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Assuming the recipient qualifies for estate recovery: If rather than putting the money into a special needs trust, the recipient simply accepts the money -- disqualifying themselves from Medicaid/SSI in the process -- does the state wait to take what's left over when the recipient dies, or want payment for what they have received so far up front? (this is in Kansas) I've read a lot about "spending down the money," but have seen some user comments on various sites about the state making them pay back medical costs the moment they got the money. But can't seem to find any info about when and where that may happen...

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Is it possible for her to sell the house and then spend down the proceeds and reapply if she outlives the proceeds?
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Read again and hope you have a lawyer. I see where u would worry about her not excepting the house and where it could effect her if she needs LTC. Putting her insurance money in a Special Needs Trust will protect it from Medicaid.
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Sorry, like I said confusing. Is Mom considered disabled? I am under the impression that a Special Needs Trust is for disabled people only. It's set up for those on or Applying for Social Security disability.
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Hi JoAnn,

she is on medicaid, and (I believe) falls under risk for Estate Recovery - because she is over 55 and has had a lot of expensive medical care over that age (cancer). (while they say being over 55 qualifies her for Estate Recovery, most of the consequences seem to be in context of living in a nursing facility only. So I'm not entirely sure what her exposure here is.)

A special needs trust is also happening here - since she's received life insurance death benefits which she did not disclaim, and I am putting in such a trust. However, the problem is that she made the (potential) mistake of disclaiming the inheritance itself (in an attempt to spare her father's home, which she couldn't afford to live in on SSI, so didn't want to lose for no good reason...). While it turns out the house was transfer-on-death deeded to her, thus hasn't been transferred, she did manage to disclaim the money. Which, from my understanding, will disqualify her from medicaid (for a number of months based on how much and what the current cost of nursing facilities is).

And if there's no fixing that (e.g. having her brother give it back or put the money into the trust for her) and she's disqualified regardless, then I'm thinking she may as well keep that money. (I suspect the state will consider it a "voidable transfer" and force him to return the money to her, but I'm not sure.)

But, before considering the option of having her keep the money/not put it into the trust, I wanted to check that the state wouldn't simply take it. (my understanding, is that federal law prohibits estate recovery prior to the medicaid recipient's death, so "no" they wont take the money. But I've seen user comments here and there suggesting otherwise, so I wanted to verify.)

I just worry about a scenario where she's stuck living in her father's home with no SSI and no money for the bills...
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Looks like the others understand your questions, I am confused.

Your Mom is in an independent living, not on Medicaid as of yet? She has inherited money or may? No house is involved?

Is your Mom disabled? My nephew has a "Special Needs Trust" to protect insurance money he received upon his Moms death. He is physically disabled with a neurological problem. He received SSD. I had a lawyer set up the trust and Judge had to sign off on it. It's irrevokable. The money cannot be used for housing or food. I am under the impression only a disabled person can get it. Also, under the impression that if my nephew inherits the money maybe put in the trust but not absolutely sure. Medicaid is aware of the trust but cannot include it in their calculates for income, either can SSD.

Saying that, if Mom inherits before she needs Medicaid for LTC, if the money is used for her care and upkeep there maybe no problem with collecting Medicaid. Now, once she goes to LTC, even under private pay, the money can only go to her care. With me, Mom had a house, I was not allowed to pay taxes, house insurance or utilities out of her money. If Mom is in LTC on Medicaid and inherits, then Medicaid stops until the money is spent down then u have to reapply for Medicaid. My Mom has a house and now she has passed Medicaid will put a lean on it and when it sells they will get their money. Probably the same thing if there is an estate of any kind. They will be considered a debt that has to be paid.
This is just my thinking.
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@igloo572 Thank you. And I have contacted 2 NAELA attorney's so far, and neither knew how to help me. One called said we had "opened pandora's box" and suggested I speak to the estate attorney - which I am on monday.

But at this point I'm just trying to understand the options available to her. Specifically in this case, IF there's no saving the home she may as well keep it, and let it go to the state - but she wouldn't be able to afford the bills. (And I wouldn't be able to help out of the trust, either...)  So, we're considering the option of her simply accepting the money, not putting it in a special needs trust, getting private insurance, etc. And once she spends that money down we figure out how to deal with paying the bills (I imagine she'll be dead by then, though...)
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As Medicaid is administered uniquely by each state - but within overall federal guidelines - it’s all about just how Kansas runs its program.

Glad is spot on as to their ineligiblitity once they go over Medicaid’s set income & asset limits. But whether or not, a windfall inheritance is dunned for the outstanding Medicaid bill depends on your states laws and administrative code.

Grip, have them get a NAELA or CELA level attorney. Ferreting around on this site hoping to find answers that align with your view isn’t worth much. What Kansas requires of Medicaid receipients (whether alive or from their estate) is what is going to matter. And that is what a NAELA CELA atty provides.

The $$$ is going to surface eventually. There will be a match up to the elder or to whomever inherited. States have a renewal process for Medicaid which someone (dpoa or elder) signs off on & with penalty for omissions. For an executor to do a distribution, there’s going to be a W-9 involved. $ surfaces.
Get an atty.
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Don't know for sure. I would think that the person would no longer receive Medicaid and would start spending down the money. Then would have to reapply for Medicaid. If person dies before money is spent then Medicaid has claim on the estate.

In a way that does not make sense to me. I wonder if Medicaid would request reimbursement from the inheritance, then cash pay until time to reapply for Medicaid. This is a question for an elder law attorney.
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