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If I closed bank accounts or if I took out cash periodically and put under my mattress how does Medicaid know it was for a transfer during the lookBack period for Medicaid penalty?

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Warren, you told us you were going to see an eldercare certified attorney. Have you done that?

A NAELA certified attorney who is familiar with Medicaid regs in your state is the person you need to be talking to. You are the 'community spouse" and there are regs to assure that you are not impoverished, but it's not a DYI project.

Don't be penny wise and pound foolish. You'll regret it for the rest of your life.
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Does Medicaid tell me how I must 'spend down' my savings to qualify for Medicaid? Can I go on a luxury world cruise or gamble it away?
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Warren, it's nice you want to save something for your grand kids.... but there might be a time when you need funds for your own care.

This is what I have noticed with my own relatives, not all grown children or grandchildren want the house. I was glad when my Dad sold the house and used the money for his Independent Living and then Assisted Living cost.

Right now, one of my late Aunts left her house to her 3 grown children. Two want to keep the house, one wants to sell it because she cannot afford to pay 1/3 of the property taxes and house insurance on a house that has been sitting vacant. The other two cannot buy her out. Now the siblings are barely talking to each other :(
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Good job Warren, seeing a lawyer was the best decision
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Warren, I know that your wife has dementia as you have stated, but what type is it and how far has she progressed? Does she have any medical ailments that she would require a Nursing home, rather than an Assisted Living?
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Warren, you would need to check with your State Medicaid office as to what are acceptable spend down items, every State is different.
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Warren - honey you are overwhelmed. And rightly so. The "annuity" if it was suggested by the atty to do one, I'd do it. But it needs to be a "medicaid compliant" annuity. There isn't a lot of insurance underwriting on this type of product. I'd imagine the atty has a financial planner that they work with and understands about Medicaid compliant annuities.

The annuity will need to make the state as the beneficiary & usually requires a lower & more specific limited commission structure & required reporting.

It is a great single action way to get all the $$ over the amount allowed by Medicaid for a community spouse (usually 118k) to go into the annuity so the ill spouse can be eligible for Medicaid. Normally I hate hate hate annuities but for community spouse situations, they can be a solution. The annuity structure will be determined by actuarial tables, so if your a younger CS, you maybe could outlive the tables & outlive the annuity. Totally a win-win!
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warren my experience with medicaid applications for Hospice patients is that the social worker is able to handle the applications.
I also feel strongly that everyone pays their own way if that is possible. Why should some be able to hide their money while their bills are paid by other taxpayers. Inheritance is not a right. If there is something left after the parent dies that of course is a benefit. At present medicare only looks back five years but that could be extended anytime. so if you must give your heirs funds during your lifetime but be sure they understand that if you require medicaid during the five years medicaid will expect them to pay if back. Spending down means using your money to pay needed expenses such as medical or household adaptions for the handicapped but no luxury cruises. Ordinary household expenses are allowable
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Warren, You might ask your attorney about Filial Responsibility. When all is said and done, will your state's healthcare authority ask your children to "reimburse" the Medicaid paid portion of a nursing facility's fee.
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Walk away, harsh though it may be.
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