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I don't trust him and I don't think legally my mom is in a frame of mind to sign any legal documents. My mom feels like she has to secretly tell me what is going on. We have always been open about how to care for mom. I need advice on how Medicaid works because I believe he is keeping this from me for a reason just not sure what?

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If it was that simple everyone would be doing it. Medicaid will want to scrutinize their accounts for the previous 5 years looking for exactly this kind of transfer, beyond that some jurisdictions consider that marital assets such as the house are co-owned regardless of whose name is on the deed.
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If he’s doing this in the belief that it will be a method to avoid Medicaid look back regulations, he is beyond mistaken. And could be creating problems for her future Medicaid eligibility and for himself.

Do you think its for medicaid avoidance or could it be that he himself has some dementia & is acting on bad advice coupled with his own fears?

Medicaid does NOT require the community spouse (your stepfather) to themselves become impoverished. They can have their home (under a set value) and a (1) car as exempt assets, his monthly income is not a factor for her eligibility, plus he can have his own exempt assets (most states have this at 119k). He can possibly move assets above the 119k to a SPIA to pay him income. Only your mom will need to be at 2k in assets and have income below your states max for her Medicaid eligibility. If he should need some of her monthly income to enable him to continue to live as a community spouse he can request CSRA or MMNA waived from mom’s income to go to him rather than be paid to the NH. Community Spouse Resource Allowance/ Monthly Maintenance Needs Assessment..... think of these as kinda like old school alimony for the nonNH spouse. But how to best do any of these are imho not ever a DIY project. SPIAs in particular are very much speciality underwriting to be ok for Medicaid. Really imo they need to work with a NAELA or CELA level of elder law attorney to come up with a plan that will work for however Medicaid reviews LTC applications for your state. Not a DIY.

His transferring stuff now may actually be placing her into getting a transfer penalty when she finally applies for Medicaid. He’d have to do everything like now and not apply till Spring, 2024 to get past the 5 yr look back. That’s a l....o....n...g long time.

On another note, My late mom had Lewy and in many ways at the beginning and mid stages it was quite different than Alz was my experience. They stay lots more competent & cognitive and can continue to be pretty good at their ADLs. Which can be problematic for being found to be medically “at need” for skilled nursing care in a NH. Most states Medicaid LTC programs only will pay for NH level of care. If she cannot be evaluated to be “at need” medically for SNC then no Medicaid paid NH so either it’s private pay in AL or at a NH. It’s often a fine line to get Lewy to show “at need” medically for Medicaid. For my mom, she was in IL and it took abt 5 mos of seeing her gerontologist every 3-5 weeks to verifiably build up her health chart to show she was at need. She did the jump from IL to NH bypassing the AL phase. At the time, I didn’t realize just how unusual this was. For those living at home or in IL, they flat often do not have the fat medical chart to show need like someone hospitalized (MediCARE) then discharged to post hospitalization rehab (MediCARE benefit) at a NH with a rehab unit does. Most NH admits come via this process, so they come into NH with MediCARE paying at least till 20/21 days & if they aren’t “progressing” in rehab, they remain in the NH and transition to skilled nursing care (which is either private paid, LTC insurance or they file to be Medicaid Pending). Plus They have a nice fat medical chart that clearly shows “need”. And family kinda has that rehab period to pull together the documentation needed to file for &/or spend down till Medicaid eligible.

So so what’s your vibe..... he’s care for her but is fearful / panicking doing stuff without fully realizing he’s creating problems OR he’s moving on & away from his wife your mom??? To me your next step kinda needs to be determined by what his intent is.
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Kim2bake Jan 2019
Thank you so much for your advice. I'm hoping he is jyst making bad choices out of panic. My husband doesn't agree he thinks my step dad is wanting to put mom in a home and take off somewhere. I need to do some investigating and present him with the facts about Medicaid. I have had this conversation with him already but maybe he just didn't believe me I will get someone else to explain this time. Thank you for your knowledge I really appreciate it.
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This is Medicaid fraud. He would need to go to a lawyer to change the deed. If u find out who that is, make them aware of Moms condition. Same with DMV, contact them about the situation.

