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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
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In TEXAS: My grandmother (94) is in a nursing home on Medicaid and was not required to sell her house. When she dies, will proceeds of house go to heirs or Medicaid? I've been paying insurance and utilities for this empty house for several years.
my mom still has her home & is in a NH on Medicaid so I try to keep up with all this, therefore the previous posts. Long story short....you have to start to get all the documentation together for all the expenses on the house. Cancelled checks, invoices, etc. That would include utilities, yard work, taxes, insurance, repairs, etc that you paid on the empty home. If the home was occupied, then this exemption is out. I'm pretty sure it has to be an empty home. Also remember that you have to get this to the state (HMS) within the timeframe on the letter after death that is sent out. MERP needs to evaluate the cost-effectiveness of the claim as it is eventually a legal process in probate court. Which in TX probate can go for 4 years from the date in which Letters are presented to probate court. Also TX does require an TX attorney if the executor of the estate is not a resident of TX. Good luck.
TITLE 1 ADMINISTRATION PART 15 TEXAS HEALTH AND HUMAN SERVICES COMMISSION CHAPTER 373 MEDICAID ESTATE RECOVERY PROGRAM SUBCHAPTER B RECOVERY CLAIMS RULE §373.213 Deduction Allowed for Expenses for Home Maintenance and Costs of Care (a) An amount equal to necessary and reasonable maintenance expenses and taxes may be deducted from the Medicaid Estate Recovery Program (MERP) claim for maintaining the home of the deceased Medicaid recipient, provided that sufficient supporting documentation of these expenditures, such as receipts, is provided to MERP by estate personal representatives, heirs, or legatees. Necessary and reasonable expenses for maintaining the home include real estate taxes, utility bills, insurance, home repairs, and home maintenance expenses such as lawn care. (b) An amount equal to the necessary and reasonable expenses for the direct payment of the costs of care (including payment of personal attendant care) provided for a deceased Medicaid recipient that enabled the recipient to remain in his or her home and thereby delayed the institutionalization of the Medicaid recipient may be deducted from the MERP claim, provided that sufficient supporting documentation of these expenditures, such as receipts, is provided to MERP by estate personal representatives, heirs, or legatees. (c) Requests for obtaining allowable deductions from MERP claims for expenses under subsections (a) or (b) of this section must be made in writing within 60 days after receipt of the Notice of the Intent to File a Claim by MERP. All supporting documentation must be attached to the request and sent to MERP, Home Maintenance/Costs of Care Request, P.O. Box 13247, Austin, Texas 78711.
Source Note: The provisions of this §373.213 adopted to be effective March 1, 2005, 30 TexReg 830
What will the heirs to the estate have to pay? The amount of a MERP claim against the estate of a deceased Medicaid recipient is the amount paid for the benefit of a Medicaid recipient for covered long-term care services, including related hospital and prescription costs, received after the Medicaid recipient reached age 55. If the total of the claim exceeds the value of the estate, heirs will not be liable for the balance.
Are there any other allowable claim deductions that may reduce the amount owed? Under MERP, certain deductions from the claim amount may be considered when sufficient supporting documentation is available. These include necessary and reasonable home maintenance expenses for vacant homes of institutionalized recipients. Costs such as real estate taxes, real estate insurance (excluding liability), utility bills, home repairs, and other maintenance expenses such as lawn care would be allowed.
In addition, deductions from the claim amount may be considered for necessary and reasonable expenses for care (including payment of personal attendant care) provided for the Medicaid recipient that enabled the recipient to remain in his or her home, thereby delaying the need for institutionalization. The documentation submitted must be paid invoices from a provider showing the allowable charges and payments made.
How will Medicaid costs be recovered? The acceptance of Medicaid assistance provides a basis for the state to file a Class 7 probate claim. (my NOTE: This means there are six other classes of claims that receive priority in payment from the estate before Medicaid gets paid. this is important.... examples of estate debts allowed prior to the MERP claim are funeral costs, estate administration costs, and secured claims such as mortgages or tax liens. a Class 7 claim is way down on the list in probate)
The state will make a claim in Probate Court against the estate. Medicaid cost recovery will follow claims procedures specified in the Texas Probate Code. (NOTE: MERP in TX is now being done via contract with HMS and they are very through and very precise. )
How will beneficiaries be notified of the state's intent to file a claim? Within 30 days of the notification of the death of a Medicaid recipient, MERP will send a Notice of Intent to File a Claim to the decedent's estate representative, guardian, agent with durable power of attorney or medical power of attorney, or family members who have acted on behalf of the recipient, provided that their name and address are known. The notice will include a program overview, a questionnaire to be completed and returned, and an undue hardship waiver request form. (NOTE: it is CRITICALLY important that you file whatever within the timeframe indicated on the letter. The timeframe is central to whether or not a MERP claim is to be done. If you do nothing, then MERP seems to take the approach that there are no exemptions or other claims against the estate.)
