Transfer the house to me before applying for Medicare/Medicaid?

I'm familiar with Iowa Medicaid, there is a five year look back on all transfers of assets at the time of Medicaid application. If this is true for Medicaid in every state, you needed to do the transfer of assets five years before your parents needed nursing home care.

Sure, you can transfer the house to you or another - but your parents won't qualify for medicaid for several years, depending upon your state. Medicaid gives money to those with little or no assets. Your parents don't qualify as of now.

Most of us have to sell our parent's house to afford assisted living.

MediCARE & MediAID are very different. Medicare is a age based entitlement which just about everybody gets & pays into via FICA (or taken from their SS if they are drawing that) and in general does hospitalization, providers fees and med's, and it's federal. Medicare is about short term medical situations. Medicaid is a joint fed & state based program that is needs-based....in general about 2K in monthly income and 2 K in non-exempt assets and also they must demonstrate the need for skilled nursing care - so just because they are old, or have dementia, etc in & of itself may not qualify them for skilled care. You have to spend down or be at poverty level to qualify. Medicaid is managed by the states and vary in the requirements state by state under a general federal guidelines.

CMS is the umbrella for both Medicare and Medicaid - their site is pretty good for finding out details on how the programs do and don't work. You really want to understand how they are different and how to qualify and how they can overlap.

Really there is alot to think about when they have a home. The house is right now a totally exempt asset for Medicaid & can remain exempt for their lifetime in most states BUT there will be estate recovery possibility by MERP. But if they sell, gift or transfer ownership for 5 years prior to their application, then the house in no-longer exempt and the proceeds from the sale is income that has to be spent-down. If they gift or transfer it to you, then they will get a "transfer penalty" for the value of the home based on the annual assessor report.

Transfer penalty is a hot mess to deal with too....and will show up eventually, as all property ownership from the local assessor is dovetailed to the state system. The transfer is based on your state daily reinbursement rate to the NH by Medicaid. For example in TX, it's about $ 145.00 a day (TX is low too). So say the house is 100K value and and they gift it to you and your brother. That would be a transfer penalty of 690 days in which your parents will be ineligible for Medicaid payment to the NH. Each state has it's own formula in how it's determined too. If you are the point person for your folks @ the NH, the NH will fully expect you to pay the penalty.Often the other siblings who benefitted from the transfer, will just disappear and you are left to deal with the private pay needed. A mess.

If you rent it, then it becomes "income producing" property and the rent has to be paid to the NH in addition to their SS and retirement. Realize that all their income less whatever your state has as their "personal needs allowance" ($ 35 - 90 a mo) MUST be paid to the NH as their co-pay. Realisticaly they won't have any money to pay for the insurance, taxes, yard, repairs, etc on the house for the months & months or years they might be in the NH.

It's alot of things to think about and you don't want to make a decision that could be very costly a couple of years from now. That's why an elder care attorney is so worthwhile to meet with. If you have over 5 years, then you can plan it out. But otherwise it's as Perseverance said. Good luck.

This may be a new take at an existing problem. Two possible options:

1) a lawyer recommended putting the property into a Living Trust that includes other family members so that it can't be broken to provide funding for just one family member.

2) If you can LEGITIMATELY claim that you have provided "Professional Services" to our relatives (not "caregiving" - that could be looked as a "duty" - more like things like legal, accounting, Power of Attorney, etc. - or incurred hard costs), and you can put these under Billing from your company (preferably incorporated, and there are hard costs that were also billed ) you "may" be able to claim "settlement of all claims" by the "transfer of the property." The government subsidies can't usually go back on a legitimate payment of a bill.

I'm not a lawyer. You need legal advice. I do legal research, so I can NOT give you legal advice - I can explain what may work for us, but the long-range "last shoe to drop test" has not completed yet.

Good luck.

Should also mention - if (2) works above, see if you can record a lien on the property.

Ditto, you need legal advice. You will only jump into a gigantic pile of hassle if you try to hide the asset. There may be considerations in your parent's situation that you don't know impact this (positively or negatively), so see an elder law attorney (not any old attorney!).
Bottom line is, your parents assets are meant to be spent for their care (or you can provide their care, thereby protecting their assets for your inheritance). That's the way the government looks at it (and me, too).
You don't describe your parents' abilities. If they are able to live with the support of assisted living, which is MUCH less expensive than skilled nursing, you may be able to sell their house and have enough to pay for their care. If they aren't truly in need of a nursing home, an AL can be a much more pleasant lifestyle.

Always these situations revert back to the lack of Medicaid preplanning families engage in.
Had the house been transferred into an Irrevocable trust understanding the right for parents to live there (while they could, five years prior, you maintain their exemption and would not be subject to recovery, I would EXPECT however that income or sale $$; if they then qualified for Medicaid, would be used to "beef up the care in the NH, say pay for private room or extra care.

Way - if you're taking about using a mechanic's lein approach what we were told was that it can be done if the provider is an existing business with a legitimate address and business license &/or trade affiliations that has done same for others You have to file the lien however it is done in your state or county and re-file as per your state law until the property is settled via probate or at closing if property sale. So say you have a business and do staging for real estate and charge a $ 500 day rate...and you have & can prove an existing client base on this (like you do interior design) & you spend 10 days cleaning up & staging mom's house, then you can have a 5K invoice and lein on the property. Or your a stockbroker , attorney or financial advisor who does fee for service, then you can bill your fee as a claim or lein on the estate or on settlement.

And it has to be a fair cost. The problem usually is that the fair cost of your services is significantly below the assessor value of the property (this seems to be the benchmark that MERP uses). So yes you have a 5K on staging & 12K on legal and 8K on financial advisor, but the house is worth 125K so there still is 100K that MERP could file a claim or lein on if they keep the house till the elder dies or 100K that has to be spent down if the property sells or 100K transfer penalty.

