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I don't think anyone is saying that people who use Medicaid for LTC are moochers.
What is being said is that Medicaid doesn't kick in until the person has nothing left. It is there to make sure an elderly person isn't just dumped on the side of the road and abandoned. But it is for the poor--those who have no other ability to pay--no matter if their circumstances might have been different at another point in their life. Medical issues can get expensive fast.
And so it is perfectly appropriate that if someone is using Medicaid to pay for their care at the end of their life, any remaining assets should be used to repay the cost of that care, rather than being passed down to their children while the taxpayers pick up the bill.
I think you cannot really say everyone on Medicaid is or was poor and mooching off the state. My sister and her husband owned 3 houses, cars, had stocks in several banks where they lived, received Social Security and had pensions from their jobs that they retired from. They were even invited to stay overnight at the White House because they were big contributors in a Presidential campaign back in the 80s. At 66 she had a stroke that left her paralyzed on one side and ended up in a nursing home. Her husband fell on ice going to see her, broke a hip and had a heart attack before his hip surgery. He ended up in nursing home too. My family moved them to their town and both were in a nursing home receiving therapy for 3 years. Then they bought a house with cash there and paid for 24 hour care in their home. But several years later her husband suffered from dementia and he had to be placed in a nursing home. My sister followed a few months later. So for over 16 years they paid for their care out of pocket selling their homes, selling stocks and bonds, depleting their bank accounts, etc. It cost about $14000 a month while both were alive. That is $168,000 a year so over $2 million before he died. After my BIL died, we sold the last house and paid for her stay for a year or 2 with that. But the money ran out and she had to go on Medicaid. They looked for every asset and even cashed out her whole life insurance policies so even though my sister and I were named as beneficiaries we did not receive anything. She lived on Medicaid for about 3 years and the care at the homes became iffy and treated her totally different than when the pay was out of pocket. Her Social Security went straight to the nursing home and Medicaid paid the rest giving her less than $100 a month to buy clothes, personal care items, etc. They allowed her to keep her prepaid funeral so we only had to pay some of the funeral expense.
I SAID people should be embarrassed to use the phrase "protect the assets from the nursing home" and I stand by that.
You didn't do that so why do you feel you were accused of mooching?
And YES your sister WAS poor or she wouldn't have qualified for Medicaid so I don't know what your point is with that.
All that wealth and they never bought long term care insurance?
Yes there are many sad stories. Yes her Social Security goes to the nursing home why shouldn't it? That's how it works.
My mother rotted in a SNF for a year after a stroke and the SNF and her lawyer threatened to take me to court if I even TRIED to let her go home where she had more than enough money to pay for private RN care 24/7. FORTY THOUSAND A MONTH. Not 14.
And while we're on THAT subject, lemme tell you my mother's care in 1998 was DISGRACEFUL and she was paying $6000 per MONTH BACK THEN. Lying naked in her own waste how about?
Skilled Nursing Facilities that have Medicaid beds also have full pay beds so any perceived difference in care is probably attributable to the difficulty managing her dementia which is a nightmare.
You can't compare her STROKE care to DEMENTIA care did you say 14 years ago?
In Florida if you feel your loved one's care is substandard you can file a complaint to the state Ombudsman but the only REAL assurance people have about care is to witness it as much as possible. People with money pay private aides to attend to make sure they're treated properly, even.
EDIT: This is a world wide crisis and I'm pretty sure everything's the same essentially, for example, in Canada but I don't know if they have government paid dementia care. Doubt it.
Last edited by huitrecouture; 07-17-2022 at 11:50 AM..
But they only do it with a subset of people (55+). It is discriminatory. And why 55, most people don't enter long term care until well after that.
What about all the other groups who never paid into the system, we all know them- then they use the resources to go to college, do well and own assets they pass on to their children. They never have to pay it back.
You mean like the one I know. He was severely hurt in two accidents. Sued the crap out of everyone and ended up on disability maybe Medicaid. At the time he didn't own anything. Then his mother passed away. She left everything to him and his sister. He could not get any money from selling her house or he would lose the money he was getting from the Government. to fix this problem the sister took his half of inheritance and purchased a condo in her name. He lives in it and she owns it easy peasy. Now if he ends up in a facility they cannot dare take any money he receives even after receiving disability/Medicaid because it's in his sisters name. On paper she owns the property.
