SaraLJ5731 Asked July 2023
Medicaid Estate Recovery: Anyone have experience with requests to pay back premiums?
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My father had Medicaid for 4 years (Feb 2014 through April 2018) he would have been 58 in 2014 and 62 in 2018. He never filed a claim, by that I mean, Medicaid never paid out for any type of medical services during that time.
Somehow he owes $40,800 dollars.
The Attorney General is saying that Medicaid is trying to recover the "premiums" that Medicaid paid to the managed care plan. Which totals about $800 a month for those 4 years.
He did not have (or qualify) for Medicare at this time.
Has anyone heard of this?
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You should get a form asking about Dads assets after death.
Is Mom still alive? She is not responsible for the debt. If there is a house, a lien will be placed on it. It will need to be satisfied at her death by the sale of the home or she leaves or sells the house. Same goes for a disabled child living in the home.
I have dealt with Medicaid for LTC and actually contacted them when a lien was not put on my Moms house, in a timely manner, I was selling. I needed that lien placed so they got their money at time of closing.
I think you may need an Elder Lawyer to help u understand what is going on and how to manuver it. If Dad had no assets at time of death, he owes nothing. But since he has a home, thats an asset and Medicaid can recover if Mom is gone and no disabled child. The home will need to be sold to cover the lien.
Like I said, there should be a form that you fill out. Medicaid has to try and recover by law. If there is no money, they cannot recover. You just have to show them there was no money. But the, looks like Dad has a house.
I see you say he has a lien on a house and he died actually in 2022 when he was on medicare. You honestly need an attorney.
This is HIS bill and he is gone. His estate stands to pay this legitimate bill, but if you go to court, this being a bill they CANNOT itemize, may not be collectible. This is worth seeing an attorney on. Otherwise, yes, when the home is sold this lien will be paid off.
It sounds like Medicaid contracted with a private company (Paramount) to provide Community Medicaid to eligible customers.
It doesn't matter if you don't USE the insurance ( I pay my auto, home and umbrella premiums each year; no claim doesn't mean I get my money back).
Blue Cross has acquired Paramount, obtw.
https://www.medicaidplanningassistance.org/question/medicaid-estate-recovery-statute-of-limitations/
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Was his care managed by a licensed fiduciary as POA?
Did the Social Services or APS or anyone else file for his care under Medicaid?
Did your father leave any estate (money, car, home).?
If so you will have to find out.
When were you notified that this money was owing?
Who notified you?
Who was the executor or administrator of your father's estate if there was one?
It makes no sense to me at all that your father is gone since 2018 and you are just now being notified that his estate owes money to Medicaid. Any estate would have gone through distribution to heirs in four years time.
But if this is the case YOU NEED AN ATTORNEY, or whomever was executor of any estate if there was one (home, car included) needs an attorney to look this over. Trust and estate attorney.
If there was no money, no home, no car at the time of your father's debt then this is all nonsense, as there would have been no recovery possible. Nevertheless it needs clearing up.
Hope you will update us on this curious and unusual occurance.
See a trust and estate attorney with all your facts.
Let me clarify though, he had Medicaid from 2014 - 2018 and then he dropped it. He didn't have insurance at all until he qualified for mediCARE at 65.
He passed away in December 2022 at the age of 66 (probably because he NEVER went to the doctor) so the attorney general got involved when his death was reported. Now they want $40,800 even though he never used his Medicaid. They are saying Medicaid paid premiums to the managed care plan for those 4 years.
He does have a house and there is now a lien on it.
Im just baffled that the premiums would be $800 a month and he would owe all of that back even though Medicaid never paid a claim on his behalf.
Seems so high.
Everywhere I read about Estate Recovery it talks about repaying medical expenses and nursing home stays, I cant find anything about repaying premiums, but I guess its a real thing.
"I wouldn't even know how to look into identity theft." One finds out about Identity Theft whether you are the victim, or in your case a relative, in different ways. Oddly enough, the branch of the Federal government that deals with this, in my experience, is the FTC (Federal Trade Commission). At least this is the branch of Federal government that deals with it, when the IRS is involved (i.e. a false tax return is filed in your name). If you think this is a serious possibility with your relative, you might want to give them a call. Good luck.
they appointed a lawyer to take over all assets of my father to repay said medical care Bills & facility care.
It is intended to help the poor, not preserve assets for future generations or engorge someone's asset portfolio.
If you get social services, it should be repaid if the assets exist.