K. Gabriel Heiser
Attorney, author, Medicaid asset protection planning
K. Gabriel Heiser, J.D., is an attorney with over 25 years of experience in elder law and estate planning. He is the author of "How to Protect Your Family's Assets from Devastating Nursing Home Costs: Medicaid Secrets," an annually updated practical guide for the layperson.
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Question
My husband and I live on Social Security. He has no assets, I have a 401k from a previous job. Is my 401k sa...
Currently, the at-home spouse can protect (i.e., exempt) up to $115,920 of the total amount of assets of you and your spouse. However, in... Currently, the at-home spouse can protect (i.e., exempt) up to $115,920 of the total amount of assets of you and your spouse. However, in many states the 401(k) or IRA of the at-home spouse is exempt regardless of amount. So that would be the first thing to determine, i.e., what the rule is for your particular state. If you cannot find the answer online, you will need to contact an elder law attorney with expertise in this area to assist you (probably a good idea in any case).
As for your daughter's stock, under Medicaid rules a child's assets are never subject to claims by the state and never come into the picture at all when a parent's eligibility is determined. see more
As for your daughter's stock, under Medicaid rules a child's assets are never subject to claims by the state and never come into the picture at all when a parent's eligibility is determined. see more
Question
Are there provisions through Medicaid made for caregivers in regards to funds used in taking care of a parent?
If you are asking if a parent's funds may be used to pay a child for his or her caregiving efforts without it affecting Medicaid... If you are asking if a parent's funds may be used to pay a child for his or her caregiving efforts without it affecting Medicaid eligibility of the parent, the answer is yes (i) if the payments are equal to the local going rate for such work, (ii) a written contract between parent and child spells out the terms of the work, and (iii) the payments are made on an ongoing basis as opposed to a large up-front lump sum for future services. Notwithstanding that last requirement, there are indeed many states that allow a lump-sum payment for future caregiving services and they will not be deemed a penalty-causing gift subject to the five-year lookback rule. You will need to do further research to find out the rules of your own state in this regard. see more
Question
Will a Warranty Deed exclude a home from the Texas Medicaid Recovery Program?
If your mother gave you the house and the transfer was not reported to Medicaid, they could claim fraud against the state with various dire... If your mother gave you the house and the transfer was not reported to Medicaid, they could claim fraud against the state with various dire repercussions. If she sold it to you for the full fair market value, and it was properly recorded, then Medicaid cannot come after the house. If she gave you the house and you qualified for the "Caretaker" exception to the transfer rules then you can argue that, and hopefully establish that no transfer penalty should apply. see more
Question
Can you create a trust inside the Medicaid 5 year look back?
Cace: Since your home will continue to be an exempt asset so long as you live there, you can make repairs to it, add on a room, etc.,... Cace: Since your home will continue to be an exempt asset so long as you live there, you can make repairs to it, add on a room, etc., without it being deemed a transfer that can cause a penalty.
As far as income, none of your income will need to go to your husband's care, ever, once he is on Medicaid. To the contrary, it is sometimes possible to get some of HIS income allocated to you, if your income is below around $1,900/month. Since the rules do vary per state, before transferring assets it is definitely a good idea to consult with an elder law attorney. see more
As far as income, none of your income will need to go to your husband's care, ever, once he is on Medicaid. To the contrary, it is sometimes possible to get some of HIS income allocated to you, if your income is below around $1,900/month. Since the rules do vary per state, before transferring assets it is definitely a good idea to consult with an elder law attorney. see more
Question
Can a POA be taken away after the giver is deceased?
Yes, the POA terminates immediately upon the death of the "principal" (i.e., the person who gave the power to someone else,... Yes, the POA terminates immediately upon the death of the "principal" (i.e., the person who gave the power to someone else, called the "agent"). You'll need a lawyer to straighten this out, for sure, and possibly bring charges against the rogue agent. see more
Question
Can you create a trust inside the Medicaid 5 year look back?
