Hello,
My Mom just moved to a skilled nursing facility, due to her running out of money. Her assisted Living that she was in for two years cost her a large amount of change which is about 80,ooo.oo. give or take. I am on her bank account, like it is a joint account as if a husband or wife would be on their spouses account, but I have been on her account for years. Now we are on a Spend down for Medicaid. I do know that with her funeral, that is put in an account, the funeral director said it is called a burial insurance account and by Law, Medicaid can't touch it.
I know they do a five year look back. My Mom has given freely in the past five years money to me as a gift (in essence what she was doing was paying me for taking care of me) and my Dad when he was alive.
So, a rough estimate would be 15,ooo.oo in the past five years, possibly 20 grand.
Will Medicaid make me pay that back?
I look forward to your answer
Jan H.
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But that is my rant for people who are earlier in the process than you are. For you, I agree that you should see an Elder Law attorney and see what can be salvaged at this point. And I sincerely wish you well. You and Mom both were just trying to do the loving thing.
Transfer penalties are set for a period of time formula based on a what your state has set as it's daily reimbursement rate for Medicaid room & board. Lets say mom is in TX and TX daily R&B is $ 145.00 (which is pitiful low too). Now mom gave you $ 25K, it will be viewed as a gift (If you didn't have a personal care agreement or contract in place and didn't have mom do a W-9 to you, etc., then it probably will be viewed as gifting) The 25K means that for 172 days mom - although now qualified for Medicaid as she is impoverished - will be ineligible for Medicaid to pay for the stay @ the NH. (25K divided by 145 = 172). If your state's reimbursement is higher, say $ 380, then penalty period would only be 65 days. Understand?
Now transfer penalties for $$ gifting seem to be set on period of time rather than repayment. They kinda expect you to private pay for whatever the # of days of ineligibility. Now if mom gifted her home to you, those seem to be OK just to be "sold back" or transferred back to the elder to be OK almost as if it didn't happen and then can qualify (although usually the family puts the house for sale)
Transfer penalties are also sticky in that the NH will get the penalty letter too. So they know that mom is Medicaid ineligible for X # of days. THe NH will fully expect you to come up with payment or sign off on a contract in order for mom to continue to stay @ the NH. If mom went into the NH under "Medicaid Pending" and gets disqualified from Medicaid, it can be a total panic situation for family. If you know this is coming, I'd suggest you go and speak with the billing office as to what is possible. You mom has monthly income (her SS & retirement) so the NH will be getting that income, so can you pay the difference for the penalty period?
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