In a Medi Cal "look back" would they find fault with my mother giving gifts of money to her grand children and kids?

I asked that question a few years back when I was POA for a relative. I was also concerned about charitable gifts and church donations. I was told that the case reviewers would look for a long-term pattern to the gifts. If your mom has been giving monetary gifts to the relatives for several years, and the amounts have not changed, there would not be a problem. Same with charitable gifts. Of course, this was in Nebraska, and was a few years ago. You could call the Medi Cal office and see if their rules are similar.

If you're talking Medicaid, the answer is "yes." Be very careful about monetary gifts. And yes, you should check the rules for your state. But keep in mind that small gifts can add up to large sums of money. And that is always a red flag for Medicaid because they see it as a way to transfer assets to avoid paying for your own care.

My father in law has only SS & Vets benefit per month, about $2,000.00. He also has a Reverse Mortgage, owns a Condo, is joint owner of another Condo in Fla. He is 90 with dementia & we are in the legal process of getting Guardianship. His girlfriend, who is in Joint Ownership of Fla Condo also has Joint Accounts with him in Fla and has been taking large monies from Rev Mortgage and putting it into their joint accounts in Fla. She tells him what to do and sign and he does it. We have had many explosions with her over this and she tells us "not to tell her what to do with her money". Its not her money, it belongs to my father in law. If we had to apply for Medicaid...would he be eligible? How does this "LOOK BACK 5 YEARS" work and what do they look for?

I talked to a lawyer about that a month ago. He said "No monetary gifts to grandchildren at all!" However he did say it was ok to make gifts so I am trying to be creative and sew some gifts this year.

I should have added that I live in Maryland. No monetary gifts at all.

I must be going crazy. In these United States, I have been under the assumption that one may give money to anyone at all. If one has it, and one wants to give it, then let it be done. I'm not talking Schedule A under Charitable Gifts, I am just talking about giving your dollars to whomever.
Now if you want to involve Medicaid, then the story changes, I guess.
Lesson: Avoid Medicaid and live your life.

NiK2R3: We all do try to avoid Medicaid but when you are caring for an elderly parent and you do not know how long their money will last, you have to do some asset planning. You do not want to rush out and purchase things or spend their money in a way that Medicaid, when you REALLY NEED IT, will "look back" and say your mother spent " $30,000 for gifts in the past 5 years and we will not accept that so we are going to refuse your mother medical coverage for the next year because of it." Therefore you have to look ahead at what the possibilities may be down the road and live accordingly. I would not have $30,000 to make up for it therefore I am trying to make sure her assets are handled as wisely as I know how.

N1K2R3, you are not going crazy. You may still give your money and other assets to anyone you please, in any amounts you want. Your gifts may have tax consequences. Your gifts may cause a "penalty period" if you ever have to apply for Medicaid. But you can give the assets away as you like.

And you can certainly avoid Medicaid -- if you are generationally wealthy, if you never get a disabling disease, if you have family who can/will support you, if you die young.

Here is an even better solution: Avoid getting dementia. Avoid having COPD. Avoid developing cancer. Avoid having any health problems that will require expensive medical care as you age.

Gabriel Heiser, an elder-care lawyer has written a book on how to avoid the pitfalls of Medicaid.
I AM aware of the Gift Tax..
To avoid Medicaid, one does not have to be generationally wealthy, but one does need Medicare, and it's expensive 20% Supplement. That, I believe, will take care of you if you are disabled, demented, COPD-ed and cancerous. You will also need Medicare Part D, as well as A and B. I see no need for Medicaid unless you are poor......and I don't mean lacking in funds, I mean poor.
All of us will require expensive medical care as we age. Medicaid was never intended for most of us. It is a state-supported, state-funded program, now with some federal money, that will take care of the poor among us.

N1K2R3: I do not agree with everything you have written back to jeannegibbs. My mother does have Medicare and that expensive 2ndary insurance that pays 20%. If you don't have it you need to obtain the "Medicare and You 2014" book that goes into detail what Medicare does and does not cover. Read the book and become well versed on coverage. "Medicare does not cover long term care or custodial care."

When a person has Dementia or Alzheimer's or many other illnesses they may require long term care, possibly not in the very beginning, but as their diseases progress it may become necessary to admit them for long term care because they can no longer be cared for within the home.

Personally I have taken care of a number of people and they were taken care of at home but my Aunt had to go into the hospital and her days began running out because Medicare has what they call "benefit periods" and you have to leave the hospital and be out for a certain number of days. At that time my Aunt had to be out of the hospital for 45 days before she could be readmitted. These are all things that none of us see coming when an elder becomes ill. She had to be transferred to a "rehabilitation unit" for a while and then to a nursing home for a short time. She was eventually brought home and lived for two days and passed away. My mother was unable to get the nurse to the house in time due to traffic and she administered medication that she was told to give but my Aunt died. My mother lived with the guilt for a long time, thinking she possibly caused my Aunt to die. The other people I have cared for all died relatively fast within the hospital due to their illnesses.

