K. Gabriel Heiser
Attorney, author, Medicaid asset protection planning
K. Gabriel Heiser, J.D., is an attorney with over 25 years of experience in elder law and estate planning. He is the author of "How to Protect Your Family's Assets from Devastating Nursing Home Costs: Medicaid Secrets," an annually updated practical guide for the layperson.
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Question
Will Mom paying her daughter for doing chores she couldn't do for herself cause a Medicaid problem?
An elder can legally pay a family member for assistance, so long as it is at the going rate for such type of work, and the payments are... An elder can legally pay a family member for assistance, so long as it is at the going rate for such type of work, and the payments are made concurrently (e.g., at the end of each week for the number of hours worked).
One auto OF ANY VALUE s exempt from Medicaid countability. The $4,500 limit was changed a few years ago and no longer is current law.
When she put your name on the car she was making a gift of one-half the then-value of the car. If she applies for Medicaid within 5 years of such gift it will count against her as a disqualifying transfer. see more
One auto OF ANY VALUE s exempt from Medicaid countability. The $4,500 limit was changed a few years ago and no longer is current law.
When she put your name on the car she was making a gift of one-half the then-value of the car. If she applies for Medicaid within 5 years of such gift it will count against her as a disqualifying transfer. see more
Question
Can someone explain what the 5-year "look back" period for Medicaid is?
If you sell the house, you will have converted an exempt asset into a countable asset. Then she would be disqualified from Medicaid. If she... If you sell the house, you will have converted an exempt asset into a countable asset. Then she would be disqualified from Medicaid. If she gives away the house, you run into the 5-year lookback rule and penalty period discussed above. see more
Question
What must a beneficiary of stocks/annuities do to be able to receive Medicaid?
At this point, your father must deplete the total value of the assets he received as a result of your mother's death, to less than... At this point, your father must deplete the total value of the assets he received as a result of your mother's death, to less than $2,000 in value. However, that does not mean he has to spend it all down. There are a number of ways he can reduce his countable assets without giving them away, such as purchasing a Medicaid-friendly annuity, purchasing exempt assets, pre-paying a funeral/burial fund, etc. I explore these options in great detail in my book Medicaid Secrets. Perhaps other readers of this column will also chime in with more specific ideas from their own experience. see more
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Handling the finances for an elder that lives with you. Are you feeling lost too?
If you have paid down her excess cash, your mother would now qualify for Medicaid in a nursing home, I believe. Are there any near you that... If you have paid down her excess cash, your mother would now qualify for Medicaid in a nursing home, I believe. Are there any near you that you and your sister would feel comfortable placing your mother in? That could solve your ongoing financial problems with your mother. see more
Question
Legal documents. Any advice?
As an estate planning attorney, my standard charge for a durable power of attorney was $150. That includes two meetings with the client:... As an estate planning attorney, my standard charge for a durable power of attorney was $150. That includes two meetings with the client: determining their specific needs, drafting the document with the needed clauses, explaining the document and answering client questions, and supervising the signing of the document. So a $10 stationery form or online form is worth exactly that. see more
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Legal documents. Any advice?
Note that such form, while possibly helpful, does not include any specific powers that would facilitate Medicaid planning. That frequently... Note that such form, while possibly helpful, does not include any specific powers that would facilitate Medicaid planning. That frequently can be extremely important should the person who signed it ever face long-term care. see more
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Can someone explain what the 5-year "look back" period for Medicaid is?
Hospice care is covered by Medicare (vs. Medicaid), which does require a means test (i.e., it does not matter how much in assets or income... Hospice care is covered by Medicare (vs. Medicaid), which does require a means test (i.e., it does not matter how much in assets or income the person has). So the five-year lookback does not come into play. see more
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Does anyone know a Medicaid specialist in or near Franklin Lakes, NJ?
You may want to check with the local bar association to see if there is a list of attorneys who will help the indigent "pro bono"... You may want to check with the local bar association to see if there is a list of attorneys who will help the indigent "pro bono" ("no charge"). If indeed your mother has assets that would disqualify her from Medicaid, then hiring a Medicaid planning expert attorney would be worth the money, if there is a substantial amount of money at risk. I have a section in my book that deals with how to find such an attorney in your area.
If your mom is only a little bit over the resource limit, then some of the ideas I discuss in my book may be of value, too, such as pre-paying a funeral/burial plan, purchasing certain exempt assets, improving the home, etc. The book is here: www.MedicaidSecrets.com see more
If your mom is only a little bit over the resource limit, then some of the ideas I discuss in my book may be of value, too, such as pre-paying a funeral/burial plan, purchasing certain exempt assets, improving the home, etc. The book is here: www.MedicaidSecrets.com see more
Question
Does a Deed of Trust protect me from Medicaid seizing my Mom's house once she passes?
imsaknco1: The date you took your father's name off the account is the date of the gift. The five-year lookback period starts on that... imsaknco1: The date you took your father's name off the account is the date of the gift. The five-year lookback period starts on that date. So if your father applies for Medicaid within the next 4 1/2 years, then that transfer will count against him as a gift to you, and result in a disqualification (penalty) period.
The revocable trust is irrelevant in this case, since the money is not in the trust. see more
The revocable trust is irrelevant in this case, since the money is not in the trust. see more
Question
Legal documents. Any advice?
For example, I always included very specific language in my DPOAs that permitted transfers for Medicaid planning purposes. Without that in... For example, I always included very specific language in my DPOAs that permitted transfers for Medicaid planning purposes. Without that in the DPOA it would not normally be permitted, which could wind up costing the family thousands of dollars in the long run. Thus, don't be penny-wise and pound foolish, as they say! see more
Question
Legal documents. Any advice?