If he does this outside the five year look back, he will be OK. But if within, he can be held responsible for her care. He needs to talk to a lawyer versed in Medicaid. Medicaid does not take the house and car. SD will be considered the community spouse and will not be made impoverished. With my GFs parents Dad was in LTC. Mom remained in the home and had the car. They had 60k in the bank and that was split between them. Dads 30k had to be spent down to the 2k my state allows. When mother passed a few years later, she still had the 30k. So she had enough money to live.

Medicaid does not take the house. They put a lean on it which needs to be paid when and if the house sells.
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I'd get legal advice pronto to find out what is legal and proper. There are lookback periods, so, some things, may not likely help. Also, there are protections for spouses, so, I'd inquire about that.
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Medicaid won't take the house or cars as long as your mother and stepdad are living in them/using them. Medicaid will charge back to the estate what is owed after everyone has passed. You can google a lot of this information -- and there are several responses on this site (search at the top under Forum) that can get you started and start to allay fears. But, yes, above all, talk to a elder care attorney.
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If anyone should be in what is called "Living Trust, Make sure it is what is called "The 5 Year Look back, Which means if a Nursing home is brought into this Picture Here, dear, It should have been Put in a Trusty old account in Someone else's "Trusty" name to Protect Everyone who has this account, Or it will Raise a Red Flag when applying for Medicaid in a Nursing Home and that Person could be Disqualified.
If Mom and StepDad have joint accounts, It would turn into a Spousal Improvement if One of them should go in. Right now while she is at Home, He can't do anything without her permission, She is of Sound Mind.
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I was told they go back ten years when looking at assets.
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gdaughter Feb 2019
It may be 5, not so long as 10...
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See an eldercare attorney--Medicaid is highly complex and laws vary from state-to-state. a lawful spouse has protections, but like I said Medicaid is highly complex. There are alternatives to nursing home care such as hospice. It's far better to keep off of Medicaid if at all possible.
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There are different ways btw, of determining someone's competence and ability to sign papers. While there may be problems with short term memory, they may not prevent someone from being asked enough questions in the moment, being told things they can still comprehend, and having the capacity to sign things. Certified Elder Law attorneys know about this sort of thing.
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This is illegal. Everyone tries this. There are specific laws that address this as no one wants to be "spent down." This is also taking advantage of system. They don't take anything. They access all income and assets and set up a budget and you can live in the house if it's an asset; they will have rights over it. Fraud it is and writing into a public forum is not a smart idea as they do watch. There's so much fraud in this area and so many people end up on medicaid and people wonder why we're in debt. If the guy thinks he's smart the IRS also looks and keeps tabs and is observant of this behavior as well. Also, it's not 5 years: they can look back 15 years if they suspect fraud.
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gdaughter Feb 2019
didn't realize they could look back 15 years...learn something every day...
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Your stepdad could be making a huge mess. What you're describing is illegal.

Insist that he consult with an elder law attorney. Some assets can be legally protected. For others, there is a 'look back' period. If any significant assets are transferred within that period, they will still be counted as belonging to the Medicaid recipient and will be recovered.
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gdaughter Feb 2019
It's not so much illegal as stupid, and looks bad when they do the look back, but my guess is, so long as they would be honest about what they did, they're just going to wind up paying for it somewhere along the line. If they don't apply for medicaid for X number of years into the future after this, the impact may be different. But I definitely agree to get to an elder law attorney ASAP before doing something that can't be changed. Medicaid shouldn't be so complicated but it is. I also think there is something that allows the spouse to keep the house so he may be doing something for nothing.
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Many people try this route to avoid paying the government for whatever.
Even Sen. Diane Feinstein tried it several years ago when her husband was near death. She got caught when he passed and had to pay a lot.
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Medicaid will catch them red handed. They'd best seek out an elder estate attorney.
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Well, he’s kinda right. But he should have done this 5 yrs ago, because if they see transactions less than 5 yrs, there is a penalty.
www.elderlawanswers.com/protecting-your-house-after-you-move-into-a-nursing-home-6897
A lot of people do this, this is nothing new, whether it’s right or wrong.
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If there is any concern that he will liquidate all of these assets and take off, you need a certified elder law attorney like yesterday.