The current system totally considers what family does the their elders as out of love, duty, whatever & done without consideration of compensation. Most of this is done by women and totally devalued. It is imho an overwhelming women's issue. Most elders don't have kids with businesses that can do a legit mechanic's lien; or have the ability or desire to pay for momma's house for the possible years & years of NH; or the time to oversee the parents house. What seems to happen is that mom goes into NH and everybody wants to keep momma's house. The first few months are all kum-ba-ya, then towards the end of the year, utilities aren't being paid by Sissy # 1; Big Bro stops cutting the grass; Sissy # 2 forgets to file the homeowner exemption & pay property tax....BUT you have paid the insurance and go regular to check on the property. Momma is still in NH and it is looking like she will live for years (& years & years) & your siblings just aren't going to keep up their agreement or better yet start to nitpick on whether the grass needs to be cut or that you selected a plumber that was too expensive.....ad nauseum. The house ends up being sold at lower than assessor value & the money from the sale all needs to pay against what Medicaid spent on momma.

Planning to 2018 is great but most just don't and can't. I really do think that if you have assets, then you really need to spend some of it on a elder law attorney.

Federal mandates for Medicaid state that if an adult child has lived with the parent for at least 2 years and has provided care that kept the parent out of the NH for those two years can legally posses the home.

BUT nevertheless....get professional legal counsel before you do any 'kitchen table estate planning' as they call it.

Don't do ANYTHING until you find out what you should and should not do...from an eldercare lawyer!

Yes I was given same info as Babylon...but 5 ys in home care and that is just with reference to the title/MERP. they are still going to give all of the "current/future" monthly ssi income to the nursing home! In my case there is a mortage involved and I have no money left in savings to pay it. But half the battle is secure, they cant take it from us...if I can clean up this mess in time and maybe get some kind of income to make the mortage payment but my credit and work history are shot so I doubt I can assume the loan! so I am still kinda screwed!! maybe they will be gentle and look at cg for 9 plus years as work history, but I doubt a bank would!!
I haven't had good luck with finding an eldercare atty in my area and ones I have consulted haven't impressed me much so I kinda in limbo on spending money we don't have on mediocre at best, advice at $400hr or whatever it is! sorry I rant...meant to just include the ssi monthly income issue with that loophole

Bab - some states are requiring a letter from a medical provider in order to prove that you provided care that kept them out of the NH for 2 full years prior. If you had a full time job, they can't do the letter.

Agree totally you need an elder care attorney at the start of all this. We did my mom's legal well over a decade ago & used an estate attorney as the elder law speciality didn't exist. there's just so many things to consider and each state's law makes a huge difference.

Yeah, the thing about the SS income makes it hard to just put someone in the NH for longer than skilled pays for but less than the rest of their lifetimes. Because if you can't pay the bills, there is no home to come home to. And by the time one finds a job, if they are that lucky, it is time to quit to take care of the returning family member.

I'm lucky in that the house is paid for (twice actually). And I've had no full time job for ten years! I needed 'disposable' jobs and then I began a home business but even that was put on hold for the last couple of years due to broken hips and care increasing pretty much to total in that time.

It is good for me to know that I could still get medicaid help if I needed it to make mom's life better or safer or whatever. We've discussed the fact that one day it might prove impossible to keep her home and stay together. And that's okay because I will only do that if there is nothing else left to do or try, We are still a long ways from that point although in everyone else's eyes I should have put her in the NH several years ago. That's okay. This is my life and her life...not theirs. They can deal with it as they see fit just as I intend to.

I do feel, tho, from recent experiences, that they will do everything they can to corner you into NH placement. But they don't know me like mom and I know me. I have amended my promise with her consent and so it has eased my stress a lot.

Knowing I will have a place to live when it is all over is also a relief since I spent the years I could have worked toward that taking care of her without any income hardly at all. And knowing that even if I have no other choice but NH, I won't lose the one thing she was able to give me out of love makes my choice more clear and just strengthens my resolve. I just want her to live out her last days in her own home no matter if I get the house or not. Proving to me, thankfully, that it is really and truly all about her in my own heart!

well put Babylon I could not agree with you more 8 ys 10 months of hard labor for me and counting. all I want is to know I have a place to live when it is all over. But the truth is I deserve that security for what I am doing, and I don't have it ....it is scary if I don't change the situation before It is too late!!!

There are legal clinics that accept "sliding scale" for legal advice. Legal Aid also does lawyer referral - expect to pay about $30 for the first law visit. Otherwise, you may be able to get a law professor at your local university (usually they are lawyers), to give you off-the-record "non" advice which might be the cost of lunch or dinner. When in doubt do it under the heading of "research for an article" - - then actually WRITE THE ARTICLE or LETTER TO AN EDITOR so you are truthful in calling it this. (I'm a writer, and blogger. I do this when I research for information that I need and suspect that others do, too. ) If you are wondering "where" to submit your article or information, consider maybe sending it to this website and forum.

When did they start needing fulltime care? It has to be documented by a doctor that they can not live alone nor do 3 or more things themselves in order for it to be considered real "care-taking" of them. The reason my Mothers Attorney didnt do Trusts is because then the family doesnt step up to the plate and help take care of them themselves. He said that "the family knows the money is safe and then they put the parent into a nursing home, a State Funded Nursing home that takes medicaid, and do you really want them there?" You could move them in with you, sell their home and use the money for their care by you, or someone else, in your home. You could get a reverse mortgage on their home and hire a nurse for them too. Other than that, there is a 5 year lookback on all assets, including other assets as well they might have.

What kind of attorney was your Mom going to (re: reverseroles)