Will Texas dual Medicare/Medicaid recoup money paid out to hospital or hospice upon death?

I am with Igloo. Someone in the family has to become an Administator. That person will have the same responsibilities that an Executor would have. The difference, the State gets involved.

It could take Medicaid a while to put a lien on the house. I actually had to call them. Moms house was up for sale and I needed to know what was owed. Her caseworker was able to get me the info. That way I had an idea how much I had to ask for the house, When I did not hear from them, I called and they sent me the recoup form. I sent it back and a lean was put on the house.

Moms house is now an asset that Medicaid can recoup their money against.

If she died with no will, it’s an intestate death for TX. In my not an atty but been executor experience there’s going to be two issues revolving around it being intestate:
- assets “escheat” to the State. So the State is in control of assets
unless & until
- lineal Heirship is done & Lineal establishes who heirs are. Once heirs determined then they can file to the court to be able to deal with the estate..... so sell property, transfer title, etc.
That Medicaid claim or lien will be an issue in all this. Just what, I don’t know, as I didn’t have to deal with lineal stuff and Medicaid.

Doing a lineal isnt a DIY, you will need a atty who does these. They are kinda specialty work / filings. Not expensive per se but are very time consuming. Basically what has to be done is establish & verify a history on your mom, your dad and any prior marriages & all possible children & all possible assets wherever they lived. Notices go in newspapers of records in cities or counties they lived in or had assets in that state her death and if you are a heir or debtor to contact the attorney. Only after these are done can the atty do the paperwork to let court know who hires are and then file a request for 1 heir to be named Executor under a dependent administration. Sometimes if there’s dissent w in the family, the atty becomes the outside dependent administrator.

Right now, as far as my understanding is, property cannot be legally sold or transferred as nobody has been given the authority to act on the estates behalf. There’s no Executor with Letters Testamentary issued by a probate judge. There’s nobody named as Administrator. Both of those give you ability to deal with the property. I’d be super sensitive if there are members of your family who insist they can run the paperwork thru and get house sold or if you get approached by a “we buy @ any condition” buyers.

On the houseless family member, I’d ask the atty who does the lineal if it’s appropriate to do a time limited caretaker agreement (notarized & witnessed) for them to stay at the house and oversee it as they can secure & maintain the asset. The caution would be that you do not want them to become a “tenant” as being a tenant means it’s their home and can be hard to remove them from the property once they move in. “Caretaker” kinda keeps that from happening, comprende?

Medicare does not have any recovery.
It will be only Medicaid costs that you need to deal w on MERP if she subject to it’s terms.

Igloo, thanks for the correction; I thought Medicare actually filed a lien which was reflected in a title search.   Perhaps I misunderstood, but thanks for correcting me.

Curious, though, if it doesn't file a lien, how can its interest be reflected in any title search, such as for selling the home after death?

Dorabea, please accept my sincere apologies for providing incorrect information.

Have you received a letter &/or envelope from the “State of Texas” probably postmarked from Irving and with a multi page questionnaire in it? This ime & imho is what you want to wait to get. There isn’t likely to be already a recorded lien on the property for TX as Medicaid is not a securitized lender like a mortgage co would be. You can do an online search in courthouse records, to see if that’s the case, but I doubt there will be one recorded at this point in time.

The letter will be brief; it states your mom according to records is deceased and as she was on Medicaid and as such then the State is required to attempt a recovery of all costs paid for her care and the amount owed is $12345.67. It is not a warm & fuzzy letter. The letter technically is a “Notice of Intent” and has a tight timeframe in which to respond. The “intent” refers to the state or its outside contractors intent to file a claim or a lien related to MERP (Medicaid Estate Recovery). The questionnaire is all about family or old POA or future Executor submitting information as to what assets mom had upon death and that could become her estate. It will ask for info on her bank statement(s) for month of death, info as to tax assessor value on the home, if there is a will, status on the property & if occupied by whom and relationship to mom, her life insurance & beneficiary, and if family / heirs intend to or have opened probate (btw for TX you have 4 years from DOD to open probate, if need be). Etc. It’s a few pages. In theory, if you do NOT respond to the NOI, the State can assume that the amount is accurate and owed and there are no exemptions or exclusions to recovery. You’ll find if you Google MERP TX that some atty suggest submitting questionnaire & others say forgetabtit and state can wait to find out what’s what in probate. It’s up to you 2 decide.

Please look at postmark too as there could be lag time from date of the letter inside and when actually mailed. It can matter.

