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There must be an error best to let the pension plan know the payment is to go to pay for care. Is the pensioner in a nursing home? If so nursing home should offer assistance.

It will be discovered by Medicaid. I would rather be working towards a fix than doing nothing when it is found out.
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Unless the pensioner is dead, the plan would not be paying beneficiaries. If the pensioner has died, then it makes sense for the beneficiaries to be paid. Pension benefits generally are exempt from the claims of creditors under federal law, which means the beneficiaries get to keep the money.

If the pensioner is living, it's a different story, but it may not be an error. It may be that the plan has been informed that the pensioner is incompetent. In that case, the plan would try to pay to the pensioner's guardian or conservator. There may be a vague phrase like "those persons who would normally be expected to provide care for the pensioner if incompetent." In other words, the plan is probably trying to make sure the people taking care of the pensioner are receiving the pensioner's funds, not realizing the pensioner's funds should be going to Medicaid or the nursing home.
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Who is the beneficiary, spouse? Not sure how it works when a spouse is involved. Otherwise, I know of no pension that pays out to anyone else. My Mom just passed and her pension she received from my Dad stopped. At the time of filing for Medicaid all income should have been reported. In my circumstance, the NH became payees for Mom's SS and small pension. Then...Medicaid payed their part.
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Just a thought. There are no beneficiaries to pensions from employers. It's called a survivors benefit and is set up at time of retirement. The pensioner takes less in income so the survivor can have income when pensioners pass. Now if the pension is a 401K or annuity there are beneficiaries. Medicaid will not leave a spouse broke.
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