How long does it take Medicaid to request payback after death?

That money from her spend down is hers. As is the PNA (personal needs acct). I never had Medicaid ask for either. I showed the NH my short certificate, and I was sent a check for her PNA. Since Mom only had $184 in her acct, I asked Medicaid if I could close the acct. They allowed it.

Her home will have a lean put on it. Doesn't matter who it is left to. When the house is sold, the lean will need to be paid. If, a family member has been living in the house as their primary residence and that had been Moms main residence, at time she entered LTC, the person may be able to stay in the house. A lean will still be put on the house but not recouped until the person living there dies or sells the house.

There was a post where Medicaid didn't come after the house until 3 yrs after the person passed. By that time the house had been sold and monies split between beneficiaries. The poster hasn't returned to tell us what happened.

Me, I knew there would be a lean, so I contacted Medicaid and received a letter telling me what was owed. When a lean was never put on the house, I contacted the state and found paperwork had been sent to the NH who was suppose to send it back to the state with contact info for Mom. They sent me the paperwork and now a lean is on the house. Because of tax leans, Moms house maybe taken by the County. I wanted to make sure the lean was in place so it didn't come back on me yrs down the line.

Given that the taxpayers have been funding her care as a Medicaid recipient, it seems reasonable that money from the sale of the house should go back to the state as reimbursement.

However, random internet articles do seem to imply that it's possible to avoid a recovery claim on a house in Texas. For example:

https://www.dallaselderlawyer.com/10-ways-to-protect-my-home-or-sales-proceeds-from-medicaid-estate-recovery/

"Ladybird Deeds – the state has a right to make a claim on assets that pass by probate or by intestate (without a will) succession. This type of enhanced life estate deed (which can be done in several ways) avoids probate and intestate succession and does not result in a transfer penalty even if signed within five years from the date of Medicaid application. As long as this is done before the Medicaid recipient’s death, it should avoid a successful claim."

Legal advice from the internet is worth what you paid for it of course!

What if the deceased has zero assets upon their death? No house, no stocks, literally nothing. Would the family have to pay back Medicaid LTC?

NO, if a person dies with no assets, Medicaid CANNOT go after the family. MERP is NOT allowed to go after the family!

the only thing Medicaid can acquire is if something (cash, home, for example) goes into PROBATE. estate planning with an eldercare attorney prevents probate.

If the house was put in a trust to the family, Medicaid can't touch it

Poor people go on Medicaid....that's the purpose of it, they owe nothing when they die. Just went through this....

If you are saying she is in a facility and Medicaid pays for her bed, there would have been a MERP form signed when she was admitted saying you agree to recovery of payments Medicaid made while she received benefits. The state would be looking at her estate at time of death - her assets that are listed in a probate. State could file a claim against the estate. Depending on how her bank account was set up, that money may not be a part of the probated estate. If you had the house set up in something like the lady bird deed (no relationship to Lady Bird Johnson as some people think), that house would not be a part of the probated estate either.
If she's at home getting social security (because she/her husb had earnings in their life) plus some SSI with the Medicaid (because her social security earnings were below a poverty level threshold), it's possible the payment she received in the month she dies will be taken back.
You really need to talk to an estate planner to find out what will be taken back and how the house will be treated. Medicaid worker may offer some advice, but they are not allowed to give legal advice.

caregiverhelp11 - none of us could possibly know how you set this deed up. you need to talk with an elder/estate attorney to find out how the process you have in place will be done. worriedincali is correct...just transferring the deed won't mean the house isn't subject to the MERP (estate recovery prog)

If the value of her estate will be $1700, if that’s all she will have to her name when she dies, then She’s exempt from MERP. They don’t get after estates under $10k in Texas.

If she owned a home, MERP won’t come after it if it poses an undue hardship to her heirs or if it will cost more to sell the house than it is worth.

Read through this and see if any of it applies to your situation https://hhs.texas.gov/laws-regulations/legal-information/your-guide-medicaid-estate-recovery-program

The sticking point is if the elder's estate has not been put into a trust (best bet). My attorney bro did this for our mother's estate and that way when the elder dies, it does not have to go through probate.

