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My mom has dementia and I need to place her in a nursing facility and would need a Miller trust set up, but she has a Treasury offset payment being taken out of her social security check each month (USDA home loan payment). She got behind on a payment plan because she forgot, so Treasury started taking out so much to help pay for the delinquent amount. I don't know what to do about that and how would it affect the Medicaid resources and the trust.

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AJ, Also abt the USDA debt, if it is related to a ranch or a farm, so your mom has “working” one, should she go onto LTC Medicaid program (this is the one that pays for custodial care in a facility like a NH), I’m pretty sure her property that comprises the ranch or farm, it is not subject to any Estate Recovery after mom dies. TX estate recovery has all sorts of exemptions and exclusions…. with working farms and ranches as an exclusion. It could 20 sections spreading over couple of counties or could be a small 100 acre place. Like W Tx & Panhandle dry so lots of sections as need more acreage per cattle; but E Tx & lower Valley more lush so smaller ranches and farms. It’s on the applicant or their POA or their heirs to research this and do whatever needed to establish it’s “working” and file exclusion or exemption to TX MERP after the applicants death.

On her life insurance, the precise type of life insurance (Term, Whole Life, a GUL) she has is critical as to what must happen with it. It if is a whole life policy, those I’m pretty sure need to be cashed in with $ used for spend down (till at 2K as 2K is maximum amount on assets allowed for TX LTC Medicaid). GULs - in my understanding - dependent on how it builds value. But if it’s “term” those can stay as the policy is worth nothing - like zero value- as long as she’s alive. For term policies, their value only happens after her death. It does not matter if it’s $5,000.00 policy or $50,000.00 policy, or does not pay till after death. Right now a Term has no hard cash value; its all theoretical after death value.

Please pls realize that Medicaid caseworker is not an insurance agent, they are not licensed or registered as insurance agents, so they can make a mistake on type of policy IF all they do is look at the “face value” of the policy and tell you it has to be cashed in but actually it is Term policy and does not have to be.

If this is an older life insurance policy, it can be hard to read it and figure out exactly what type it is. You could get an insurance agent to look it over and tell you. And ask for them to do a statement on their letterhead that based on their being an insurance agent, it’s “Term” or “whole life” or even a “GUL”. You can provide this to Medicaid to establish why your mom can keep it. In my experience, on TERMS, it’s only if the “term” will eventually pay out a large amount (maybe over $50,000 or over $100,000) will Medicaid be concerned; and what Medicaid tend to do for those is require mom/POA to request to the insurance company to do a change to whomever is listed as the beneficiary to be paid after death to have the State be the first/primary beneficiary and then whomever was the primary becomes the secondary beneficiary. Policy stays in place. This way State gets back it’s costs paid and $ left over then goes to the secondary beneficiary. Things like this happen all the time to life insurance policies, mainly because beneficiaries end up predeceasing the person who has the Life insurance policy. It should be pretty straightforward to do. Like if she has MetLife, she calls their customer service or goes online to get the document needed to change beneficiaries.

Good luck in all this. Try to get and stay organized. If there is a ranch or farm, it’s will be a lot of paperwork and details to keep track of and for years.
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Couple of different issues imho:
1. Does that there is a USDA payment mean that your mom still has a home and this is the mortgage on it? If so, is it only a home / primary homestead or is there ranch / farmland as well?
OR has the house been lost (maybe foreclosure or short sell) and this is the balance left on the USDA loan?

2. Does mom only have her SS payment as her only source of monthly income? Or does she have another monthly income coming in?

I ask this bc the Miller can be done on income other than SSA $ as well IF it meets the guidelines for “guaranteed”. Hang with me on this…. what Miller does is it become the new owner of a (1) income source. Most of the time it’s their SSA retirement mo income as the paperwork for this is easy peasy straightforward to do. And as SSA usually has a comma in the payment, it’s big enough once it’s gone into the Miller to reduce their other income(s) still in their name that they get paid to be under the $2829 income max that most States use for LTC Medicaid eligibility. But mom can use another income source instead of SSA as well. If there is, she uses that one for her Miller.

But if has to meet the Miller “guaranteed” requirements. And that’s for an atty experienced in your States Medicaid & Miller to weight in on.

Her SSA $, this is the usual retirement based income, correct? Not SSDI or SSI, right?
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AJ12345 May 27, 2024
Yes. Just regular social security check after retirement
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This is something to discuss with the elder law attorney who helped in creation of the Miller Trust. You really are not going to get reliable, solid, bullet-proof legal advice from a Forum of strangers. Do check on your individual problem/situation with an attorney and I sure wish you the best of luck.
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AJ12345 May 27, 2024
Thank you!
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