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tlover94 Asked August 2020

My MIL just lost her husband 3 weeks go. She has been in a rehab facility since February. She is on Medicaid. Any advice?

She has 5 children...last one (30 yo) living at home. My husband and I are taking care of everything now that her husband has passed (bills, etc). She will be receiving a large sum from his life insurance. Will Medicaid try and take that from her? Also, from what I've read - will they also try and take her Social Security (she was not eligible for it before cause she has never worked)? I'm beginning to think we need to bite the bullet and get a lawyer - this is all so overwhelming. My thought was to take the life insurance $ and pay off the mortgage, which would then just leave a few thousand left. We are in Virginia if that makes a difference - I couldn't really find too much online regarding VA Medicaid law. Thanks for any light you can shed at this time.

igloo572 Aug 2020
Oh my, so MIL is 67! That is super young
Do not, again, do not try to DIY any of this. She is likely to live for years and years and you all have to have some sort of tight legal and financial planning done that all can come to terms with. Not so much all agree to as that 30 yr old slacker will be a continuous drain but there needs to be an understanding of just what is likely to happen and budget for it; and a clearly understand what MediCARE & MedicAID is and isn’t.

on her SSA & not getting $, I’m guessing she was not 62 when they looked into it, so she was not able to file for earliest age for SSA retirement benefit (would have been abt 50% of his SSA draw and whatever pittance based on her work history). You can do it at 62 but it will permanently affix payout at lowest possible amount until hubs dies and only then SSA will pay her whichever one is higher. As She’s past that now - since she’s 67 - so she could have filed based on his earnings. She has essentially left $ on the table last 6 years. I’m sure this is infuriating, but use it as a cudgel to show why she cannot DIY any of this. She needs solid legal and financial advisors to give her options on what to do.

Im so with GuestShoppe on red flags on that 30 yr old slacker.
I’d be especially wary of slacker be DPOA or MPOA or signature on any banking. It’s not like he just lost his solid job due to Covid, amirite?

? for you? She’s in rehab, right? So went there after a hospitalization?
if so, as shes 67, her hospitalization was on Medicare and her rehab is / was also on Medicare. mediCARE not MedicAID. Medicaid could maybe be her secondary insurer, but Medicare would be her primary. She did sign up for Medicare when she turned 65, right?? Please tell us she has Medicare! Her having Medicare’s super important in all this. Find out exactly what insurance paid for her hospital stay and now for rehab. If she is a “dual” so she’s MediCARE and MedicAID, that is a different insurance system (it would be Medicare and community based Medicaid) than having her permanently as a resident of a LTC facility and having LTC Medicaid program pay for her stay.

Community based Medicaid is also needs based but she is allowed to have assets (unlike LTC Medicaid which has a strict 2k nonexempt asset max). Just what the limits are depending on your states program. Paying off a mortgage may not be the best plan. A lot of this dependent on just what the $ limits are for community Medicaid and what other right now things that she needs. It flat may be that she will need to use some of the life insurance $ to pay for inhome care 5 days a week and then family fills in on weekend and at night.

unless dads life insurance policy was huge, or they have significant savings, at her age of 67, she is likely going to run out of $ before she hits the female in the US actuarial tables age of 84 as she’s not a healthy 67 yr old but right now needs caregiving in some way. Care is expensive whether in a AL or MC of NH or at home by an agency. Family can only do so much as we just don’t have the training to do PT, OT that she sounds like she needs.
Really it’s something to discuss with pro. That $ has to s..t...r...e...t...c...h out, I’d suggest you get an appointment set up with a CELA level of elder law attorney as they will have FA they work with. She has $ from life insurance to pay for this.

as others have said, she cannot, CANNOT, gift any of her $ to others as she sounds like will eventually need LTC Medicaid. Plus she needs $ to pay for in home care. That insurance will file a 1099 Misc income to her, so state will know to the penny what she was paid. If any $ gifted from now till 2025 it will have her ineligible for Medicaid to pay.

Again pls pls find out if she in fact did sign up for Medicare at age 65.
igloo572 Aug 2020
Just to double check..... she is in “rehab” right?
so it’s NOT that she is permanently living & staying at the facility and has become a long term care / LTC resident of the place, right?
Even tho she’s been there since Feb, she’s still rehab patient but maybe in limbo there due to Covid, right?
Rehab patient not LTC resident.

imho you need to clearly find out ASAP if she is a rehab patient or a LTC resident.