All the assets in a revocable trust are countable--not exempt--for Medicaid eligibility purposes, including the house. So in order to avoid... All the assets in a revocable trust are countable--not exempt--for Medicaid eligibility purposes, including the house. So in order to avoid having the house as a countable asset, you will need to deed it back out of the revocable trust (there may be one or two states that still exempt the house inside a revocable trust).
Because all the assets in a revocable ("living") trust are countable, transfers into such a trust do not incur a penalty.
Spending down excess assets by pre-paying funeral and burial funds is an excellent idea and will not cause a problem so long as the total expenditure is within your state's limits under the Medicaid program (various states have different maximum amounts for such pre-payment funds). see more
Because all the assets in a revocable ("living") trust are countable, transfers into such a trust do not incur a penalty.
Spending down excess assets by pre-paying funeral and burial funds is an excellent idea and will not cause a problem so long as the total expenditure is within your state's limits under the Medicaid program (various states have different maximum amounts for such pre-payment funds). see more
Question
My wife and father-in-law have a joint bank account is there a penalty if we apply for medicaid for him?
All the money in a joint bank account is deemed owned by the Medicaid applicant except to the extent the other co-owner of the account can... All the money in a joint bank account is deemed owned by the Medicaid applicant except to the extent the other co-owner of the account can prove they contributed funds to that account. The only time there would be a penalty is if an account NOT in joint names is changed to an "AND" account with someone else. Then, the original 100% owner is deemed to have made a gift of the full amount in the bank account on that date. see more
Question
Can you create a trust inside the Medicaid 5 year look back?
If $100,000 is transferred to an irrevocable trust and the parents have no access to the principal, then 5 years from the date of transfer... If $100,000 is transferred to an irrevocable trust and the parents have no access to the principal, then 5 years from the date of transfer that transfer will not cause a penalty period when one of the parents applies for Medicaid. If the trust allows for repairs to a house not in the trust but owned by the parents, then the entire trust would be deemed countable for Medicaid purposes. A better way to handle this would be to transfer the house into the trust, too. Then after 5 years the house is exempt AND avoids estate recovery. Also, should the house need repairs, the cash in the trust can safely be used for that purpose without it being deemed a gift back to the parents. see more
Question
Does Medicaid pay for co-pays?
It depends on the state! Please note the following: The following services must be offered by all states : • inpatient hospital services... It depends on the state!
Please note the following:
The following services must be offered by all states :
• inpatient hospital services
• outpatient hospital services
• physician services
• medical and surgical dental services
• nursing facility services for individuals age 21 or older
• home health care for persons eligible for nursing facility services
• lab and x-ray services
• family nurse practitioner services
The following services are optional , but most states will offer them, also:
• ambulatory services to individuals entitled to institutional care
• home health services to individuals entitled to nursing facility services
• prescribed drug coverage
• optometrist services and eyeglasses
• prosthetic devices
• dental services
• in-home assistance
• physical therapy
• (there are other optional services, too) see more
Please note the following:
The following services must be offered by all states :
• inpatient hospital services
• outpatient hospital services
• physician services
• medical and surgical dental services
• nursing facility services for individuals age 21 or older
• home health care for persons eligible for nursing facility services
• lab and x-ray services
• family nurse practitioner services
The following services are optional , but most states will offer them, also:
• ambulatory services to individuals entitled to institutional care
• home health services to individuals entitled to nursing facility services
• prescribed drug coverage
• optometrist services and eyeglasses
• prosthetic devices
• dental services
• in-home assistance
• physical therapy
• (there are other optional services, too) see more
Question
Can you create a trust inside the Medicaid 5 year look back?
Regarding trusts, note that only an irrevocable trust--not a revocable "living" trust--can possibly offer protection from... Regarding trusts, note that only an irrevocable trust--not a revocable "living" trust--can possibly offer protection from Medicaid countability, and then only if it is drafted correctly. In some states, for example, it is possible to retain the right to income while in other states that will cause the entire trust to be counted, defeating the purpose of setting it up in the first place.
