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As to dealing with a five year look-back on gifts prior to qualifying for Medicaid, the $25K gift will count against grandma. My neighbor’s ex-husband gave their daughter $20,000 for college as part of a decades-ago legally-drawn joint custody agreement when they divorced. My neighbor agreed to no monthly alimony payments while she had primary custody of their daughter if her ex agreed to pay their daughter’s college expenses when she turned eighteen. He (the dad) ended up in skilled nursing care within less than five years after she used his funds for college. The daughter was told she had to pay back those funds in order for her dad to qualify for Medicaid. My neighbor appealed the decision on behalf of her daughter because the legal custody agreement went back much further than five years. Medicaid decided in this case that the daughter did not have to pay back her father’s funding of her college tuition. Essentially his gift was documented as having been made decades earlier in the financial custody agreement.
What happens is that Medicaid places a transfer penalty on your moms LTC Medicaid application. And for more fun in this, the date the penalty period starts is based on the date that mom files her Medicaid application AND NOT the day of the transfer of the 25k.
Transfer penalty is basically a math problem - a division equation but based on details unique to your states Medicaid program.
Here’s my understanding of it: Each state has fixed $ amount it pays each day for room & board to LTC facilities for Medicaid beds. Some states, esp southern ones, pay a pretty low rate abt $160 a day. While upper E coast ones pay double that rate abt $275/$300 a day. Amount set by your states legislature. Let’s say it’s $185 R&B day rate.
if mom gifted $ 25,000.00 that’s the dividend.
$185.00 is the divisor. 25k by 185 = 135 DAYS (quotient), 4.5 months of private pay due BEFORE Medicaid eligibility kicks in.
Yeah it’s a penalty by DAYS of ineligiblity. Not $ 2 $ penalty.
Penalty period - again - starts day 1 from which LTC Medicaid application filed. Keep in mind, that to file LTC application, they have to be in the NH. They are already a resident there so they are building up a bill each day. Remember if they filed for Medicaid they are impoverished. They have no $ other than 2k max in nonexempt assets.
If they were admitted “Medicaid Pending” then all they are paying while application gets evaluated is their monthly income (like SS $) copay to the NH. But once a penalty has been determined, Medicaid sends out correspondence to the applicant, thier DPOA. And ALSO TO THE Facility. In quick time, the facility will expect all $ due from day 1 at private rate to be paid to them ASAP or mom will get a 30 day Notice. They will Bill DPOA or whomever in the family that they can. It’s really important that you read in minute detail the admissions contract and pay attention as to how you sign each & every page to limit your exposure on this. Over & over on this site there’s posts from family who get billed for various reasons from the NH.... in the rush to get mom placed, in the drama with hospitalization, in dealing with family conflicts, etc., you are just oh so glad you got mom into a place, you just sign the paperwork and don’t get a copy of all pages. If mom moves out due to eviction, the bill still exists and will be turned over to collections. NH does not have to bill at lower Medicaid day rate either, although I think you could negotiate on this if your a real pittbullie personality.
So knowing all this, would moms gifting 25large be the thing to do???
Ignoring morality, it could be, if your ok on risk.
Risk that mom dies before ever needing Medicaid.
Risk that daughter will have income in 3, 4, 5 yrs to pay grannies 4.5 months of private pay rate NH & she will gladly pay the penalty.
I will say this, if mom insists on doing this, try to get her to do it as a up & up loan, so its done as a Promissory Note & drawn up by an atty.
Also if you think daughter won’t be able to uphold agreement to pay, I’d suggest that you get an attorney to do a caregiver contact between you & mom, and every cent Mom pays you as per caregiver contract goes into a new bank account that you will draw from to pay the penalty should mom have to apply to Medicaid before 5 years + 1 month lookback. Mom ought to do a caregiver contact or rent agreement with you whatever the case, but bank the $ to have to deal with penalty. Unless $ is of no object for you.
This isn't my area of any expertise so basically I am reporting to you thinks I have learned from Margaret or Igloo of Mstbil or Cali here as far as medicaid is concerned. I will caution your mother to make no gifts without first understanding all about it. I hope some of the above mentioned will chime in here to give you more, likely better information. But for now, full stop until you understand the rules. And feel free to call medicaid office, which is basically medicare office for all intent and purpose at 1 800 medicare. Long wait but they are helpful.
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