Rather, Medicaid will only pay for assisted living services and supports). The Caregiver Child Exemption also applies when the child caregiver and parent have lived together in different residences, as long as they lived together for the two years before the parent being institutionalized. Federal guidance on uncompensated asset transfers can be found in Section 3257 and 3258 of the State Medicaid Manual at: http://www.cms.hhs.gov/manuals/45_smm/sm_03_3_3257_to_3259.8.asp#_3258. Oregon is widely reputed to have one of the nation's most effective estate recovery programs, in 2003 collecting more than 5% of its Medicaid nursing home expenditures.12 Yet, Oregon is also notable for its efforts to work with families to arrange a suitable payment schedule that: 1) keeps the home in the family, and 2) allows the Medicaid recipient to receive care in a nursing home.13, 14, Elderly home owners at all income and asset levels can choose among a growing variety of options to convert equity in their homes into income, while allowing them to continue to live in their homes. 172.46Kb), Note: Documents in PDF format require the Adobe Rules and documentation may vary based on the state. This documentation should include a statement of all medical conditions in which the senior suffers, such as Parkinson’s disease, dementia, or a stroke, and the length of time these illnesses have been present. This could include in-home care, respite care, or adult day care. Read more about the Medicaid Sibling Exception. This also applies if there is a minor child or special needschild living at home. (pdf, As the minimum period required is two years, the Exception does not apply. Medicaid treatment of the home -- an overview: The home is an excluded resource in determining Medicaid eligibility, regardless of its value. In 2020, the Community Spouse Resource Allowance (CSRA) is: $128,640.00. The SSA Program Operations Manual defines dependent relatives in Section SI 01130.100 A.7. See the article on how medicaid counts life insurance. Yes. After the Supreme Court ruled in 2015, these benefits are now available to same-sex marriages as well. Medical records may be needed as proof as well. The secondary, but considerable benefit is the family is able to keep their family home rather than surrender it to Medicaid to offset the cost of residential care. Sooner or later, recipients may not have sufficient funds to pay property taxes, insurance, or other expenses necessary to maintain their homes after spending most of their income to meet Medicaids monthly share-of-cost payments for long-term term care.10 In this scenario, selling may be their only viable option. The so called 209(b) states8 can opt to use more restrictive criteria that disregard the individuals intent, such as the assessment by a physician or other treatment professional of the likelihood that the institutionalized individual will be discharged to return home. They are considered eligible recipients of a home transfer if they have lived in the home and provided a level of care for their aging parent for a period of two years that enabled him / her to continue to live at home. As long as it serves as the principal place of residence of a Medicaid recipient (and/or spouse, if any, and/or certain close relatives), the home is not factored into the Medicaid eligibility determination, regardless of its value.2 This exclusion has a dual purpose. If the child caregiver was not able to provide full time care for his or her parent, proof that other care was provided might be necessary. In addition, the adult child is compensated for their caregiving duties. Condominiums and mobile homes are eligible properties. 1. This should be done during the two-year period in which the adult child lives in the home and provides care. No information contained in this post should be construed as legal advice, nor is it intended to be a substitute for legal counsel on any subject matter. Chicago Tribune. Burwell, BO and Crown, WH. One might receive limited assistance by contacting their local Medicaid office or their local Area Agency on Aging. Siblings must have an equity interest in the home and have lived there for at least 1 year immediately before the deceased Medicaid recipient was institutionalized. However, given the considerable amount of documentation that is necessary to meet the requirements, it is strongly recommended that families prepare for the transfer in advance. "24 Second, it is up to each state to determine how the general principles laid out in Federal guidelines apply to specific cases. June 12, 2002. For the Caregiver Child Exception, the home is transferred from the elderly parent to the caregiving child. 7.      Assets that cannot be sold - classic example is a timeshare. Adult children must have lived in the home for at least 2 years immediately before the deceased Medicaid recipient was institutionalized and have provided care that may have delayed the recipients admission to a nursing home or other medical institution.23 Hypothetically, states can initiate recovery if and when the sibling or adult child moves out of the home. They are also prohibited if the recipients sibling has lived in the home for at least 1 year and has an equity interest. This article focuses on the asset test for Florida Medicaid: and luckily, Medicaid does not require all if itâs recipients to be completely impoverished because certain assets will be âexemptâ. Since the period of time she needs assistance is less than two years and Sophia won’t need to live in a care facility after this time, the Child Caregiver Exception won’t come into play. It is worth noting that many elderly persons are resistant to move into residential car… Each state makes Medicaid policy choices and administers its program within broad Federal guidelines.1 In order to meet Medicaid eligibility criteria, such individuals must first deplete or spend down their assets. What happens if the elderly individual passes during the two year caregiving period? However, recipients in nursing homes are not typical of the Medicaid population in general. A Medicaid claim against home equity is regarded as a penalty for people who have accumulated enough wealth through hard work to own their own home. Reader®, Disability, Aging and Long-Term Care Research. "What we can't do is just pretend that there isn't a claim. This policy brief was prepared under contract #HHS-100-03-0022 between the U.S. Department of Health and Human Services (HHS), Office of Disability, Aging and Long-Term Care Policy (DALTCP) and Thomson/MEDSTAT. Because home equity conversion is a relatively new and evolving phenomenon, there is a very real potential for confusion; misunderstanding or misapplication of the rules; or legal uncertainty when the home conversion involves a contract or other legal instrument.17 While home equity conversion may be a useful tool for long-range estate planning, Medicaid rules that penalize uncompensated asset transfers anticipate situations where conversions serve, by design or accident, to help the homeowner avoid paying long-term care expenses, while preserving home equity for the homeowners heirs. However for an objective and thorough analysis and for assistance in the creation and collection of documentation, it is recommended one contact a Medicaid planning professional. Federal Medicaid guidelines instruct states to use the same subjective test of intent to return that is used by the Supplemental Security Income program (SSI).5 A home is not counted as an available asset in determining Medicaid eligibility as long as the recipient expresses an intent to return home from a nursing home or medical institution, regardless of how long he or she has been institutionalized or whether there is any reasonable expectation that the individual could possibly return home.6 This totally subjective intent may be expressed in a letter or affidavit signed by the homeowner.