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My 88-year-old father has been living with me since the start of the pandemic. We sold his property in March of this year. His profit from the sale was $30,000. This is his only savings. I am his caretaker and he does not require any in-home nursing care right now but his health is slowly deteriorating. He earns about $1,000 a month from social security benefits and he qualified for Medicaid before he sold his home and moved in with me. He uses Medicaid for twice a year appointments to his cardiologist and urologist and once a year checkup at his regular medical doctor. He also used Medicaid in 2012 for a hospital stay recovering from a mild heart attack. We charge him a small amount of rent to cover his living cost and we put aside the rest of his money to use for in-home nursing care in the future and would also like to make adjustments to our house to accommodate his walker/wheelchair. We do not plan to put my father in a nursing home. I have reported the home sale to Medicaid (we live in Georgia) and I’m waiting to hear back from them.


1. Will my father lose his Medicaid benefits?


2. Will he be required to start paying for his doctors visits and medicine out of the savings from his home sell?


3. Will we be required to turn over the $30,000 to the state to cover the cost of his doctor/hospital visits in the past?

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You should contact your state Medicaid office and a certified elder care attorney specializing in Medicaid in the event that in spite of your current intentions to keep Dad out of long term care, his medical needs become too great to handle at home and placement is needed. About 10 years ago in NJ we had a woman penalized and denied Medicaid placement in an LTC because her SIL and dgt. with whom she lived had made 'modifications to their kitchen" supposedly for her accommodation about six months before they applied for placement. There had been no radical change in her medical condition and it was ruled and upheld that the particularly kitchen modifications did not benefit the woman. Now improvement made for wheelchair access and bathroom access are different but it is never too early to get the ducks in a row.
Good Luck to you and your Dad
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In July of this year the allowance for medicaid assets will move from a small amount al the way up to 130,000 for individual and 195,000 for a couple.
Check with your own state for their allowance.
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There are 2 kinds of Medicaid-community Medicaid --which it sounds like dad has, and Long Term Care MediCAID, which covers nursing home care.

Both are means tested, meaning that the state looks at how much you have in ASSETS and INCOME. Assets refers to money in the bank, stocks, CDs, while income is what comes in monthly, like SS and pension.

You need to check what the ASSET limit is on Community Medicaid in your state.

A consultation with a Nelf.org certified eldercare attorney would be a good idea. You want to make sure that it's crystal clear that the payments dad is making to you are for rent and that they don't look like gifts.

Consult with the lawyer about the home modification. That may not be considered a legitimate use of dad's money if Medicaid is involved.

Your father will still have Medicare for doctor and hospital visits, right?

Here is a concise article/table with a lot of good info about Georgia Medicaid:

https://www.medicaidplanningassistance.org/medicaid-eligibility-georgia/
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igloo572 Jun 2022
If he used Medicaid for hospitalization and for MD/ clinic visits, lab work, its imo probably that it’s Medicaid as health insurance. So his MediCARE is his primary insurance with Medicaid as his secondary. He’s a “dual”. It’s yet another category for Medicaid and different than the programs for LTC Medicaid (resident in a facility) or community based programs (like IHHS/ in-home care).

fwiw PACE programs get real in the weeds on which Medicaid gets billed. The elders day long visits to PACE center and its activities are community based Medicaid; but health related actions like if they get flu or Covid shots, diabetes monitoring, get nutritional counseling those can be billed to Medicaid as health insurance as those can get a ICD-10 codes which MediCARE & Medicaid as health insurance uses for billing. The super sticky with this is that health insurance Medicaid does NOT have estate recovery/ MERP aspect but the day program aspect of PACE does as it’s community based Medicaid.

In my area we have 2 PACE centers, 1 by us is the Benson Center and it’s on land owned by & run by Catholic Charities, the other is on land owned by State but run by CC. This one had complaints filed with CMS and litigation filed with the State as to the PACE requirement for participation to have to be a “dual”. It’s that an individual should be able to do a copay or pay a fee to go to the PACE and not at all have to be in any way on any type of Medicaid. That the PACE center cannot barr participation by elders who are not low income or require an elder to have to go onto Medicaid. That as it’s a community center anyone from the community can go and not place themselves subject to “at need” financial verification or MERP. I’m not surprised that this happened actually I’m more surprised that this doesn’t happen more often, or more litigation on estate recovery by heirs.
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