GLP AFTER DARK - Discussion - Medicaids Dark Secrets

Valuable information, thank you Phenn. I have medicaid and I worry about them screwing over my wife if when I go.

What is the difference between Medicare and Medicaid? Medicare is a medical insurance program for people over 65 and younger disabled people and dialysis patients.

Medicaid is an assistance program for low-income patients' medical expenses.


Phenn, is your thread all inclusive or does it just apply to Medicaid?

For many participants, the program that provides health care to millions of low-income Americans isn’t free. It’s a loan. And the government expects to be repaid.

Medicaid, isn’t exactly free. It can function like a loan. Medicaid recipients over the age of 55 are expected to repay the government for medical expenses—and states will seize houses and other assets after those recipients die in order to satisfy the debt.

In most states, it will not seize a home occupied by a spouse or a dependent child of the late Medicaid recipient until they die or move. It also offers waivers for financial hardship and an “adult child caregiver” exemption for those who lived with a parent for at least two years and “provided care that allowed the applicant to remain at home.

Bill Clinton signed the Medicaid Estate Recovery Program into law as part of his deficit-reduction act in 1993. Previously, states had the right to seek repayment for Medicaid debts; that new law made it mandatory.

Estate recovery punishes working- and middle-class Americans who, despite the odds, have managed to scrape together a little something to pass on to their children.

The majority of states, however, took a harder line. Some started allowing pre-death liens, tacking interest onto past-due debts, or limiting the number of hardship waivers granted. The law gave states the option to expand their recovery efforts to include other medical expenses, and many did, collecting for every doctor’s visit, pharmaceutical drug, and surgery that Medicaid covered.

during the rollout of the Obama administration’s Medicaid expansion more Americans considered Medicaid as a health-insurance option, more came across the fine print. At least three states passed legislation to scale back their recovery policies after public outcry.

excerpts taken from
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[link to www.theatlantic.com (secure)]


It’s possible to protect your assets by putting them into an irrevocable trust or transferring a deed to a family member before you reach retirement age.

How Medicaid Takes Its Money Back After You Die

Medicaid, the state/federal health coverage program for low-income people, may take its money back from your estate after you die. It can do so if you received Medicaid-funded long-term care after the age of 55. In some states, this can happen if you received Medicaid-funded services before the age of 55 if you were permanently institutionalized or any Medicaid-funded services after age 55.

Known as the Medicaid Estate Recovery Program (MERP), Medicaid can recover the money it spent on your care from your estate. This is a longstanding provision enacted as part of the 1993 Omnibus Budget Reconciliation Act (OBRA).2 Prior to OBRA, it was optional for states to seek estate recovery of long-term care costs. Upon the enactment of OBRA in 1993, it became mandatory for states to recoup funds from the estates of those who incurred long-term Medicaid costs from the age of 55 and beyond.

Impact of Obamacare
The expansion of Medicaid under the Affordable Care Act (ACA), also known as Obamacare, pushed the issue of Medicaid estate recovery to the foreground in states that had strict estate recovery programs in place.

Under the ACA, Medicaid eligibility for adults under the age of 65 has been expanded to include most people with household incomes that don't exceed 138 percent of the poverty level.5 Moreover, assets are no longer taken into account for people younger than 65; eligibility is based only on income.

Like expanded Medicaid, eligibility for the ACA's premium subsidies (premium tax credits) is also based only on income, without regard for assets. And premium subsidies to offset the cost of private coverage are not available to those who are eligible for Medicaid

Protected Estates
States aren’t allowed to make estate recoveries while your spouse is alive, but they can try to recover Medicaid funds spent on your health care after your spouse dies. States can’t make recoveries if you have a living child who is under 21 years old, blind, or disabled.1
In some situations, states can’t recover funds from the value of your house if an adult child who cared for you is living there. But, these rules are complicated, so if you’re relying on this to protect your house from MERP, you’ll need to consult an estate planning professional or get legal advice.

States must provide for hardship exceptions to MERP. But, each state decides for itself how it defines hardship. The federal government suggests that estates which include small family businesses and family farms be considered for a hardship exception if the income produced from the property is essential to the support of surviving family members

How to Protect Your Estate
In some cases, you may not be able to protect your estate. In others, advanced planning with the help of an elder law attorney or estate planning professional may shield some or all of your estate’s assets. Or, you may discover that the laws in your state make it unlikely that MERP will try to recover assets from your estate.

Income that counts towards Medicaid eligibility includes annuities, pensions, rental income, wages, and Social Security benefits. Any funds in an irrevocable trust are not countable assets, though funds in a revocable trust are. Unlike your assets, however, your personal income does not affect your spouse's eligibility and you will not be required to contribute your income towards their Medicaid expenses.
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[link to www.verywellhealth.com (secure)]

When Medicaid Can and Cannot Take One’s Home

All 50 states and the District of Columbia have Medicaid Estate Recovery Programs (abbreviated as MERP or MER). These programs became mandatory with the passing of the Omnibus Budget Reconciliation Act of 1993. Following the death of a Medicaid recipient 55+ years old, MERPs attempt reimbursement of long-term care costs for which the state paid for that individual. This can be for in-home care, community based care, such as adult day care and assisted living services, or nursing home care. Medicaid estate recovery is also mandatory for deceased Medicaid recipients under the age of 55 if they were receiving nursing home care.