www.nelf.org can help you find one in your state.
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You want to maintain your good working relationship when it comes to café for your mom so if I were you I would soft pedal it a bit. Ask him if an attorney or accountant advised him to do this and if not clue him in that it might be a good idea to consult an elder attorney or professional that is versed in elder legal matters and in particular Medicaid since how he goes about this might make a big difference in the future. Tell him there might be a better way to "protect" assets and money, not that you know what they are you just know that people have ended up loosing/paying more in the long run by just transferring stuff or removing names and the last thing you want is for him to get into trouble or end up paying out more. Maybe he does have his own reasons and maybe it's all on the up and up, truth is it doesn't matter he needs to be careful and get good guidance in how to do what when it comes to financial matters here. So you might as well stay on the same side.
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He is right.
There is a lot of misinformation in the answers you are getting about Medicaid and spend-down.

The spouse of a person needing Medicaid eligibility is allowed to keep ownership of their home and a specified dollar amount of other property. This amount differs by state. To be eligible for Medicaid, however, your mom can't own more than $2000. So, cars, as long as they are worth less than the amount the spouse can keep, can just go over to the spouse alone. This is NOT gifting, and has nothing to do with look-back.

If you and mom are afraid stepdad is preparing to fly the coop, which you didn't seem to suspect before, consider these alternatives:
He can do (with the advice of a competent elder law attorney) the above planning and transfers, and Medicaid will pay for most of Mom's care. He will possibly be left with some assets after she's gone, which he can use all for himself or maybe leave in his will to his loving step-daughter.
Or
He could sell all their assets and leave himself destitute paying for her care, maybe ultimately qualifying her for Medicaid anyway, since the average survival after diagnosis of LBD is 8 years. Then, maybe he can move in with you, right? Since he'd be homeless and all as a result of taking care of your mom; and you get no inheritance.
OR
Maybe Mom could divorce him--although I'm not sure since she may be incompetent to do that. Then she'd get half their stuff, which she'd have to spend down to $2000 to be eligible for Medicaid. That won't take long once she needs full-time care. Stepdad would have half of what they own and bitter memories. He wouldn't be very likely to see to her care anymore, would he? So, who would do that? Mom will have no inheritance to leave you, and he may not feel like he wants to leave you anything from the half of their assets that he otherwise might have had most of.

So, consider carefully which way you'd choose. My advice is to help him every way you can as long as he is trying to get good care for Mom. Both of you working together will be a lot better for all of you in the long run.

