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EdVDay Asked August 2017

My brother-in-law is with hospice, and they claim they can seize all of his assets. Is this true?

Friend and brother-in-law is at end of his life due to cancer, and hospice claims they can seize all his assets which is very little except a $100K 401K plan. Is this true? I believe the 401K money should be protected and used for all estate settlement costs including executor help.

RayLinStephens Sep 2017
I have never heard of Hospice charging or seizing assets.

EdVDay Sep 2017
Thank you very much, all who responded. It has been a great help. Unfortunately we are hitting a low in my brother-in-laws health, its the weekend and a holiday weekend to boot. We have a great team of hospice people, nurses and a social worker who have rescued the immediate family from a rough spot right now. I can only emphasize, our time on this garden earth is short, we all need to put our affairs in order while we can. Thanks again. ED

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Dad_Was_Robbed Sep 2017
The others are right, these services are actually free. What you need to do is take the money he has but with his help in guidance if he's able and what you need to do is take that money and cover his final expenses if these aren't already in place. Find out if he has a funeral plan and if it's paid off. If not, take that money with his permission and even if you take him with you to the funeral home of his choice, arrange for immediate payment from wherever the assets are sitting and don't let no one grab them. It sounds like there after money due to corruption and you need to do whatever you must to protect yourself against this type of corruption. Get an eldercare lawyer involved if necessary and make sure his final wishes are honored and paid for. You also want to help him make sure everything else is covered that needs covered. Make sure he owes no debt on his death so his estate can go to his family or whoever he chooses. However, if he has any needy family members experiencing hardship, the right thing would be to leave something for those specific family members. He better be doing the right thing if he has any needy family members experiencing hardship and poverty because he will soon meet his maker and give an account for what he did with his money and anything else God let him have.

GrannySmith Sep 2017
If he's on Medicaid I would think he would not have qualified for Medicaid to begin with if he had 100.000 tucked away for retirement. If by chance this is the case, then yes they will get it. If he's on Medicare, he can go into hospice care for 60 day time slots, 60 day in a hospice facility, 60 days out. He would need a supplemental insurance to cover the room and board at a hospice facility, otw, Medicare Plan B. Also if someone is caring for him in their home or his, mainly family. He can be admitted into a hospice facility or skilled nursing for one week every 60 days, Medicare will cover that for respite care for the caregiver. If he received in home hospice care from a reputable facility associated to a local hospital Medicare will cover it 100%. Check everything everyone says to be sure. Laws change too.

igloo572 Sep 2017
I'd like to add as one who has been an executor now 3 times, ONLY IF there are substantial a$$ets will there ever be $$$ to compensate executor for their time. If his $ is only this 401k, there's may be just a modest $ left after private paying for care, funeral costs, other debts, distribution as per will, etc. Executor fee can be set by state to be a % of final, like maybe 5%. Please realize that it's only once your appointed via Letters Testamentary, that you can draw from estate assets to pay bills from an "estate of" account. Often executor fronts the immediate post death costs. Also It may be that estate required to be a "dependent administration" & with you posting bond to be executor.

Now the actual costs paid by executor (atty fees, court filing costs, taxes paid, property costs paid, etc.) can themselves become a claim against the estate. But just how paid dependent on your states probate laws. Often executor time to do the whatever's out is out of a sense of duty without hourly fee paid for compensation.

anonymous434963 Sep 2017
You have some good advice here. I will add that funeral/burial expenses can be prepaid out of his money, so that relieves his estate of having to pay that. He will still be able to have his care covered by Medicaid once most of his money is gone; and with a prepaid plan, his final expenses will be covered.
So sorry that you and your family are facing this.

igloo572 Sep 2017
The 401k is an asset either for him to use now to pay for things or becomes an asset of his estate when he dies. And as an asset of this estate can be used to pay claims against the estate which unpaid bills can become. Facilities know "billing" for terminal patients & expecting payment from an estate is not a viable business plan; they need to have payment system established. 401k can be placed into an escrow like account for this. $$$ is not "seized" but converted in some way for facility to draw from.

