This whole Medicaid money stuff is nerve wracking! What about true reimbursements?

Heysilky, the easiest day-to-day system is to keep one dedicated credit card that you use only, but for all bills paid or purchases made on your mother's behalf. Then she writes you a check which you use to pay it off (and make sure you do!).

Plus, avoid making mini-purchases with cash - it's a bit like labelling seedlings, you promise yourself you won't forget, you'll do it in a minute, you'll remember... but you *never* do. If you must, keep a small cash float in a separate change-purse.

It's a minor pain in the buttons, separating out her groceries at the checkout and keeping itty-bitty receipts; but it's worth the slight aggravation for peace of mind.

Was the 20K each part of her Required Minimum Distribution for that year?

Is mom still managing her own money? Does she understand about RMDs and how to best take them?

"Legal gift" of $20k is legal for tax purposes. Medicaid doesn't care. I'm glad you're going to see a CERTIFIED elder care attorney. That is a proper use of her money, so she should pay for the attorney fees. Also, her pension and SS will go toward her NH bills. Some facilities require that they be paid directly.

The 20K was to each of us 4 kids almost 5 years ago. It was some investment that she either had to pay tax on or give away. (I think.). I honestly don’t know much about those sorts of rules/laws; only that it was a very generous one-time gift to each of us. But, getting back to reimbursing me for only the shopping I do for her...this includes everything she would buy for herself, if she could physically go out and shop: groceries, gas, scripts, clothes, restaurants, home & car insurance...you get the idea....since I use my cash and/or credit card to pay for all of those things and she writes me one check a month to pay me back, that is ok? And, I agree, I ought to see an elder attorney but I do appreciate hearing from those in the know before hand. One more thing...she has a pension & receives social security. Hopefully she won’t have to go to a NH but, if so, are those two things then paid directly to the NH or Medicaid? Thanks again.

One year your mother gave "all you kids" 20K - what, between you? Or each, x how many? And when was this?

On the expenses question, that bit is easy: no, it won't be a problem. If you are buying items for your mother's use on your mother's behalf, and you have the receipts and credit card statements to show what they were, that's absolutely fine. And doing it on a dedicated credit card is a good idea - it keeps it neatly separate from everything else.

I always reimbursed myself when getting Mom her personal items. I kept and still have all the receipts by month. When I paid her bills, one ck was for me. When she went to an AL, I cashed her pension ck, which was small, and used that keeping all receipts. My Medicaid caseworker never questioned it and he saw the copies of the checks on Moms statements. So, I see no problem with reinbursement. I do see a problem with the 20K gift if it falls within the five year look back.

Medicaid won’t gripe about it. Medicaid will place a gifting/transfer penalty.

On the face of it, when a caseworker reviews the stack of financial documentation required to accompany mom’s Medicaid application, it looks like mom has regularly gifted to you & also gifted to other family members.

The 2Ok if within 5 yr look back from her eventual date of a Medicaid application, will likely trigger a transfer penalty inquiry for her overall application, as that’s just a obvious red flag. 20k at $170 average Medicaid daily reimbursement R&B rate is about 118 days of ineligibility. The stickies in this are that...
- penalty starts on Medicaid application date not when 20k gifted
- penalty is by # of days
- mom has already spent-down so is impoverished (2k in assets)
- mom is in a facility when she applies for LTC NH Medicaid, so needing skilled nursing. Her care plan by this point in time could be quite involved.
- NH may not accept her as a “Medicaid Pending” admission if they spot it. That means she’s private pay from day 1 till finally cleared Medicaid.
- once penalty placed, she will have a private pay bill from the NH. If she is to stay in the facility, someone (like you as her dpoa) will need to pay the NH & sign some sort of binding contract for admissions. Otherwise NH will send her & you a 30 Day Notice which is cc’d to APS and the state and a pro bono legal clinic in the area. She is toast on getting into any other facility.

The 2Ok transfer in & of itself is enough reason for mom to meet with an elder law atty to review the situation and have atty shepherd her eventual Medicaid application.

Ask the atty for how to deal with shopping for mom. If Medicaid disallows half of the checks written, that’s going to be added to the existing transfer penalty.

Also ask atty as to mom doing a personal care agreement with you, so she pays you for caregiving. Done all above board with taxes paid / filed. You could set this $ aside to pay towards the private pay period due to the penalty.

Medicaid is a program for the indigent.

If mom had multiples of 20k to gift within 5 years of being indigent, then she's not truly indigent.

Regarding your method of receiving reimbursement, you should schedule a consultation with a certified eldercare attorney.