Medicaid and Retirement pension

As an aside, it is common in these posts for folks to ask "...will Medicaid take...".
Please remember that nobody is "taking" anything from anyone.
Medicaid is a public benefit program from which we are requesting assistance.
We are being asked to pay our fair share and we are voluntarily doing so.
That's reasonable, isn't it?

Glenna69...All of her gross monthly income, regardless of the source, minus a Personal Needs Allowance which varies by state (in Florida, for instance, it is $105) will be paid to the nursing home as Patient Responsibility.

I have a disabled daughter that draws a retirement check from her ex husband. We have put her in a nursing home pending medicaid. As of now we are paying out of pocket because she cannot walk or stand and we cannot lift her. We are 69 and 70. Will medicaid take her military retirement check she receives each month which is under $1000 to help pay for her nursing home care. We have spent so much money on her care the last few years.Glenna

First, it depends on the nature of the VA award. Pension or Compensation. 100% of compensation is considered countable income towards Medicaid eligibility limits. How Pension is treated depends on the state in which you live. Some states will count only the "Basic" portion of the award as income, the rest will not be counted towards the income limit but will be counted when determining Patient Responsibility and the Community Spouse Resource Allowance. Other states do not apply the Pension award to the income limit but, again, it will be counted in determining Patient Responsibility and the Community Spouse Resource Allowance.

Once the above is determined you will then have discover how your state treats countable income exceeding the $2,205 Medicaid eligibility income limit.

Some states require that an Irrevocable Qualified Income Trust be established. A bank account is then opened in the name of the trust and the amount over the Medicaid income limit of $2,205 per month is diverted to the trust each month. The diverted funds in the trust's bank account are then used to meet the Medicaid recipient's Patient Responsibility (the amount paid to the nursing home) or go to the Community Spouse as a resource allowance.

Other states simply look at the Medicaid recipients total countable income vs. cost of care and as long of the cost of care exceeds countable income the recipient continues to qualify. The Community Spouse resource allowance may also be increased if there is an increase in income.

Another consideration is any lump-sum retroactive award that may be received. Again, depending on the state, it may be considered income in the month received or as an asset. How to handle this aspect of the award and maintain eligibility can also become quite complicated.

Much of this information can be found online however it will probably be easier to contact a professional.

My husband qualified for Medicaid (he is in a care facility) but he has since been awarded a benefit through the VA, which puts his monthly income (SS and VA money) over the state limit. How will this affect us?

If you apply for Medicaid, all sources of income - pension, social security, 401K, etc. are used to pay nursing home. If the total of income puts you over Medicaid limit, you can see about setting up a trust for the balance. You will only be able to keep a personal needs allowance (PNA) of between $60-$100 depending on the state.
IF you are married, the rules are different. A community spouse will have different amounts that can be kept for the spouse in the community. This more complicated scenario needs a lawyer or someone well versed in the rules and paperwork for Medicaid planning.

Do they take pension as well and social security when applying medicaid. 

fyi - most states have an "qualifying income trust" or earned income trust. this isn't about the life insurance (though I think it is reasonable that that money be used for a parent's care - you would likely cash it in to help pay for their care if you didn't get medicaid). This is about the "maximum income". My mom has qualified for medicaid in 2 states - while her income has been higher than the maximum. The key is if your parent qualifies for long term services based on her need of help with activities of daily living. If medicaid screens your parent and they are seen as needing care that costs far more than their income and assets - medicaid will usually approve - you just have to set up a trust that manages all money for the parent's care. Google "income cap trust" or "qualifying income trust". I did these on my own with no lawyer with zero problem. It isn't hard (and your bank can help you set up the trust account). You can usually get the template online. In any case - unless your parent has tons of assets they want to pass on to someone or those assets are needed to protect a current spouse or disabled child -- do not bother with a lawyer (imo). It is a pain in the a** but you can do it on your own. Lawyers were quoting me 2500 to even answer a QUESTION about the trust stuff - and I was able to do it on my own for the cost of a notary. I am not usually someone who feels comfortable doing that type of stuff - but since my mother didn't have any extra assets, was only not qualifying b/c of basic monthly income, I felt comfortable doing it. And, again just my opinion, but medicaid will end up paying thousands of dollars a month to help take care of your parent. It would not be fair for them not to ask for any and all assets to help pay that (again, assuming there is no spouse or disabled child that needs the asset) - as you would have to tap into that asset anyway to take care of a parent who needed care of upwards of 6-10K a month, and you would spend through it very quickly.

