response to MERP. MERP sends out the NOI (notice of intent to file a claim / lien) routinely to whomever is on file as contact for the now deceased. LBD takes precedence over MERP but there’s still paperwork to deal with.
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When you say "deed their home without penalty", are you saying sell the home to someone else? Transfer the title? I'm no attorney but if the homeowner is already a Medicaid recipient, I'm pretty sure the answer is 'no'. When the homeowner can no longer live in their home Medicaid will claim it to pay for the services that person has been receiving.
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