She set up a bedroom and said she stays with him so that explains how he got disability without a spouse or social worker. Single people have it much harder to get anything without a family member living with them or a doctor to vouch for them. Of course, she didn't live with him but visited now and then.
The idea is to get rid of assets or put them in a trusted relatives name. Most people do a Trust or add et, al to their homes. But he didn't have to it was already in her name. He knew she wouldn't take it from him and evict him because she was breaking, I assume, a law just as much as he was. Plus he really did have a lot of problems but didn't yet need LTC. In the end he died before her and she got his half of the inheritance when she sold the property. So, you see his assets went all to her and nothing was given back to Medicaid or disability.
You mean like the one I know. He was severely hurt in two accidents. Sued the crap out of everyone and ended up on disability maybe Medicaid. At the time he didn't own anything. Then his mother passed away. She left everything to him and his sister. He could not get any money from selling her house or he would lose the money he was getting from the Government. to fix this problem the sister took his half of inheritance and purchased a condo in her name. He lives in it and she owns it easy peasy. Now if he ends up in a facility they cannot dare take any money he receives even after receiving disability/Medicaid because it's in his sisters name. On paper she owns the property.
She set up a bedroom and said she stays with him so that explains how he got disability without a spouse or social worker. Single people have it much harder to get anything without a family member living with them or a doctor to vouch for them. Of course, she didn't live with him but visited now and then.
The idea is to get rid of assets or put them in a trusted relatives name. Most people do a Trust or add et, al to their homes. But he didn't have to it was already in her name. He knew she wouldn't take it from him and evict him because she was breaking, I assume, a law just as much as he was. Plus he really did have a lot of problems but didn't yet need LTC. In the end he died before her and she got his half of the inheritance when she sold the property. So, you see his assets went all to her and nothing was given back to Medicaid or disability.
You are right they never have to pay it back.
Interesting case.
Federal law requires you to report to the Social Security Administration if you are beneficiary of an inheritance – even if you refuse to accept the inheritance. Failing to report an inheritance can result in financial penalties and cause your SSI payments to stop for up to three years.
snip
But they were stupid and lazy without even asking a lawyer or even a bank. You can set up a special needs trust with that inheritance and not lose SSI. IF that's what he was on.
I SAID people should be embarrassed to use the phrase "protect the assets from the nursing home" and I stand by that.
You didn't do that so why do you feel you were accused of mooching?
And YES your sister WAS poor or she wouldn't have qualified for Medicaid so I don't know what your point is with that.
All that wealth and they never bought long term care insurance? on that wealth
Yes there are many sad stories. Yes her Social Security goes to the nursing home why shouldn't it? That's how it works.
My mother rotted in a SNF for a year after a stroke and the SNF and her lawyer threatened to take me to court if I even TRIED to let her go home where she had more than enough money to pay for private RN care 24/7. FORTY THOUSAND A MONTH. Not 14.
And while we're on THAT subject, lemme tell you my mother's care in 1998 was DISGRACEFUL and she was paying $6000 per MONTH BACK THEN. Lying naked in her own waste how about?
Skilled Nursing Facilities that have Medicaid beds also have full pay beds so any perceived difference in care is probably attributable to the difficulty managing her dementia which is a nightmare.
You can't compare her STROKE care to DEMENTIA care did you say 14 years ago?
In Florida if you feel your loved one's care is substandard you can file a complaint to the state Ombudsman but the only REAL assurance people have about care is to witness it as much as possible. People with money pay private aides to attend to make sure they're treated properly, even.
EDIT: This is a world wide crisis and I'm pretty sure everything's the same essentially, for example, in Canada but I don't know if they have government paid dementia care. Doubt it.
what you missed is that the poster you are responding to was still paying taxes, and probably big taxes, on all that wealth before it was all gone. I dont think they owe the govt anything! And I know of no financial planner who recommendd LTCI. Its usually junk! and costly junk at that!
Kicks above $11-12 million (Depending upon what year he croaked.). Your Uncle must have been loaded, to trigger the "inheritance (estate) tax..."
And you only ended up with "not much over $3,000?"
Somebody didn't have their estate succession planned very well....
