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FIL got a girlfriend before his wife passed with dementia in January. We thought we had him back and realizing she was a controlling narcissist, but now they are celebrating their “anniversary” in the mountains. Medicaid owns his house but she insists on what needs to be done to sell it so “they” can get an RV, a timeshare, or her to blow the money. Does a realtor find out from Medicaid about the lien (which isn’t filed yet in the courthouse) so they get paid and not her, or what should we do? He’s completly blinded by her.

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I don't know enough about property law or what checks have to be made before a house is sold to have the answer. But I would be extremely surprised if a buyer didn't discover that your FIL doesn't in fact own the house he is trying to sell.

Does this have to be your problem? You can't just let them fall flat on their faces all by themselves?
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Any buyer's lawyer will have to update the title and and will find the lien so don't worry about it. let them fall flat on their faces.
When Medicaid owns something they let the owner stay till they die. If Mom is dead unless the house was willed to someone Dad will own it.
I am afraid girlfriend just fell out of her tree.
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There will be a title search done prior to closing that should show the Medicaid lien. The lien would have to be paid prior to the completion of the sale.
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If the home was owned jointly by FIL and MIL, then I believe that the most that Medicaid can claim would be 50% of the sales proceeds. However, if FIL knows about the lien and does not notify the settlement agents, he may be committing fraud. Or, a little birdie could suggest to the realtor that they might want to check with Medicaid before the house is sold.
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Yes, they can lien only half legally.

Why would you think Medicaid would come after your assets?

You sit dad down and tell him "what you are doing may be illegal. If you spend the money you've saved for your old age on this "person" just understand that you will be relying on the kindness of strangers when you need care. We're not taking you in".
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RSmith1232, this can become really complicated. When mother-in-law passed, the house automatically goes to her husband unless the Deed was written differently. I wonder if Dad-in-law understands that Medicaid will be first in line to get Mom-in-law's equity, some elders don't realize that.

Usually no one knows there is a hiccup on title until the Settlement Attorney has a tilte search done [as mentioned by other writers above]. Usually a problem with the title search will delay the closing. Either Dad-in-law pays to wipe off that lien, or Dad-in-law accepts that he will get half the equity [minus closing costs, taxes, Realtor commissions, etc.].

I would have your hubby contact Medicaid to give them a heads up that his Dad is going to sell the house. Otherwise, if Medicaid waits they can track down Dad and hand him a bill for Mom. Hopefully Dad hadn't already spent half of the equity by then.

So Dad-in-law's girlfriend wants a timeshare? Apparently she hasn't kept up with the issues of owning a timeshare. The yearly maintenance cost can keep climbing. And she and Dad can only use the place one week or two weeks at a certain set date unless they switch the weeks with another timeshare owner. They need to save for their much later years.
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RSmith, yes the house would need to be sold at current market value.

If the house needs updating, don't bother, there are enough flippers out there who would prefer a house "as is". I would recommend you get a licensed Appraiser to give you a value on the house. I did that with my own Dad's house. The Realtor sold the house pretty close to Appraised value, so it was a win-win for Dad and for the buyer.

Don't worry, Medcaid cannot come after you for the reimbursement.
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Again, didn't read all posts. When a house is involved a lean is put on it at time of the persons passing. I requested a letter telling me what was owed Medicaid. Once the person dies, it doesn't matter what the house sells for as long as the Medicaid lean has been satisfied. I would think in Dads situation that he needs to realize that Medicaid will require payback for Mom from the proceeds of the house. Like said, maybe up to 50% which would be her half. If the lean is in excess of 50% they would get just 50%. I would inform the realtor way before title search, like said its only done when a buyer is found, that if a lean doesn't show up for Medicaid, it probably will.
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My husband is still looking for the name of the “nice” lady that had his mom’s case before she passed, but I think he can ask to speak to the one who holds her case. He got swamped at work and sent the question by email to another worker who sent back, “ If your mother has passed away the Medicaid case is closed. Unless your father is applying we will not have an active case on him. However, property must be sold at fair market value or high to avoid in transfer penalties in the future.“
That doesn’t answer squat unless they believe we really think they don’t own the house.
Can they only have a lein in half leagally, since the care for his Mom would easily take to whole cost of the house?
And no, the girlfriend doesn’t care what she does to him or us. She’s going after a FIFTH husband to dog money out of is all she’s after. That’s the reason we are trying to save our own asses from Medicaid coming for us if she screws him around.
Is there anywhere other than the courthouse where a lein could be filed? We had someone look and they don’t see one on the house yet, or does Medicaid wait until something flags them it’s sold and the unknowing sellers have already used the money?
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I think FF and BB have covered it.

So your father has never received Medicaid for himself. The Medicaid lien applies to the 50% share of the equity that belonged to your late mother.

The house must be sold at market value or higher. When it is, Medicaid will recover their costs to a maximum of half of the sale price. The rest of it will be at your father's disposal.

You can kind of see your father's point of view, no? He doesn't want to stay put with his memories in a house he only half owns. He wants to grab the cash and have fun with an exciting - whatever else she is, she's exciting - lady friend while he still can.

Naturally you would like him a) to be safe from a dangerous influence and b) to behave in a practical and responsible way, having a care for his future.

Can you think of a way to make that sound a bit more attractive to him?
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