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If you’ve lived with your mother full time and taken care of her full time for at least 2 years & it’s properly documented then you probably qualify for the caregiver exemption.
Please note that Medicaid [different from Medicare] is funded by us taxpayers. If everyone was able to "hide" assets then Medicaid would no longer exist, or if it did our taxes would double to help fund the project.
MERP aka Medicaid Estate Recovery Program was part of Bush 2005 DRA aka Deficit Recovery Act of 2005. DRA 2005 required all states to have a uniform system for eligibility and recoup / recovery for all sorts of federal/state cost shared programs; done to provide a path to a more balanced budget.... a deficit recovery. Within DRA 2005, there is a section on Medicaid for those receiving benefits over age 55. Due to Bush DRA 2005, if a state wanted to get their federal share of $ for Medicaid, a state had to have placed in their states administrative code eligibility and recoup that falls into overall federal guidelines for Medicaid but done for however your states needed to do compliance within your states laws and administrative code.
Prior to DRA 2005, estate recovery was pretty much nil. The ability to do a recoup has been within the public law that created Medicaid since the 1960’s and thru every PL add on since. The feds didn’t mandate that a recovery be attempted prior to DRA 2005; and most states did very very little recovery. Some did zero.
Medicaid is administered by each state uniquely. The feds do NOT run your states Medicaid system. It is your states legislative that has determined just what MERP can attempt within the recovery process.
Again, Just how MERP will be done is dependent on your state.
For example, there’s about a handful of states that allow for a homeowner to do a “Lady Bird Deed” aka Enhanced Benefit Deed to have their homestead transfer outside of probate and does not affect the elders LTC NH Medicaid eligibility or be subject to MERP. If your state doesn’t do Lady Birds, then you find others concerned abt this and get organized to get this placed as part of your states administrative code.
Another example of how states can deal with compliance is how property values factor in for Medicaid eligibility. States set the $ ceiling is for having a homestead ok as an exempt asset for LTC Medicaid eligibility. Most states have it at 500/550k. But there are eastern seaboard states that have it higher at 750/850k. Elder w/a property bought or inherited in 1960’s that’s now assessed over Medicaid max set by your state will not be eligible for Medicaid. It’s not the feds who do this but your states Medicaid program.
For MERP, how your state attempts recovery will be interdependent on your states laws & administrative code. Whether MERP is a lien or claim depends on your states laws. If your disabled heir, that’s an exemption or exclusion to MERP by & large. But it’s totally on you to clearly find out what documentation is anticipated to be needed to do this type of exemption to MERP after elders death. Ditto for caregiver exemption or any other various exemptions or exclusions to Estate Recovery. It’s on your mom, you or whomever would be heirs to find out how MERP runs for her state and do now what you can to be prepared for it.
It’s on your mom to do a valid will for her states laws to establish who is her heir(s). If not, then when she dies it’s likely to be considered an intestate death and for most states - as far as I’m aware - that means the state determines what happens with the assets of her estate until and unless a lineal Heirship is done in probate court.
MERP is due to Bush era Deficit Reduction Act 2005. Not Clinton.
I did not randomly mention the Clinton Administration. I read that information in an article from The Atlantic (which you can research online), that states the Clinton Administration signed MERP into law, so I guess one of us is misinformed. But truly it really doesn’t matter WHICH Administration signed MERP into law. The fact is, and all I am saying, is that it causes a lot of hardship for the people who are facing a lien being put on property that they rely on for shelter so it can be sold to pay their state Medicaide Agency back for funds that were paid for their relative’s care. Based on the article I read, it has been proven that Medicaid only recoups about 13% of their spent funds even with this estate recovery process in place and just perpetuates multi-generational poverty for the state’s citizens.
It was signed into federal law but I understand that each state oversees the collection of the funds. And whether it’s the federal government or the states that enforce this MERP doesn’t matter either.
My only concern is where I’m going to live when my mother passes away, which hopefully won’t be anytime soon. It looks like I’ve got my work cut out for me and I better get busy finding out my state’s laws and what I need to do to prepare.
Again, I’m very appreciative for your response and information as I really don’t know anything about MERP other than what I read online in that article so your information was very helpful.
Thanks
Mom will have ziltch, zip, nada of $ to pay a penny on the house.
So all property costs - taxes, insurance, utilities, repairs - has to get paid by you or other family. If there still is a mortgage, this could be quite a tidy sum. So look at last 2 years of expenses.... can you afford all house costs AND your own living expenses? And be able to do this for an unknown period of time.... could be 5 months or 5 years..... Assume it will take a year or so after death to deal with this too.
Unless your state has it so the caregiver exemption goes in tandem with her Medicaid application, it’s going to be after death paperwork. If right now it’s that moms SS$ is what’s needed to keep the household afloat, then the $ is really not there for you to pay property costs on your own. You imo have to rethink how to manage in home care for her.
If a parent wants to keep thier home, Medicaid allows that by & large. But family / heirs need to have the wallet or purse to afford all house costs, plus a pretty good sense of humor on what old houses mean, and be ok on keeping details on property for future MERP and be comfortable with risk that exemption & estate recovery may not be quite as easy as you’d hoped for. You really must to be pretty solid on your affordability on house costs. You don’t want to find that you cannot pay property taxes as nasty delinquency interest and can go up for tax sale.
If there are siblings or other heirs, what seems to happen is everybody all gung-ho that govtmt not taking maws house for maybe 6 mos. then big brother doesn’t cut the yard anymore, Sissy put off paying taxes, tree falls down & nobody wants to deal with it, etc. The one that’s dpoa or living in the house ends up paying. But each heir will have to deal with thier own exclusion / exemption to MERP or if no Medicaid involved all heirs will want thier share of house sale $. Really if property is kept, you & your family have to imho be able to be all-in for the long haul for both time & $$$.