A surprise bill from medicaid

Larrytherunner

This is an interesting article about a daughter who was taking care of her mother, who had dementia, at her mother's home and her father ended up with a $226,611 bill from medicaid after the mother died.

https://www.npr.org/sections/health-shots/2023/03/01/1159490515/they-could-lose-the-house-to-medicaid

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M1

As the article says, almost all states who provide nursing home coverage or in-home coverage instead of nursing home placement are estate recovery programs.  The NPR article talks about how much they recover, but frankly the states all spend more on care than they recoup.  Looking at the percentages would be interesting.  

A lot of people don't realize this, and that's where the "surprise" comes in.  Kind of like reverse mortgages, you're spending the money on the front end.  But just like Victoria said, talking to an attorney early can at least educate the public.    

Ed1937

Thank you Larry. Articles like this should get a lot of exposure.

HSDaughter

I saw this article too.  Here's my experience in the state of Virginia.  I was POA for an aunt with dementia, who had no assets other than social security, and a couple annuities.  Medicaid covered the balance of the long term care costs, which was more than her monthly income.  She was allowed to keep $40 each month.  I took no funds from her account other than reimbursing myself when I had to buy clothes or other necessities for her.  After she passed away, I received a notice from the state asking for a written confirmation of her funds remaining in her account.  I provided that amount, signed the statement and mailed it back.  I then received a letter requesting those funds be returned.  The amount was about $1400. While I had prepaid most of her funeral expenses, I did have some other expenses that I incurred.  Those funds covered costs for a gravestone, one small arrangement of flowers for the final service, an honorarium for the church/pastor, and a donation to the long term care facility (this was at the start of Covid--they needed to buy all of the PPA).  I had all of my receipts, which I provided to the state.  The state approved those expenses, and I did not need to send any funds back to the state.  Again, it was a small amount, and I did provide all receipts.  The facility where I made the donation had provided me with a thank you letter noting the donation, so that was ok too.  It did take some time for me to make all the copies of the receipts, write a letter, send it certified mail, etc.  That was on my own dime.

Nowhere

This is not a surprise to me. My husband qualified for state aide easily having possessing early disorganized thoughts long before a diagnosis he had suffered many careers changes resulting in loss of income from our early years. As a mid life crises and result I was motivated to secure further education and became a second “bread winner” for our family. His disease motivated me to grow, (hey, a positive)  and we had enough between the two of us to raise our kids and thank goodness, they are well-educated, responsible, healthy, successful, self sufficient and married with their own families. 

So, for the last two and half years he is now in a facility and on state aid, “Medicaid”. Our estate will be “recovered” and the monies to pay for his care will be “clawed backed” by the state he resides in. And, I feel so grateful and believe it is only right that this happen, otherwise, what is to happen the future Alzheimer’d persons without the savings for care? If everyone takes, the system will break. 

Knowing this, I had not ever seen a statement for his care other than for the portion his facility collects from his social security pension each month paying for his room & board and a fraction of his $7,100 a month care. They also pay incidentals such as when behavioral specialist’s are consulted to observe him and then train the care staff to help him.  Just last month I inquired what we owed to date from the Administration of Estate Recovery because, honestly, no such statement is sent unless requested (who knows this stuff)! 

Well, they sent an itemized bill and I have learned that the state is paying for a pricey healthy insurance premium that my husband doesn’t even need, as he is fully covered under Medicare and my private retiree gap insurance, and so it’s a duplication of expenses (to be on state aid one must accept the state health insurance even though in our case it is a secondary inferior and unneeded coverage and the premium cost is more than our private premium cost) and our estate will be required to pay this back. 

To date, upon my death, our estate owes back in the neighborhood of $150,000. Who knows how many more years this will continue to grow? I am so grateful for community spousal laws allowing me to keep our house, drive almost any model of vehicle, and keep my own income.  Another positive, our son is a transactional attorney, and he says for me to relax, as when it comes time to settle our estate, he’s the one who will be overseeing the settling. He just advices for me to document the discrepancies.

I’m sharing this so that other spouses have, hopefully, a clearer picture of how state aid- Medicaid operates. Each state operates individually, but the laws protecting spouses I believe are national. For the record, my husband resides in Oregon. 

I should add, as if this isn’t long enough, if I should sell out home and not reinvest in another within a six month time frame, I would owe 50% of the equity to him. This would make him ineligible for Medicaid until spent down. I am free to move as long as I reinvest the entire equity (not above a certain ceiling) into another house. The system is designed that the state doesn’t end up with both spouses on welfare. Thank goodness! 

markus8174

Not a surprize to me.  I saw 2 eldercare lawyers when it became obvious I would need to place my beloved into a nursing home/memorycare unit. I'd never heard about "Estate Recovery" when I started exploring the needs. I know now.  Even if I had known before the lawyers, there is nothing I could do about it.  The government own's my house-any mortgage after my death. When people talk about the "Medicaid Expansion"  I want to scream! The only "expansion" is so they can seize nicer homes.  No money to be made seizing homes in the run-down part of the inner-city.  I did have a lawyer advise me, the house is mine to sell if I choose to. If I rent, or go far away to a distant state, my state isn't likely ot track me down. I'm just not sure how that will work out for me being buried next to my beloved. Someone will have to notify Social Security and file for the pittance of life insurance I have from my old employer.