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I just read another post where someone asked if their Mom could take them on a family vacation during “Medicaid” spend down and the answer was no. My immobile, totally dependent Mom recently took a 4 night trip to Florida, nothing fancy at all but she did have to pay two of her caregivers at their normal hourly rate to take her. She wanted to see the ocean one last time. She will be applying for Medicaid in about a year. Will she be penalized for this?

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I shouldn't think so. Taking your family off on a jolly for their benefit is not the same as having to pay for essential support to enjoy an activity for your own benefit.

Or, to look at it another way, if she hadn't had the expense of support to include in the cost of the trip, your mother could have made it a 12 night stay for the same money and that would have been fine too.

The point is, the expense was incurred primarily for your mother's benefit and can legitimately be included in her own costs.
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It's gifts (or transfers at less than true value) that are caught by Medicaid's look-back period. If the caregivers weren't family members and were normally paid, I doubt if it would be a problem.
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Are the payments being reported as income by caregivers? The other scenario was a family trip paid by still mobile mom. Unless you are paying under the table and caregivers don’t declare income, it’s a different scenario.
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mollymoose Oct 2018
Yes, their income is reported to the IRS by us.
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