Medicaid exempt assets: What Federal and State Laws grant

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PostPosted: Fri Feb 10, 2012 7:27 am   Post subject: medicaid spendown  

If you have a mortgage on your home and receive social security disability retirement benefits, will this disqualify you for medicaid?


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PostPosted: Fri Feb 10, 2012 11:14 am   Post subject:   

As far as I know, SSDI benefits won't be affected by a mortgage but Medicaid might. You should have a talk with your SSDI and medical advisor to clear your doubts.

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PostPosted: Fri Feb 10, 2012 9:08 pm   Post subject:   

Quote:
You should have a talk with your SSDI and medical advisor to clear your doubts.


Heller's answer, like many of his others elsewhere, is both incomplete and fundamentally incorrect. We don't know anything about his background or qualifications, but by the nature of his frequent misinformation, it is dubious, to say the least. The person to speak to about qualifying for Medicaid is the Social Worker employed by your local county Welfare/Public Social Services agency who will determine your eligibility -- Social Security has nothing to do with it (even though our Social Security dollars are being stolen to pay for Medicaid benefits), and a person's "medical advisor" (whatever that is supposed to mean -- a doctor, perhaps? -- is not likely to be in a position to advise about Medicaid eligibility in any way.



Here are some facts:



Eligibility for Medicaid for Long Term Care is a two-pronged test of assets and income. A personal residence (and personal jewelry, one car, and any business property/assets) is among the major assets exempt from the spenddown test if the "confined" person "intends to return" to the home [who would not so intend?], but the residence will have a lien placed against it for mandatory asset recovery following the death of the Medicaid recipient -- this will be extended for as long a the recipient's spouse remains in the home. The amount of the mortgage payments (assuming both spouses are on title) will be divided between the confined spouse and the "community" spouse as part of each person's spenddown liability. The value of stocks, bonds, and mutual funds are all "countable" assets.



Monthly income, such as pension or retirement plan distributions, income from rental property or other passive investments, or from a "reverse annuity mortgage", cannot be "sheltered" through the purchase of annuities or life insurance, and the cash value of any cash value life insurance is also countable as an asset down to about $1500 (the average cost of cremation services).



The cash value of annuities not in the distribution phase are a protected asset -- as long as the annuity(ies) was purchased more than 60 months prior to the Medicaid application. The "value" of any money used to purchase any annuity within 60 months of applying for Medicaid will remain part of the "countable" assets of the applicant on paper, and that value, along with the value of all other countable assets, will have to be spent down to the asset retention limit (even if it requires withdrawing money from the annuity, and even if that withdrawal is subject to a surrender charge -- the surrender charge does not count toward the spenddown, it simply reduces the remaining value of the annuity).



SSDI payments end at age 65, so would not be a factor in Medicaid eligibility at or after that age. Prior to age 65, however, SSDI is simply part of a person's monthly income, which must be spent down to the $35 allowance level before Medicaid eligibility may be established for the month (assuming the community spouse also meets his/her income spenddown). At age 65, a SSDI beneficiary simply begins to collect their SS Retirement benefit (which is usually lower than their SSDI benefit), but that is INCOME, and must be counted toward the monthly spenddown.



There are many abuses in annuity sales directed toward seniors, and some agents promote annuity sales as a means of qualifying for Medicaid. For anyone considering the purchase of annuities as a way to qualify for Medicaid . . . that 60 month hurdle is a very large one to jump over. Some agents fail to discuss both the 60 month lookback period or the surrender charges in the annuity -- both of which are now violations of the NAIC Suitability in Annuity Transactions Model Regulations which were adopted in all states in 2010 or 2011 and are in effect as of January 1, 2012 in most or all states.



For more information about those regulations, visit your state's Dept of Insurance website.


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PostPosted: Wed Feb 22, 2012 9:02 pm   Post subject: Medicaid Exemptions  

My wife is in a nursing home. I own a farm and this is my only source of income. Is my farm exempt. I live in Minnesota.


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PostPosted: Thu Feb 23, 2012 6:05 am   Post subject:   

If you and your wife live in the home on the farm property, it is exempt from the Medicaid spenddown test if your wife's "intent" is to return to the home when she no longer needs to be in the nursing facility (of course, she wants to do that).



If your farming is a business, those assets (land, equipment, etc) are also protected from the spenddown test.



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PostPosted: Mon Apr 16, 2012 7:01 pm   Post subject: medicaid  

If I apply or medicaid in Indiana will I have to give up my car? My car is the only way I have of getting anywhere even to the doctor. I am 63 years old and on Social Security, I rent my apartment, I have a checking account so that social security can deposit my funds.I have no other assets


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PostPosted: Mon Apr 16, 2012 7:01 pm   Post subject: medicaid  

If I apply or medicaid in Indiana will I have to give up my car? My car is the only way I have of getting anywhere even to the doctor. I am 63 years old and on Social Security, I rent my apartment, I have a checking account so that social security can deposit my funds.I have no other assets


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PostPosted: Mon Apr 16, 2012 7:01 pm   Post subject: medicaid  

If I apply or medicaid in Indiana will I have to give up my car? My car is the only way I have of getting anywhere even to the doctor. I am 63 years old and on Social Security, I rent my apartment, I have a checking account so that social security can deposit my funds.I have no other assets


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PostPosted: Tue Apr 17, 2012 5:49 pm   Post subject:   

The Medicaid spenddown rules permit the retention of one automobile. So nothing to worry about when it comes to your car being taken away. Go ahead and apply if necessary.



