Medicaid is not free, it is a hidden loan, when you die the Gov't will come for your assets.

[dixiegrrrrl]

The expanded Medicaid rules, under Obamacare, are this:

Estate Recovery
Excerpt: "... a state may recover any assets of the deceased recipient" (to help recover costs
for medical assistance provided by the government)

Overview of what estate recovery is:

a federal law imposed on anyone who enrolls into Medicaid in any state
a way for the government to recover some or all of the money that it pays for health care to those on Medicaid


When a person is found to be eligible for Medicaid, they will be automatically enrolled into their state's Medicaid program. Those forced into Medicaid will, due to the federal law, also be forced into estate recovery. Their estates will be partly or fully taken over by the federal or state government when they die.

Estate Recovery is a Federal Requirement

Highlights of the 1993 Estate Recovery Mandate: from www.hhs.gov

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;
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.

When people sign up for Medicaid, they usually do not read the very very fine print that says the above.

Happened to the family of my next door neighbor when she had to be placed in nursing home.
The son thought he was gonna get the family house, but the state made him sell it to pay for her Medicaid bills when she died.

[DURHAM D]

1. I have no problem with this.

I know too many people who put Mom in a home and moved into her house while thinking they were getting away with something.

[tk2kewl]

4. what about inheritance taxes on large estates?

what do you think the rate ought to be?

[DURHAM D]

6. Do you mean estate tax? nt

[tk2kewl]

7. yes

[tk2kewl]

41. Yes... And your answer?

[cleanhippie]

38. 100%

[hollowdweller]

55. This is the real "DEATH TAX" that keeps the poor and middle class from accumulating wealth.

It's gotten to the point that so much of any money that the middle class or poor accumulate is taken away from their heirs by end of life care.

I personally would like to see this provision made illegal and the shortfall in revenue being made up by raising the actual estate tax for the very wealthy.

We have got to work as a country on getting the working class to have enough money to become at least slightly more wealthy generation to generation, rather than poorer and poorer.

[TBA]

2. You don't have to die

At least in Florida that is the case. I have a disabled son and his part of my assets will be managed by a trust for created for his benefit. I did this on the advice of an elder care attorney for exactly this reason.

If money is given directly to him, the State of Florida will take it all.

He would be destitute without my financial support.

[whatthehey]

3. Of course it works like that . MedicAID is for the indigent.

If it did not consider assets especially post mortem everybody who subsists on low income but with valuable property would deluge the program and "sign over" their houses to children etc to shield their estate from having to cover costs. You shouldn't be able to get programs designed for the very poor unless you ARE very poor, including not having property wealth.

[dixiegrrrrl]

11. there is an opposite side, however

You can have a house and a car, excluded from your income, and still have Medicaid.

Down here in the South, many many people live in very old houses on land that has been in the family for 100 years or more.
They are land rich but cash poor.
Normally they would pass on the land to their children/grandchildren.

Problem is, with the advent of the AHCA, , you HAD to have health insurance, and your perhaps affordable insurance was replaced by expensive insurance, so many people were forced onto Medicaid rolls.
Because the Health Care Act increased how much you could own and still be eligible for Medicaid, there are seniors who now have Medicaid, still live in their homes, and their children are unaware of the payback rule.

[okaawhatever]

17. The ACA wouldn't affect a situation like this If anything it would help a low income individual use

their private insurance and not have to deal with estate recovery.

Estate recovery is triggered primarily (solely?) for those who go to nursing homes. IIRC the law was created because people with wealth or means were taking assets out of their parents name, putting it into theirs and then putting their parent on the government dole. There was a two or three year rule for asset transfer (if you give your children your house you don't qualify for 2-3 years) but the financially and legally savvy were creating some kinds of trusts to avoid that rule as well.

I don't think the law was designed to hurt the poor, it was to stop the more well off from fleecing the system. Even with the current law I think some people still do it, they just put all the parents assets in their name several years sooner than they normally would.

[PoliticAverse]

54. You apparently missed the changes made by the ACA. Assets are no longer considered for eligibility

determination in the ACA's expanded medicaid, only income.

[dixiegrrrrl]

58. Thank you......x10.

[Gormy Cuss]

5. Most Medicaid recipients have no estate

because it's specifically limited to very low income people.

Recovering costs after death is actually a kindness -- the alternative is to force liquidation before establishing eligibility. That would mean, for example, that a senior who needs a few months of rehab in a nursing home would have to sell her residence to pay for, then after recovery would have to find a new, affordable place to live. By establishing a lien instead, the senior goes back to living in her home until she dies. After death, the state is repaid from the proceeds and any remainder is distributed according to the will.