Likely, they will require a sale (or equivalent money) for what they paid for her care. If a spouse still lives in the home, then a lean is placed against it but the spouse is allowed to live there. However, if this home has been empty, it is an asset. I can't speak for Texas, but I expect this will be the case. If anyone is reading who lives in Texas, please chime in : )
I might add that no matter how much advice your read about Medicaid, it's best to check with your state. If you have major questions, an elder law attorney is a good resource. Good luck, Carol
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Texas Administrative Code
TITLE 1 ADMINISTRATION
PART 15 TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 373 MEDICAID ESTATE RECOVERY PROGRAM
SUBCHAPTER B RECOVERY CLAIMS
RULE §373.213 Deduction Allowed for Expenses for Home Maintenance and Costs of Care
(a) An amount equal to necessary and reasonable maintenance expenses and taxes may be deducted from the Medicaid Estate Recovery Program (MERP) claim for maintaining the home of the deceased Medicaid recipient, provided that sufficient supporting documentation of these expenditures, such as receipts, is provided to MERP by estate personal representatives, heirs, or legatees. Necessary and reasonable expenses for maintaining the home include real estate taxes, utility bills, insurance, home repairs, and home maintenance expenses such as lawn care.
(b) An amount equal to the necessary and reasonable expenses for the direct payment of the costs of care (including payment of personal attendant care) provided for a deceased Medicaid recipient that enabled the recipient to remain in his or her home and thereby delayed the institutionalization of the Medicaid recipient may be deducted from the MERP claim, provided that sufficient supporting documentation of these expenditures, such as receipts, is provided to MERP by estate personal representatives, heirs, or legatees.
(c) Requests for obtaining allowable deductions from MERP claims for expenses under subsections (a) or (b) of this section must be made in writing within 60 days after receipt of the Notice of the Intent to File a Claim by MERP. All supporting documentation must be attached to the request and sent to MERP, Home Maintenance/Costs of Care Request, P.O. Box 13247, Austin, Texas 78711.
Source Note: The provisions of this §373.213 adopted to be effective March 1, 2005, 30 TexReg 830
What will the heirs to the estate have to pay?
The amount of a MERP claim against the estate of a deceased Medicaid recipient is the amount paid for the benefit of a Medicaid recipient for covered long-term care services, including related hospital and prescription costs, received after the Medicaid recipient reached age 55. If the total of the claim exceeds the value of the estate, heirs will not be liable for the balance.
Are there any other allowable claim deductions that may reduce the amount owed?
Under MERP, certain deductions from the claim amount may be considered when sufficient supporting documentation is available. These include necessary and reasonable home maintenance expenses for vacant homes of institutionalized recipients. Costs such as real estate taxes, real estate insurance (excluding liability), utility bills, home repairs, and other maintenance expenses such as lawn care would be allowed.
In addition, deductions from the claim amount may be considered for necessary and reasonable expenses for care (including payment of personal attendant care) provided for the Medicaid recipient that enabled the recipient to remain in his or her home, thereby delaying the need for institutionalization. The documentation submitted must be paid invoices from a provider showing the allowable charges and payments made.
How will Medicaid costs be recovered?
The acceptance of Medicaid assistance provides a basis for the state to file a Class 7 probate claim. (my NOTE: This means there are six other classes of claims that receive priority in payment from the estate before Medicaid gets paid. this is important.... examples of estate debts allowed prior to the MERP claim are funeral costs, estate administration costs, and secured claims such as mortgages or tax liens. a Class 7 claim is way down on the list in probate)
The state will make a claim in Probate Court against the estate. Medicaid cost recovery will follow claims procedures specified in the Texas Probate Code.
(NOTE: MERP in TX is now being done via contract with HMS and they are very through and very precise. )
How will beneficiaries be notified of the state's intent to file a claim?
Within 30 days of the notification of the death of a Medicaid recipient, MERP will send a Notice of Intent to File a Claim to the decedent's estate representative, guardian, agent with durable power of attorney or medical power of attorney, or family members who have acted on behalf of the recipient, provided that their name and address are known. The notice will include a program overview, a questionnaire to be completed and returned, and an undue hardship waiver request form. (NOTE: it is CRITICALLY important that you file whatever within the timeframe indicated on the letter. The timeframe is central to whether or not a MERP claim is to be done. If you do nothing, then MERP seems to take the approach that there are no exemptions or other claims against the estate.)
If a spouse still lives in the home, then a lean is placed against it but the spouse is allowed to live there. However, if this home has been empty, it is an asset. I can't speak for Texas, but I expect this will be the case. If anyone is reading who lives in Texas, please chime in : )
I might add that no matter how much advice your read about Medicaid, it's best to check with your state. If you have major questions, an elder law attorney is a good resource.
Good luck,
Carol