Any advice on the best way to repay transfers to become Medicaid eligible?

Repaying the gifts to you before applying for Medicaid is a good idea. If fully repaid before you apply, such gifts will not count against your mother for purposes of determining her Medicaid applicability.

It will be considered a gift by Medicaid and expected to be paid back and used for her care. I don't think paying it back now or later will avoid that, but I'd ask medicaid about it. If you had the authority to transfer her money, why didn't you just pay her bills using her checks? I don't understand why you mixed her money with yours. How much money are we talking about?

I assume that you do have Durable POA. That gives you the authority to write her checks to pay bills with her money. It's not meant for you to transfer her money to your account so that you can pay her bills. Was the amount transferred over the allowed limit before her facing a tax for giving away too much in one year?

Hopefully you have receipts or can get statements on what her expenses were. Health insurance statements. What a mess. Document, document, document, see an elder law attorney to assist with how best to straighten this out.

If you have receipts to prove the money transfered to your account was used to pay bills or make purchases for your mother's use, then you don't need to transfer the money back. If you cannot prove it was spent for Mom, then you need to transfer back as soon as practical. Medicaid assumes any transfer is a gift until proven otherwise.

In years past, I would occasionally order something or pay a bill online for my mother and use my debit card to pay for it because (1) there wasn't time to mail a check (Dad kept the insurance bill until due date) and/or (2) Mom didn't have and didn't want a debit card. After the transaction posted on my account Mom would write me a check with "for" the company and order/invoice number in the memo field. It works better with online banking because the memo field persists in the electronic record and not just on the check. Mom kept the original paper bill/statement and entered it into her checkbook bookkeeping journal. I kept an electronic copy by printing the payment statement to a pdf saved in a dedicated folder. I haven't had to Medicaid qualify either of my parents but the guardianship judge accepted this documentation.

They will need statements for five years. They will see where you transferred the money. Like said, get all the bills and receipts together showing where the money was spent. Your pharmacy can give u a readout of medications paid for. I would make everything easy to read, Show the transferred amount, then name of deduction (pharmacy, rent, electric) and amount. What u maybe responsible to pay back would be the balance left.

I had a lawyer for my Mom because she had a house. As my lawyer said " we start from here" Meaning that we can't do anything about our previous decisions, so we have to work around them. I don't think any of us understand the ins and outs of Medicaid until we are faced with it. I learned a lot from this forum.

I’d suggest 2 - possibly 3 - things:
- do NOT move any $ in an attempt to pay back or transfer back, wait till a specific determination is made by Medicaid. If it’s really truly a series of bookkeeping clusterF and you can work back payments to show no gifting or ineligible transfers done, it might be allowed by the Medicaid caseworker. You might want to start an Excell file and line up & xerox all receipts to be able to provide in detail $ trail and provide it all in a single document drop.
- clearly speak with the SW and admissions or/ billing at the NH where your mom is in now as to how Medicaid application gets processed in your state & be upfront that there was commingling of funds using your bank acct to sometimes pay mom’s expenses and may be a red flag for her Medicaid application and ask how to best approach the situation. For both my mom & mil, their LTC NH Medicaid application & the supporting documentation was given to admissions at the NH; in turn admissions gave it a review to determine IF they would accept them as “Medicaid Pending” resident (if Pending, they do not have to pay the private pay rate but instead just ok on the NH getting almost all their monthly income as the required under Pending copay or SOC - share of cost) and only after this internal NH review did the NH submit our paperwork along with thier bill to the caseworker assigned to the NH. Facilities do not have to take them as Pending if there’s something amiss but can instead have them only as private pay with DPOA or someone in the family doing a signed contract to be personally responsible for mom’s bill.

the 3rd thing - to me - depends on what comes of the caseworker determination of your mom’s eligibility and transfer penalty. If she’s determined ineligible and medicaid places penalty on all the $, I’d get an elder law atty to shepherd the appeal and also possibly negotiate with the NH as to rate paid. If mom is an relatively easy care resident and has a higher monthly income that she is already paying to the NH (like close to the Medicaid income max of about $2100), NH might be ok on you paying the state daily room & board reimbursement rate rather than full freight private pay. Personally think it’s better for an atty to do negotiations and deal with the appeal and atty explains out the accounting issues and knows what’s time sensitive for Medicaid.

In theory a NH is not supposed to favor a prospective resident with a higher monthly income vs one who is just a low SS a mo. But they do. My mom was in 2 different NH, mom had SS & a federal annuity & abt $1900 a mo. They all were positively giddy when each saw her SS & FER “awards letters” as that’s almost 2k they will be getting as a for sure copay while NH is waiting possibly 5-8 months for Medicaid to approved and pay retroactive. If your mom has a somewhat higher income, I’d definitely take her awards letters when speaking with NH.

Best of luck. You know applications often have errors or omissions, after all with a 5 yr look back that’s going back to 2013 & lot of bills, checks, etc. It’s my experience is that if your upfront and transparent on a glitch or a concern, that the caseworker wants to make it work out if it’s a sensible error. Transferring a home for zero no way; but paying mom’s Property taxes and then getting mom to reimburse for it months later is ok as long as there’s paperwork to support it.
Let us know what happens as we all learn from each other!

I agree that you would be best served by discussing this with an elder care attorney.

Yes, the commingled assets will be considered a gift in the five year look back and your parent will not become eligible until those assets are spent down.

Medicaid does this because too many people do commingle assets as a way to hide assets.

Other people do it as a way to financially abuse the elder by taking assets away from siblings or other family members.

If financial abuse is determined, even if the exchange was done innocently or ignorantly, there is always the possibility of a criminal charge.

Thank you for these replies. After reading them, I think we should discuss how to handle the medicaid application with an elder care attorney so we don't mess up any further.
Can we use mother's funds to pay for the elder care attorney as part of her spend down? Are these legal fees seen as allowable expenses by medicaid?
This may seem like a silly question but trying to learn about the medicaid rules by searching the internet and don't know if I've seen that question raised and answered.

Go to an elder attorney, they can really help you with this part of the financial complexities. They are worth the cost especially if there are assets.

Elder law attorney is needed here.