Q: I have lived with my mother my whole life. I have cared for my mother the last 15 plus years. My brother had power of attorney though and put her in a nursing home 20 months ago. She is getting low on funds and the guardian wants to sell her house. I am not on the deed, but left the house in her will. Can they sell her house if she needs Medicaid? Can they wait until she passes and then sell her house? I was told that she can still own a home and be on Medicaid and sell the house after her death to pay back Medicaid.
A: You may be OK, but I cannot answer this without much more information. It sounds like her liquid funds are depleted and now it is necessary to sell her home to spend down to qualify for Medicaid. Her guardian may in fact have a duty to do this. It would be good to know if she is considered able to return home. Another thing for you to consider is what was referred to as “undue hardship” under DPW (now DHS) rules. This applies if you have lived with your mother in the home as her caretaker for a two-year period prior to her hospitalization. If so, the home may be excluded as a Medicaid asset, at this time, and you could remain residing in the home.
Q: I have been renting a room in an apartment from the apartment’s tenant/leaseholder. The leaseholder is now applying for Medicaid– and to show that there is a roommate (someone who is staying in one of her rooms and paying for that room), the leaseholder is submitting my name, address as well as my phone number in her Medicaid application process. (We are not related.) I guess my information would be listed in her file and I was wondering what implications there might be for me. Would Medicaid contact me for any reason? Would they request more information from me? Would I have the right to ask the leaseholder not to submit my information? Thank you in advance for your help. (Brentwood, PA)
A: Medicaid is just trying to verify her income. Medicaid likely is not interested in your personal information other than the amount of rent you pay and perhaps how long your lease is. Unless you are in the witness protection program, on the lamb for child support or back taxes or a fugitive of some sort, you should help her out.
Q: What trust should I use to protect mom’s assets if she enters long-term nursing care? How long will it take to be in effect? What else can we do?
A: If it is foreseeable that mom will run out of funds to pay for nursing care, an application for Medicaid eligibility may be necessary. Medicaid has a look back period of five years. This means that any transfer of her assets in those five years, that are done without consideration (like a gift to a child), can render her ineligible for Medicaid. A penalty would be assessed in the dollar amount of the gift. I don’t have nearly enough information to advise you here. Consult with an elder law attorney who is versed in Medicaid regulations.
Q: Hi. My mother will soon be going to a nursing home. Is my step father responsible for her nursing home expenses after her money? My mom has $75,000 in liquid assets. I own the home she and my step dad live in. My step dad has about $200,000 in liquid assets and owns a farm valued at $950,000. The farm and his assets are in his name only. They have been married 27 years. Is he responsible for her nursing home expense after her money is used up? He lives on his social security and the income from his farm. My mother’s funeral has been prepaid through at trust. Is there anything else we should be doing? (Cecil, PA)
A: If your step father just paid your mother’s medical expenses out of your mother’s money and waited until she was out of money, he few choices. He would either start to pay from his funds. If he refused, your mother would need Medicaid funding to maintain her care. Your mom has to be eligible for Medicaid, to receive Medicaid benefits. If she is not, her husband could be personally liable for care costs as PA recognized filial responsibility. For determining eligibility for benefits, Medicaid pools the resources of a married couple together so it doesn’t matter at this point who owns what. Through appropriate Medicaid planning, assets can be transferred and repositioned is such ways as to accelerate Medicaid eligibility while protecting the estate, but you need professional help. You really should seek a consultation with an elder law attorney versed in Medicaid regulations.
Q: If a husband has Alzheimer’s disease, is it true that only half of a couple’s savings need go to memory care before Medicaid takes over? He is in a very nice memory care home but I am afraid we will run out of money and was told that when his half is used up he could go on Medicaid.
A: It is somewhat of an oversimplification of the issues, but not far off point. Medicaid looks at the combined marital estate and as the community spouse (he is the institutionalized spouse) you can shelter the home and a share of the other assets. Under the guidance of an experienced attorney versed in Medicaid regulations, you may be able to shelter one-half or more of your marital estate.
Q: When a 65 year old woman gets married can she lose her Medicaid benefits? My prospective husband does not make a good income.
A: Yes. Medicaid eligibility depends on income and resource and income and assets from one spouse can be attributed to the other spouse, in some cases. If you marry, your spouse’s income and resources could [but may not] cause you to lose Medicaid. Consult an elder law attorney to learn your options.
