Medicare And Medicaid Legal Questions

Hello.  It is possible for you to establish a "self-settled irrevocable trust" to fund with the inheritance.  This is a complicated process, but does allow you to maintain your government benefits.  You would have to appoint an independent Trustee to manage the funds.  I don't see why you couldn't work with that individual to decide how the funds are invested though.... Read More

Hello, an experienced Medicaid planning attorney should be able to evaluate your mom's situation and determine how mom can qualify for Medicaid. You will need to show any and all statements of mom's gross income for determination purposes so I recommend you gather those documents now if possible to expedite the process. You will also need copies of her bank statements, pension accounts, and any property she may have. Feel free to reach out to me directly if you have more specific questions. ... Read More

You absolutely need a supplemental needs trust which will enable Evan to keep both his inheritance and his government benefits. The trust needs to be approved by Medicaid and contain a provision that if any money remains when Evan passes away it goes to Medicaid. The trust agreement must appoint a trustee who is responsible for keeping records of expenditures and file an annual accounting.... Read More

You should call the company that is going to take over.  They will explain the benefits.  It probably provides prescription drug coverage and will pay for Medicare deductibles.  You may use it in place of the AARP but its not possible to advise you until you know what the other plan is intended to cover.  Good luck to you. ... Read More

If your parents have a disabled child, they can transfer assets to that child and not cause a Medicaid penalty.  The assets your parents transferred to the disabled child should be placed into a SPecial Needs Trust to keep the disabled child from becoming ineligible for SSI.  You can either transfer it, or cash it in and give the disabled child the money.   ... Read More

There would be no penalty if your father did not apply for Medicaid for five years after he gave you the money.  Its true, there is no crime committed, and yes, this is still America, but Medicaid is "medical welfare".  Think about the implications of that.  Should a person be allowed to give all of their assets away, and then have the govenrment pay for all of their care?  If that was permitted, no one would pay for nay of the care needed.  If your transfer is outside of the five year look back no lien will accrue. ... Read More

If you receive social security disability, you are eligible to get medicare earlier than the normal time.  The disability payments you get are considered income, and you will have to use a small portion of that income to pay for Medicare, which will provide medical care.  If you currently have medical insurance from some other source, then you will still sign up for MEdicare, but MEdicare will be your secondary provider.  ... Read More

Medicare?  Or Medicaid?   Was this in relation to a car accident?  And was there a separate claim for the estate?  Make sure to see the breakdown of what is owed, it should be calculated on a percentage of payback if Medicare was the insurance provider, or if Medicaid was used.  It may also depend on whether your father's car insurance provided personal injury protection or if the medical insurance was supposed to be primary.... Read More

the monthly amounts given are all added up on the date of the Medicaid application and then the amount is used to calculate the period of ineligibility.  there is no "allowable" amount in New Jersey.  If she pays you - it has to be done pursuant to a Medicaid Care Agreement. ... Read More

If you live in New Jersey, and you have been careful to sign your name AS POA FOR DAD and not just your own name, and if you have used all of dad's money for dad's care and not taken any of it, then no, NJ Medicaid willnot come after you for anything.  If there is anything left in dad's estate when he passes, they may put a lien on that, but you will still be able to use it to pay final bills, funeral costs, etc.... Read More

I do not believe that MRSA is a "never" event.  A "never" event is an event that is never supposed to occur - such as he amputation of the wrong limb.  there are certain "punishments" that are enacted if a hospital or facility are found to have done a "never" event - such as the facility does not receive payment from Medicaid or Medicare.  I do not believe an infection such as MRSA falls into that category.... Read More

You need to look at the Caregiver Child Exemption.  Its complicated, but I believe form the facts you have given that the house would be an excludable resource for your mom becuase of the care you have been providing her.   N.J.A.C. 10:71-4.10(d), which contains the caregiver exemption, provides as follows: (d)[A]n individual shall not be ineligible for an institutional level of care because of the transfer of his or her equity interest in a home which serves (or served immediately prior to entry into institutional care) as the individual's principal place of residence and the title to the home was transferred to: . . . . 4. A son or daughter of the institutionalized individual . . . who was residing in the individual's home for a period of at least two years immediately before the date the individual becomes an institutionalized individual and who has provided care to such individual which permitted the individual to reside in the home rather than in an institution or facility. i. The care provided by the individual's son or daughter for the purposes of this subchapter shall have exceeded normal personal support activities (for example, routine transportation and shopping). The individual's physical or mental condition shall have been such as to require special attention and care. The care provided by the son or daughter shall have been essential to the health and safety of the individual and shall have consisted of activities such as, but not limited to, supervision of medication, monitoring of nutritional status, and insuring the safety of the individual.... Read More

The short answer is: "Yes they can."  This is either done with a TEFRA lien while the recipient is still alive or can be done through "estate recovery" after the recipient passes away.   However, that is not necessarily the end of the story and there are some ways to address that situation that might save the home/land.  I suggest that you speak with an elder law attorney who might go into greater depth with you on this issue.... Read More

Before you do anything further - talk to a lawyer about creating a Special Needs Trust for you to protect this money from Medicaid.  It should be done BEFORE you accept the settlement.  If your personal injury lawyer does not know anything about this, have the lawyer call a certified elder law attorney to find out what needs to be done.  ... Read More

No - there is no upper limited on Medicaid - if she is on Medicaid, her medical care should be covered.  Depending on what coverage she had - she could have exhausted her Medicare benefits, and now needs to apply for Medicaid, they are two different programs.  You need to ask for clarification from the nursing home.... Read More

The Medicaid look back goes back five years from the date the application for Medicaid is made.  Its not as simple as the look back, they have to divide the assets, regardless of whose name they are in, and there could be additional planning things to do.  You should go to an attorney. ... Read More