How responsible am I for lost money when it comes to Medicaid?

Bree - Medicare doesn't care what your do or don't own. Medicare is a national federally run entitlement for hospitalization and physician fees and meds. The key is finding physicians and other providers who take Medicare.

Medicaid is totally different and is a needs based entitlement designed for the very poor. Most NH residents will if they live long enough, have to apply for Medicaid to pay for their NH stay. Medicaid is a joint federal and state program which is run by each state according to their spin on state laws. Now this is why it get's tricky in that what works in 1 state might not be valid in another. that is why so often you see that finding an elder care attorney to work out a plan for you is so important. This is what my mom did and it was invaluable - we used an estate planning attorney though as it was done well over a decade before she did NH.

In general, for property like a house, land, vacation house, only the homesteaded property is considered an "exempt" asset for Medicaid application approval assuming they meet all the other Medicaid criteria of $ and medical need. If the property is raw land or an investment property, then it is not exempt and has to by & large be sold with the proceeds going to the owner (according to their % ownership) who then is fully expected to do an approved item spend-down to get to the Medicaid limits (which is by & large 2K in "income" and 2K in "non-exempt assets" but can vary from state to state.) For jointly owned property by each person's name (not an LLC or Inc or other legal entity like a trust), it is going to get sticky as everybody's interest is exposed. You really should find an elder care attorney to work with all of you to get a plan going. Remember all states have as a minimum a 5 year look back and the property transfer will come up as it is recorded by the state and you sign off in the Medicaid application to allow the state to go into all your finances. Somebody could face a transfer penalty before Medicaid will pay for their NH stay so they can't just sign it over to the others for free. Understand?

If one of you is facing an imminent NH, then do the attorney as soon as you can. What might have to happen is that the other 3 will have to buy the NH one's ownership 1/4 share. In general, I've found that whatever the current tax assessor's value is, is what the state expects the property to be sold at. This could be either very good if it is low or very bad if it was set on 2002 - 2008 real estate values (when real estate skyrocketed) . If you need to have it adjusted down, you will likely have to provide detailed documents as to why - which may or may not be acceptable. Really you need an experienced attorney. Good luck.

We 4 individuals are all over 65 and retired, we have a piece of property,all 4 of our names are on the deed. What will medicare do if 1 of us needs to go into a nursing home. What can we do?

Thanks for the answers

What I think the caseworker looks at is a pattern of spending that could account for where the $ went and if there is something that appears to be significantly out of line, then you will be asked to account for it to determine if it could involve a transfer penalty. They can spend their $ on whatever they like as long as it's for them or their property. So if they want to spend 20K on a facelift or 10K on a trip on the QE2 or play the ponies or the casino's, that is totally fine. Personally, I'd keep a journal of her trips or outings anyways, to be able to review changes in her ability over time - could be really useful health care wise plus if Medicaid asks too.

It's when say they have 80K in 2010 and then today in 2013, they have $ 1,200.00 left and they live with a family member for all that time with no real expenses, that ?'s about where the $ went get asked. Or when a home, property or car get's sold either significantly under value or for free (all recorded by the state), that the potential for a transfer penalty becomes an issue.

For a few hundred dollars I doubt it.

What Medicaid will do with the look back period is have you get bank statements for those 5 years.

The main concern will be any deposits that are not part of Mom's normal income. I was never asked about any withdrawals from her account throughout the process.

My mother did have some withdrawals of this size...a few hundred dollars. so I would guess you are in the clear.

Additionally, if you want to know more about the Medicaid process I write for AgingCare and contributed this post:

https://www.agingcare.com/articles/applying-for-medicaid-155854.htm