Q: My grandfather is unresponsive in a long term rehab center. He is 65 (December Birthday), has Medicare and Bankers Life/Colonial Penn Plan N. He is about to run out of covered days. The thought was to put him on Medicaid, but we don’t know what they can take (home, savings, property, cars, etc.), what the widower is entitled to keep, and so on. We also don’t know how it will work with Social Security – will she be able to keep his monthly check? Together last year they made a total of a little less than $40,000. Everything they own, their house (no mortgage), 3 cars, and all bank accounts are in both their names. The other problem is that my grandmother doesn’t have power of attorney, and since my grandfather is unresponsive, that isn’t possible (to my knowledge). What about guardianship? (Forest Hills, PA)
A: You really need to find an elder lawyer versed in Medicaid regulations to guide you through your situation. Generally, the state takes a snap shot of the assets a married couple owns at the time of eligibility for Medicaid. It doesn’t matter if the accounts are titled jointly or in either spouse’s name. There are certain assets that will be excluded such as the primary residence, one car, certain life insurance and qualified retirement accounts of the community spouse (the spouse not in the hospital). This snapshot value is added together — the community spouse gets to keep at a certain amount of assets pursuant to Medicaid’s convoluted formula. Sometimes, you can increase the maximum amount that can be retained if. Again, you really need a thorough assessment of the situation. If grandfather is not competent to sign a Power of Attorney, you may need to have an attorney file for a guardianship over him.
Q: Hiding assets to acquire Medicaid for a nursing home. My mother put my father in a nursing home after I took care of him for 3 years and blocked me from being his POA. Also, they took all his assets and put them in my sister’s name to hide everything from Medicaid to pay for the nursing home. She is also taking his social security benefits and keeping that money. What can I do to help my father? He do want me to be guardian. Can anyone help me and are they committing fraud? Thank you
A: Medicaid regulations involve a five year look back for transfers of assets without consideration. When she filled out the Medicaid eligibility application, if your mother failed to report transfers of your father’s assets that took place within the five year period before Medicaid coverage was to start, this could be Medicaid fraud. It’s unlikely that your mother is taking his SS benefits, since they likely will be paid over to the Nursing Home. This is a big mess. You should look for an attorney versed in Medicaid law to straighten this situation out. If it is as bad as you say, perhaps you will be favored by the court over your mother if you file a guardianship petition. Most attorneys will work with you on the fee as they will be paid out of your father’s assets under court approval.
Q: If I told Medicaid I had rented instead of owning the property, and was approved. With today’s new health care changes, am I ok?
A: Providing false information to obtain Medicaid benefits unfortunately is a crime. Medicaid could take action to recover payments they wrongfully made based on that information, by having you charged with the crimes of theft and fraud and/or suing you in civil court. If by “today’s new health care changes” you are referring to the Affordable Care Act, it has no bearing on the fraud and overpayment issue.
Q: I am a 59 year old female, legally married but my husband left me and moved from Monroeville to AZ. We had no savings and the only asset I was left was a 20 yr. old mobile home which my 20 yr. old son and I currently reside. I was a homemaker and have no skills but was able to secure a full time minimum wage fast food job with no health ins. benefits. I had no savings and I applied for Medicaid and now rely on it for health insurance. My mother recently passed away and I received an inheritance check (have not cashed) worth more than what I think Medicaid allows. I have been told that I need knee replacement surgery and I need the Medicaid to get it. I need to know what legal options I have regarding keeping Medicaid and my inheritance. Could I apply for disability, social security, some other option?
A: You need to see a lawyer versed in Medicaid regulation and SS Disability issues. Two separate issues and perhaps one attorney can advise on both. Without knowing more, generally, depending on the amount of your inheritance, you may be able to “spend down’ this money prior to your Medicaid application for eligibility, or, establish a special needs trust (SNT). The special needs trust requires some administrative work and my only be worth it to you if your inheritance is significant. As to a potential disability claim, issue one will be whether or not you worked long enough to have full credits for eligibility for Social Security Disability Insurance (SSDI) benefits. Generally you’d need 5 years of earnings over the last 10 years. If you don’t have SSDI coverage, then you’d want to look at Supplemental Security Income (SSI) and the resource limits will be same as Medicaid. Please see a lawyer so these issues are addressed thoroughly.