Applying for medicaid

[plastermaster]

What is the name of your state (only U.S. law)? PA
I am wondering if it would be worth my parents expense to have an attorney help navigate the medicaid application given the following. It seems most of the info below is addressed on the application form. I did have an attorney I was working with a few years ago who drew up the POA docs, but we parted ways due to a misunderstanding, and I am leary of a repeat of spending a few hundred $ per simple question. My objective is to make sure my disabled Bro is taken care of and not made homeless, and to protect assets willed to him and I. Please advise if any of the below info raises concern.

My father has been transferred from assisted living to Skilled nursing. Due to the nature of his admission he is not eligible for medicare. I figure in about 8 months my parents will spend down to the appx. $101K limit allowed by PA medicaid. I am the POA for him and Mom (who is in assisted living). The total assets are about $180K and joint income is $5,600/mo. My older bro is mentally disabled and living in a house they own in VA. They also pay his utility bills and property taxes. I live in CA and have made a couple trips to visit them for which they have paid my airfare and lodging. Really I would like to be reimbursed for many hours of my time I have put into my POA duties. They pay to have their taxes prepared as well as anything else. They have not paid for anything I have done because I do not charge for it. So instead it goes to assisted living and skilled nursing until they spend down.

Thanks
Ron

 

[candg918]

Did your parents create and fund any kind of trust for your brother? A POA is a very basic document; there should have been much more to require the services of an attorney.

I suggest that you consult with an attorney with experience in Medicaid and SSI issues. You cannot "protect assets willed..." since there are spend down requirements for Medicaid but may be able to keep you brother from becoming homeless. Check with the local advocacy group for the handicapped where your parents live for any lists of attorneys with interest and experience in the issue of providing for a disabled child.

 

[plastermaster]

There is no trust for my bro. Also there is not a will. There is only an estate when they pass away. The law firm that helped me and my parents with the POA documents were also helping with organizing a plan for managing the assets and dealing with spend down. The POA was not all that basic in that it is comprehensive for all aspects of their life. Perhaps we could have done a Nolo press 'do it yourself' POA but I find dealing with such matters to have snags at every turn. Not much was done with the financial planning other than laying the groundwork. There was too much money to do anything other than getting organized and wait. From what I gather form other threads, my parents will spend down, receive medicaid, and reimburse medicaid out of the estate. Both my parents will be taken care of by their assets, medicaid, medicare and private endowment funds from the assisted living/nursing facility. If there is any money left over when they pass away, it is looking like it will go toward reimbursement even though I am the beneficiary of their annuities. THAT is the area that I would like to keep in tact. Medicaid is allowing $101K of assets to stay in my parents possession. This will be in the form of an annuity which I am beneficiary of. The issue is whether or not I will be the beneficiary or if the state will have claim to it. Really if the state is going to claim it, the only benefit of the $101 spend down limit is for the state. The annuity is a source of income that I will manage for them (the state) until they claim it, if you follow. (it is a little convoluted). The bottom line though is that it makes no difference if my parents recieve money from medicaid while keeping 101K and medicaid claiming it later, or if we spend down to 0 and then recieve medicaid. Go figure. As for my bro: my mother wants him to be able to stay in the house, where he lives alone and refuses to take his meds. The state of VA will not offer assistance as long as he is in the house. If he were to lose the house (which is in severe disrepair) the state would offer him housing and take care of some of his other needs (like making sure he stays on his meds). The uncertainty is whether or not he would choose to be homeless. People who are severely mentally ill are free to make their own decisions as to their care. If he wants to jump off a bridge, he violates the law. If he wants to live under the bridge and die of exposure, that is his right. It is an unfortunate social loophole. But, lets not turn this into a rant

In general I have high respect for attorneys and what they do, but it is also important to weigh cost vs benefit. How many people have spent $20K on a divorce lawyer to keep 20k from their spouse? It might have been more beneficial to give the 20k to spouse and perhaps had a better after-marital relationship. So anyway I am leery of paying for legal help unless It will clearly be worth it.
Thanks
Ron

 

[candg918]

I sympathize with your problem. I still believe that you would benefit from the assistance of an attorney/financial planning team who are knowledgeable and sympathetic to the particular situation. That is why I recommend looking for referrals from members of organizations representing individuals with problems such as mental illness or developmental disabilities. When I had a problem relating to a disabled relative, I received the best referrals from a local prganization; that attorney was far more helpful than the attorney I had dealt with on simple estate planning.

Another suggestion, see if your local law school professors in the area do any private practice work. Look also for seminars on these issues; occasionally in my community there are presentations on these issues; the presenters will likely be good choices for an advisor. Good luck!