As others have said, he & whomever is his dpoa needs to get with an elder law atty asap, like this this week make calls and schedule an appt.

I'm going to take a guess..... he's been discharged from hospital & now in a free-standing in-unit hospice and about to enter 3rd week there?? Is that it?
If so, & he's over 65 & has Medicare, any post hospitalization Medicare benefit is phasing out. In order for him to stay at in unit hospice, there needs to be a payment stream established. Either private pay or Medicaid unless he has a rare secondary Medicare or LTC policy that covers inunit hospice. (He won't be eligible for Medicaid until he's at 2k in assets.) Now family can opt to take him home and have at home hospice done & paid by Medicare (so no room & board). But family will be responsible for all care outside of the limited time (3 or 4 day a week visits of abt 3 - 4 hrs) that hospice is there.

If he's under 65, then whatever the terms are of his health insurance policy will determine if & how hospice paid. And it too is ending coverage.

Both my mil (80's on Medicaid & in NH) & oldest aunt (90's private pay & in IL) went to in unit hospice following Medicare paid hospitalization. In visiting & speaking with others at hospice, the majority of patients were younger in 30's or 40's end stage cancer patients on black box drugs with serious medication management (like Fentanyl). Most seemed to have been at home but care got beyond what family could deal with; maybe under half with better employer private insurance & the rest private pay. If this sounds like what the situation is, thank goodness he has a he 401k to draw from.

momhelper123 Sep 2017
Guestshopadmin has really given you some VALUABLE information!! I've been through this process in California as my Mother is 96 and approaching the depletion of her funds. I want to "be prepared" . Many people mistake Medicare and Medi-Cal (or Medicaid) - I sought the counsel of a CPA Senior Financial Advisor who came highly recommended. For a few thousand dollars for a year of guidance and actually doing the heavy lifting of the application process, I am prepared for when the money is gone. Most elderly who are in nursing homes are being subsidized by the State. It's too expensive to sustain these monthly charges (especially MemoryCare) forever. My mom may live to 100, and while the state nursing homes aren't like private, it is a solution when the money is gone.

Bela10 Sep 2017
This is a critical question requiring professional guidance NOW...
As with freqflyer and guestshopadmin, I am in complete agreement.
I olwould add "immediate, urgent, eldercare lawyer consult & assistance is needed". Your friend/brother-in-law and his family could very well loose everything, when it is possible to safeguard, or at the very least, slow the drain of funds and protect assets now-before it's too late.

Guestshopadmin Aug 2017
Ed, many people don't understand that hospice services like medical care, prescriptions, equipment are provided under Medicare hospice benefit (Part A) at no cost.
However, if your friend/brother-in-law is LIVING at a hospice facility or nursing home where hospice services outlined above are being provided, the separate charges for room and board are NOT provided under Part A benefit by Medicare. Living expenses still have to be paid like you would pay rent and food living at home. An individual caregiver or 24/7 attendant would have to be paid for. These are either private pay by the person receiving care or their family (which is what your friend's 401K funds of $100,000 would be used for) or Medicaid paid (which your friend would need to be low income and low assets - under $2000 - to qualify for). If your friend/brother-in-law is married, that might alter how the 401K assets are "spent down" (not seized - they don't take your money from you, but Medicaid does require that you pay for services that you have assets to cover before the state and federal government pay for care). It's worth finding out if it's the hospice company or Medicaid that is talking about the money to be spent-down. You need a lawyer familiar with Medicaid and elder care and if high level of care in medical facility is required for a longer time, there will not be an estate to help executor.

freqflyer Aug 2017
Hospice is free through Medicare. Medicare does not seize anyone's assets.

Now, if your brother-in-law has applied for Medicaid [different from Medicare], then Medicaid will require savings to be use for his care before Medicaid kicks in.

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