With dementia and Alzheimer's we try to care for our elders at home for as long as we can, I have been caring for Mom for 7 years at home. I never thought her condition would get as bad as it has. A month ago I was willing to look for a nursing home because I was losing MY MIND due to HER condition. Hallucinations, OCD behaviors, screaming and yelling, her inability to sleep caused everyone in our house not to sleep. She was admitted to the hospital for surgery and it became worse, her doctor took me to the hallway and told me, "You have to admit her to a nursing home, you cannot handle this alone, you will fail and you will hate yourself, then you will be sick!"

Medicare does not pay for "long term care or custodial care."

At $5,000 to $10,000 a month for Nursing Home Care you would have to be wealthy because most people do not have that kind of money and if your insurance doesn't cover it, you have to come up with the cash, or you have to apply to Medicaid for help.

People mistakenly think that only totally indigent people have to apply for Medicaid help, that is not the case anymore. Many of us who mistakenly thought we were "middle class" have now found ourselves having to turn to Medicaid for assistance or in my case, trying to live by their guidelines, just in case it may be needed down the line. My mother's Aunt lived to be over 100 and my Mom is 84, what if she lives as long as her Aunt. By then I do not think I will still be alive but she will need care.

Please make sure you check out what is and is not covered by your insurance but also do not pass judgment on others who may see the need now or in the future to have to use Medicaid for their loved ones or themselves. None of us ever thought we would find ourselves here, needing assistance, but life happens and people get ill and many exhaust all their financial resources due to these illnesses.

I'll do just that, Raven, and I'll also read the Medicare and You, 2014 Booklet that arrived about a month ago at my home.
I don't know what the parameters are for Medicaid, but I was told that one has to be very poor in order to qualify. Like I said in my previous post, Medicare Parts A, B, and D cover most hospitals, doctors, tests and drugs as long as you have that 20% Gap payment to a private insurer.
Notice that I did not mention Nursing Homes, Assisted Living, Independent Living, or even a Home Health aide. These are considered outside the Medicare provisions, unfortunately.
Many people purchased LTC Insurance to cover Nursing Home care. I did not. How 'bout you? It's expensive, but pales in comparison to the costs of Nursing Home Care, which we all may/may not need someday.
I am aware of the "Benefit Period" and the in and out rules for a Medicare patient. I would suggest that you follow them, as best as you can, and arrange for someone other than yourself to care for your mother. She will eventually go into a hospital, not Nursing Home, unless you put her there, and she most likely will die in a hospital. I dislike being so blunt, but most people die in a hospital ( statistics). If she is 84 now, she may live for many years. No one knows, not even the MD's who care for her.
I am greatly concerned about her hallucinations, OCD behaviors, screaming and yelling and insomnia. What you have described is a patient who has been over-medicated, or who has been given incorrect meds. Next will be wandering and getting lost, if it hasn't happened already.
You didn't ask me what I would do, but I'll tell you anyway: First check her Will and her Life Insurance Policy. Make sure the amount is adequate to pay you after her death, obviously you should be the first beneficiary, and then the contingents after that. You may put her in an Assisted Living facility that will handle her condition( very selected). If they won't take her, then you'll have to bite the bullet and place her in a Nursing Home. The average stay in a Nursing Home is about eighteen to twenty-four months. It will relieve your family of the stress that they are now experiencing. Sorry. Make some kind of payment plan and realize that it's not forever. Good Luck.
Let her give money to her grandchildren and be happy. Avoid Medicaid or read Gabriel Heiser's book on the pitfalls of Medicaid. I am against Medicaid because of the extreme government involvement it imposes on all tax-paying citizens of this country.

I don't understand all of this but if my mother wants to give us $50 or $100 to take care of the lawnwork and no one else knows about it......who cares. Why would you report getting gifts of $50 to take care of stuff around the house. I always refuse but somehow she sneaks it in my purse or other places that I don't find for months down the road. What about that? So unless BIG amounts of monetary gifts are given who needs to know. and IF you don't put it in the bank....who needs to know what you have in your house? I understand that medicade needs something to help people out. So I guess if you want to give money, give it when you are about 60 (take out a loan, give the money away) and hope you don't get sick and need care untill you are about 80. that would solve all problems.

Wolflover451: The question was asked because we wanted to know if Mom can no longer shop for Birthday or Christmas or any type of gifts and I am her 24/7 care giver and POA can I give gifts of money for her to her Children and grandchildren and not have Medicaid (should it be needed down the road) do their 5 year look back and say, "You were not allowed to do that so now we are going to penalize your mother and not cover her for x number of months to make up for the cash that was given away." When cash is given away Medicaid believes you are trying to get rid of funds that they would take into account when determining if your relative can qualify for their assistance.

