Paying for assisted living, can relative keep their house?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:In general, you should be aware that an elderly person can go on Medicaid for long-term care while owning a home but Medicaid puts a lien on their real property, and there is a clawback provision which goes back 5 years, meaning any transfer of real property, including putting into a trust, would be pre-empted by Medicaid.

There are provisions (not real familiar but aware they exist) where if a person meets Medicaid criteria for long-term care but stays in their home with care provided by a family member (probably could be someone unrelated as well) and receives Medicaid-funded care, the services provided by the caregiver protect some or all of the real property from Medicaid liens.

I worked for awhile as a home health aide, and we had clients whose family had them move into senior housing and privately paid for the home health aide services to save money compared to having Medicaid liens on their parents' home and other assets. If the elders could get by without 24 hour care and the family handled doctor appointments and grocery shopping, it seemed to work for them.

This is state specific. Some states pay for an aide, some do not. MD does not in less you go into a nursing home under medicaid and then are discharged back "home" but they only provide a few hours a day a few days a week.

Notice I said "privately paid" -- Medicaid was not involved at all and these were also not services that would be provided under Medicaid definitions. This was the kids' strategy to provide care while keeping costs down to preserve assets and avoid Medicaid. IDK what you are referring to about Medicaid in MD, it doesn't make much sense. Since you put quotes around 'home' you must not have meant home, not sure what you did mean.

Most people who go on medicaid don't own their own home, like my relative and are living with someone else or family.

[Anonymous]

We had an elderly relative in this situation. Yes, you more or less have to liquidate all assets before you qualify for Medicaid, so she will need to sell the house to self-pay first. She can let Medicaid put a lien on it instead, as a PP noted, but it doesn't make much difference since any equity will be drained pretty quickly. There are a few workarounds if you plan far in advance, but there is a five-year look-back period (except in CA, where it is only 2.5 years for some reason) so if she is at the point of needing assisted living now, it isn't an option.

[Anonymous]

Anonymous wrote:We had an elderly relative in this situation. Yes, you more or less have to liquidate all assets before you qualify for Medicaid, so she will need to sell the house to self-pay first. She can let Medicaid put a lien on it instead, as a PP noted, but it doesn't make much difference since any equity will be drained pretty quickly. There are a few workarounds if you plan far in advance, but there is a five-year look-back period (except in CA, where it is only 2.5 years for some reason) so if she is at the point of needing assisted living now, it isn't an option.

Medicaid does not pay for assisted living. It only pays for a nursing home.

[Anonymous]

Consult an elder care attorney!!! There are ways to protect assets.

[Anonymous]

Anonymous wrote:

Anonymous wrote:We had an elderly relative in this situation. Yes, you more or less have to liquidate all assets before you qualify for Medicaid, so she will need to sell the house to self-pay first. She can let Medicaid put a lien on it instead, as a PP noted, but it doesn't make much difference since any equity will be drained pretty quickly. There are a few workarounds if you plan far in advance, but there is a five-year look-back period (except in CA, where it is only 2.5 years for some reason) so if she is at the point of needing assisted living now, it isn't an option.

Medicaid does not pay for assisted living. It only pays for a nursing home.

This is determined by the states, and most do now allow Medicaid to cover assisted living if you can show that it is less expensive than a nursing home would be--I think there are only half a dozen remaining that don't. MD and DC both cover assisted living.

[Anonymous]

If she wants to consider this, she should look on the NAELA website and find an elder law attorney in her state to consult.

If you want her to do this because you're hoping you'll get the house eventually,
a) it's unlikely
b) stop being greedy
c) butt out

[Anonymous]

Anonymous wrote:That is fraud. If you have assets, you use them to pay. You cannot gift them to family, you cannot hide them. They pay attention to these things and will come after people - happened to a relative of mine when she was gifted funds by her elderly parents. She had to pay the money back. I now have 2 elderly aunts in assisted living in NY, they are probably the only full payers in the place. They would love to gift some of their savings to their great grand nieces, but cannot as it is fraud if its more then a few hundred bucks.

If timed correctly, it is not fraud. Know the rules, plan your finances, make your gifts, wait out the clawback period and then apply for Medicaid.

[Anonymous]

Anonymous wrote:That is fraud. If you have assets, you use them to pay. You cannot gift them to family, you cannot hide them. They pay attention to these things and will come after people - happened to a relative of mine when she was gifted funds by her elderly parents. She had to pay the money back. I now have 2 elderly aunts in assisted living in NY, they are probably the only full payers in the place. They would love to gift some of their savings to their great grand nieces, but cannot as it is fraud if its more then a few hundred bucks.

My grandmother worked it out to keep the house before going to assisted living. An attorney helped and we had to do a couple stupid formalities like put her "life estate" up for sale in order to appease the state Medicaid collectors. It's not fraud if an attorney helps you and the state doesn't come after you, right?