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PostPosted: Mon Oct 15, 2012 11:29 pm   Post subject: Medicaid Lien  

Daughter had a trust and the house is in the name of the trust. Daughter died and medicaid is to be refunded the lien for medical services the decedent received while living. Can the lien be put against the property while the mom and minor sibling live in the home? This would allow the mom and her child the opportunity to stay in home. Does the mom have to sell the home right away?


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PostPosted: Tue Oct 16, 2012 2:16 am   Post subject:   

If the home has been in the trust longer than 60 months prior to applying for Medicaid, the home is a non-assessable asset, and Medicaid cannot put a lien against it.



If there are no other assets available to satisfy the lien, Medicaid is out of luck when it comes to asset recovery.



So the all-important question is: How long has the home been in the trust?



Also, if I'm not mistaken, asset recovery should only apply if the decedent was age 55 or older, and I get the impression that this person was younger than that.



Additionally, when Asset Recovery was instituted in OBRA 1993, this is was it was intended to do:



States must pursue recovering costs for medical assistance consisting of:



Nursing home or other long-term institutional services;

Home- and community-based services;

Hospital and prescription drug services provided while the recipient was receiving nursing facility or home- and community-based services; and

At State option, any other items covered by the Medicaid State Plan.



At a minimum, states must recover from assets that pass through probate (which is governed by state law). At a maximum, states may recover any assets of the deceased recipient.




Anything in a trust is a non-probate asset, and it is not an asset of the deceased recipient. But originally, the time in the trust was 36 months. A few years ago it was increased to 60 months (obviously to make it harder to hide assets and escape asset recovery).



Additionally, there is also this discussion:



Recoveries may only be made from the estates of deceased recipients who were 55 or older when they received Medicaid benefits or who, regardless of age, were permanently institutionalized. However, states may exempt recipients if their only Medicaid benefit is payment of Medicare cost sharing (i.e., Medicare Part B premiums).



If a state has elected to impose TEFRA liens on recipients’ homes, then it must also recover from the estates of those recipients. States may impose liens on property of Medicaid recipients of any age if they are permanent residents of a nursing home or other medical institution, and if they are expected to pay a share of the cost of institutional care.




Finally,



States are prohibited from making estate recoveries:



During the lifetime of the surviving spouse (no matter where he or she lives).

From a surviving child who is under age 21, or is blind or permanently disabled (according to the SSI/Medicaid definition of “disability”), no matter where he or she lives.

In the case of the former home of the recipient, when a sibling with an equity interest in the home has lived in the home for at least 1 year immediately before the deceased Medicaid recipient was institutionalized and has lawfully resided in the home continuously since the date of the recipient's admission.

In the case of the former home of the recipient, when an adult child has lived in the home for at least 2 years immediately before the deceased Medicaid recipient was institutionalized, has lived there continuously since that time, and can establish to the satisfaction of the State that he or she provided care that may have delayed the recipient’s admission to the nursing home or other medical institution.




Hopefully, the answer to your specific situation may be in these statements.



You can read more from this article at http://aspe.hhs.gov/daltcp/reports/estaterec.htm



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PostPosted: Tue Oct 16, 2012 2:33 am   Post subject:   

There are four other companion articles which may also be of value to you:



http://aspe.hhs.gov/daltcp/reports/liens.htm

http://aspe.hhs.gov/daltcp/reports/hometreat.htm

http://aspe.hhs.gov/daltcp/reports/spouses.htm

http://aspe.hhs.gov/daltcp/reports/MAliens.htm



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PostPosted: Wed Nov 07, 2012 4:10 am   Post subject: medicaid exemption  

In Wyoming when my health became increasibly worse, I qualified for a medicaid exemption. I receive medicare but need medicaid to help me with medical expenses. I have reduced lung capacity and have had an electric stimulus implant for chronic pain. But I need someone to do the deep cleaning.


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PostPosted: Mon Mar 18, 2013 8:31 pm   Post subject: Law in NM, can Mom keep house in Fl as exempt?  

My Mom's house in Fl, is worth about 65K, she is needing caregivers 7-8 hrs a day, since 7/11. She is running out of her funds, as her income is only $1770, and caregiving is costing $2800/mo. Plus her household and living expenses! She has SS, and spousal VA benefits. She is frail, 88yrs old. She probably has to move to NM, where the bulk of her family now is. Her family is confused as to whether they should sell her house. Can she keep it as an asset, and rent it for more caregiving funds? The sale proceeds won't be enuf to pay for assisted living only 2 years, then she's broke. Any advice?


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PostPosted: Sat Apr 27, 2013 1:22 am   Post subject: 401k assets  

I am on SS disability. When I became SS eligible after 24 months I received Medicare. I applied for Medicaid eligibility for my Part B benefits and prescriptions..it was granted,but I did not know a 401k was an asset.It doesn't ask about a 401k anywhere on the form. Now I find out it is an asset. I have received those benefits for 2 years..This has nothing to do with LT care. But what do I do now that I am aware of the fact it is an asset and have been getting benefits. It isn't much, only 12K, but obviously over the threshold..I am in Fla. What are my liabilities ? Thanks in advance


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