Little update on friend with Medicaid issues

Dznypal

DIS Veteran
Joined
Mar 29, 2001
So she now tells me thst they are 137000 over the limit to qualify so now she’s to give her friend a check for that amount friend is to deposit into her account then pay 1/12 of the amount back to my friend who then puts in an account just in her name so Medicaid can’t get that money. For her husbands care he had a stroke almost a yr ago. They’re also taking his pension and SS for his care test is coming from Medicaid. Which friend doesn’t think is right. She’s almost under the impression that Medicaid will give her back pay for the yr that’s she’s been paying out. Which to me doesn’t seem right either along with making this loan. She’s also complaining that she’ll only have 600 a month left. She does get a pension which I don’t believe SS can touch. She’s not collecting SS yet and also works up until this happened to her DH used to be full time but now it’s more she just fills in. I still can’t see this loan deal or being paid back for the last year she’s been using the home equity for his care and doesn’t know how she’s going to pay it back. Well if she knows for sure she’s getting the money back then just pay it off then. I know she’ll have to make monthly payments. Just wondering if anyone else heard of this. I like reading what others have to say.
 

tvguy

Question anything the facts don't support.
Joined
Dec 15, 2003
Well, I have not heard of that arrangement regarding basically hiding assets. But there will be an electronic trail so I wouldn't do that. They expect you to spend most of your assets before Medicaid will pay. All but $2,000
Sounds like your friend needs a lawyer with experience in Medicaid law. It seems she can keep half that $137,000, but the other half has to be spent on her husband's care.
We dealt with this with my wife's grandparents. We could pre-pay their funeral expenses, but their house had to be sold, and everything down to $2,000 spent on care before Medicaid would step in. We even had to have the house appraised and sell it for at least appraised value, otherwise Medicaid might think we were hiding assets. Made it interesting because the house appraised at $15,000 and we had an offer of $12,000 from someone who really wanted it, felt their offer was generous, and insisted it wasn't worth $15,000. Our hands were tied, so they raised their offer to $15,000
 
  • cabanafrau

    DIS Veteran
    Joined
    May 10, 2006
    Well, I have not heard of that arrangement regarding basically hiding assets. But there will be an electronic trail so I wouldn't do that. They expect you to spend most of your assets before Medicaid will pay. All but $2,000
    Sounds like your friend needs a lawyer with experience in Medicaid law. It seems she can keep half that $137,000, but the other half has to be spent on her husband's care.
    We dealt with this with my wife's grandparents. We could pre-pay their funeral expenses, but their house had to be sold, and everything down to $2,000 spent on care before Medicaid would step in. We even had to have the house appraised and sell it for at least appraised value, otherwise Medicaid might think we were hiding assets. Made it interesting because the house appraised at $15,000 and we had an offer of $12,000 from someone who really wanted it, felt their offer was generous, and insisted it wasn't worth $15,000. Our hands were tied, so they raised their offer to $15,000
    In the situation with your wife's grandparents were both spouses applying for Medicaid at the same time, therefore neither one would need the home to reside in any longer? That's not the case in OP's situation, as only the husband requires care, leaving the spouse needing the house to live in. I'm not sure in this case a sale of the house can be forced, effectively making one spouse either homeless or in need of a new living situation.
     

    tvguy

    Question anything the facts don't support.
    Joined
    Dec 15, 2003
    In the situation with your wife's grandparents were both spouses applying for Medicaid at the same time, therefore neither one would need the home to reside in any longer? That's not the case in OP's situation, as only the husband requires care, leaving the spouse needing the house to live in. I'm not sure in this case a sale of the house can be forced, effectively making one spouse either homeless or in need of a new living situation.
    Thus for the need for a lawyer
     

    Dznypal

    DIS Veteran
    Joined
    Mar 29, 2001
    Seriously I would like to but not sure how and I’d like do it unanimously also she does have an elder care attorney but then I’m not sure my friend has all the facts either. Time will tell
     
  • piccolopat

    DIS Veteran
    Joined
    Apr 25, 2014
    Sounds shady to me. In many states, there is a look back period for assets and so giving money to this friend will not alleviate the need for her to pay an equivalent amount for her husband's care. Also, I believe that in some states there are protected assets that aren't used for Medicaid eligibility and this can include the family home. This person needs to contact a qualified elder attorney that is experienced in Medicaid issues. What is being described sounds like fraud, something that could lead her to legal problems including the possibility of criminal prosecution. Be a friend and tell her exactly this.
     

