Another Home Deeded To Kids

[S T]

Calif and Medi-cal/Medicaid

Yes I also have had several clients that eventually were on the Medi-Cal Plans. Originally they were placed in Long Term Care facilities (which were quite nice) and as their private benefits ran out, rolled over to the Medi-Cal Plan, with no change of care.

Now on the other hand, I have also seen facilities, that a client was placed in with no source other than medi-cal, and some of those weren't so good.

So I do believe that it depends on how you enter the facility. I have not checked on in quite some time, and I am not as well versed on the Medi-Cal (Calif) rules as I once was. Several years ago, the information that was available, if a client was already placed in a long term facility and made private payments, and then exhausted their "nursing care funding" they would be eligible to remain in that facility and Medi-Cal benefits would then take over (assuming all of the qualifications were met of course). However, the caveat was that the client would not be "evicted" from the current nursing care facility and moved to another facility.

I do believe that some of those rules have changed in California and possibly some other States did not have the same rules in place. Now also as stated prior, the difference between a physical ailment and a mental ailment, such as Cancer vs Alzheimer's should have no bearing on the care available and whether it is private pay, Long term care insurance or eventually covered under the State/Federal care.

I urge most of my clients to plan for Long Term Care or estate planning of some type that fits their individual net worth and financial affordability. What I am also finding out from some of my clients, that now more than ever there is more at Home Health Care or Assistance, whether it be private pay or through some of the Insurance that some clients have. And then again, some families have just taken on the financial burden and emotional burden to make sure that their loved ones are cared for at home.

Sandy

[erchess]

To DTS

1. I am not sure that a comatose person suffers when things are done to his or her body. If they do suffer then competent care is worth paying for. If they don't, it isn't unless there is a realistic shot that they will come out of the coma. Both my parents and I would like to be euthanized immediately upon entering a not medically induced coma and our wish would not be affected by any Doctor's opinion that we may or will come out of it. Since that isn't possible in this country right now we would regard the proper course to be spending the absolute minimum allowed by law on the patient.

2. A senile person is not comatose and does (I think) feel physical pain. It is therefore worthwhile to spend money on competent care for such a person.

3. As you point out, we were raised differently. My parents are like you. I am not..

[JenMO]

I appreciate all the imput. (Sorry my internet has been down and I haven't been able to respond earlier). I agree with joanmcq and the others not wanting to subsidize someone else's inheritance, but we still have to deal with and do the taxes who don't feel the same way we do. My clients, I believe, would have sold the house before the parents died if they could have found a buyer. It was for sale during that time. Since I did not do the taxes of the parents, I don't know for sure, but don't think any type of gift tax return was filed. I don't believe the estate was big, probably only owned a home. I believe that parents basis will be my taxpayer's basis in this instance.

[Lion]

What if you don't

What if you don't have children? Or, don't have children that can afford to pay the average $300,000/year on your care? Then you spend all your assets on your own care before you draw Medicaid -- leaving your elderly spouse with no home, no savings, no hope,.... How will he/she manage in the homeless shelter with no medications nor help of any kind? If I have $200,000 in LTC insurance and "save" a $200,000 IRA for him/her, then my spouse can pay rent, doctors, pharmacists, or even have a few months in a care facility after my departure.

[joanmcq]

If you are married and must enter a care facility, your spouse does not have to liquidate the house to pay for your care, nor liquidate all the assets. Look up the rules before you post.

[Lion]

Opm

According to the OPM: Partnership Consumer Government Programs publication, a married person cannot keep his primary residence unless his spouse is living in it or some other qualifiers such as child under 21. And he can keep the greater of $20,880 or half the combined assets of husband and wife up to $104,400. So, if both spouses need care, that max $52,200 isn't going to allow the surviving spouse to live well for very long. Especially since, once the first spouse dies, the now single person can keep no more the $1,600 in total assets. Those are the Medicaid eligibility requirements for both nursing facility care and home & community-base care in CT. I read them before I posted.

[joanmcq]

Ok, so if both spouses are in nursing care, the home is sold to pay for it. If one spouse is still living in the home, then the home does not have to be liquidated. So where is the spouse not in care left homeless and with no assets? so he or she has a house and up to 52000 in other assets. Then the spouse in care dies. So you still have the remaining person in their house with 52K. if that now single person now goes into care, the 1600 figure comes into play.

[Lion]

That's what I'm saying

The first spouse gets the best care with using up most of their savings, investments, equity in their home, etc., built up over a lifetime, maybe even brought into the marriage by the other spouse. He goes into a private facility, maybe ending up on Medicare eventually or maybe not outliving their joint and separate assets. But, because he entered the facility as a paying patient, they can't throw him out. Now the less sickly spouse is left with a $52,000 IRA to cash in to pay her income taxes, mortgage, property tax, medications, electricity, oil, etc. After paying the first three items for one year at today's rates, I'd have enough left to buy less than a tank full of oil and no electricity nor healthcare nor medications. So, my health is going to go downhill fast. And, I'll end up on a four-year waiting list for a medicare facility. While waiting for an opening, I'll lose my house. No, I do not believe that it is fair to use up everything on one spouse and not split assets by ownership or at least 50-50.

[mactoolsix]

I didn't make the rules.

You may claim "I didn't make the rules,' however if you vote, you made the rules.

I have had the pain of taking care of three parents - My mother, father in law and mother in law as they got old and passed on. Some of my most difficult decisions came during those times. In the end I'm happy to say we "spent the farm" and gave them the best, even those that had no clue in the end. It was their assets to spend on their care. I hope in the end you will feel you did the right thing.

What ever you do, make sure you have a good elder law attorney in your court.

Good luck with this one,

Mike