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We live in TX and my Mother only has about $1700 left in her checking account and has been on Medicaid the past 3 years. I am assuming Medicaid will expect that money?


Does anyone know how this works, will they send a letter requesting the money in her checking account? Her home has been deeded to her children upon her death.

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That money from her spend down is hers. As is the PNA (personal needs acct). I never had Medicaid ask for either. I showed the NH my short certificate, and I was sent a check for her PNA. Since Mom only had $184 in her acct, I asked Medicaid if I could close the acct. They allowed it.

Her home will have a lean put on it. Doesn't matter who it is left to. When the house is sold, the lean will need to be paid. If, a family member has been living in the house as their primary residence and that had been Moms main residence, at time she entered LTC, the person may be able to stay in the house. A lean will still be put on the house but not recouped until the person living there dies or sells the house.

There was a post where Medicaid didn't come after the house until 3 yrs after the person passed. By that time the house had been sold and monies split between beneficiaries. The poster hasn't returned to tell us what happened.

Me, I knew there would be a lean, so I contacted Medicaid and received a letter telling me what was owed. When a lean was never put on the house, I contacted the state and found paperwork had been sent to the NH who was suppose to send it back to the state with contact info for Mom. They sent me the paperwork and now a lean is on the house. Because of tax leans, Moms house maybe taken by the County. I wanted to make sure the lean was in place so it didn't come back on me yrs down the line.
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Caregiverhelp11 May 2019
A lien will be put the house even if the house was set up to be deeded to the children after her death and bypass probate?
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NO, if a person dies with no assets, Medicaid CANNOT go after the family. MERP is NOT allowed to go after the family!
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my2cents May 2019
Correct. They do not go after the family. They go after the 'estate' - property that you have left when you die. The state can take back the money they, basically, loaned you while you were getting medical care paid for by Medicaid. Then the family gets whatever is left after bills are paid.
If there are absolutely no assets or property left to be handled in probate, you are correct - they do not go after the family.
However, there are so many people that try to make someone 'poor' to qualify for free medicaid healthcare, it's always possible to get caught when you start removing someone's name and doing shady things. You'll find there are lots of people who, politically, will verbalize their disdain for others who 'get something for free' all the while they are trying to hide mom's assets to get free medical benefits!
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the only thing Medicaid can acquire is if something (cash, home, for example) goes into PROBATE. estate planning with an eldercare attorney prevents probate.
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Given that the taxpayers have been funding her care as a Medicaid recipient, it seems reasonable that money from the sale of the house should go back to the state as reimbursement.

However, random internet articles do seem to imply that it's possible to avoid a recovery claim on a house in Texas. For example:

https://www.dallaselderlawyer.com/10-ways-to-protect-my-home-or-sales-proceeds-from-medicaid-estate-recovery/

"Ladybird Deeds – the state has a right to make a claim on assets that pass by probate or by intestate (without a will) succession. This type of enhanced life estate deed (which can be done in several ways) avoids probate and intestate succession and does not result in a transfer penalty even if signed within five years from the date of Medicaid application. As long as this is done before the Medicaid recipient’s death, it should avoid a successful claim."

Legal advice from the internet is worth what you paid for it of course!
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DarkSeaglass May 2019
I can confirm, based on what I consider a reputable eldercare law firm, that here in Michigan, at least, a ladybird deed would prevent Medicaid from claiming the house.
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If the value of her estate will be $1700, if that’s all she will have to her name when she dies, then She’s exempt from MERP. They don’t get after estates under $10k in Texas.

If she owned a home, MERP won’t come after it if it poses an undue hardship to her heirs or if it will cost more to sell the house than it is worth.