    ronandannette

    I gave myself this tag and I "Like" myself too!
    Joined
    May 4, 2006
    Sounds shady to me. In many states, there is a look back period for assets and so giving money to this friend will not alleviate the need for her to pay an equivalent amount for her husband's care. Also, I believe that in some states there are protected assets that aren't used for Medicaid eligibility and this can include the family home. This person needs to contact a qualified elder attorney that is experienced in Medicaid issues. What is being described sounds like fraud, something that could lead her to legal problems including the possibility of criminal prosecution. Be a friend and tell her exactly this.
    Of course it is shady - that’s the whole point. They are purposely trying to hide (and retain) assets that under your system should to be used to provide for their own medical care. I think it’s a terrible system and heartbreaking, but the law is the law and their current approach is 100% intended to be fraudulent. Hopefully there is some other way that isn’t but only a legal expert could advise them with certainty.
     

    mnrose

    Queen of all she surveys
    Joined
    Jun 18, 2009
    Why do people do things like this? Why does she think the government (that's you and me folks) should pay, but they should not? So annoying.

    My father had the same mindset, but we made him sell his assets to pay for his care. 100% of his end of life care was funded by HIM, as it should be. Now, of course, that meant he could not "pass on" what he wanted to "pass on" to us, but that's what the money was for! His care first!

    This attitude always astounds me.
     
  • Cannot_Wait_4Disney

    Ok all you A cattle, get in ...
    Joined
    May 18, 2005
    So she now tells me thst they are 137000 over the limit to qualify so now she’s to give her friend a check for that amount friend is to deposit into her account then pay 1/12 of the amount back to my friend who then puts in an account just in her name so Medicaid can’t get that money. For her husbands care he had a stroke almost a yr ago. They’re also taking his pension and SS for his care test is coming from Medicaid. Which friend doesn’t think is right. She’s almost under the impression that Medicaid will give her back pay for the yr that’s she’s been paying out. Which to me doesn’t seem right either along with making this loan. She’s also complaining that she’ll only have 600 a month left. She does get a pension which I don’t believe SS can touch. She’s not collecting SS yet and also works up until this happened to her DH used to be full time but now it’s more she just fills in. I still can’t see this loan deal or being paid back for the last year she’s been using the home equity for his care and doesn’t know how she’s going to pay it back. Well if she knows for sure she’s getting the money back then just pay it off then. I know she’ll have to make monthly payments. Just wondering if anyone else heard of this. I like reading what others have to say.
     

    lifesavacation

    DIS Veteran
    Joined
    Jan 24, 2016
    Why do people do things like this? Why does she think the government (that's you and me folks) should pay, but they should not? So annoying.

    My father had the same mindset, but we made him sell his assets to pay for his care. 100% of his end of life care was funded by HIM, as it should be. Now, of course, that meant he could not "pass on" what he wanted to "pass on" to us, but that's what the money was for! His care first!

    This attitude always astounds me.
    People do shady stuff like this all the time. There are many many people that would rather take someone else’s hard earned money than spend a dollar of their own. I love my dad, but he is one of them, and he gets it from his mom. I can totally see both of them doing something like this.
     

    barkley

    DIS Veteran<br><font color=orange>If I ever have a
    Joined
    Apr 6, 2004
    retired medicaid eligibility supervisor chiming in-

    it's fraud, when discovered (it should be-we went back 5 years w/a fine tooth comb using resources the public signs off approval for in the initial application and at every re-certification that show all financial records for both spouses) at minimum-the months the fraud occurred, even if the asset would have been entirely or partially exempt for program consideration, will be an entirely ineligible period. they will be on the hook for every penny medicaid paid out for those months. there can also be other financial penalties, periods of ineligibility (even if all the hidden assets are now gone) and jail time. the 'co-conspirator' who is helping with this can be prosecuted as well.

    to make an anonymous fraud report you've only to call dshs in the state/county the person lives in and wait for the option to report fraud. if there's no option then wait for the operator and they can direct you anonymously to the division that handles this-they never have to know your name.
     

    robinb

    DIS veteran
    Joined
    Aug 29, 1999
    I totally understand why your friend is frustrated and has to spend down the money that they worked hard to set aside. I think it's terrible that you have to make yourself destitute to receive medical care, but that's how our system is set up. I found your earlier post that said an elder care attorney is suggesting this ploy. I suspect that there was some methods to try to protect assets, but this feels like fraud to me (a total non-expert). Before your friend goes forward with this, I would suggest that she contact another elder care attorney for a second opinion. Maybe this loan thing is a legal loophole and maybe it's not. If it is, it's worth a couple thousand to verify. If it's not she'll lose a lot more than $137,000.
     

    tvguy

    Question anything the facts don't support.
    Joined
    Dec 15, 2003
    You don't know whether your wife's grandparents were both in need of care and applying for Medicaid?
    They ultimately were. But there was a brief period where that was in question. I just know Medicaid has very hard and fast rules that you need an expert to navigate.
     


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