Several states have inheritance taxes- specifically PA where Jtab lives. I live in PA as well- tax is based on relationship to the deceased. My husband and siblings inherited his mothers estate and the taxes were 4.5% of total value. Sibling to sibling as in this instance is 12%.
There is no minim threshold for inheritance taxes in PA. If you have a decedent with a nickel in the bank Pa wants their cut.
I think the difference is this. Those on medicare contributed taxes for most of their life to pay for medicare. Also, we either make or will contributions to medicare out of our social security payments as well. If a benefit is paid for by medicare, the logic is that that benefit was actually earned. Benefits paid by medicaid were not earned. They were extended to the poor and poor elderly by our government to prevent utter destitution and to take care of the poor elderly in some reasonable environment.
I realize there are some complexities here. Medicare does not pay for LTC. However, it was expected that each of us would make those arrangements on our own. Some have done so. Some do not require LTC. Some have private LTC insurance. Others simply plan on paying for LTC out of retirement income and savings. However, there is no secret what these rules are.
I personally believe that a retired person's estate should first pay for all their needs--including LTC. Only if the estate is utterly depleted should the government be paying for LTC.
Since federal and state taxpayers fund Medicaid, the goal of MERP is to lower Medicaid costs. If it can recover part or all of the money spent on your health care, it saves taxpayers money.3
If Medicaid is paying for your long-term nursing home care, it’s likely thanks to Medicaid that there will be any estate left from which to recover funds. Without Medicaid coverage, you may have had to sell your house and other valuables to pay for your care, in effect liquidating your estate while you’re alive to pay for your long-term care.
And if the Medicaid beneficiary was truly without any assets at all, the estate recovery program won't be able to recover anything, as they cannot attempt to recover the money from the beneficiary's heirs (they can use the estate recovery process to recoup assets that may have passed to a surviving spouse, but only after that spouse has passed away as well).
Also, if you applied for help paying for your Medicare premiums, you won't have to worry about Medicaid estate recovery.
It is important to understand that Medicare beneficiaries who qualify for help paying their premiums through one of the four Medicare Savings Programs (MSPs)—the Qualified Medicare Beneficiary (QMB), Specified Low-Income Beneficiary (SLMB), Qualifying Individual (QI) or Qualified Working Disabled Individual (QDWI)—are not subject to estate recovery for those benefits.
Some states combine the application for full Medicaid with MSP benefits. You and/or your loved one can choose to apply for a Medicare Savings Program without applying for full Medicaid, and therefore not be subject to estate recovery.
For most of the people here, medicaid doesn't kick in until you have nothing left. Now you are poor but you are a different subset of poor. You receive a SS check which is over the poverty limit in your state and it keeps you from probably the greatest benefit of all...one you'll more likely need over needing nursing home care. It is home care.
States very yet those who earn over 138% of the FPL in our State, do not qualify for in home care. They never will. home care provides someone, a friend, relative or more than one person to get paid about minimum wage to assist you at home. They can do laundry, clean the house, grocery shop, prep meals, etc.
Absent of qualifying for this benefit, you are sent directly to the Nursing Home where the same individual, with the same health problems, the same age, etc in the same state, yet earning below the poverty limit, will be provided in home assistance. The other goes straight to jail aka A Nursing home. Sometimes they pay a share of cost for it but it isn't comparable to the cost of a Nursing Home. This is unfair and needs to be fixed. Most people are not aware of this.
Hence why it might be wise to keep your Social Security check under 138% of the Federal Poverty Level or whatever your state's Federal Poverty level is which may be lower. Any investment accounts are forced to be drawn from at age 72 (RMD's) if you want in home help. That age will likely increase soon to age 75 due to another Secure Act legislation
What we really need is Medicare to provide an in-home care benefit. If you've ever visited a Nursing home, you can see many wandering around with their walkers who could be living at home with assistance. So sad
.
Last edited by RVerJenny; 07-17-2022 at 06:29 PM..
Oh my gosh. It's not "stealing". It's simply to recoup the monies that were given to the person for care, from the available assets.
The reason I call it stealing is in many cases it is. People are forced to go into Nursing Homes who would otherwise say No. Meaning it isn't a service they requested, nor want, nor feel they need. Many people who are still somewhat mobile but not mobile enough to Medicaid Workers liking
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on that wealth
It's simply to recoup the monies that were given to the person for care, from the available assets.
