28 March 2022

Medicaid structured as a loan program

A guardian of the state admitted Edna into a nursing home and signed her up for the state’s Medicaid program, MassHealth. Tawanda was relieved that her mother was being cared for while she was busy arranging her brother’s funeral. But when she arrived in Boston from Brooklyn, where she and her husband had settled, she heard rumors about MassHealth “robbing people of their homes” as reimbursement for their medical bills.

She soon learned that the rumors held some truth. Medicaid, the government program that provides health care to more than 75 million low-income and disabled Americans, isn’t necessarily free. It’s the only major welfare program that can function like a loan. Medicaid recipients over the age of 55 are expected to repay the government for many medical expenses—and states will seize houses and other assets after those recipients die in order to satisfy the debt...

One of the reasons estate recovery works at all is that few people know about it. Although states disclose the policy in their Medicaid-enrollment forms, it’s often buried in fine print that can easily be overlooked, especially when applicants are anxiously seeking urgent medical care. MassHealth, for example, places its notice about three-quarters of the way down page 20 of its 34-page application: “To the extent permitted by law, and unless exceptions apply, for any eligible person age 55 or older, or any eligible person for whom MassHealth helps pay for care in a nursing home, MassHealth will seek money from the eligible person’s estate after death.”

“It’s all technically accurate, but it’s hard for a nonlawyer to know that that means We’re going to send you a bill,” says Gregory Wilcox, an elder-law attorney in California who’s received “lots of calls from people who are dismayed, shocked,” first by the loss of their loved one and then by the secondary blow of losing their inheritance.

3 comments:

  1. I knew about this. My son will likely be considered "disabled" as an adult. He's already on a Medicaid waiver due to his rare genetic condition (Prader Willi Syndrome) and extensive stay in the NICU. We've been warned by multiple people within our little rare disease community to be VERY VERY careful about how we structure our wills and his inheritance and advised to limit what we put into an ABLE (529A) account for him because anything left in the account when he dies WILL be used to reimburse the state for Medicaid support. We've actually been told that if he dies before us, we need to make sure that account is emptied out by the funeral expenses.

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  2. ANyone know if all states do this? I'm in California, and I have been in the unusual position of being long-term disabled without receiving SSDI due to a lack of a diagnosis over the last 17 years and owning my house outright due to an early inheritance from my Mom. I'm liable to die before my parents, so do I have to worry about having my house stolen by the State of California after my death?

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    1. Reaper, I found this -

      "Can the State Take My Home If I Go on Medi-Cal?
      The State of California does not take away anyone’s home per se. Your home can, however, be subject to an estate claim after your death. For example, your home may be an exempt asset while you are alive, and not counted for Medi-Cal eligibility purposes. However, if the home is still in your name when you die and if it is subject to probate under California law, it is part of your “estate” and the State may make a claim against your estate for the amount of the Medi-Cal benefits paid or the value of the estate, whichever is less...."

      There's more information at the site -

      http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_recovery_FAQ.htm#:~:text=The%20State%20of%20California%20does,for%20Medi%2DCal%20eligibility%20purposes.

      - which looks to be a reliable one. Perhaps you can find some assistance via one of the links at their home page.

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