It is via one’s remaining estate that the state attempts to be repaid. Often, the only asset of any significant value that remains at the time of a Medicaid recipient’s death is their home, and it is often through the home that the Medicaid agency is reimbursed. MERP does not apply if the deceased Medicaid recipient has a living spouse. In this case, Medicaid cannot attempt recovery of long-term care costs. Furthermore, most states have a limited timeframe in which they can file for estate recovery. This is generally one year following the death of a Medicaid recipient.
Not all states run their MERP programs the same way. For instance, in some states, such as Florida, if the Medicaid recipient passes away, leaving a surviving spouse, the state will try to recover long-term care costs after the surviving spouse dies. Other states, such as California and Texas, prohibit estate recovery following the death of a surviving spouse preceded in death by a Medicaid recipient. The only exception is if the surviving spouse was also a Medicaid recipient.

Keep Assets Out of Probate
Some states only seek Medicaid estate recovery through probate, and in these states, there are ways for a Medicaid recipient to keep their home out of probate. Probate is a legal process that involves checking the validity of one’s will, determining the value of the deceased’s assets, and paying any remaining taxes and bills. Keeping the home out of probate keeps one’s home, and proceeds from selling it, safe from Medicaid. This is because only assets solely owned by the deceased go through probate, which means if the house is jointly owned, it will not be included in the probate estate. There is one exception. This is when the home is jointly owned and rather than the deceased’s share of the home automatically inherited by the other owner, the beneficiary is named in the will.
If a home is in a lady bird deed, a type of life estate deed, it will not go through probate. With a lady bird deed, a Medicaid recipient maintains ownership of their home while they are living. Upon their death, home ownership is automatically transferred to another person, often the deceased’s child.

Irrevocable Trusts
One can protect their home by establishing an irrevocable trust that holds the title of the home. Irrevocable means the terms of the trust cannot be changed or canceled. In an oversimplified explanation, a ”trustee” is named to manage the trust and the trust maker is no longer considered the owner of the assets. However, the trust maker’s children can be named as beneficiaries, protecting the home as inheritance. The problem with Medicaid Asset Protection Trusts is timing. This type of transfer violates Medicaid’s look back rule and creates a period of Medicaid ineligibility. Therefore, this strategy needs to be implemented 60-months prior to applying for long-term care Medicaid. One exception is California, which has a more lenient “look back” of 30-months. New York is also an exception. While the state currently has no look back period for long-term home and community based services, they plan to begin phasing in a 30-month “look back” in 2022.
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[link to www.medicaidplanningassistance.org (secure)]

Let's all add in the discussion, for shits & giggles, REVERSE MORTGAGES


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Brother in law died in 2008. Was in the county hospital to three weeks due to a mistake from doctors contracted to said hospital. Long story short, State of Texas tried to ge reimbursed by his sister. Long legal battle ending in the State losing in court. Cost them another $125,00 in legal fees.
Still, the hassle they put us thru was an enormous burden on us. Be Leary of this shit.

Medicare is how they steal all the money the money counters keep dead people alive then they have mass die offs when that president leaves office even though they died 4 years earlier they stagger it to make it look mathematically correct too

look, the end game is to leave us with nothing. no inheritance.

From your original post, Phenn:

“It also offers waivers for financial hardship and an “adult child caregiver” exemption for those who lived with a parent for at least two years and “provided care that allowed the applicant to remain at home.”

I know that in New Jersey, the adult child caregiver must live with and provide care to the parent for at least three years to obtain a waver. Came across that info from the state website when taking care of my elderly mother with dementia.

Got any info on Montana???

put ur house in a trust!!! worth the 1000-1500 to do it.

Phenn,

I’m under 55 and on Medicaid cause I can’t afford health insurance.

If I’m understanding this right, I don’t have to worry about this shit as long as I take myself off Medicaid before age 55 right?

Because they can only place a lien against my estate if I’m still on Medicaid after 55 and in some kind of long term care program (nursing home).

Or am I not understanding this right?

in NY its 2yrs

You’d think that it would be a federal standard but I guess if the state’s paying for it…

Btw, if anyone could tie Tom Selleck’s eyebrows together, it’d be you.


Or my wife…

To secure recovery of Medicaid payments made, the State may place a lien on real property (real estate; land with or without improvements) owned by a Medicaid recipient living in a nursing home or other medical facility or institution such as the Montana State Hospital or Montana Developmental Center
its a p-d-f
[link to dphhs.mt.gov (secure)]

put ur house in an irrevocable trust NOW. prepare now. then they cant touch you later.

its a federally funded program. ur state aint really payn shit. they'd getta cut but its the feds behind it.

During 2020 lockdown a man & his wife went on unemployment & applied for medicaid. 6 mos later he decides to flee Pennsylvania. his realtor calls him & tells him he has a 20k state lien against his property. he went nuts trying to figure out where this lien came from. after contacting me, this was the first thing i thought of. turns out - bingo. i was right.
he never used medicaid. never saw a doctor nor filled a Rx. it was for....ready? PREMIUMS!!! no way to get the lien released either. sold the property & had to pay Pennsylvania the money.

"It’s possible to protect your assets by putting them into an irrevocable trust or transferring a deed to a family member before you reach retirement age."

No, it's not possible. They will still get it. I know for fact. Iv'e had an "I T" since '08'. More on the later, I'm trying eat.