My husband has dementia and other health issues and is currently in a nursing home in Arizona. I want to move to back to New York State and was wondering can I just transfer him from facility to another, or do I have to reapply for Medicaid and is there a waiting period to be eligible in the new state?
In NYS, you have the right of "spousal refusal". Make sure the lawyer you are working with takes that into account.
So the state could move the NH souse to another facility without needing to consult them?
Thanks again everyone.
- if hubs went onto LTC Medicaid, home was exempt asset for his Medicaid application. It could stay in his & your name. Not required to be sold.
AND
- You could well be getting a community spouse waiver $ (CSRA, MMNA) of some of his mo income to go to you instead of almost all going to NH as you have a home & costs to deal with
BUT
- Medicaid has it that if you applied for Medicaid program after age 55, state needs to attempt to be repaid costs paid by Medicaid. The system is called MERP or MERS, it’s basically estate recovery. After NH spouse dies, state needs to attempt to recoup $ from assets of his estate unless spouse or heirs have exemptions, exclusions to recovery OR if state has no recovery action if surviving spouse. MERP is imo very much state law (probate, property) interdependent. But after death system.
Hubs is very much still with us. So MERP cannot be done.
BUT
some states allow for a lien to be placed on property before person dies if on a 55+ Medicaid program. It’s not a normal lien like a mortgage would be. Mortgage are securitized lending, you cannot sell or trader the house unless that securitized lending is cleared. Pretty straightforward lien. But if your state allows Medicaid to proactively do a placecard lien, when you go to sell the house, title search will usually find Medicaid lein. It’s a subterranean lein as it is not securitized lending. Tends to happen in states that allow TEFRA type of actions. It shows up when title co is doing their detective work. If it’s there - this really varies by state- it will clusterF the time line on the Act of Sale. I’d try to clearly find out before putting house on the market how AZ runs LTC Medicaid lien attachments. A better Realtor who deals w older sellers should know abt this, good title company also. Try to find out so you don’t have a surprise @ Act of Sale.
once house sells, the $ -if property was joint - is income to both of you for month of the sale. The month after it becomes an asset. Medicaid is very sensitive to income and assets and has set max on each for both the NH spouse and you, the CS. For most states it’s 2k in assets and $2300 for income max for the NH spouse. CS tends to be $128k in your own assets (excludes house and 1 car) and your income does not count. ((Ok usually doesn’t count unless your income is high as your still working and making a hefty salary.)) Now sticky in house $ is that if you don’t quickly buy another house, income becomes an asset the next month. You gotta spend the $ so that it clears within the month, or maybe 2 months, so hubs starts mo ok for Medicaid & ends mo ok for Medicaid. You want Act of Sale set for 2nd or 3rd of month, this way you have more days to get $ in & out so hubs starts his mo within Medicaid limits and ends it within Medicaid limits. If the $ sits there for 4, 6, etc months till you buy a house in NY, it looks like assets he could have to private pay for new NY NH. My point it you have to kinda have a plan to limit further issues w Medicaid.
Folks on Medicaid do move to different states. The new state will require the house in old state to be on the market w MLS listing. No FSBO so it’s a true arms length sale. You can have it on the market for a while. You may need to file a waiver w Realtor listing every 6 mos. You can move, get him ensconced in a Medicaid bed and then deal with house stuff. The issue I’ll bet will be that in current housing market, it will sell right away and your dealing w everything all in 1-2 month. I’d try to enlist family & friends to be helping you early in all this to lessen stress. Like get house interiors minimized now.
I think NYS has higher asset limits than other states. You need clear definitive info from atty or SW familiar with NY rules. NYC may have their own max as cost of living is so high. More info = less stress.
Medicaid - although a federal & state program - is administered uniquely by EACH state for its state’s residents. You need to find someone knowledgeable about NYS Medicaid rules. I’d try to find a SW in the NY county or nearby county you r planning in moving into, who has a practice as a geriatric case manager & you hire them to do some of your / your hubs groundwork. Or is the SW at the already selected new NH in NYS. And then get a CELA level elder law atty in NYS.
At some point in his eligibility, he will need to become a NYS resident. As his wife, you too will need to do that as well (assuming you r moving to NYS). Just how difficult that may be varies by state.
Like some states require that you need to have a state issued ID or Drivers License to establish residency, which mean surrending the old DL and physically able to get to the state licensing bureau to get a photo taken w new ID issued. It’s something you might not think about but can be quite the challenge. I had to deal w this for my mom in TX, fortunately I was able to schedule her a time and she bypassed the very long line and got a permanent ID, but she was still able to walk slowly with a Walker at the huge TX DOT license site….. she fell like couple of months after this and became bedfast, so thank goodness it got done when it did. I mention this cause if hubs is not really ambulatory or somewhat competent and cognitive, getting things done that require him physically to be there & participate - banking changes, Social Security office, license bureau - it’s going to be quite the feat to accomplish.
I would also heavily suggest to you find a CELA level of elder law attorney to work with you in getting your finances perhaps reconfigured to have him eligible for NYS Medicaid. If right now, you are getting some of his income waived to you (instead of going as a copay to NH) under AZ community spouse income needs (CRSA, MMNA whatever acronym AZ uses, lol) that will have to be recalculated for however NYS does community spouse assessment.
If you have a home in AZ, that will need to be sold or placed up for sale with a Realtor. A home is a exempt asset for LTC Medicaid for the state of residency. Once you move out of AZ, it reverts to non exempt asset. The $ from Act of Sale will be a joint asset unless you ASAP buy a new property in NYS. Just how to juggle this, really needs savvy knowledgeable on NYS Medicaid atty.
As a very first step that you can totally do on your own, I’d find a bank in AZ & NYS with a branch nearby wherever you r moving to in NYS, and have all - ALL - banking moved to this bank. So if hubs has his own solo account for his SSA income, the same thing is set up for the new bank. Along this train of thought…. If he actually has made the current NH his representative payee for his SSA income, or other retirement income, those all will need to be changed. This too he can do now and move it so that his SSA goes direct deposited into his solo bank account and he / you write a check to the NH for his required Medicaid copay. Logistically I’d allow 3 - 4 months to get all banking changes to get new bank statements and have old showing zero / closed out balance. Medicaid is gonna want to see bank statements with NYS address at some point in time.
Good luck and let us know how it goes.
That would be my 1st step, because they can guide you on what to do and how it all works.
Have you figured out how you are going to transport him? Medicaid/ALTCS will NOT pay for a move to a different state.