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If it is not a joint account but a signature account with full rights, then the funds in that account can also be viewed as their asset. I would imagine that a Medicaid ineligibility for this can be successfully challenged via a hearing. You are going to have to clearly show that there was no co-mingling of funds and that the account was not used for them or by them.
I do know of this being an issue for TUTMA accounts - kinda really need to closed out & placed in new minor account with nothing from grandparents anymore.
If the spouse is $ dependent on the other (like a wife who didn't work and everything $ is tied into hubby's SS & retirement), then she will have to file to get MMNA - monthly maintenance needs allowance. Most states have this set @ pitiful low rates and it seems you have to get an attorney to work it so that you can get his income (which is expected to be his Medicaid co-pay to the NH) diverted to you to provide you income to live in the "community".
One issue for couples, is that Medicaid allows for only 1 car. So they give away the extra car to a grandkid & that triggers a Medicaid transfer penalty inquiry. Total PIA to deal with. For couples, what is often best is to trade in both cars and get a newer and more reliable car for the "community" spouse to use. If you have a mortgage and have funds beyond the 112K, then using the extra $ to pay off the mortgage is often a very good spend-down if she is staying @ the home. But you kinda have to do all this before the Medicaid application.
For community spouse/NH couples, Medicaid does a "snapshot" day in which all the couples finances are set on that day. So you have to get everything done before that day (like get the mortgage $ done & cleared; the cars done, etc) to optimize your use and control of your assets. Although you can do all this yourself, I would imagine for couples it is just too overwhelming to deal with as you are focused on your spouse & their care. If this sounds like you, then you should look into getting an elder law attorney to work with you on this. This site has a drop down list of elder lawyers by state which is an easy way to start all this. Good luck and try to keep a sense of humor in all this too.
In most cases, after a person who gets Medicaid nursing home benefits passes away, the state must try to get whatever benefits it paid for that person back from their estate. However, they can't recover on a lien against the person's home if it's the residence of the person's spouse, sibling (who has an equity interest and was residing in the home at least one year prior to the nursing home admission), or a blind or disabled child or a child under the age of 21 in the family.
Your assets: Most people who are eligible for Medicaid have to reduce their assets first. There are rules about what's counted as an asset and what isn't when determining Medicaid eligibility. There are also rules that require states to allow married couples to protect a certain amount of assets and income when one of them is in an institution (like a nursing home) and one isn't.
I had to supply Medicaid with my dad's bank statements. They never requested access to his accounts.
Medicaid NH application rules are set by each state & are state specific even though is a joint federal & state program. Qualification is both financial & medical & is very much needs-based. You are fully expected to spend down your assets first & foremost before the state will pay. You provide the documentation - up to 5 years back - to show that you are at-need financially. If you don't want to do this, fine. Nobody is making you apply for Medicaid.
Medicaid doesn't want or takes anybody's home. Really like the state would want a bunch of old homes filled with old lady stuff & decades of delayed maintenance.
But what the state does want and is required to do, is to attempt to recover some of the costs it spent on your NH stay from your estate after death. This is done via MERP - Medicaid Estate Recovery Program. MERP has all kinds of exemptions - for careproviders, for other at-need heirs, for upkeep on the property, etc. - but it is up to you to do the homework and documentation for the exemptions.
Medicaid estate recovery gets to the heart of the issue of who should pay for long-term care -- the public through the tax-supported Medicaid program, or users of long-term care through their personal resources, including those remaining after death. Amounts collected from Medicaid recipients' estates are not insignificant in absolute terms. As Babalon well described. They do, however, pale next to total Medicaid spending for long-term care. This is not surprising, given that Medicaid is available only to those with very limited resources. The system is not perfect, but everyday I am so grateful that Medicaid & Medicare exists for my mom and all the other elders out there who need skilled nursing and cannot private pay.
They do try to 'recoup' on houses by putting liens on them, etc, and if the home is worth over a certain dollar amount, they will not approve the application. In which case the solution is to sell the house and use the proceeds to pay for nursing home care until they run out and Medicaid is approved then. Under a certain amount, or if there is a qualifying family member still living there, they don't do anything to the house. If a house is sold while the person receiving Medicaid is still alive but in the NH, the proceeds go to Medicaid because of the lien. Those are just general details I have learned in my own research and experience so don't take them as focused accurate information. The Fed Gov't has guidelines for states receiving Medicaid block grants and then each state makes some rules for themselves based on those requirements.
All in all, I have to say I don't see anything wrong with what they do, particularly in this day and age when so many people are using Medicaid as if it were long term care insurance (which it is, but I mean the kind you pay for in advance by planning). And that really only applies to those who could have afforded to plan ahead and who have the money and/or assets to provide for their old age themselves but instead choose to try to circumvent the guidelines and keep their funds from Medicaid so that they can then use everyone's money as their own, so to speak.
Medicaid tries to recoup these costs on behalf of ALL taxpayers since we all pay into that fund. If we need it, they will provide it. But if it isn't needed, it seems only fair that it is not used so that others who have no other options can use it.
It is unfortunate that people aren't assured they will be able to leave behind anything to their heirs other than bills. But that isn't anyone person or agency's fault but rather a combination of factors that don't seem to be preventable in part or instantly rectified otherwise.
With just a quick search, I found data from 2004 here:
http://aspe.hhs.gov/daltcp/reports/estreccol.htm
For that year, Medicaid NH spending was $45,835,646,786.
Estate recovery was $361,766,396.
Medicaid, then, that year, only recovered 0.789% of what was spent on NH/long term care.
I live in New Mexico, a state unique in that we receive the most assistance from Gov't and pay the least in...and Medicaid estate recovery is just about 0%.
It is simply because it is a very poor state to live in.