It’s very different payment & eligibility system as rehab patient is more all about her health insurance (MediCARE & her secondary insurance like BCBS or community based Medicaid) paying for it with each insurer paying a set % VS. long term care resident which is Medicaid LTC program pays 100% but only if she’s “at need” enough both financially and medically to be eligible for LTC Medicaid. Difference is mucho importante.
worriedinCali Aug 2020
Medicaid isn’t going to take her money. They are going to require her to pay for her care with her own money. She coul have collected SS based off her husbands earnings, she can now collect his SS as a survivors benefit BUT no matter what, that money plus the pension will have to be used to pay for her long term care should she need it and since it won’t be enough to cover the entire bill, that’s where Medicaid steps in and will cover the rest. If she comes home, she won’t be able to give away the life insurance money either. It’s her asset and it will have to be spent wisely because she ends up in a nursing home again or requires home & community based Medicaid, she won’t be eligible if the money was misspent/given away.

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Guestshopadmin Aug 2020
If no one has financial POA you can’t just decide what to do for her anyway. Be cautious the 30 year old isn’t expecting a share of windfall; fastest way to lose Medicaid eligibility is gifting.

Guestshopadmin Aug 2020
Your mother went from having community spouse and her with no income so she qualified for Medicaid in rehab to a single person. Please consult attorney. If she is beneficiary, no one takes it but she will be required to pay for her own care. And it can be retroactive. Do not just take money and pay for things, get legal advice. What if she does need to stay? There will be no money to support house and sonny boy. It will go to her direct needs. And Medicaid will find out, all computer databases dovetail together and are reviewed.

tlover94 Aug 2020
MIL has never worked in her life, therefore they told her she did not qualify for SS (I'm guessing they tried before, not sure - just going by what they told us). She will get some of dad's retirement - so i'm assuming medicaid might take some of that too?

30yo son has just been coddled all of his life, so he's never had to do anything for himself. He does have a job, but not enough to provide for himself. That's all - just spoiled.

Not sure how she was put in there...short term I think...but with Covid -they are on lockdown..so we haven't been able to see her since March and she hasn't had the physical therapy that she needs since then. So not sure how much longer she will need to be in there until she will actually be able to walk on her own.

My husband has medical PoA for her (dad was first, my husband (oldest son) is 2nd), but mom doesn't want to give up control - so no one has any type of PoA or anything now.

Thanks for all the advice - still a work in progress.

tlover94 Aug 2020
She's not there longterm (that we hope for her to be..just short term) - she supposed to have physical therapy there to get her to walk again, but that has been put on hold because of covid. As soon as she can walk by herself, we hope to get her out of there. Noone has POA - she wants to control everything herself for now (insert eyeroll). Long-term plan is to have her get better, walk on her own and home again - is that realistic - no clue - but that's the long-term plan as of right now. She's 67yo. And yes, reapplication is right now..which is why we are asking all of these questions. We have no clue how Dad filled out all of the forms in the past and what he put on there to get her in there - he's been the only breadwinner. Thanks for the info and advice!

JoAnn29 Aug 2020
I am pretty sure your MIL could have received SS when your FIL received it from his record. My Mom got both SS and Medicare based on my Dads employment record and she didn't work after having children. Yes, Medicaid will require the SS and any pension used to offset the cost of her care. Yes, that insurance money will need to go towards her care. Why is a 30 yr old still living home. Is he disabled in any way? Is Medicaid aware of his living there? Because, he maybe required to pay the bills associated with the house. Mom is allowed the house but her income cannot be used to keep it up. At her death, the house will have a Medicaid lean put on it.

Is Moms stay permanent? Because a lot of what I said is based on longterm. I really think you will need to consult with a lawyer versed in Medicaid to help you work thru this. Or make an appointment with Medicaid. You do not want to fool with Medicaid. It can cause penalties.

Geaton777 Aug 2020
TLover,
What is she in rehab for?
How old is she?
What is the long-term care plan for MIL?
Who is her durable PoA?

Medicaid requires reapplication every year about the same time the first qualification occurred. At that time, and if she did come into a large sum of money during the application period, she probably won't qualify and will need to use the life insurance funds to pay for her care. Please consider that she should pay for her own care if she has the funds, otherwise she is forcing all the rest of us taxpayers to pay for her when in fact she has the money. Whether or not she should pay off the mortgage depends on other factors. Generally speaking, if she did pay off the mortgage but then developed some cognitive or health issue that lead her to facility care, then it sounds like she'd need to apply (and probably qualify) for Medicaid again...but Medicaid would then put a lien on the house so that when it sold, it could recoup some/all the cost of her care. But I'm not an elder law attorney for VA so her financial PoA and she would need to go speak to a real one. FYI Medicaid has a "lookback" period and in my state (MN) it's 5 years. Be very careful how her funds are managed moving forward so that she can still qualify if she needs it.

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