She cannot simply keep the pension. She HAS to report it to Medicaid/her case worker. Databases feed together, former employer reports pension to federal government, this is provided to state government. If she does not report it, it will get found out and she could get in a lot of trouble for it. It's considered fraud not to report assets and income for Medicaid and other public (state/federal) benefits. The Medicaid folks will recalculate her benefits, but she cannot simply "keep the extra money". If it puts her over the income limit for the state, there are various trust options so that she can stay qualified for Medicaid. Please don't cause both of you problems by trying to hide money from state agencies. It never turns out well, and pensions that are paid and not reported will be found out when she is re-certified for benefits at Medicaid review.

A friend of mine, for whom I am POA, is 65, had a stroke, and is living in assisted living. She is receiving NJ medicaid and just discovered that she has a pension from her previous employer of around $400/month. Does she report this to medicaid? Can she keep the pension?

A friend of mine is receiving NJ medicaid, is living in assisted living, and just found out she is entitled to a pension from her previous employer. Can she keep the pension of about $400./month? Must she report it to medicaid? Thanks.

Incha, you should see an eldercare attorney and ask about provisions for the
" community spouse".

Husband is in nursing home. Can spouse have the pension & social security to maintain my house &a expenses?

Because financial limitations are so important to Medicaid eligibility, applying can be complicated. The application process, which may take from weeks to months to complete, allows the state agency to scrutinize the potential recipient’s income and assets to see whether he or she is sufficiently needy to qualify for benefits. In long-term care cases, medical screening also is done at the application stage, and the individual is investigated for past transfers of assets.

The first step in any application is to be certain that the agency understands whether the applicant is for community Medicaid or long-term care benefits, as explained above. Some states use completely different forms for institutionalized and community-based applications. Others simply provide boxes to mark on a unified form. Check with your local Medicaid agency to find out the rule in your state.

source: http://longtermcare.gov/medicare-medicaid-more/medicaid/medicaid-eligibility/financial-requirements/

My uncle has had several strokes which have resulted in dementia. He moved in with me from another state recently. It was unexpected and it happened rather quickly. He has a green card but is not a citizen. I need help talking care of him during the day while I go to work. He only receives social security and has no assets. I need help and I have no idea where to begin. I have been told that I should hire an elder consultant who would assess all of the benefits that he is eligible for and help complete the necessary forms.Has anyone heard of this before? Can you recommend any companies to use (or stay away from)? He's 68 and we live in New York City. My mom helps take care of him during the day but she's older and I worry about the effects on her health. We left him alone for 10 minutes and in that time he fainted (though he says he tripped) and he ended up in the emergency room. This has been overwhelming, stressful and sad. Any advise would be greatly appreciated!

My husband is in a nursing home and has been for the past four years. His Social Security Disability and Medicare and Medicaid have been going to the nursing home. I have been receiving his retirement check and spousal diversion from the nursing home. Medicaid stopped paying the nursing home and now have to reapply and therefore I am not getting my spousal diversion check. Will I still continue to get the retirement check which is automatically deposited into a trust account and then I am allowed to withdraw it each month to live on.

MariaP5pin, Certainly the NH will take her Germany pension, but will that cover the whole bill? To get Medicaid, check your state rules; she must be a US citizen if you are in the US.

I have been my mothers caregiver for 6 years, she has dementia confusion etc.
I would like to know how to apply for Medicaid for her and the long term facility will take her Germany pension Maria P.

this is from stefani..he has passed from an overdose of metformin toxisity thst the nh was given to him i only have term 1000 policycan i sue the attending dr?

aww1015, you should talk with an elder-care attorney who has experience with Medicaid. There may be a way to convert the lump sum to a Miller Trust (I'm not sure if that is the correct name....someone else can correct me), which designates the funds will go for your care only. But keep in mind, in general, the whole idea behind Medicaid is that it is meant to provide for those who literally have nothing.....so, if you do have "something" then there is nothing to keep it from being taken by the government, now, or even after you die, they have a right to be repaid for whatever amounts they paid for your care. It's just like the sale of your home, that too can be used to pay for your care (even after you die). Best to have an attorney explain your options, but don't be surprised to learn, you have to use your assets to pay for your care, that is what everyone is supposed to be doing.

im a disabled man 57 years old....I live in a nursing facility..and my monthly disability benefits ssd go to the state of Washington.for Medicaid ...I recently got a letter from a previous employer and they are offering a lump sum payout of my pension...I think if I did that the state of Washington would take the money..is there anything I can do with the pension money to protect it from the state?

