Gifting = ineligiblity for medicaid = transfer penalty period for which although they now qualify for Medicaid (their impoverished) due to gifting they are ineligible for Medicaid to pay.
Trusts are going to be dependent on just what kind of trust was done and if they need to be Medicaid compliant. To me if the elder has a trust (except perhaps for Testamentary Trusts) , they need to have a CELA or NAELA atty shepherd their LTC Medicaid application.
The day a person submits their Medicaid application starts a lookback period of 5 years as to the applicants financial status. Each state administers its Medicaid programs uniquely but within overall federal guidelines as it’s both federal and state funding. This is totally unlike Medicare which is federal.
So everyone’s experience is going to be somewhat different. Basically the lookback means submission of anything that has a value with her name &/or her SS# tied to it.... banking, property ownership (home, land,cars), investments, insurance policies, etc. which is reviewed to determine if gifting or transfers appear to have been done. And if so a transfer inquiry letter is sent. Caseworker can in a few keystrokes access state database for all real property, like tax assessor data, as well as trusts tied to property.
In addition they MUST submit their “awards letters”, these are the mailings sent Nov/Dec from SSA, civil service, pensions, retirements, etc that state what their income will be for the incoming year. It’s my take that between all this the caseworker submits the data into a formula / algorithm to determine what their finances should look like. For example, say 4 years ago, moms banking shows 250k savings (assets); she gets $1500 a mo SS income (18k year) & lives with a son with no personal needs contract. And now she is down to under 2k. Well in the words of the handsome and talented Ricky Ricardo.....”Lucy you got some esssplainin to do “. Over 5 years mom would have had 340k & now just 2k, the math flat just doesn’t work. Transfer inquiry time!
If something seems amiss, a transfer inquiry is done.
For both my mom & mil, each facility we looked at gave us a list of items they required for them to submit to the NH which in turn submitted to the state. The lists were slightly different even though the same state, lol..... Part of this is done so the facility can determined IF they will accept them as a “Medicaid Pending” resident or if not, then it’s private pay till their Medicaid application determines eligibility. For my mom the document stack was abt 130 pages, yeah nothing but fun there; but it was very much about her life insurance policy & burial policy which were old and lengthy full legal double sides. Mil was less, maybe 40 pages.
Personally I think it’s critically important to submit all the items on the list as one giant document drop. You / DPOA want it so every item on the list is there so it’s a Yes or a No for the caseworker. Caseworkers seem to have very narrow timeframes for reviewing application. If your missing something, it will delay application and after a set time (30-45days) application is cancelled and ineligiblity letter goes out both to applicant and the NH.
If you know there’s looming transfer penalty issues, I’d suggest you do NOT try to DIY Medicaid application for your elder. Have your elder get an atty to deal with the entire situation.
Applying for Medicaid means the state gets an All-Access Pass to your elders life.
So...here is the deal. Let's use example to explain it. If your Mom has to use Medicaid to pay for her nursing home...she has exhausted all her own money and needs Medicaid to cover from now on,
You apply to Medicaid. They see that she made a gift of some value (money, house, other valuable asset)... and this happened in the last 5 years. This would include transferring money into the trust.
Let's us say the amount of the gift was valued at $30,000. Also, let's say the nursing home costs $5,000 per month. So..that 30k would have paid for her for the next 6 months.
What Medicaid requires is that the $30k be paid for the nursing home...THEN Medicaid takes over.
I had this happen in my family. My Aunt made a gift to her son...he later died. MEdicaid required someone, anyone, pay the money for her care. NO, it is not good enough to take her into your home for those months..because...there is no payment happening.
I and several cousins got together and put up the money to keep her in the NH for those months. In other families, it might mean the person getting the gift must pay it back.,even if they must mortgage their house to do it.
3 Answers
Helpful Newest
First Oldest
First
Trusts are going to be dependent on just what kind of trust was done and if they need to be Medicaid compliant. To me if the elder has a trust (except perhaps for Testamentary Trusts) , they need to have a CELA or NAELA atty shepherd their LTC Medicaid application.
The day a person submits their Medicaid application starts a lookback period of 5 years as to the applicants financial status. Each state administers its Medicaid programs uniquely but within overall federal guidelines as it’s both federal and state funding. This is totally unlike Medicare which is federal.
So everyone’s experience is going to be somewhat different. Basically the lookback means submission of anything that has a value with her name &/or her SS# tied to it.... banking, property ownership (home, land,cars), investments, insurance policies, etc. which is reviewed to determine if gifting or transfers appear to have been done. And if so a transfer inquiry letter is sent. Caseworker can in a few keystrokes access state database for all real property, like tax assessor data, as well as trusts tied to property.
In addition they MUST submit their “awards letters”, these are the mailings sent Nov/Dec from SSA, civil service, pensions, retirements, etc that state what their income will be for the incoming year. It’s my take that between all this the caseworker submits the data into a formula / algorithm to determine what their finances should look like. For example, say 4 years ago, moms banking shows 250k savings (assets); she gets $1500 a mo SS income (18k year) & lives with a son with no personal needs contract. And now she is down to under 2k. Well in the words of the handsome and talented Ricky Ricardo.....”Lucy you got some esssplainin to do “. Over 5 years mom would have had 340k & now just 2k, the math flat just doesn’t work. Transfer inquiry time!
If something seems amiss, a transfer inquiry is done.
For both my mom & mil, each facility we looked at gave us a list of items they required for them to submit to the NH which in turn submitted to the state. The lists were slightly different even though the same state, lol..... Part of this is done so the facility can determined IF they will accept them as a “Medicaid Pending” resident or if not, then it’s private pay till their Medicaid application determines eligibility. For my mom the document stack was abt 130 pages, yeah nothing but fun there; but it was very much about her life insurance policy & burial policy which were old and lengthy full legal double sides. Mil was less, maybe 40 pages.
Personally I think it’s critically important to submit all the items on the list as one giant document drop. You / DPOA want it so every item on the list is there so it’s a Yes or a No for the caseworker. Caseworkers seem to have very narrow timeframes for reviewing application. If your missing something, it will delay application and after a set time (30-45days) application is cancelled and ineligiblity letter goes out both to applicant and the NH.
If you know there’s looming transfer penalty issues, I’d suggest you do NOT try to DIY Medicaid application for your elder. Have your elder get an atty to deal with the entire situation.
Applying for Medicaid means the state gets an All-Access Pass to your elders life.
If your Mom has to use Medicaid to pay for her nursing home...she has exhausted all her own money and needs Medicaid to cover from now on,
You apply to Medicaid. They see that she made a gift of some value (money, house, other valuable asset)... and this happened in the last 5 years. This would include transferring money into the trust.
Let's us say the amount of the gift was valued at $30,000. Also, let's say the nursing home costs $5,000 per month. So..that 30k would have paid for her for the next 6 months.
What Medicaid requires is that the $30k be paid for the nursing home...THEN Medicaid takes over.
I had this happen in my family. My Aunt made a gift to her son...he later died. MEdicaid required someone, anyone, pay the money for her care. NO, it is not good enough to take her into your home for those months..because...there is no payment happening.
I and several cousins got together and put up the money to keep her in the NH for those months. In other families, it might mean the person getting the gift must pay it back.,even if they must mortgage their house to do it.
ADVERTISEMENT