And may God help you all in this difficult journey.
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i agree with agingmyself. My family is going through the process of getting Medicaid, as my mother was admitted to a LTC, 6 weeks ago. Fortunately, 6 years ago my one brother was able to convince my dad to seek advice of an elder lawyer. Everything was put into dad’s name. An irrevocable burial arrangement was paid for from investments, so that money could be used in the most equitable way to benefit Mom. One thing we overlooked was changing beneficiaries on Dad’s life insurance. As far as stepdad not sharing you need to evaluate what signals you may be sending him. It Has been a difficult emotional and knowledge journey for my family. Being able to imagine and plan for the worst possible scenario at least 5 years ahead of time. Of my 5 siblings, two have had a hard time seeing what is happening right before their eyes, while us 4 saw the need to act. So we do what needs to be done and then inform the other 2, when they will agree with the care. The one when you tell him the plan ahead gives solutions that do not seem practical in the long and he is not willing to search out all the facts to show it as a better choice. It is a emotionally and strategically difficult and complicated journey caring for a LO with dementia. Many times there is no perfect situation, so planning for the worst ( this is very hard, 14 years into Alzheimer’s) and hoping for the best. I believe that one thing we have learned from this is we need to give each other grace. I hope your journey makes you feel you did a good job and that regrets are few and your important relationships remain strong.
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I've known people who have had their assets put in their children's names before going on Medicaid or putting their spouse on Medicaid.
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Kimber166 Feb 2019
If they do that five years before the apply for Medicaid for long term care - it is OK - past the five year look back. But if they are year three and need Medicaid - they will be denied and then there is a mess. How is the nursing home to be paid for as Medicaid will not? Is someone who received the gifts going to take parents in?
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I also know someone who is in the process of fighting to keep Medicaid from taking their property to pay for his deceased mother's nursing home and/or medical bills
They've been fighting this for a year now.
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igloo572 Feb 2019
Teresa - what is happening with your friends and what can be done is imho really dependent on which side of Medicaid the problem is on...... like
- is this an eligibility issue to get onto Medicaid and the property in question with Medicaid was transferred or gifted within lookback or that property value is an issue? That is a Medicaid transfer penalty issue and imo they need a Medicaid speciality atty that does litigation.
If they transferred the property via a QCD - Quit Claim Deed - and did it as a DIY filing at the courthouse it will be quite a mess to deal with beyond Medicaid eligibility requirements.
or
- is this a Medicaid Estate Recovery issue, so elder has died and now family is dealing with MERP? If it’s post death, they need imo to have a valid will and whomever named as Executor needs to hire a probate atty who understands MERP to start the probate process. Probate then rolls onto however your states laws are for claims against the estate.

If it is “their” property - that meaning an unencumbered property is/ has been transferred & recorded into their name at the courthouse - it can not be seized by Medicaid. I’m guessing that the property in question is not and has not been properly transferred and recorded at the courthouse.

Medicaid wants the applicant to either have spent down appropriately to be eligible or post death has to attempt to get a recoup of $ paid by Medicaid from the deceased estate.

Now property owned by an individual can have a judgement placed atop the property if the owner has a judgement issued on them. Then it goes to whatever system your state does for judgements..... like 5 years and then it falls off or indefinitely but has to be renewed wth fees paid to renew annually.

I’d bet a case of Prosecco that your friends are not giving you the exact details - like property vacant or occupied, documentation provided in detail to the state, exemptions valid, no other securitized lending on property - of all issues & possible cockups in this matter and there’s been actions done on their own without legal advice that have caused the impasse with Medicaid. Medicaid isn’t apt to wait a year to do an eligibility nor is a facility likely to have a resident Medicaid Pending that long. Now if this is in probate, that can be till forever long your state allows probate to stay open assuming there was a valid will to open it and get Letters Testamentary issued.
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Who is the doctor who made the diagnosis of Lewy Body Dementia? That physician may be in the best position to help you confirm that your mother lacks capacity to sign legal documents. And from the way you wrote "My mom feels like she has to secretly tell me what is going on" it sounds like you may be concerned about financial elder abuse.

How old is your stepdad? What is his health like? Does he take good care of your mother?

What kind of cars are we talking about? There's a big difference between a Buick with 90,000 miles on it and a classic Cadillac that's in mint condition that could be sold at auction to a collector.

How much do you estimate their house is worth? Is it a million-dollar mansion or an ordinary house?

Medicaid is not heartless. They don't take assets away from old people that allow them to live in dignity; however, if your mother has assets that could be sold in order to pay for her long term care that's another matter indeed.
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Medicaid is extremely complicated! I have seen individuals take advice from well-meaning folks that ended up disastrous. Please, please, please seek the advice of an elder law attorney.
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