We are not there yet and she would definitely have money to go trough first also. I think we will start with a live in and then see if she can literally get back ok her feet. I am just trying to be proactive especially since my brother is questioning me on Medicaid.
Yes on the attorney. Mom spending on anything for herself, her needs or her property are all OK for spend down. If you are at the point that mom may be needing a facility in the very near future (like 2015 or 2016) there you are kinda limited to what can be done at this late point in time.
An experienced elder law guy will be of immense value in providing options that will work for how your state evaluates their Medicaid application. they will also have FAs they work with if there is something mom can do on that front.
Btw for my moms application, it was 3 years & 6 months of all financials; all pages of insurance documents; awards letters; real property tax statements, etc. & for more fun a on bank letterhead statement as to the disposion of any account closed over 5 years & this signed by bank officer. Easily over 100 pages but mainly due to her old term life insurance. The NH reviewed all - mainly looking at the monthly bank statements - to determine if they (the NH) would accept mom "Medicaid Prnding". Then in turn the NH sent these with their bill to Medicaid to the caseworker assigned to their area (done by zip code).
This time of the year (Dec-Feb) is good to start the notebook on all this as mom will be getting her awards letters; tax statements for real property; interest paid statements; 1099's etc. good luck & keep a sense of humor going.
Transferring house to an adult child can be done if medically necessary care was provided for a period of two years prior to the transfer, in many states. See an attorney specialized in Medicaid planning.
Their home & 1 car are an exempt assets for the rest of their lifetime under Medicaid by & large. Although that seems great, your elder will really NOT have any of their $ to pay for anything on the house once in a NH.
Medicaid requires a copay or SOC(share of cost) of all their monthly income to the NH. They do get a small -$35/$90- personal needs allowance each month. PNA varies by state & is just enough to pay for hair salon & phone costsv@ NH. So mom will have no -nada- zilch -zero $ to pay for anything house. Family will need to pay everything house: taxes, insurance, maintenance, utilities, etc. If there is a regular mortgage or heloc, the costs could be significant.
Once on medicaid, the house will be subject to a MERP claim or lien on it. All the states are now required to have MERP in place. Many states have turned this function over to outside contractors who approach it very aggressively like a debt collector would. Now average NH stay is about 60-100K a year, so you can expect a lien or claim on the property to be that amount. If the home is modest & sold after the elders death, there could be no $ left once MERP claim or lien paid.
If family has deep enough pockets to afford to pay for years & years & have a reasonable expectation of exemptions, exclusions or hardships to offset MERP, then keeping moms house can make sense. Still a gamble on ownership, but could be worth doing. It would be like having a 2nd or 3rd home but without any benefit of ownership. For most folks, having a second home is just not affordable. The exclusions for costs on house are for an empty house, if family is living in house they are expected to pay for all without later exclusions.
To avoid all this the house would have to be transferred to family 5 full years before a Medicaid application is done. That would mean Dec, 2019, if you did it this month.
All gifts will be a penalty period where the money, to pay her back will have to be come up with another way. If it is hundreds that would be a portion of her first month in a care. Some are concerned about thousands that can add up to many months of care.
One more question. When you say gifts will be counted against her does that count if you are talking small gifts or big ones? How does cash work? I am not talking thousands but hundreds.
She can spend her money for things for herself. Any gifts will be a penalty in the eyes of Medicaid that were done in the give years prior to entering the program. The house is an exempt asset but if she still owns it when starting Medicaid a lein will be placed on it to cover the cost of her nursing home care.
Seean elder law attorney well versed in Medicaid planning.
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An experienced elder law guy will be of immense value in providing options that will work for how your state evaluates their Medicaid application. they will also have FAs they work with if there is something mom can do on that front.
Btw for my moms application, it was 3 years & 6 months of all financials; all pages of insurance documents; awards letters; real property tax statements, etc. & for more fun a on bank letterhead statement as to the disposion of any account closed over 5 years & this signed by bank officer. Easily over 100 pages but mainly due to her old term life insurance. The NH reviewed all - mainly looking at the monthly bank statements - to determine if they (the NH) would accept mom "Medicaid Prnding". Then in turn the NH sent these with their bill to Medicaid to the caseworker assigned to their area (done by zip code).
This time of the year (Dec-Feb) is good to start the notebook on all this as mom will be getting her awards letters; tax statements for real property; interest paid statements; 1099's etc. good luck & keep a sense of humor going.
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Medicaid requires a copay or SOC(share of cost) of all their monthly income to the NH. They do get a small -$35/$90- personal needs allowance each month. PNA varies by state & is just enough to pay for hair salon & phone costsv@ NH.
So mom will have no -nada- zilch -zero $ to pay for anything house. Family will need to pay everything house: taxes, insurance, maintenance, utilities, etc. If there is a regular mortgage or heloc, the costs could be significant.
Once on medicaid, the house will be subject to a MERP claim or lien on it. All the states are now required to have MERP in place. Many states have turned this function over to outside contractors who approach it very aggressively like a debt collector would. Now average NH stay is about 60-100K a year, so you can expect a lien or claim on the property to be that amount. If the home is modest & sold after the elders death, there could be no $ left once MERP claim or lien paid.
If family has deep enough pockets to afford to pay for years & years & have a reasonable expectation of exemptions, exclusions or hardships to offset MERP, then keeping moms house can make sense. Still a gamble on ownership, but could be worth doing. It would be like having a 2nd or 3rd home but without any benefit of ownership. For most folks, having a second home is just not affordable. The exclusions for costs on house are for an empty house, if family is living in house they are expected to pay for all without later exclusions.
To avoid all this the house would have to be transferred to family 5 full years before a Medicaid application is done. That would mean Dec, 2019, if you did it this month.
Seean elder law attorney well versed in Medicaid planning.