Medicaid/Nursing Home

[acd]

What is the name of your state (only U.S. law)? NY

We are currently trying to place my father in a nursing home. He has been living with us for 23 months and my sister for 4 months before that. Prior to him moving out of his house we had him and my mother transfer the house to us for protection, but my mom died after the transfer and dad is failing with Alzheimer's disease far too quickly. They both had life lease also. (It was transferred in late February of 2006. I know the law had changed on 2/1/09.) He could no longer live alone, so we sold the house while it was in our name. Each Sibling has a share of the money from the house. Is the money protected? Can Medicaid still come after us for the principal from the house? Can we spend the money? What can we do?

Best Regards,
acd

[commentator]

'Scuse me, but why shouldn't the proceeds of the sale of your father's home go to pay for his medical expenses, instead of tax dollars? Why should you and your brothers and sisters get to keep and spend this money, and then have the government pick up the tab for his care?

Since the house is not needed as a place for Mom to stay while he is in skilled care, and it was sold during the last five years, four by what I'm seeing here, yes, I'd make a good solid assumption that you'll probably have to pay this money back for his care before he qualifies for Medicaid. New York's department of social services, family services, whatever it is called, those who administer your state's Medicaid will be the best place to obtain information concerning this, as each state is a little bit different.

They will tell you that only in the case that it becomes a medical necessity for your father to be in a skilled care facility and his assets are depleted to a certain level can he be there without self-paying. There must be a medical event (hospital stay) to place him in the hospital and then in the nursing home, and Medicare will pay for a certain amount of time. They will tell you about the "look-back" period and what will be done about assets used and moved during the past five years.

[trust_id_09]

Commentator is right to a degree. Medicare will pick up the first 100 days at a skilled facility. But, any time left within the five year lookback period you will be charged for until the residual amount is fully depleted as commentator pointed out.

There is a formula used, it is the total amount left within the look-back period divided by an amount set by NYS three years ago it was nealy $8300 for downstate, NY. Which will give you the number of year(s) until your relative will become eligible for institutionalized medicaid. Check w/ department of social services for the current fiscal year amount.

[anteater]

Medicare will pick up the first 100 days at a skilled facility.

Just a qualification. Medicare pays for the first 20 days. For days 21 -100, there is a copay, currently $133.50 per day.

[trust_id_09]

Originally Posted by anteater

Just a qualification. Medicare pays for the first 20 days. For days 21 -100, there is a copay, currently $133.50 per day.

Contingent upon your insurance. Perhaps that has changed. I had a relative who went through it three years ago. I received an invoive from the nursing home for request payment the week after the 100 day-period elapsed.
That relative was civil service employee w/ Blue Cross and GHI. So, perhaps that was the difference.

Hope that helps! Good Luck

[anteater]

Originally Posted by trust_id_09

Contingent upon your insurance. Perhaps that has changed. I had a relative who went through it three years ago. I received an invoive from the nursing home for request payment the week after the 100 day-period elapsed.
That relative was civil service employee w/ Blue Cross and GHI. So, perhaps that was the difference.

Hope that helps! Good Luck

Yes, the more comprehensive (and expensive) supplemental Medicare plans may cover the copay. And some employer retiree plans (a vanishing breed in the private sector) may also cover the copay.

[legalbeagle87]

New York City
My father passed away last year in a nursing home where I was granted his power of attorney. This was done purely for his sake to establish a system to pay off his debt. He initially entered the home after being hospitalized under his personal insurance, but when the insurance ended, medicaid needed to be applied for in order for the nursing home to receive payment. Because of the complicated nature of a medicaid application, I could not complete the form. Though my mother was alive, she did not participate in ANY WAY. Usually with medacaid, the spouse is required to be invovled in the process, but this was not the case. (she barely took the phone calls of the nursing home representititives). To ensure payment, legal action was taken by the nursing home. The Courts deemed my father mentally incapacitated and I was removed as his power of attorney. My fathers only income was SS and pension which was direct deposited into his account, and paid his monthly bills automatically (i.e. credit cards, loans, etc. ). Before the nursing home had a chance to complete the application, my father passed away in the nursing home. Almost a year later I am being sued by the nursing home for not turning over his monthly income to the nursing home ($29,000 over the course of 15 months). I DID NOT COMPLETE THE MEDICAID FORM and did not sign any other documents promising payment to the nursing home. Do they have a legal premise to sue me or are they just trying to recover funds any way possible?

[commentator]

I think thishere is what's called a hijack, right folks. If you want an aswer, you need to post your own. But yeah, if he was on Medicaid, and somebody, somewhere was getting his pension and his ss, they can most definitely ask for that to pay his health care expenses during that year. Even if you did not sign up for Medicaid. Somebody had to pay for his care, somebody did pay for his care, the taxpayers of your state, and they are going to do their best to recoup this money. Why not?