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emerald0562 Asked May 2015

Has anybody ever gone through requesting an undue hardship waiver for Medicaid penalties?

Two years of this fight. With delays, denials, more delays. You are allowed to have financial help with your bills if you're the sole caregiver and can't work because you're taking care of your loved one. But guess what? You have to have a contract in place BEFORE you do that. We were on fire trying to take care of everything and it was either use my dad's money to help my bills or file bankruptcy. I kept my dad home at least a year beyond the time others were advising it. I just could not do it until there was no way he could ask me not to - the last year my dad thought I was a girlfriend or partner which was traumatic. I guess I don't understand why there is an undue hardship waiver option available the criteria for which the client would be at risk of losing his life, health, shelter, food and clothing. My dad can no longer speak intelligibly, walk, carry out ANY activities of daily living (he went into Depends 2 weeks after he got there - there is no way I would have been able to handle that) - most days he can't figure out a spoon. I didn't have any help - a sibling grabbed the money she could early on and didn't even make a phone call. I can't show where those funds were deposited because we don't speak and she no longer accepts certified mail from me. I wasn't kind - I did send her some of my dad's dirty underwear. So my question is - if my dad meets the criteria for the hardship waiver - why the denial? Here's the kicker - you can request an appeal. You can call the number on the form or the only number given on their site. 1-800-435-0774 option 3 for appeals. It rings 30 times and disconnects. Nobody ever answers - I have been trying for days. I didn't place my dad by choice - my psych gave me the choice, I either place him or he would admit me involuntarily for depression and exhaustion. We can meet half of the nursing home bill. So far the nursing home is being patient with us but every denial we get - they remind me that there can be an eviction with a 30 day notice. Mostly I'm hopeless. I can't take him back in the advanced condition he is in now. If I were forced to I would just take both of us out. That's where we left off when my doctors stepped in. I don't know what to do. I'm in such a hole financially I can't borrow more money. I charge my dad's depends at almost $100/month. This has been going on 2 years - my mind can't take anymore.

igloo572 Sep 2017
Sui- transfer penalty happens & is placed if Medicaid in the review of the applicants financial documents determines that assets $ was gifted or transferred. The gifting most often is parent transferred their home or car to their son / daughter and within the 5 yr look back period of time. For real property like a home, the value of the property is pretty easily determined as base on tax assessor figure. For cars assessor or Kelly Blue book figure used.

Penalty is basically a math (division/fraction) problem. Your states Medicaid has a exact amount paid to NH as the daily reimbursement rate for room & board. Amount varies by state, with average about $ 170/180 day. That's the denominator. The amount gifted is the numerator. So a house worth 250k gifted in a state with $ 175 daily R&B is 1,428 day penalty. Or almost 4 years will need to pass before they will be eligible for Medicaid.

If you as dpoa is facing dealing with a penalty, really you need to get with an elder law atty asap to see what options might be possible for your elder. Often family finds the they have to gift house back to their parent to get beyond penalty. Or let them become a ward of the state. Or take them into their home to caregive. All tough decisions.

suiee7005 Sep 2017
I am beginning same problem but if has been 2 years for you since application How come still penalty period? ..i am new to this process so trying to understand how penalty time works

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emerald0562 May 2015
We don't have filial responsibility laws here. As a first time dealing with this situation - I just jumped in, didn't have a clue about caregiver contract until after the fact. I'd never had a reason to look into that kind of information before. In the beginning - the sibling who does financial planning, in 2010, said it was okay and got a chunk herself. AND in Illinois - they didn't adopt the federal Deficit Reduction Act until January 2012, which changed when penalties started. NOW penalties start from the day you apply. Before January 2012, transfer penalties ran from the time of the transfer so we are well beyond that problem. But even that information wasn't known to me until WAY after the fact. We certainly would have done that if we had known - my dad was comfortable with doing that as he knew he was having difficulties still at that time. That was the worst part of this whole thing --- watching him be so frightened and confused. Now he doesn't know anything - they've even removed his wander guard because he wouldn't be able to figure out how to open a door. Spoons are a challenge even at meals. It's ugly.

pamstegma May 2015
This is why we always tell folks to get a written care contract when their parent moves in with them. A lack of records or receipts means Medicaid will consider the money a gift. If funds were "stolen" they are still a gift unless the parent sues or presses charges. About your only out is to be admitted to hospital, then Social Services can take you dad into protective custody.
If you are in a state with filial responsibility laws, the Nursing Home can sue the children for the unpaid support. In Pennsylvania, a Judge ordered a man to pay $93,000 to his mother's nursing home. Look up HCRA vs Pittas.

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