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My father is 64 he is currently on SSI and Medicaid medical assistance. He turns 65 in two months and wants to transfer the house that he lives in to me. He would still qualify for Medicaid and would be on it to pay the Medicare deductibles. He currently does not need in home care or a nursing facility. If he transfers the house would the 5 year look back period in Pennsylvania interfere with the his medical assistance through Medicaid? Meaning would he be able to transfer the property without penalty of losing his Medicaid medical assistance? Or does the look back period just count for nursing home and in home care?

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This will almost certainly not work. I would definitely pass this past an elder law attorney who will know all about protection of assets. This home will likely be fold to pay back medicaid, whether before or after his death, which of course is as it should be. The home is his asset to hopefully give him care the rest of his life. But do go to an elder law attorney; well worth the cost of one hour of advice to avoid any accusations of fraud and any unpleasant surprises. There is a gentleman on the forum who calls himself "EXPERT" (John L. Roberts) who may have some good advice, as might DollyMe who handles some estate planning if I recall, but remember, unless we ARE, we are not legal advice, and in the case of the asset of a home, that is what you honestly need.
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QuestionBos’s dad is on SSI. Her dad is under 65.
I think we’re overlooking what these 2 are & what it means.
If I'm right, these 2 things make a huge HUGE HUUGGEEE difference as to what happens if he sells or transfers the house which right now is an exempt asset.

His being on SSI is what is providing his having Medicaid.
Not ACA, not Medicaid Expansion. He’s getting it via SSI.
SSI is “means tested”. It’s for low income folks who cannot work but are “at need” or means tested to be eligible to get a minimal income to live on AND since their low income they automatically qualify for Medicaid. SSI pays abt $770 a mo. BUT Medicaid enrollment is included.
Right there that’s a big $$$ deahl imo.
If he’s been on SSI for ages, he’s likely also getting a bunch of other state supported low income items, maybe SNAP, property tax decrease, no shut off on utilities, free bus pass. But he has to be poor & giving away assets gets him ineligible.

He is not on SSDI (worked but now disabled and cannot work, you don’t have to be low income; SSDI is $ paid based on work income history). As an aside on this, if on SSDI, after a 2 yr wait & they get to go on MediCARE no matter what age. It’s like if after 2 years, they are not better or recovered from their disability, so Medicare is the better way to manage their permanent health care needs.

Personally I would NOT do anything till after he is whatever age he needs to be to be considered full retirement age FRA for regular SS.
I’d wait to see what exactly happens with his SSI / Medicaid combo once he’s able to be FRA age so could go onto Medicare & onto traditional SS retirement. If SSI at FRA stops & he then goes onto regular SS monthly income; he could go onto Medicare & off Medicaid.

?box, try to go onto SSA site to see when his FRA (full retirement age) is. (Like if born in 1959 that’s age 66 & 10 months.) So if he does anything with his assets before then, he’s gonna be ineligible for SSI as it’s means tested. He’s gotta stay poor. Transferring house to you is loss of an asset that has value. When the transfer is recorded at the courthouse, it goes into state database. Medicaid will find out.

To me, if he’s able to go onto Medicare & get a gap / advantage/ supplement for the stuff that Medicare doesn’t cover I’d look to do that. That’s when I’d transfer the house. And I’d keep him on MediCARE and the supplement for 5 years. Not be on Medicaid at all for 5 years. So outside of any Medicaid issues as he’s not on Medicaid. Only after the 5 yr mark would he ever apply for Medicaid.