If she applied for LTC NH Medicaid, a lot of these items were submitted in her initial Medicaid application and in annual renewals. So state & contractors know quite a bit already.
BUT
if mom was on community based Medicaid, that program doesn’t require the heavy documentation that LTC Medicaid does, so the info is new to them.
whatever the case, the Notice let’s family / heirs know that MERP is there looming & might can cloud title so transferring will be problematic.

seems to take 5-12 weeks for NOI to go out. May not get to whatever address Medicaid had on file till summer. Post when you get it.

Id suggest that in the interim you find her will, review who are heirs and if any qualify for the many exemptions under MERP. Medicaid website has this info. Also if any of y’all are or have been paying property costs, get those receipts together as some items can be exclusions to recovery. What exclusions are exactly, are in TX State Administrative Code for Medicaid, you can Google it & it’s pretty straightforward.

Any idea of just when she went onto Medicaid? Sometimes elders are low income for decades, so on Medicaid since the 1990’s or before 2006.

No mortgage, right? She died with just her name on it & with homestead exemption? Expect tax assessor to send you an increased tax bill as homestead exemption died with her.

Also IF assessed value is whack to what it might could ever sell for, please please please ASAP go online to file a protest w Assessor District. Most counties have a separate assessor district that does evaluation and sets value NOT tax collector. Protests must be postmarked by May 13, 2021 (I think that’s the date statewide, but check to make sure). The assessed value will be mucho importante if y’all need to deal with probate and negotiate with MERP. I cannot stress enough the importance of correct valuation on all this.

part 2 on the no will stuff

Dora, thank YOU for your kind words, as well as your response.  Many posters never bother to come back or provide further information, so your questions are very helpful in helping you!

To check on a lien, there are a few methods.  Records are generally maintained in a county level governmental building, but sometimes (in smaller area), at other governmental institutions. 

My recollection of McAllen is that it was a nice haven for Snowbirds, but w/o checking, I don't know anything about its governmental structure.   So first locate a Recorder of Deeds department through an online search.

If they don't keep deed records, they should be able to tell you which department does.    Then inquire whether or not they can check the property to see if a Medicaid lien has been filed.  All liens must be filed to "perfect" the lien process.

You'll need to preferably have a Sidwell (number used to identify platted parcels), or if not that, usually the street address can suffice.  Sidwells are noted on deeds as well as tax bills.     A quick check can determine whether or not a Medicare lien has been filed, and hopefully that can be done w/o a personal trip.

If you can't find a deed or don't have access to it, and your parents can't either, call the Treasurer's office.   They should be able to get the Sidwell for you quite easily.   

You could also use the platted information (i.e., Lot x of ABC Subdivision, of the NW 1/4 of such and such county, ….).    I doubt if it would be a metes and bounds description (with detailed description of starting point, distances from that to each other point), as I would think McAllen would be completely platted.

Check your own property deeds and tax bills for a quick survey of property descriptions.  That'll give you an idea what to ask your parents to find, if you need to go that route.


Alternately, some jurisdictions post property records online, so you could search by your parents' names and street addresses.     Some years ago our county had a not very intelligent or sensible individual who hired a contractor to recategorize property listings.  When I checked mine, I found numerous liens and mortgages that I knew weren't correct.

It was explained to me that this know-it-all decided to categorize first by house number.   In my city, house numbers are fairly similar from one street to the next; the street is the only difference.  So mortgages from neighboring streets showed up as liens against my property!    When the next election arrived, I voted against that incumbent.

I really do understand not wanting to address death, at any level.   And it's unfortunate that it has become so complicated.   

Feel free to post again if you have any other questions.

Dora, I'm sorry to learn of your mother's passing.    It seems as though the adult children were "there" for her, and are now peacefully addressing her assets.  That's a good sign, and will make post-death activities easier.

Fortunately or unfortunately, the heirs can't decide among themselves how to dispose of assets.    Since your mother died "intestate", which means w/o a will, the Texas intestate statutes govern distribution.

https://www.thebalance.com/dying-without-a-will-in-texas-3505052

There are more detailed descriptions, including the statute, from which the above cite is derived:

https://statutes.capitol.texas.gov/Docs/ES/htm/ES.201.htm

I would spend some time studying the intestate line of succession, while inventorying her assets to determine if there are any others beside the house.    It maybe that at this point you can only address the non-house assets, since as Alva indicated, Medicaid is still in the picture.

Did Medicaid file a lien against the property...yet?

Hospice is usually completely covered by medicare. All other bills of your mothers come from her estate. As your mother died without a will one of the siblings now needs to get probate started and be appointed as executor of the estate. If a lawyer is needed to help sort through the process that is paid for by the estate. A letter of medicaid recovery demands will come to the estate of your mother. You will need to know recovery law for your state, and this is only part of what a lawyer can help you with. The Estate requires its own EIN tax filing number and this the executor can easily get online with the help of the lawyer. Wishing you good luck.