It is not the date the trust is created that counts but the date when money is transferred into the name of the trust. All such transfers within the 5-year period before application will count toward the penalty period. see more
It is not the date the trust is created that counts but the date when money is transferred into the name of the trust. All such transfers within the 5-year period before application will count toward the penalty period. see more
Question
Can you create a trust inside the Medicaid 5 year look back?
To spaulding: There is no reduction in penalty for gifts under a certain amount. That is a federal gift tax law (currently $14,000 per... To spaulding: There is no reduction in penalty for gifts under a certain amount. That is a federal gift tax law (currently $14,000 per donee per year). Medicaid will tally up ALL gifts made within the five-year period before the date of application to figure out the penalty period. see more
Question
Does Medicaid pay for co-pays?
As for coverage of prescription drugs while on Medicaid, you may want to review this helpful chart:... As for coverage of prescription drugs while on Medicaid, you may want to review this helpful chart: http://kff.org/medicaid/state-indicator/prescription-drugs/
However, if you are in a nursing home receiving Medicaid, there is NO co-pay required at all. According to a federal government document, "Dual-eligible beneficiaries are eligible to receive both Medicare and Medicaid coverage. Prior to Medicare Part D, Medicaid paid for most of the prescription drugs for dual-eligible nursing home residents. Under Part D, these residents now receive drug coverage through Medicare, and are eligible to have their premiums, deductibles, and copayments fully subsidized." http://oig.hhs.gov/oei/reports/oei-02-06-00190.pdf see more
However, if you are in a nursing home receiving Medicaid, there is NO co-pay required at all. According to a federal government document, "Dual-eligible beneficiaries are eligible to receive both Medicare and Medicaid coverage. Prior to Medicare Part D, Medicaid paid for most of the prescription drugs for dual-eligible nursing home residents. Under Part D, these residents now receive drug coverage through Medicare, and are eligible to have their premiums, deductibles, and copayments fully subsidized." http://oig.hhs.gov/oei/reports/oei-02-06-00190.pdf see more
Question
Will Medicaid make me move out of my home?
Re unikornfairy: There's a difference between requiring a surviving family to pay back Medicaid out of assets that belonged to the... Re unikornfairy: There's a difference between requiring a surviving family to pay back Medicaid out of assets that belonged to the deceased family member, vs. forcing the family to pay Medicaid (or the nursing home) out its OWN assets. There are no Medicaid laws that look to the children for contribution. The only time that might come up is if there is an unpaid nursing home bill and the nursing home looks to the children to pay the bill, and as I mentioned, this can only happen in a very few states. see more
Question
How much money can Mom gift me without raising red flags with Medicaid?
Why is okay for Apple to shift billions of dollars (literally) of taxable income to other countries, to minimize their tax exposure (all... Why is okay for Apple to shift billions of dollars (literally) of taxable income to other countries, to minimize their tax exposure (all perfectly legal), and then have their CEO indignantly stand up in Congress to declare proudly that Apple pays every dollar of taxes it owes, but it's not okay for a person to save their hard-earned assets and still qualify for Medicaid, by also availing themselves of Congressionally approved legal techniques? see more
Question
How much money can Mom gift me without raising red flags with Medicaid?
Yes, to be sure everyone knows the rules, one can avoid the impact of federal gift tax by limiting one's annual gifts to any one person... Yes, to be sure everyone knows the rules, one can avoid the impact of federal gift tax by limiting one's annual gifts to any one person to $14,000 (used to be $10,000). However, as a couple of folks mentioned above, this is not a Medicaid rule; Medicaid has no "de minimis" exceptions: They simply add up ALL gifts made within the five-year period before the individual applies for Medicaid and calculate a penalty for a certain number of months based on the total amount gifted. see more
Question
Will Medicaid make me move out of my home?