Read through this and see if any of it applies to your situation https://hhs.texas.gov/laws-regulations/legal-information/your-guide-medicaid-estate-recovery-program
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Teresa914 May 2019
Thank you for the info! I live in Texas and we just applied for medicaid. My mom had to be put in the nursing home because it was getting to be too much for me to handle. I've been concerned about Medicaid taking my house after my mom passes. I've been my mom's caregiver for nine years now. I've always lived with my mom except when I was in college. I'm legally blind and on disability. After reading this info I see that some of this applies to me and I'm hoping that they won't take my house or the money from the sale of the house.
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What if the deceased has zero assets upon their death? No house, no stocks, literally nothing. Would the family have to pay back Medicaid LTC?
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worriedinCali May 2019
No
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If the house was put in a trust to the family, Medicaid can't touch it
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Poor people go on Medicaid....that's the purpose of it, they owe nothing when they die. Just went through this....
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my2cents May 2019
They sign a MERP form that allows for recovery of an assets left at the time of death....like their home, if they still have one. The recovery form was created because the state was paying for medical care while the patient still owned property that they 'intended to return to someday'. If the patient owns things at time of death, they are part of the estate and can be recovered by the state to pay for care they received when they could not afford it. Qualifying for Medicaid does not always mean a person owns nothing.
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If you are saying she is in a facility and Medicaid pays for her bed, there would have been a MERP form signed when she was admitted saying you agree to recovery of payments Medicaid made while she received benefits. The state would be looking at her estate at time of death - her assets that are listed in a probate. State could file a claim against the estate. Depending on how her bank account was set up, that money may not be a part of the probated estate. If you had the house set up in something like the lady bird deed (no relationship to Lady Bird Johnson as some people think), that house would not be a part of the probated estate either.
If she's at home getting social security (because she/her husb had earnings in their life) plus some SSI with the Medicaid (because her social security earnings were below a poverty level threshold), it's possible the payment she received in the month she dies will be taken back.
You really need to talk to an estate planner to find out what will be taken back and how the house will be treated. Medicaid worker may offer some advice, but they are not allowed to give legal advice.
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I've been reading all answers with great interest as this estate recovery issue seems to be a Federal mandate yet the states are allowed to put their own twist on this practice.
When we can not even get a consistent answer, if any answer at all, I take that to mean there is really no organized way of handling things. Lack of organization leads to lack of information - including when to expect the flurry of documents that arrive at an undetermined time after death.

The only common thread seems to be that it applies to the estates of those who were age 55 or older when they received services. Each state uses a Federal mandate and tries to tweak it how it sees fit. 50 different takes on a law + thousands of individuals and families involved. Maybe a Federal mandate states how many days the states have to notify families of when to begin repayment of the total bill.

I signed papers that require any remaining monies in a personal trust or bank account (owned exclusively by the deceased) to be "immediately" sent to the state. Papers signed also require agreeing to "Expanded" recovery. This means real and personal property that normally passes without Probate is now up for grabs by the state. This is another example of 50 ways to claim repayment for nursing home care.

In our state since your mom has deeded it to you upon death (instead of at least 5 years before she ever got Medicaid) that means she would still have an interest in the property up until her date of death. I would check on the deed to the house to determine if the state can still claim it using either the 5 year rule or the "Expanded" definition of estate.

Our state can expand it's recovery efforts to property inherited by spouses and families. Spouses might be allowed to keep some or all up to their date of death, at which point the state is supposed to collect. So again, nothing for heirs as the parent still owes the state. The families are only supposed to receive anything leftover after the nursing home bill is paid off.

Monies in a regular checking account or a QIT or other trust account are not refunded to the estate or heirs. If my spouse died today, I am supposed to immediately close the QIT, valued at $12.00. I am supposed to write the check for $12.00 and mail it to the state. His personal account at the nursing home would yield about $35.00. The state would thus collect $47.00.

It might not be cost effective, but those funds can not be kept by his estate or me according to the rules. I've not been able to varify, but I think the nursing home has to mail it's $47.00 to the state. So the state will process the $47.00 repayment received from my spouse's estate.

Our state has not given any timeline for this rest of the recovery, just that it gets started sometime after death.
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Caregiverhelp11 May 2019
Thanks for your reply. Everything seems to be so complicated, nothing is cut and dry. In the past I've contacted the Medicaid
office and have received very little help or answers regarding
other situations I had questions about. It can be very frustrating. I just hope they send me a letter shortly after my
Mother's death telling me what I need to do.
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