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Has anyone used "Gift and Loan" strategy relative to some of the asset protection before a full spend down? How effective is this method and are there any pit falls one should consider?

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I resent the people who just say, spend down. I am a caregiver for my husband who has Parkinsons/Dementia. We are in our mid-sixties. I really don't look forward to living poorly because my husband has to go in a nursing home. I will do everything I can to hang on to the money we have. We worked for it and paid into the system all our lives.
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I know this may not sit well with some, but why not just spend down ? What purpose is working and saving money all you life if you refuse to use to care for yourself ?
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Caringlove, trying to gift away money will get you in a lot of hot water when it comes to medicaid. If it is within the five year look back period you will face penalities, and a delay in services that can be quite lengthly. Loans must have a payment plan and interest at current rates attached and are also risky. The money a person has is suppose to be used for their care. What you are trying to do is have taxpayers foot the bill for someone so you can benefit from their money. Programs are in place for those in true need.
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My understanding re: how Medicaid works when there is a "community spouse" is that the spouse who is NOT going into a NH is allowed to shelter about $100,000 in assets. The house, if the spouse is living in it, is a protected asset until the community spouse vacates, dies, etc.

I would not take financial advise from someone whose job it is to get the facility paid any way it can. I would suggest that anyone who is facing loss of assets due to a spouse needing nursing home care engage an eldercare attorney whose job it is to work for YOU and protect your assets.
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contact a good ELDER ATTORNEY and they will guide you in how to protect some of your assets........which certain ways of doing it are allowed by Medicaid.
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Medicaid will insist the loan is at prevailing interest rates. They do not allow gifts. The pitfall is that the loan is subject to collection by MERP.
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I do not blame people for sheltering funds. Many caregivers have and will continue to use their own assets for care. Traveling, running errands buying groceries or items. Many people, me included, compromise their own earnings and retirement to caregive. That said, im sure my mother will run through all her assets in AL before she gets to the point of applying.
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I think the problem is that Medicade is for the truly poor & you want Medicate benefits without being truly poor (ie keep your assets). You do not have a "right" to tax payer funded nursing home care. You don't expect tax payers to pay for your house? Nursing home care is the same. While I agree that it stinks that nursing home care is so expensive - there are long term care policies etc that cover/mitigate some of the expense.

I'm coming from an angle where my dad/step mom didn't purchase long term care insurance (too expensive) yet they spent money on annual trips to Alaska and casinos and new cars. Now they are outraged that they have to either spend their own money for dad's nursing home care (not in yet, but really should be) or spending down so they are poor and then can be covered by Medicade.

For those who worked hard all of their lives, saved dollars - now angry about having to spend for your care..... if you don't why should taxpayer?

I know i'll get flamed but as a taxpayer - I'm not very sympathetic - you want the care, pay for it. If you can't, thank goodness you live in a country with a safety net.
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The interesting thing about this question...even though there have been many answers...is I am not really certain what the OP wanted to do. Rely on medicaid in her home? Use Medicaid for a NH? Spend down? Question brought many comments but still........wonder what they really want to do.....
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Babalou it is similar here in North Carolina. I was told my wife would be able to have a maximum of $3,000.00 of cash and would surrender her Social Security check each month to help pay for her care. In my name, I would be allowed to have $120,000.00 in cash and investments, our home, a newer car and a second car but it had to be older. All would be left alone until after we both have passed and then the state has the option to come after to estate for what they paid out on her as well as anything they may have paid out on me. My daughter asked about a "medicaid divorce" (I did not like that idea) however it was his opinion that the state could most likely challenge that and nullify it unless it was done before the end of the look back period. Their were some scenarios he indicated I could look into but most would limit my access to any money shelter and even then may be subject to the state seeking recovery of expenses. At this time I am paying 100% out of pocket.

It is my understanding that the North Carolina Department of Health pays out +/- 75% of it's budget for medicaid costs alone so I would guess the rules here are subject to change again at any moment.

As you said, I would not take advice from anyone except a good eldercare attorney.
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