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Medicaid Pay Down
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I am trying to understand what medicaid pay down is and why and how someone would do this. A couple of years ago, my mother's attorney advised me that in order to protect her estate, I should arrange to have a certain amount of her money transferred, on a monthly basis, to me and to my brother. The attorney said that once all of the money was transferred, my mother would qualify for medicaid. He advised me that after that, if I needed to place my mother into a nursing facility, her costs would be paid by medicaid and if I wanted her to have special services such as manicures or a private room, I could negotiate to pay for those items myself (using, of course, the money that I transferred from my mother to me). My opinion was and is that my mother's money is there for her care. This whole idea just seemed fraudulent to me and I wonder if anyone has had a similar experience or received similar advice. Is what the attorney told me to do anywhere close to what medicaid pay down actually is? Thank for your insights...
Posts: 30 | Location: springfield, virginia, usa | Registered: November 18, 2002Report This Post
Hi Peg, I was also given similar advice from my Mom's Attorney, and like you, something felt not quite right about it. I didn't do anything at the time, but now, a year later, I am beginning (i think) to understand the wisdom in the advice.
With the cost of nursing home care running around $84,000 a year in my area, my Mom's assets won't take long to be depleted. Here's the theory as I understand it (and mind you, I'm no attorney, just a 'daughter'.)

In Massachusetts, Medicaid has a three year 'look back' period. (five years if in a trust) That means that when the elder is placed for care, they can look back three years to see how and where their money was spent. If the POA or whoever is handling the money, spends anything that is not allowed by their guidelines (and they are quite strict) then that person is expected to pay back that money to the government. Then, the assets are carefully watched and, (in Massachusetts anyway,as of about a year or so ago...) $40.00 a month is allowed for personal expenses. Certain things (like dental care for one aren't covered and there's not enough money to pay for it if you have not squirreled away something for it...Some plans don't allow for funeral expenses either..) So the theory is, to get monies out of her name so that if she should need things that the system can't pay for, your hands aren't tied. You do have to be careful how you do this as after about $11,000 a year (per person), I believe there are tax implications.

Initially, I felt outraged that I should be asking the government to pay for someone's care when they have assets of their own. However, after some thought, and watching her money go out so rapidly (she's in assisted living, private pay right now) I have reconsidered. It is not my intent to take more than would be reasonable, but I do intend to move some before we get to that three year point (and who knows when that will be) so that I am able to add the things that she may need at a later date.

Our plan is to hopefully have enough to pay for three years of a nursing home under private pay (so that we have some power to choose the facility). However, watching the money flow out right now, I'm not so sure we'll make that goal.

I'm going to heed some of this advice and then, hey, if I end up with monies, I'm sure the government will let me send it to them to ease my conscience....

I'd too be curious how others perceive this or to hear from folks who are already at the Medicaid/Nursing home stage....

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I would visit this webpage to learn more about the process of spending down!
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Whom ever the Tom is, he gave excellent information

Oh, the comfort, the inexpressible comfort of feeling safe with a person, having neither to weigh thoughts nor measure words, but pouring them all out, just as they are, chaff and grain together, certain that a faithful hand will take and sift them, keeping what is worth keeping, and with a breath of kindness blowing the rest away.
Posts: 4364 | Location: west chester, pa | Registered: July 06, 2001Report This Post
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