My mother in law is currently recovering from a fall in a rehab nursing facility. She has many health issues and it is really taking it's toll on my father in law trying to care for him at home. The family wants to see her go into a long term care facility following her rehab. She is on Medicare, state of MN. Medicare will only cover 100 days following her hospital stay. We understand that the county will need to take her SS check. Will they require my father in laws SS or pension check? They really don't have much in personal assets. A mobile home in a park, a pick up truck and a handicap van for transporting mother in law.

Sharonlee, there is a state-specific Community Spouse amount, and what will happen is this: when he goes to NH, the Medicaid will reserve an amount from his pension which, when added together with your SS check, brings you up to the Community Spouse amount. For example if your state's CS amount is $2300/month, you would receive $900 of his pension. The rest would go to the NH. But also keep in mind you can only have the maximum CS assets in bank (it's something like 114,000), one home, and one car. You can pre-pay both your funerals (not lavishly ) and make reasonable repairs to your home, to get down to the CS asset maximum. Read Gabriel Heiser's book "Medicaid Secrets" because I am certainly not an expert. It's important to plan for Medicaid in advance, because you could wind up having a longer penalty period, unless you organize it to your benefit. However, with a huge pension ($72,000 per year) added with your Social Security check, you probably will never qualify for Medicaid, ever.

We live in Fla. My husband took a reduced benefit, so that upon his death, I would continue to receive the same amount as him.

Sharonlee, check with an Elder Care Attorney who you have carefully vetted to know in advance, they have financial planning & Medicaid planning Expertise. They can advise you about your specific situation. The cost will be well.worth it. There are Community Spouse allowances which vary by state and your individual circumstances. No, it is not to your benefit to get a divorce--Medicaid looks at all transactions within 5 yrs of application. Don't worry they are not going to leave you out in the cold. With 6,000 /month pension he has enough assets that he won't qualify for Medicaid. The bigger question is if his pension was structured to include a spousal benefit or not.

Stefani...what type of insurance policy is it? If life insurance, who is the owner of the policy, who is the insured, who is the beneficiary? If life insurance is it a policy that has cash value and what is the death benefit? Lastly, what state do you live in?

I have a question about retirement benefits from the state. My husband retired after 30 years of teaching. If he were to have to go to a nursing home, would all of his retirement benefits go toward paying his expenses there? I only make $1400. in social security and could not live on that amount. His monthly benefit is over $6,000. a mo. What if I had to go in a nursing home, would they just take my $1400. or would they require that he also pay toward my expenses? Maybe it would be best financially if we got a divorce!

Want to address this question to whoever is knowledgeable about nursing homes
if you have someone in your family wife cousin or spouse. And you have an ins policy for them as an asset ..can the n.h. take it away from the beneficiary upon the spouse passing?

Dedicated Son...
If your mother was financially and otherwise eligible in September there is no reason why benefits should not be retroactive to September.
File an appeal. In most states you have 60 days from the date of the decision letter.
Search for the procedure in your state.

My mother who is 86, suffers with Dementia and is a a care facility in NJ. I am her legal guardian, along with a care giving sister. My mother was a christian pastor for over 50 years, who accepted no salary (since Jesus did not get paid). Her income consisted of congregation monetary gifts, paid speaking/preaching engagements, and fees for wedding, funerals, counseling etc. She filed her taxes and paid SS taxes. Due to the cost of her care, over a period of 2 1/2 years I liquidated all of her assets to cover her care. Last year in April 2014, I engaged a geriatrics manager we started the process of preparing a Medicaid application.
The plan was to start in April, file the paperwork in June with an effective date of September 2014. After the application was filed there were a few questions, but not much activity on the part of the medicaid worker. As of September I spent down the remaining funds, to $2,000, and paid the care facility her SS less $100.
Starting late September through December 2014, I started receiving 7-10 pages of questions (many were repeat questions that were previously answered. the biggest issue was the checks Mom would get from individual members of her congregation. I had to provide individual copies of each deposit over $700 for five years. The local bank manager was an Angel, as he research each deposit and copied each check in some cases there were 30-40 check ranging in amount between $10-$100. By November 2014 all of the questions were answered, and it took another month to get final Medicaid approval.
It is now April 2015 and the dementia facility has not been paid. Upon checking on when payment would start I was informed that the payment would not be retro active to the September date. My concern is since all funds were spend down there are no funds to pay the facility and they need their money. Has any one experienced this situation, what advice do you have.