The home will be considered an exempt asset, although the exact rules on how to do this and how long the exemption lasts will vary from... The home will be considered an exempt asset, although the exact rules on how to do this and how long the exemption lasts will vary from state to state.In most states, your wife will have to say that she "intends to return" to the home, even if that's unlikely. A few states will count the home once again after 6 months, if it appears she will not be able to move back there, based on the determination of a physician.
In any case, a piece of real estate that cannot be sold also cannot be considered a "countable asset" for Medicaid purposes. They only count assets that can be liquidated, i.e., sold and turned into cash. see more
In any case, a piece of real estate that cannot be sold also cannot be considered a "countable asset" for Medicaid purposes. They only count assets that can be liquidated, i.e., sold and turned into cash. see more
Question
Will Medicaid make me move out of my home?
Filial Responsibility Laws: First of all, there have only been two states that have enforced these laws in their states. As for the other... Filial Responsibility Laws: First of all, there have only been two states that have enforced these laws in their states. As for the other states, while these laws have not been enforced for many years (once Medicare, Social Security, and Medicaid were enacted to offer a safety net to seniors, they were less important), some nursing homes have now started to file lawsuits under these statutes.
However, these laws do not even matter if the parent is able to obtain Medicaid, which is where I would focus my efforts.
As for the individual who posted here who is currently receiving Medicaid, the answer is Yes, the state is required to make a claim against your former home following your death, up to the total amount of benefits they paid out to the nursing home during your lifetime. see more
However, these laws do not even matter if the parent is able to obtain Medicaid, which is where I would focus my efforts.
As for the individual who posted here who is currently receiving Medicaid, the answer is Yes, the state is required to make a claim against your former home following your death, up to the total amount of benefits they paid out to the nursing home during your lifetime. see more
Question
What do I do if Medicaid won't cover my mom in a nursing home and I can't pay the bill?
The spouse in the community is permitted to have at least $1,939 per month in income. If their income is below that, they are permitted to... The spouse in the community is permitted to have at least $1,939 per month in income. If their income is below that, they are permitted to shift income from the nursing home spouse to get up to that level. In some cases it is possible for the community spouse to shift income to as high as $2,898. see more
Question
Does Medicaid pay for co-pays?
CMS, the federal govermenl agency in charge of Medicare and Medicaid says this: Q: I have Medicare and Medicaid, both of which pay for most... CMS, the federal govermenl agency in charge of Medicare and Medicaid says this:
Q: I have Medicare and Medicaid, both of which pay for most of my health care. But my doctor is telling me I still owe money. Is this right?
A: If you have both Medicare and Medicaid, and the service you received is covered under Medicare, your doctor's office cannot bill you for any Medicare co-pay costs. If you have Medicare Parts A and B (also known as Original Medicare) or are in a Medicare health plan, AND Medicaid helps you pay for Medicare premiums deductibles, and coinsurance, you are probably a Qualified Medicare Beneficiary (QMB).
Note: your doctor may bill you for Medicaid co-pays. Please check with your local Medicaid office to find out more about your Medicaid status, including Medicaid co-pays. If you are still being told to pay a Medicare co-pay and the service is covered by Medicare, please contact 1-800-MEDICARE to file an anonymous complaint. see more
Q: I have Medicare and Medicaid, both of which pay for most of my health care. But my doctor is telling me I still owe money. Is this right?
A: If you have both Medicare and Medicaid, and the service you received is covered under Medicare, your doctor's office cannot bill you for any Medicare co-pay costs. If you have Medicare Parts A and B (also known as Original Medicare) or are in a Medicare health plan, AND Medicaid helps you pay for Medicare premiums deductibles, and coinsurance, you are probably a Qualified Medicare Beneficiary (QMB).
Note: your doctor may bill you for Medicaid co-pays. Please check with your local Medicaid office to find out more about your Medicaid status, including Medicaid co-pays. If you are still being told to pay a Medicare co-pay and the service is covered by Medicare, please contact 1-800-MEDICARE to file an anonymous complaint. see more
My husband and I live on Social Security. He has no assets, I have a 401k from a previous job. Is my 401k sa...