Estate Recovery Law More Agressive Than Ever

Estate Recovery Law More Aggressive Than Ever

Your mother is in a nursing home and has qualified for Medicaid. She’s been able to keep her home because it is an exempt asset so long as she is living and “intends to return home.” But what happens to the house after she dies? What if it was your spouse on Medicaid and the state has paid thousands in benefits? Will they attempt to recover benefits upon your spouse’s death?

After a Medicaid recipient dies, the state has the right to recover any assets remaining in order to reimburse itself for Medicaid benefits paid out. This process is called estate recovery.

Certainly, it makes sense from a public policy standpoint----if the state is going to help pay for a resident’s care while they are living, then the state should be reimbursed, as fully as possible, by any assets remaining at the resident’s death. But while this policy may make sense, families are never happy to learn that the state may try and take your/your parent’s home after your spouse/parent dies.

At one time, my state of Texas for instance, was only pursuing certain real and personal property the Medicaid recipient had titled in their name, alone. But now, Texas is taking advantage of the Federal law’s expanded definition of “estate” that allows the state to recover most assets in which the Medicaid recipient has an ownership interest.

Fortunately, the state Medicaid Estate Recovery Program (MERP) does not have the authority to put a lien on property, but may file a claim in probate.

There are still, in certain circumstances, perfectly legal ways of avoiding estate recovery. For example, if mom is the Medicaid recipient, and she has a child with a qualifying disability, she may be able to give her home to that child penalty free and avoid estate recovery at her death.

Also, if mom had an unmarried child who moved into her home with her, cared for her for at least one year, then mom can transfer her home to that child, penalty free, and avoid estate recovery. This is called the caretaker/child exception.

There may also be other strategies to consider for avoiding estate recovery including purchase of the home by family members or, perhaps, even using a reverse mortgage.

Medicaid estate recovery rules are complicated. I MUST CAUTION YOU THAT THE RULES VARY SIGNIFICANTLY FROM STATE TO STATE. The examples I used here pertain to Texas, but your state may be more or less strict.

You should consult an Elder Law Attorney who practices in the area of Medicaid before drafting your estate plan with the intent of qualifying for Medicaid, with the hopes of avoiding estate recovery.

For more information, please visit us online at: http://www.williedasherlaw.com/

Or for more information on Alzheimer's, please visit the Alzheimer's Legal Resource Center at: http://www.alrconline.com

Deficit Reduction Act Creates Problems for Alzheimer's Patients

I'm still dumbfounded that Congress determined it was necessary to take away much of the Medicaid Planning that was available to the public. What is Medicaid you ask?

Well, it's complicated.This is a federal and state funded and state administered medical benefit program which can pay for the cost of the nursing home if certain asset and income tests are met.

There are basically four ways to pay for nursing home care:

1. Private Pay. This is the method many people are required to use at first. Quite simply, it means paying for the cost of a nursing home out of your own pocket. Unfortunately, with nursing home bills averaging between $4,000 and $4,500 per month in our area, few people can afford a long term stay in a nursing home.

2. Long Term Care Insurance. If you are fortunate enough to have this type of coverage, it may go a long way toward paying the cost of the nursing home. Unfortunately, long term care insurance has only started to become popular in the last few years and most people facing a nursing home stay do not have this coverageThe first two methods of private pay (i.e. using your own funds) and long term care insurance are self-explanatory, our discussion will concentrate on Medicare and Medicaid.

3. Medicare - This is the national health insurance program primarily for people 65 years of age and older, certain younger disabled people, and people with kidney failure. Medicare provides short term assistance with nursing home costs, but only if you meet the strict qualification rules.

4. Medicaid - This is a federal and state funded and state administered medical benefit program which can pay for the cost of the nursing home if certain asset and income tests are met. Since the first two methods of private pay (i.e. using your own funds) and long term care insurance are self-explanatory, our discussion will concentrate on Medicare and Medicaid.

Medicaid has traditionally been the way many people paid for long term stays in skilled nursing facilities. For instance, if a loved on is facing a nursing home stay due to an illness such as Alzheimer's, Medicaid may pay for these costs.

But the rules are much tougher now than they have ever been, due to changes in the law that occurred in 2006 under the Deficit Reduction Act (DRA). The main thing to note is that there are many ways to still qualify for Medicaid paid nursing home care, and many planning techniques that may still be avaialbe, even under these tough new laws.

But you need a qualified Elder Law Attorney to help you navigate through the ever rising riptides...More on this later.

For more information on Alzheimer's, visit the Alzheimer's Legal Resource Center at http://www.alrconline.com/ or contact us a http://www.williedasherlaw.com/

Communicating With An Alzheimer's Patient

As Alzheimer’s progresses, it diminishes a person’s ability to communicate with others and makes it difficult for caregivers to fully understand a loved ones needs. Alzheimer’s patients not only have a difficult time speaking and expressing their thoughts, feelings and emotions, but also have trouble understanding others and tend to confuse words and general conversation. Learning to communicate with a loved one who has Alzheimer’s is essential because it helps to understand their daily needs.

There are several changes that take place in the communication of a person with Alzheimer’s and you may notice that your loved one has difficulty finding the right words, uses words they’re familiar with over and over and invents words that don’t exist to describe familiar objects. They may easily lose their train of thought, have difficulty organizing words in a sentence and begin speaking in their native language.

When they sense they’re not properly communicating, people with Alzheimer’s tend to become agitated and use curse words and stop speaking all together. Instead of relying on their words, they might begin using gestures and pointing to convey their message. Though the process can be frustrating, for both the Alzheimer’s patient and caregiver, it’s important to familiarize with your loved ones gestures and invented words so they’re able to communicate more efficiently.

Make sure your loved one always knows that you’re listening and trying to understand what they’re saying. Be patient and make eye contact, allowing them to finish what they’re trying to say without prodding, corrections or criticism. If your loved one is having difficulty finding the right word, help them by guessing which word they’re referring to and if you cannot guess, ask them to make a gesture or point to something that relates to what they’re trying to say.

Patience is the key to communicating with a loved one suffering from Alzheimer’s and if you focus on their feelings, rather than the facts, you may have a deeper understanding of what they’re really trying to say. Talking slowly, using short sentences and repeating information can help them to process information easier with less confusion and frustration.

Brian Willie is an Elder Law Attorney in California and Texas, and is a frequent author and speaker on the topic. He is the founder of the Alzheimer’s Legal Resource Center. For more information visit: http://www.alrconline.com/