There will come a time for many of us when we no longer will be able to directly care for a loved one in our (or their) home. It is critical that we learn what is considered an 'acceptable expense' that won't penalize you when that time comes, and what is unacceptable. Just a brief sampling: In most states, they cannot come after the home as an asset if its value is under $250,000. If you decide to move together from one house to another, you won't be penalized, assuming that you purchase something of comparable value or show that any additional monies from the sale are used directly to care for the dependent person. The government seeks to follow the "money trail." Also, any car, even a new one, cannot be tagged as an asset to go after, if you can show the car is used for taking that person to doctor's appointments, to buy food, etc., and necessary for daily living. Although purchasing a Porche 911Roaster might raise a few eyebrows. Purchasing furnishings for the home where the dependent person lives is also an exempt expense, and that includes big screen TVs or anything else. The worst thing you can do is transfer assets into your name or someone else's. That's a red flag that the government will penalize you for, making Medicaid assistance off limits to you for a five year look-back period. There is much, much more you need to know, so I advise that you read up on this. The internet can provide most of the information.
My thoughts are that that 250K figure was accurate in the past but not so now IF your state has gone with an outside contractor to do MERP compliance. HMS is now really selling themselves to states to do MERP and they have over a dz. ++ states now and are very, very good at what they do. HMS does compliance and duplication of services vetting for CMS (Centers for Medicare and Medicaid) - they are most excellent at what they do and have the database and algorithm programs to do so. (If there is a Stark Law issue, HMS provides the data needed for the legal, I'm pretty sure.) Many states are really being hit hard by the costs of NH and the states need to do what they can to enforce MERP. State employees really aren't good at it as so much of this is legal and dependent on your states death laws and how probate runs. Like if you are a claim or lein state for estate debt and if you can even do a muniment of title. For the average caseworker this is all high cotton finance and legal and they can't do an evaluation. The speciality contractors, like HMS, are perfect for carrying out MERP as they are all about the detailed nuances of death laws combined with health care costs; and then getting access to the state database to find the value of real property; and then focusing on putting pressure on the family to sell the house with the proceeds going to the state first. Yes, there are all kinds of exemptions, but they have to be properly filed for and documented in 30 - 60 days of the death and really it just falls through the cracks for families to do what is needed to keep the house or the proceeds from the sale of the house. Randy Drewitt, who is an elder law attorney in big beautiful Beaumont, has lots of case studies on his website. My mom still has her home, she is in a whole other part of TX & in a NH on Medicaid, and no, I don't know him at all. But lots of good info from him on MERP in TX.
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