I have a mother who is ill with dementia/Alzheimer's and I have cared for her for almost 8 years with zero compensation and I actually pay rent, utilities and food to her. I did not realize that her condition would become as severe as it has nor did I ever believe she would live this long with it. Knowing that her funds are becoming close to exhausted and because of the fact that I am disabled and do not have funds to assist her with when they do, I wanted to be expedient in knowing what I would be faced with should we reach the point of needing to ask Medicaid for assistance to put her into a nursing home.

If that time should arise, Medicaid does what is called a "5 year look back" where they go over all expenditures for the past five years and either approve them or they do not. If they do not approve them they are all lumped together and say it amounts to $100,000 as an example, they look at what nursing homes cost in your area per month, so lets say in your area it is $5,000 per month... they will come back and tell you that they will not cover the nursing home bill for 20 months.

Now I do not know about you, but I do not have $100,000 in cash to pay for the first 20 months of nursing home care, SHOULD MY RELATIVE EVER NEED IT!
And Medicare and her 2ndary insurance does not cover it either and even Long Term Care Insurance does not cover "forever," there is a time limit as well IF you can afford it.

Medicaid does not buy the "Oops I didn't know I couldn't do that" excuse. Not knowing what may lie down the road, I was merely asking the question in case anyone else had encountered it. When or IF my relative needs the help of Medicaid I want to know that I was a good steward of their money and took care of it in a fashion that allowed her to get the care she needed when she needed it.

N1K2R3 is making a political statement that no one should use Medicaid because of the burden it imposes on all tax paying citizens. The thing is we are all tax paying citizens and have been our entire lives. We have worked our butts off just like you have, if you are lucky enough to never need Medicaid, good for you, but there are many people not so lucky, people who owned businesses or worked jobs with 6 figure incomes that had a medical catastrophe hit them and it has taken every cent they ever saved and now they need help and you want to stand there and pass judgment on them? Really? All I can say is shame on you, perhaps you need to get on your knees and Thank God for what YOU have and also pray for those not as fortunate!

N1K2R3 said "I am greatly concerned about her hallucinations, OCD behaviors, screaming and yelling and insomnia. What you have described is a patient who has been over-medicated, or who has been given incorrect meds."

Balderdash!

Interesting question and I have wondered about this myself. I have told POA that gifts to children, grandchildren and great grandchildren should not be made by check. What about buying gift cards with a cash withdrawal that would be made from the bank account?

wolflover451 - If Mom pays you to do work for her, that is absolutely OK. If you want to do everything correctly, write up an invoice describing the work, have her pay you by check, and keep the records. You're right, probably no one will ever know about small cash transactions, but it may be better to be safe than sorry.

jeannegibbs: Regarding your reply to:

N1K2R3 said "I am greatly concerned about her hallucinations, OCD behaviors, screaming and yelling and insomnia. What you have described is a patient who has been over-medicated, or who has been given incorrect meds."

Of Balderdash!

You are absolutely correct, that is exactly what it was, "Baldersash!" When my mother was ill and doing all those things, it was NOT BECAUSE SHE WAS OVER MEDICATED, IT WAS BECAUSE SHE WAS NOT MEDICATED AT ALL AT THAT TIME!

I am very happy to say that my mother saw a Gerontology Case Manager who did a very thorough exam and began her on two medications and she is doing so well now! She has been on them for two weeks and it is a world of difference!

Everyone is entitled to their own opinion, but this person did not like the idea that I was even considering that down the line I might actually HAVE to turn to Medicaid for assistance should my Mother need to be placed into a NH. It was more of a political statement than anything else. My Mom is doing so much better however that hopefully that will never be necessary, I just think it is prudent to keep your eyes open and look down the road at what may be coming.

Thank You Jeanne

So! Raven, from October 20, 2013 to October 30th, your mother has gone from hallucinating, OCD behavior, screaming and yelling to "doing so much better" and that " hopefully that will never be necessary......" referencing Nursing Home Care. All I can say is, "well, I''ll be.." "that's wonderful".

At least here in California Birthday gifts and such are exceptable as long as the amts are within reason and not large as well as not to the same person. I guess what I am saying is, lets say grandma wanted to give $25.00 to great grantdaughter for her birthday well okay do it. If in 3 months she wanted to give $3000.00 to the same person and then again in another 3 months the same than the dept of social services would more than likely question this and possible count this as a period of ineligiblity. But same birthday, graduation gifts are a part of being grandma. As for life happens, it really does, I work for a Skilled NH and let me tell you money only goes so far and at the tune of $6800 per month for only room and board not any medical items it goes fast and AL facilities seem like they start out with a smaller amount then with all the ADL's needed it all adds up. Medicaid is a life saver for families who are not able to keep loved ones at home money or not.