The medicaid he got while on SSI can only come into play for MERP / Estate Recovery rules IF he applied for Medicaid after age 55. If he went onto SSI before age 55, it’s outside of MERP recoup attempt. QuestionBox how old was he went he went onto SSI?
Age 55 is the determining factor as to if MERP has a position.
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Questionbox33 Jul 2019
I believe he was over 55 at the time he applied for SSI. I believe full retirement age is 66 but he currently receives partial Social Security. So lets say I pay for him to get a supplemental and he stops Medicaid what happens as far as MERP. Also, I wonder what the possible cost is for someone in his health? I talked to someone at the Pennsylvania assistance office and they believe if the home was transferred he would still be eligible for medical assistance. Does that sound right? I didn't think it did so I called again the next day to talk to someone else they said the same. But for some reason I just don't believe it. My aunts friend is an attorney who supposedly does elder law he checked to see if there was a lien on the property from Medicaid and there is not as of now. So he believes it can be transferred. Then I find out he just did it for someone else and he lost his Medicaid benefits doing such.
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Being that he is in PA, this is probably a question for an attorney. Your dad is already on Medicaid and can’t just transfer his assets. Pennsylvania doesn’t use ladybird deeds so that won’t be an option. If he needs LTC in the next 5 years, he can’t transfer the house to you. It’s an exempt asset as far as eligibility goes but Medicaid will place a lein on the house that will have to be satisfied when the house is sold.
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Check with an attorney in your state. In my state I think it would be OK. People are confusing their medicaids. In my state, expanded medicaid, used for health insurance, doesn't have recovery. Only long term care, like a nursing home, has recovery. You can be on medicaid all your life but as long as you never end up in a nursing home, there is no recovery.
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worriedinCali Jul 2019
No one is confusing their Medicaid’s. Community Medicaid can be subject to MERP. In her state, if her dads Medicaid is through an aging waiver program or home & community based services then medicaid can attempt to recover the money they spent on his care.
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I would not consider doing this until I'd spoken to an elder attorney. I have been involved in this as I am an estate planner, every state has their own caveats. All that I and the attorney have handled required a pay back to Medicaid. There is a five year drop dead time, so if would need to go into AL in the next five years, his plan will not fly, they(Medicaid) will consider this a fraudulent transfer, an attempt to hide assets. Believe me, when I say that Medicaid is one of the most efficiently run offices in our government system, they are like machines when they come after $$ that they have paid.
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Isthisrealyreal Jul 2019
That is a good thing. I bet that stops a lot of fraud and based on how our rules and laws come into existence it is with intent, as people figure out how to work the system and that becomes the family life for generations.
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It doesn't matter whether he is collecting Medicaid while at his house, your house or AL.The issue is that he is collecting Medicaid, today, yes, they can take whatever they are owed. See, if he hasn't taken too much, it might be better to sell the house for all that can be gotten out of it, then payback Medicaid, investing what is left after that, and self pay until the money runs out, then reapply to Medicaid. I have no idea how long he has been on Medicaid or how much his house is worth, so there are many unanswered questions. Part of the answer lies in timing, is the home in a growing market or a downturn?The will is nebulous, he can leave the estate to whomever he wants, but Medicaid repayment comes first, it is a debt that the estate has to pay back before there is any distributions of his assets. The idea is that we take our last breathe and spend our last dollar at the same time.
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In my Mother's case, my Mother, my Sister, & I were all listed as "joint heirs" of our parents home after our Dad passed in 1979. (Which was completely paid for) However, when Mom was diagnosed with Vascular Dementia & NPH (Normal Pressure Hydrocephally) in 1986, we were faced with placing her in a Nursing Home & began the quest for the best facility we could possibly afford without "breaking the bank" According to Oklahoma Law the "Qualifying Medicaid Look-Back Period" covered the 5 years previous to the Care Facility/Nursing Home placement, and consequently, any assets would have had to have been "transferred" from her possession at least 5 years prior to her N/H Placement. Unfortunately they were not, & so the home we were set up to inherit (free & clear) from our parents, was eventually purchased by myself & I had to pay my Mother & my Sister back their 1/3 ownership in the home for me to own it outright & to enable Mother to receive the care she needed. Medicaid got their "Re-payment" via Mom's 1/3 ownership in the home, which I purchased from her for $25,000. That money went back into Mom's bank account to be disbursed to the Nursing home over the next few months (aka... "Spend Down" of assets) & once that was gone, she then qualified for the Medicaid program resources. All in all, at least we had the peace of mind that came with the knowledge that Mom was being taken care of.
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You can purchase home at fair market value based on comps in the area. That money is then used for his care, he loses Medicaid, because there are assets, until the proceeds on the home sale are spent down to $2,000.00. Then he reapplies for Medicaid.
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Yes, he can sell you the property, here in Florida a licensed appraiser has to be hired, as they will do a complete market analysis. The proceeds must be placed in your fathers account, and, used solely for him. He may lose his Medicaid coverage as he will no longer qualify based on their requirements, as I would assume that he will receive more than $2,205 from the sale. If the house is sold and he has to go into AL, and, he is not in the Medicaid program, he will be an independent pay. My step father is presently paying 6K a month. Since he is already in the program they (Medicaid) is already tracking your father, and he has to reapply every year to stay in the program. Here is an overview of what can happen if you are convicted of Medicaid fraud. Fines, restitution orders (including interest), civil judgements, liens on any real property you own, criminal prosecution and more. There is also a moral issue here, as we taxpayers are funding this program for all taxpayers benefits. Look at this logically, your father is young, he could live for another 20 years and this system, used properly, could end up being a godsend for both you and him. I suggest that you go to a Healthcare attorney for consultation. There is so much involved in this and although this is Federal program, the state is basically in charge, and each state has it own statutes.
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Questionbox33 Jul 2019
Another question since you are an estate planner. Should he make a will so assets are not in probate when he passes away or is it too late MERP for the state would claim all assets anyway? Say he passes away with out being in a nursing home the house is still gone?
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