The state didn't force him to sell, they forced him to pay the lien. If he didn't have the money to pay it off then selling the house is the only way to accomplish that.

[xocet]

8. Healthcare should simply be a right. n/t

[cbdo2007]

9. Someone still has to pay for it.

[xocet]

18. Of course. You prefer taking from the extremely poor apparently. A little reverse Robin Hood? n/t

[cbdo2007]

19. You don't know what I prefer, but thanks for the assumption, lol.

[xocet]

23. What you secretly prefer is irrelevant. What you post, however, shapes your image. Apparently...

taking from the extremely poor because "somebody has to pay for it" is fine with you. You negated a post regarding healthcare as a right. Healthcare as a right would defend the extremely poor from losing what little they have, but you apparently know better.

Lol, yourself.

[cleanhippie]

39. I always find it funny to watch someone get outraged over something another never said.

Seems like you just didn't like the response you got and decided to make something up and get all outraged over it. Classic!

[xocet]

47. It is funny. n/t

[tabasco]

22. Society as a whole should share the cost.

In a rational, decent society.

[kcr]

43. Of course

It costs more to live in a world with better infrastructure, and healthier, more educated citizens. We could return to time where everything was actually "free". No taxes at all, and in return, no services. It was pretty smelly, for one thing. I like electricity, running water, paved roads, a school to send my kids. Someone has to pay for it. Life back then was no fun.

A favorite talking point with some people is to point to parts of the world where where the poverty is horrifying and say "At least we aren't like that" There's a reason for that. We pay so that we don't just throw people out on the streets, or at least not so many that we end up looking so much like those parts of the word.

But there are some people who would be perfectly happy doing so just so that they don't have to pay themselves. But they know that's mean, so they don't come right out and say it. They just hint at it, then play, "Who, me?" when called on it, with smiley faces. "Someone has to pay for it"

[malokvale77]

10. Thank you for posting this.

I've posted this here several times, but it has gotten little notice.

The state of Texas will go so far as to take back child support payments. Texas didn't expand medicaid under the ACA.

This has always been a rule under medicaid.

[dixiegrrrrl]

13. Under expanded Medicaid with higher income guidelines

more people are now eligible, and the fact the state will come after what you think you inherited from your parents is not well known.

We need single payer so badly.

[cannabis_flower]

59. Texas

chose not to expand Medicaid

[SoCalDem]

12. Medicaid is intended for poor people

Poor people often have NO ASSETS

The rub is that many old people are cash-poor, but may have a home that was paid off years before.

Proper estate planning (often the responsibility of grown children) should include divesting oneself of assets as they are no longer needed.

The children should buy the home from their parent and use the money paid to provide long term care in that home, if possible... the home could then be sold once the parent is gone or can no longer stay there.. That recoups some of the cost.

Nothing in life is ever free..

Any state/federal help can be recouped later. A friend of mine got a police brutality settlement of her ex husband's because he had not paid child support..BUT they deducted the amount of financial help she got after she left him.. That went back almost 15 years..

[dixiegrrrrl]

24. Under the new Health care act, "poor" has a higher thresh hold.

It is now 133% of the old guidelines.

I am not arguing against the state recouping what they paid
I am pointing out that many people are now being covered who do not understand the recuperation rules.

and that medical care really needs to be Medicare for all.

[eShirl]

14. they'll find slim pickings on my corpse. n/t

[1939]

15. One of my neighors

Stayed in his house long after he should have sold and used the money to move into a care facility because his wife was in a nursing home with Alzheimers under Medicaid and if he sold the house, the state would take all the money.

[spinbaby]

16. They don't always wait til you're dead

While visiting a relative in a rehab hospital, I talked to a middle-aged man who had had a leg removed from some complication of diabetes. He had been living in a small apartment on Social Security Disability, but now that he was in the hospital, Medicaid took all but $50 a month of his SS payments. He had lost his apartment because he couldn't pay for it and was effectively trapped in the rehab hospital. I think a social worker was working on it.

[justiceischeap]

21. My parents are both in a nursing home

And that nursing home has taken their house for collateral and they also take all but $50/month from their social security to pay for their stays in the nursing home.

They are both on SS, Medicare and Medicaid supplementals. I'm not entirely impressed with the care they've received. My mom had skin cancer and had to go through chemo but couldn't do the entire course of chemo in one year because she used her total allotted benefits, so she had to go off chemo and wait until the next fiscal year to continue/complete it. I personally don't like the idea of Medicare for all from my personal experiences with how lacking it's been for my parents.