That’s pretty amazing that her home was deeded to family and she still was able to get on Medicaid. We are going through all of this now, and because of the 5 year lookback, we have to sell mom’s house and spend down any savings before Medicaid can be obtained. We can apply but many stipulations. Mom is presently in skilled nursing, transferred there from Rehab. Many rules regarding house; must be listed within 30 days upon application to Medicaid, is just one of them.

I've been reading all answers with great interest as this estate recovery issue seems to be a Federal mandate yet the states are allowed to put their own twist on this practice.
When we can not even get a consistent answer, if any answer at all, I take that to mean there is really no organized way of handling things. Lack of organization leads to lack of information - including when to expect the flurry of documents that arrive at an undetermined time after death.

The only common thread seems to be that it applies to the estates of those who were age 55 or older when they received services. Each state uses a Federal mandate and tries to tweak it how it sees fit. 50 different takes on a law + thousands of individuals and families involved. Maybe a Federal mandate states how many days the states have to notify families of when to begin repayment of the total bill.

I signed papers that require any remaining monies in a personal trust or bank account (owned exclusively by the deceased) to be "immediately" sent to the state. Papers signed also require agreeing to "Expanded" recovery. This means real and personal property that normally passes without Probate is now up for grabs by the state. This is another example of 50 ways to claim repayment for nursing home care.

In our state since your mom has deeded it to you upon death (instead of at least 5 years before she ever got Medicaid) that means she would still have an interest in the property up until her date of death. I would check on the deed to the house to determine if the state can still claim it using either the 5 year rule or the "Expanded" definition of estate.

Our state can expand it's recovery efforts to property inherited by spouses and families. Spouses might be allowed to keep some or all up to their date of death, at which point the state is supposed to collect. So again, nothing for heirs as the parent still owes the state. The families are only supposed to receive anything leftover after the nursing home bill is paid off.

Monies in a regular checking account or a QIT or other trust account are not refunded to the estate or heirs. If my spouse died today, I am supposed to immediately close the QIT, valued at $12.00. I am supposed to write the check for $12.00 and mail it to the state. His personal account at the nursing home would yield about $35.00. The state would thus collect $47.00.

It might not be cost effective, but those funds can not be kept by his estate or me according to the rules. I've not been able to varify, but I think the nursing home has to mail it's $47.00 to the state. So the state will process the $47.00 repayment received from my spouse's estate.

Our state has not given any timeline for this rest of the recovery, just that it gets started sometime after death.

I just have to reply to whoever wrote that if you don't want the State to get the parent's house, etc., take them into your home and earn it. My late father had so many terminal conditions, when Mom passed and the grown kids who were at (their) home asked the doctor if they could care for him - as he was ADAMANT about not going to a nursing home - we were told we would kill him, he needed
total skilled care, including skilled level PT, and that meant special equipment and a trained RN (which we were not) to care for him 24/7. Went to a nursing home and loved it, died shortly after at peace. So please DON:T judge others!

So confused! Geeeez, everyone really needs to research their own state laws on these issues.

Your mom is still alive, correct? If the $1700 in the bank account has the account to be POD / pay on death to you, when she dies the $ in that account is yours and is outside of being included in her estate. You need a death certificate to take to bank to get the $. If it’s not POD, then it falls into an asset of her estate upon death. If this is what the outlook is is there anyway to buy her things so that she dies with as little assets as possible? Not just in her checking account but also include the $ in her at the NH personal needs trust fund account.

TX has HMS as the outside contractor for MERP. They do about 1/3 of the individual states MERP programs. HMS is a huge co. & do other compliance work for CMS (Centers for Medicare & Medicaid) on the federal level. For MERP, they send out a NOI - Notice of Intent - to the addresses that the state Medicaid program has provided to HMS as the on file for contact for the DpOA &/or the address where the annual Medicaid recertification gets sent to about 3-5 months after Death.

