Did you know that your state can recover certain expenses paid by Medicaid benefits for adults over 55 who received long-term care? This includes any hospital services, prescription drugs, and sometimes even Medicare cost-sharing expenses. How does a state recoup its money? Take a look at Abe’s story below.
I have a friend who just received a bill from the state of Texas for his mother’s Medicaid nursing home care. No one informed him that Medicaid was running a tab of the entire healthcare that Medicaid paid and would take his mother’s house. Now, Medicaid wants to be reimbursed for over $125,000 that was spent on his mother’s care and her expensive prescriptions. This friend of mine recently received a document from MERP saying that Medicaid wants the money used for her care back because his mother owned the house that he lives in. This is shocking!
Abe, Richmond, TX
Americans should know about the Medicaid Estate Recovery Program (MERP). I have consulted with numerous confused adult children who are shocked to find out their state has taken a lien on their parent’s house because of long-term care costs that the state paid for. And, I am sure your friend was astonished to find out that the state of Texas wants its $125K back that was spent on his mother’s Medicaid long-term care.
Medicaid can recover any and all medical expenses which include any hospital services, prescription drugs, and even Medicare cost-sharing expenses which are Medicare premiums (Part A – hospital insurance, Part B – medical insurance). This also includes deductibles and coinsurance amounts that the state’s Medicaid has paid.
The care can be at home, assisted living facility, personal care home, or in a nursing home. And, it does not matter when the Medicaid system has paid for the care.
All claims against an estate, including MERP claims, must be paid before the property can be distributed as specified in the legal will. The state does not, however, require an heir to sell the deceased recipient’s homestead if the claim can be paid by other funds. But if not, then you may have to sell the house, or the state will file a lien against the house.
This is a real surprise when a Medicare beneficiary receives Medicaid-paid long-term care and then later the Medicaid recipient’s estate receives notification from the state for a “Notice of Intent to File a Claim against the Estate.”
In the letter sent to the recipient’s estate, it states: “the amount received will not exceed the value of the estate’s assets, if any. If there is no money or assets in the estate, then there is nothing to recover.”
Now … you know how Medicaid’s long-term care services operate.
Toni Says: Explore all of your options and work out a schedule with family members to take care of your loved ones. This way you can protect all of the assets your loved ones have worked so hard for.
Medicaid and Long-Term Care Planning, TO DO:
- Explore long-term care options for yourself or an elderly parent or family member while still in decent health to help avoid using Medicaid LTC to protect your financial assets.
- Seek the advice of an elder law attorney that can help with proper Medicaid planning.
- Do proper planning. No one wants their adult kids or grandchildren to be their caregivers and take care of their activities of daily living such as bathing, dressing, bathroom problems, etc.
- Do not rely on advice from well-meaning friends who are not experts in the Medicare/Medicaid arena.
Toni King is an author, columnist, and radio and TV personality who specializes in Medicare, Social Security, and long-term care planning. While conducting a Medicare workshop in 2009, Toni was approached by a member of the audience who had received incorrect information about his Medicare Part B enrollment from Social Security. After taking a couple of days to help the gentleman straighten out his overwhelming problem, Toni’s new mission had become clear. Following more than 27 years as a top sales leader in the Medicare insurance industry, Toni would become an advocate for Americans receiving Medicare. Since then, Toni has devoted her life and career to putting Medicare into “people terms” with the help of her books, consultations, workshops, and website, ToniSays.com. Read more from Toni King here!