It really should not be expensive to obtain a medical power of attorney, but I certainly recommend you get one from your mother. It will... It really should not be expensive to obtain a medical power of attorney, but I certainly recommend you get one from your mother. It will make access to her doctors (with questions) and her medical records much easier, down the line. She should also sign a living will specifying what her wishes are in a terminal situation, so you do not have to guess. see more
Question
Any American citizens have experience with retiring abroad?
Yes, unlike every other nation, the U.S. taxes you on your worldwide income, no matter where you live. So, you will indeed have to continue... Yes, unlike every other nation, the U.S. taxes you on your worldwide income, no matter where you live. So, you will indeed have to continue to file U.S. income taxes unless you take the bold and permanent step of renouncing your U.S. citizenship. Of course, then you'd be giving up your Social Security and Medicare, so only the super-wealthy typically have any interest in that! see more
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Any American citizens have experience with retiring abroad?
You can continue to receive your Social Security, but your Medicare will not be of value outside of the U.S.: If you wish to have Medicare... You can continue to receive your Social Security, but your Medicare will not be of value outside of the U.S.: If you wish to have Medicare available for you upon visits back to the U.S., you will need to continue to pay the monthly premiums even if you now live outside the U.S. see more
Question
Does CSRA apply to initial application only, or also to yearly renewal?
The CSRA is only calculated once, which is the first day of the month in which an institutionalized spouse has entered the nursing home and... The CSRA is only calculated once, which is the first day of the month in which an institutionalized spouse has entered the nursing home and is expected to remain there at least 30 days.
The federal rule (which applies to all the states) may be found here:
42 U.S.C. §1396r-5(c)(2). A website for this statute is here: http://www.law.cornell.edu/uscode/text/42/1396r-5
Good luck with everything! see more
The federal rule (which applies to all the states) may be found here:
42 U.S.C. §1396r-5(c)(2). A website for this statute is here: http://www.law.cornell.edu/uscode/text/42/1396r-5
Good luck with everything! see more
Question
Do doctors reduce the standard of care when someone is placed on Medicaid?
While it's true that the payment to doctors and nursing homes under Medicaid is less than if they billed privately, it should not... While it's true that the payment to doctors and nursing homes under Medicaid is less than if they billed privately, it should not affect the level of care. I have never heard anything to the contrary. As for Medicaid vs Medicare, it should be about the same. see more
Question
Has anyone moved a parent from one state to another...from one assisted living to another?
When moving from state to state, federal law prohibits a state from imposing a length-of-residence requirement before a patient may be... When moving from state to state, federal law prohibits a state from imposing a length-of-residence requirement before a patient may be covered by Medicaid in the new state. However, be aware that qualifying for Medicaid is determined at the state level, although there are many federal rules that apply to all the states. Sometimes there are key differences between the state implementation that may affect a particular case. Thus, before you decide to pack up a parent and move them from State A to State B, it is good advice to check out the Medicaid rules in State B to avoid any nasty surprises!
You also need to find out if there are Medicaid-certified nursing homes with available beds in the town or city to which you wish to move your parent, if there is a waiting list, etc. see more
You also need to find out if there are Medicaid-certified nursing homes with available beds in the town or city to which you wish to move your parent, if there is a waiting list, etc. see more
Question
Does a house in a trust (in CA) mean it can't be transferred to one child?
The house would need to be transferred from your father directly to you, as caregiver, in order for the caregiver exception to apply. That... The house would need to be transferred from your father directly to you, as caregiver, in order for the caregiver exception to apply. That means the house would have to come out of trust and into your dad's sole name. Then he (or someone acting on his behalf under a durable power of attorney [DPOA]) could deed it to you. However, the DPOA would have to include the power to make such a gift.
As for your other question, the child receiving the house under the caregiver exception does not need to continue living in the house. The test is that the child have cared for the parent and resided with the parent in the parent's house for at least the two-year period immediately before the parent enters a nursing home, and that such care allowed the parent to delay needing to enter a nursing home. see more
As for your other question, the child receiving the house under the caregiver exception does not need to continue living in the house. The test is that the child have cared for the parent and resided with the parent in the parent's house for at least the two-year period immediately before the parent enters a nursing home, and that such care allowed the parent to delay needing to enter a nursing home. see more
Question
When applying for Medicaid for my Dad, do we have to report those closed bank accounts and closed IRA's?
If you are spending down the money on his health care or items for his own use (i.e., not making gifts out of the money), then you need not... If you are spending down the money on his health care or items for his own use (i.e., not making gifts out of the money), then you need not worry about closed accounts. When you apply for Medicaid for your dad you may have to prove what the money was spent on, so save the receipts, just to be on the safe side. When a person applies for Medicaid, they must report all their current assets as well as report any gifts they made within the last 5 years. Obviously, lying about past gifts is fraud against the state and federal governments, so basically the government relies on applicants telling the truth, just as the IRS does when you fill out your tax returns. see more
Question
Can someone explain what the 5-year "look back" period for Medicaid is?
To AnnPA14: If your mother receives a legal interest in the home you are building--at least equal to the amount of money she is... To AnnPA14: If your mother receives a legal interest in the home you are building--at least equal to the amount of money she is transferring--at the time she transfer the money, then it is not a gift, since she is receiving equal value in return. I advise you to contact an elder law attorney to ensure this is all done correctly. see more
What about a divorce?
On the other hand, which assets each spouse brought into the marriage or inherited or received as gifts from their relatives, all play a part in which assets each spouse can receive under the divorce laws. As you can see, it gets complicated, which is why you need two attorneys working together to accomplish this.
I address the issue of a Medicaid-planning divorce in my book. Good luck! see more