STAYSTRONG57 Asked September 2013
What can mom keep for assets and stay in assisted living with help from Medicaid and Medicare?
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My Dad passed 12/14/2011. My Mom is declining real fast. Her memory and walking is not good. She needs assisted living and it is $5050.00 per month. She get$1100.00 from Social Security. Her home has mold in the basement and needs large expensive repairs.. She owns the home . But also owns some land 97 acres)
her home is included in that lot. It is farm land that my Dad earned while farming with his Dad for years. She does have some money. But does she have to DRAIN all of this in order to get assistance in her assisted living from Medicaid and Medicare?
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There are a couple of things that you all (mom & your siblings and spouses) need to evaluate.
- AL vs. NH: does mom's state allow for Medicaid to pay for AL???. Medicaid by & large is for skilled nursing services and that means a NH. For AL to be paid under the Medicaid program there needs to be a waiver program in your state that allows for a diversion of Medicaid funding to do this. Not all states do a AL waiver. My mom is in TX and by & large Medicaid pays for NH level of care. In TX, there is a community-based wavier program but it is smallish and has a waiting list. So find out if AL is even covered by Medicaid in your state. If not, then I'd start looking for a NH now and speak with the NH admissions to what to do now to have her qualify medically for NH. Medicaid requires both medical & financial qualifications.
- MERP exemptions: go to your states Medicaid site to see what the exemptions are to MERP. MERP is Medicaid Estate Recovery Program or aka "their gonna take momma's house". All states have to have MERP to get federal Medicaid $$$$. Medicaid is a joint federal & state program BUT administered by each state. So each state gets to put their spin on how Medicaid, MERP is done. Most states have exemptions for family farms (my mom is in TX and in TX this means ranches - and big ones like counted in sections - are fully exempt from MERP). So if your state allows this exemption, & the property is a working farm, it cannot ever be claimed by MERP. Now MERP doesn't come into play until after death and that often is the problem. Mom's $ is being used to pay for AL, etc and so no $ to continue the farm. If you want to keep it as a working farm, mom can file for a diversion of her SS to have it used for farm expenses. Stuff like this is complicated & an elder law attorney will know how to make this work.
- State Law: since Medicaid is administered by each state, the individual state laws make a huge butt difference. Not all states can place a lien on the property. Some states do NOT allow or a lein at all and MERP is done as a claim. Again this goes to how probate, death laws, etc. are in your state. For example, TX is a level of claim probate state. Claims are paid in order of level; MERP is a Class 7 claim in TX, so everything in Class 1 - 6 get paid first & foremost; 4 years is allowed from the time letters are presented & filed in probate court - which is a long time that an estate will need to be managed and paid for. So MERP rates are lower in TX as it is a more cumbersome process legally. MERP still happens in TX (and is now being done by an outside contractor) but recovery is lower than in a equal level of claim state or a lein attached state.
Really as Jinx said, you need to speak with an experienced elder law attorney to find out what the options are for you all as is allowed in your state. Good luck.
If your father were still alive, the house would remain available to your mother. Medicaid will not actually"take" the home until it is clear that your mother cannot plan to return to the home. But since she is a widow, Medicaid will put a lien on the house and land if they do help pay for her care. After she passes, they will try to recover what they paid from her estate.
There is an exception. Did you live with your mother and care for her and keep her out of the NH? In that case, you might be able to exempt the house and land, and inherit them.
You need a consultation with an Elder Law attorney to find the best way to fund your mother's care until her assets have been spent down.