NOI has a cover letter which states the amount owed and a multi page questionnaire as to what the status is of the estate as of DOD. In how it’s addressed, imo unless you are expecting it and know what it means, it kinda implies that it’s your debt to pay. The questionnaire is time sensitive and if not responded to then debt is assumed to be valid. The MERP system flows on the standard debt collections playbook. To me what the questionnaire is abt is for HMS to use to determine if there are assets of the estate that may fall into the recoverable category and if a recovery action will start churning out letters & phone calls and if it will be by HMS in Irving or the legal dept of TX Medicaid in Austin. Austin seems to handle recovery if they die with an a life insurance policy that names the estate as the beneficiary. HMS seems to deal with the others.

If they died owing a home that is subject to probate, it will get to be quite in the weeds to deal with as there are all sorts of exemptions and exclusions to recovery based on what costs on the property plus whatever costs post death and then entered as claims by the Executor.

So who in the family has paid the various property costs and has kept documentation of property costs (taxes, insurance, maintenance) these past 3 years? You say property is to be deeded to family upon her death, how is has this been set up? If it’s that the property has a Lady Bird Deed, the atty who did it should be dealing with it post death to get the release so title can be done and recorded. If there is not a Lady Bird, it’s going to get complicated as TX is a nonTefra state for lien placement. So you’ll likely have probate to open and everybody has to file claims as per TX probate laws.

Teresa - is House in your mother’s name or in your name?
You refer to it as your “home”, so is it actually recorded at courthouse in your name? If not, although you’ve lived there forever it’s still mom’s ownership.
Couple of things to keep in mind if it’s still her ownership:
- mom should not do anything to change the home as her primary residence. So no new state ID or drivers license done with NH address on it; she keeps it as her old address. She may need to file a right of return with the county tax assessor so that it is clear she plans on returning home. This allows her to keep house with a homestead exemption, over 65 &/or other exemptions on the property that keep taxes lower. Otherwise if she’s viewed as having moved away, her tax bill will be quite a staggering increase which it sounds like you cannot afford.
- Medicaid should have its own “right to return” form that gets filled out.
- Medicaids MERP form has a section is which you as her dpoa check off as to if house is occupied, vacant or for sale. Be sure to check occupied. You may get a follow up as to whether or not the occupant is paying rent and why occupant is not doing so.
- you will need to file either a caregiver exemption or a disabled heir exemption to Estate Recovery after mom dies. Caregiver exemption will need a letter from your mom’s old doctor or social worker detailing what type of help needed and that you provided it for a certain period of time which kept her from going into the NH & onto Medicaid earlier. For handicapped exemption you’ll need whatever documents you have to show you are legally blind, handicapped, etc. to prove you are disabled for MERP.
- did anyone mention that LTC Medicaid does an annual recertification? You’ll have to provide fresh details, like most current taxes paid, 3 current months bank statements, a new right to return statement plus once again her insurance information, any funeral / burial polices, citizenship info. You have like 14 days to get it filled out with supporting documentation and back to the state. So get a binder going where you keep all these items at the ready. It will make it lots less stressful.
- If your mom’s will has other heirs besides yourself, if she can, she needs to do a codicil to her will so that you are the only heir. MERP can look at the status of each heir to base exemptions on. So although your ok for handicapped & caregiver exemption, your siblings may not be so their share of ownership subject to recovery.

If moms SS income has been used to keep the household afloat, that $ will not be there anymore as she’s on LTC Medicaid and required to pay her income to the NH each month. There is no way around this unless there is a community spouse or you were considered her dependent and show tax filings that establish this. Please look carefully at what it costs to keep everything as it is. I’ve been on the his site for a long time and over & over the same scenario..... that the for years long caregiver cannot afford the living & property costs for the period of time while mom is in the NH and then the post death time till property can be transferred and titled in your name, so they end up in a tenuous situation in home with delinquent taxes, no insurance with lots of delayed maintenance. Any tax delinquency have to be paid to ever get property transferred or sold. Plus it can be placed for tax sale, but for TX family / heirs can pay the old taxes even decades later as TX doesn’t really do tax sale deed transfer and recordings.

Igloo572 the house is in her name and my name.

My brother is POA and has been handling the paperwork
He would have let them know that the house is occupied.y brother will also be making the house payment when they take my mom's SS.