[KentuckyWoman]

20. Long term care is $300 - $500 a DAY.

In my area the cost of hiring a nursing assistant to come in the home is $17 an hr minimum 4 hrs. Paying for rehab, RNs and MDs to come in home is cost prohibitive. People by themselves are more or less forced into long term care at some point.

I don't have any problem with estate recovery so long as we aren't forcing a spouse or disabled child into poverty in the process. In the case of generational property, it is not that expensive to put the land in a trust. Been there, done that.

All that said we really need to get a handle on costs. It's ridiculous what long term care costs. Most of the time rooms are shared. there's no reason why the costs should exceed $100 a day all inclusive and even that's a stretch. A typical nursing wing holds about 40 patients - 2 to a room. 3 CNAs per 12 hr shift - 2 RNs and 1 MD on call. Add in food, meds and building costs along with social workers, food staff etc - split by 40 residents. There is no way to justify $300 a day for a shared room.

[Habibi]

25. Here's an article from 2014 that addresses this.

YMMV, depending on your state. But it looks like it's less of a concern for ppl on Medicaid for health coverage than for those in long-term care.

http://articles.latimes.com/2014/feb/12/business/la-fi-mh-medicaid-20140212

[dixiegrrrrl]

60. Figures...'cause the long term care is so expensive vs. reg. doc visits.

The state would be better off trying to get the long term cost recouped.

[Hoyt]

26. Law existed when I worked for a state Medicaid agency almost 40 years ago. It wasn't

enforced that often even in the few rare instances a Medicaid patient had any assets left after becoming seriously ill. There were laws that supposedly kept people from transferring assets to qualify for Medicaid. Attorneys specialized in avoiding that. But it was difficult to enforce. Glad I didn't work in the asset recovery area.

[spanone]

27. medicaid is for the poor.

Medicaid
Medicaid is a joint federal and state program that helps low-income individuals and families pay for the costs associated with medical and long-term custodial care. The federal government funds up to 50% of the cost of each state's Medicaid program, with more affluent states receiving less funding than less affluent states. Because of this federal/state partnership, there are actually 50 different Medicaid programs, one for each state.

Unlike Medicare, which is available to everyone, Medicaid has strict eligibility requirements. The rules vary by state (beyond the basics set forth in the federal guidelines), but the program is designed to help the poor, so many states require Medicaid recipients to have no more than a few thousand dollars in liquid assets to participate in the program. There are also income restrictions. For a state-by-state breakdown of eligibility requirements see these websites Medicaid.gov and BenefitsCheckUp.org.

While the program is federally mandated to serve the poor, just being poor may not be enough to qualify for Medicaid. Other eligibility requirements are in place to ensure that the program serves specific groups, such as families, pregnant women, children, caretakers of children, the disabled and the elderly.



Read more: What's The Difference Between Medicare And Medicaid? | Investopedia http://www.investopedia.com/articles/pf/07/medicare-vs-medicaid.asp#ixzz41heqY5uV
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[mindem]

28. I have been living through this.

My mother ended up in our local nursing home after a stay in the hospital due to a UTI. Supposedly the stay was for rehabilitative therapy and the stay was to be covered by her medicare. Due to the fact she began to go in to physical (she is 90 years old) decline due to an infection she picked up in the nursing home from their carelessness, she was not able to keep up with the requirements set to use medicare she was de-certified and pushed in to private pay at $9000.00 a month. Who the fuck can afford $9000 a month?

Then you have to endure the right wing, scolding sentiment "well nothing is free" "someone has to pay for it". Snark isn't a solution. The problem is our for profit health care system is out of control.

[erpowers]

29. Heard About That

About a year ago I learned about this issue by talking to a woman who had to fight to keep her dead mother's assets. The woman, who I am not related to, was telling me and one of my family members that if you use Medicaid to pay for a sick family member's healthcare the government will attempt to take the family member's assets after they die. The woman also said she fought the government because she had not used Medicaid to pay for her mother's healthcare.

[geomon666]

30. Jokes on them

I don't have any assets.

[Ilsa]

31. It's a thing to plan for in old age if you

Anticipate an elderly parent going to a nursing home they can't afford. Some parents give their lids the maximum allowable gift many years in advance of going into a home. The Lookback period is something like five or seven years, or maybe it's more now.

[Liberal_Stalwart71]

32. Don't you mean Medicare?

[dixiegrrrrl]

34. no.

[Liberal_Stalwart71]

35. Medicaid is for low-income families/seniors. Do these populations have "assets"?

[dixiegrrrrl]

36. yes.

