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After a determination of Medicaid eligibility, the states give a married couple a certain length of time to separate their assets (sometimes as long as 12 months). So during this time period, the joint account should have been put in Mom's name. I assume that this did not happen, hence the problem.
I have been through this. This is regarding using Medicaid to pay for a spouse that ends up in a nursing home, if they don't have long term care insurance. In addition to an Elder Law attorney, see your local office for aging for information. Mine gave me a 4 page document that is pretty clear that the government does not want the "Community Spouse" to become impoverished. Doesn't matter whose name is on accounts...the spouse remaining at home in the community, can keep the house, no matter the value, a car, no matter the value, and well over $100,000 in cash and investments, and keep all income up to a certain amount, including income of the spouse in the nursing home. Best thing to do is start with the office for aging, then move to an elder law attorney that they recommend or that you are familiar with. They may even have one available at a reduced rate.
Yes, I have heard of this - an Elder Lawyer might help.
I never heard of "spousal impoverishment" but it sounds like she wasn't really impoverished if there was enough money to be upset about?
I know if my DH needed a nursing home, they are entitled to half of anything that has Ray's name on it.
However, there isn't much you could have done since they can go back 5 years and reclaim your dad's half of the monies. I know it stinks, but maybe it will help to know that there is nothing you could have done to prevent this.
They are trying to change the law to 7 years and they take away money that has been given away years ago. They go after the person it was given to!!! Gotta love this country, what do we pay all those taxes for our whole lives for them to take everything away if you go into long term care. Other countries take it out of their peoples taxes and don't go into the families estate at all and their taxes are not much more than ours!!!!
Daughter17 - the "spousal impoverishment" by this are you referring to - a CSRA / Community Spouse Resource Allowance or MMNA / minimum monthly needs assessment (allowance) that your mom got each mo. An "income" issue OR - was the $ sitting in a bank account, so that it's an "asset" and now got looked at as a joint asset...... So 50% is now dads. An "asset" issue
They are 2 very different issues for Medicaid. Which is it?
Also I'm assuming mom just got the notification. Your mom (or you as her dpoa) needs to file an appeal to the determination. The Notice should have to whom & by when the appeal needs to be done. Keep letter short & say determination is incorrect & you are asking for a suspension of any enforcement until appeal process has run its course. You do not need to go into why in this first letter. It's about getting appeal into the system. Mom will get hearing date likely 6 mos or so out from how. Basically buys you time to get it reversed and establish why it's incorrect. Letter to be sent certified mail with the return registered card (combo from uspo about $ 8.00). If you have a fax number I'd fax it as well but if so pls send it from a fax system that gives a fax transmission report (like a Fed Ex office store). Both of these moves are about establishing appeals request was done and received by state.
So which is it..... An income problem? or an asset problem?
Also regarding the "5 yr lookback". My understanding is that up to a 10 yr lookback is possible since the mid 1990's. But the states all approached this differently... Like some states did just a cursory 6 mo review. Then DRA happened in 2005. The feds & states opted to do a uniform 5 year look back and placed "5" as the time period when the required changes to Medicaid happened due to DRA / Defecit Reduction Act signed into law in 2005 by Bush 43. Individual states can move it back from 5 to 7, or 8, 9, or 10 years IF a state wants to. Most won't as it's too cumbersome both for state to process and for applicants. But the states - as they adminster Medicaid uniquely within their state - can move the lookback beyond the 5. LTC Medicaid is a huge budget issue for all states. If doing a 7 -10 yr look back "saves" $, states are going to do this unless theres political fall-out to keep it from happening.
Mom was on my nephew's bank account. The lawyer at the time she did her will suggested that she remove her name because Medicaid would look as his account as half hers. She removed it.
It sounds like your mom was duped, Medicaid does not take your money during the Medicaid process. They never ask for banking information to access your account. They also never ask for other financial information such as major credit card. I've been through the Medicaid process before after losing Medicaid for a time and then reapplying and not once did they ever ask for banking info to access my bank account.
What you need to do is take all of that information with whom you contacted and get a lawyer. Take with you any information and documents where your mom's money was stolen, it sounds to me like whoever was in contact with her was definitely not legit
Dontask, Medicaid for health insurance or for long-term nursing? You have not had to send an updated statement showing your income? I have for my disabled nephew every year when he is sent his paperwork. Also, have to show the statement for his Special needs trust even though it can't be considered in his income. Filing for long-term care and I had to show the latest statement.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
I never heard of "spousal impoverishment" but it sounds like she wasn't really impoverished if there was enough money to be upset about?
I know if my DH needed a nursing home, they are entitled to half of anything that has Ray's name on it.
However, there isn't much you could have done since they can go back 5 years and reclaim your dad's half of the monies. I know it stinks, but maybe it will help to know that there is nothing you could have done to prevent this.
- a CSRA / Community Spouse Resource Allowance or MMNA / minimum monthly needs assessment (allowance) that your mom got each mo. An "income" issue
OR
- was the $ sitting in a bank account, so that it's an "asset" and now got looked at as a joint asset...... So 50% is now dads. An "asset" issue
They are 2 very different issues for Medicaid. Which is it?
Also I'm assuming mom just got the notification. Your mom (or you as her dpoa) needs to file an appeal to the determination. The Notice should have to whom & by when the appeal needs to be done. Keep letter short & say determination is incorrect & you are asking for a suspension of any enforcement until appeal process has run its course. You do not need to go into why in this first letter. It's about getting appeal into the system. Mom will get hearing date likely 6 mos or so out from how. Basically buys you time to get it reversed and establish why it's incorrect. Letter to be sent certified mail with the return registered card (combo from uspo about $ 8.00). If you have a fax number I'd fax it as well but if so pls send it from a fax system that gives a fax transmission report (like a Fed Ex office store). Both of these moves are about establishing appeals request was done and received by state.
So which is it..... An income problem? or an asset problem?
Also regarding the "5 yr lookback".
My understanding is that up to a 10 yr lookback is possible since the mid 1990's. But the states all approached this differently... Like some states did just a cursory 6 mo review. Then DRA happened in 2005. The feds & states opted to do a uniform 5 year look back and placed "5" as the time period when the required changes to Medicaid happened due to DRA / Defecit Reduction Act signed into law in 2005 by Bush 43. Individual states can move it back from 5 to 7, or 8, 9, or 10 years IF a state wants to. Most won't as it's too cumbersome both for state to process and for applicants. But the states - as they adminster Medicaid uniquely within their state - can move the lookback beyond the 5. LTC Medicaid is a huge budget issue for all states. If doing a 7 -10 yr look back "saves" $, states are going to do this unless theres political fall-out to keep it from happening.
What you need to do is take all of that information with whom you contacted and get a lawyer. Take with you any information and documents where your mom's money was stolen, it sounds to me like whoever was in contact with her was definitely not legit
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