[Anonymous]

Anonymous wrote:

Anonymous wrote:We had an elderly relative in this situation. Yes, you more or less have to liquidate all assets before you qualify for Medicaid, so she will need to sell the house to self-pay first. She can let Medicaid put a lien on it instead, as a PP noted, but it doesn't make much difference since any equity will be drained pretty quickly. There are a few workarounds if you plan far in advance, but there is a five-year look-back period (except in CA, where it is only 2.5 years for some reason) so if she is at the point of needing assisted living now, it isn't an option.

Medicaid does not pay for assisted living. It only pays for a nursing home.

Not true. Many states use the waiver process to provide Medicaid covered home and community-based care as a cost-saving alternative to SNFs.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We had an elderly relative in this situation. Yes, you more or less have to liquidate all assets before you qualify for Medicaid, so she will need to sell the house to self-pay first. She can let Medicaid put a lien on it instead, as a PP noted, but it doesn't make much difference since any equity will be drained pretty quickly. There are a few workarounds if you plan far in advance, but there is a five-year look-back period (except in CA, where it is only 2.5 years for some reason) so if she is at the point of needing assisted living now, it isn't an option.

Medicaid does not pay for assisted living. It only pays for a nursing home.

Not true. Many states use the waiver process to provide Medicaid covered home and community-based care as a cost-saving alternative to SNFs.

Some states, not many and not MD. We were offered community care after my MIL had been in a nursing home for a length of time but none of the good ones took medicaid. They only offered us a few hours of care per week if she came to live with us again. That wasn't doable as she needed 24/7 care nor did we have the house space. MD mainly pays for nursing home care. There is a waiver program for assisted living but the waitlist is 10-15 years so you have to plan (different program). We've been on the list for 10 years and never gotten a call about it.

If you are married you can keep your house but they will put a lien on it. Spouse at home can keep some assets and income. You don't need to cheat the system if you are married. The biggest issue at least in MD is you cannot get approved for medicaid/nursing home in less you are in a facility and if you cannot pay for a few months, few facilities will risk that income loss to take your loved one.

[Anonymous]

Anonymous wrote:

Anonymous wrote:That is fraud. If you have assets, you use them to pay. You cannot gift them to family, you cannot hide them. They pay attention to these things and will come after people - happened to a relative of mine when she was gifted funds by her elderly parents. She had to pay the money back. I now have 2 elderly aunts in assisted living in NY, they are probably the only full payers in the place. They would love to gift some of their savings to their great grand nieces, but cannot as it is fraud if its more then a few hundred bucks.

My grandmother worked it out to keep the house before going to assisted living. An attorney helped and we had to do a couple stupid formalities like put her "life estate" up for sale in order to appease the state Medicaid collectors. It's not fraud if an attorney helps you and the state doesn't come after you, right?

If she only had a life estate in the house, it sounds as though she didn’t own it anymore. Had it already been sold or given to another family member?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:That is fraud. If you have assets, you use them to pay. You cannot gift them to family, you cannot hide them. They pay attention to these things and will come after people - happened to a relative of mine when she was gifted funds by her elderly parents. She had to pay the money back. I now have 2 elderly aunts in assisted living in NY, they are probably the only full payers in the place. They would love to gift some of their savings to their great grand nieces, but cannot as it is fraud if its more then a few hundred bucks.

My grandmother worked it out to keep the house before going to assisted living. An attorney helped and we had to do a couple stupid formalities like put her "life estate" up for sale in order to appease the state Medicaid collectors. It's not fraud if an attorney helps you and the state doesn't come after you, right?

If she only had a life estate in the house, it sounds as though she didn’t own it anymore. Had it already been sold or given to another family member?

You don't need a life estate. Read the rules in your state. They allow the remaining spouse to stay in the house and keep a specific amount of assets and income. They put a lien on the house to pay for the care once the spouse passes.

[Anonymous]

Anonymous wrote:

Anonymous wrote:That is fraud. If you have assets, you use them to pay. You cannot gift them to family, you cannot hide them. They pay attention to these things and will come after people - happened to a relative of mine when she was gifted funds by her elderly parents. She had to pay the money back. I now have 2 elderly aunts in assisted living in NY, they are probably the only full payers in the place. They would love to gift some of their savings to their great grand nieces, but cannot as it is fraud if its more then a few hundred bucks.

My grandmother worked it out to keep the house before going to assisted living. An attorney helped and we had to do a couple stupid formalities like put her "life estate" up for sale in order to appease the state Medicaid collectors. It's not fraud if an attorney helps you and the state doesn't come after you, right?

I'd never heard of selling a life estate but looked it up after you posted this. My BIL is disabled and has a life estate in farmland. Was there a buyer for the life estate? And how does it work if a life estate for someone who is elderly is sold to a young person? Sounds like a potentially horribly complicated situation.