As I wrote upthread, esp. in teh South, people are land rich but money poor.
We have a homestead law that if you own your primary residence, and adjoining land, you do not have to pay any property tax once you are 65, or blind, or disabled.
2-3 generations all live on the same land, sometimes the same house.
You are also allowed to keep a an older car without it being counted as income.

[dembotoz]

33. recently went thru this with my moms estate here is wisconsin

initial pleading form

right smack off the bat

receive medicaid
receive community options assistance
receive wisconsin chronic disease assistance
receive family care program
patient at state or county institution

not the last form the 1st form
kinda funny the community options program is where you get some paid assistance to cover home health care to avoid a nursing home for a while. they don't tell you it comes out of the estate.

as my mom became sicker and i had medical power of attorney options would be presented. i had to ask who paid for what and where.
in the end the hospice was a choice too. one covered by medicare one by community options i guess.... from what i remember, home hospice would come out of the estate, hospital hospice medicare....ass backwards....
there is no free lunch

[dixiegrrrrl]

37. But who pays for the lunch would be much more equitable under single payer

Families would not have to choose between 2,000 a month for mandated insurance premiums and food.
We could take 25% of the military budget and pay for health care for everyone.

[dembotoz]

49. no argument from me

[B Calm]

44. If a person knows they are dying, what's to stop them from giving away all their assets before

their death?

[dembotoz]

50. there are time frames thru which the state can go after the assets.

consult a lawyer
this is why lawyers exist
to cover the assets of those who have assets

[Ghost in the Machine]

45. When I got hurt on the job back in 2003, and Worker's Comp kept dicking me around, cutting

off my benefits, etc., until a judge made them restart it, my State Medicaid picked up the tab. They paid for one of my neck surgeries and subsequent hospital stays, which amounted to almost $200,000. Once everything was finished up and Worker's Comp finally reached a settlement, the State went after the insurance company to recover the money they had spent on my care, which should have been their responsibility anyways.

Peace,

Ghost

[oneshooter]

46. I have been fighting with tyhe State of Texas over this.

I am my FiL's executor. The state had filed a lien against a lot that he owned. A lein for $130,000 on a property that sold for $32000.
Texas law says that they have 70 days to file the lein, they took 84 days. Despite my attorney bringing this to their attention they continued with the lein. Only by threatening to sue did they see the light.
We close tomorrow.
I have since learned that there is no punishment in the law for those who violate this law. Makes me wonder how many have simply given up, and in doing so have lost what is legally thers.
I plan to fight to add a punishment to the law for those who abuse it.
Wish me luck. It will be a long fight.

[REP]

48. Many people transfer their assets to their children at some point to prevent this

I believe there is a period of time that has to elapse before the transfer and the incurring of medical treatment, but many families who have property but no cash arrange in advance to transfer those assets so they remain in the family. It can be tricky - there must be trust among the family involved and timing is a factor, but families with generational property are generally aware of what steps must be taken.

[notadmblnd]

51. Well, the good news is that before one qualifies for medicaid one has to pretty much prove that

they have no assets to begin with.

Maybe that has changed recently?

[PoliticAverse]

56. The ACA changed that. In states participating in the expanded Medicaid program assets no longer

matter, only income.

[ghostsinthemachine]

52. Most states have the same thing (like MediCal in CA)

Yep, when you turn 60, it is best to become indigent and give all your $$ and assets away so they do not become the States money.

[Capt. Obvious]

53. All true

We just went through this with my mother in-law.

I wonder if it would have been better to have her sell her house to her children before death.

[cannabis_flower]

57. It also will recover

money from women out of their child support. My daughter had a baby paid for by Medicaid and she doesn't get all of the child support the father pays because they suck up money to recover the Medicaid. My insurance covered her but not the baby. My granddaughter was in the hospital for two weeks because she was 7 weeks early and weighed 3 pounds 15 oz.

[haele]

61. Depending on the state, if the family home/farm/business is in a trust, it's exempt from Medicaid.

Mom's house is in a trust, as is my decesed FIL's, and our extravigant double-wide and other assets are also in a trust. Should the owner end up in a nursing home, the state has to go after other assets, not the house or any property where the title is legally held by the trust. The trick is to put everything in a trust either as soon as you buy the house, or before you get on Medicaid.
Which most generational owners and/or lower income people do not do, as they either assume the house and property will automatically pass down to the heirs as it did "in Grandpa's day" when their parents got the property, or they don't want to deal with the unpleasant issue of "what happens when I can't take care of myself" just yet, because they're still too young to think about retirement. Becoming disabled when still young has a tendancy to slap one in thet face with the reality of mortality.

Check with a lawyer, but from what we've researched, most forced sales for Medicaid costs cannot be leveraged on properties held in trust.

Haele