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Currently on Medicaid. I just received a lump sum from a moderate settlement. I understand a quick spend-down would save me from interruption of my eligibility for Medicaid. I have a long-standing personal debt to a family member (from 10 years ago). Would a repayment of this debt to my family member be accepted by Medicaid as a valid form of spend-down? If so, what documentation would I need to show? Thanks!

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This is a question for an attorney or for medicaid itself. Don't trust the opinion of a Forum, no matter the experiences of its members when there is any question of any legal, financial, medical questions in which you simply cannot afford to make a mistake.
I agree with GardenArtist, that, even if this IS allowed, you would need to have good valid dated documentation.
There are often ways that surprise payments and inheritances can be protected by directing them into something, but far be it from me of being aware of any of this; I myself with check with an attorney in the event this is any substantial amount. Well worth the 350.00 hour fee for an hour of good advice.
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I loaned my mother a significant amount of money with only a verbal agreement she would pay me back. (What can I say....I love my mother.) I tried for years to get her to put this in writing without success. Of course, I should have had the loan in writing first. When she became a NH resident, I had no choice but to file a civil suit against my mother to put a lien on her property for the loan amount. I needed the lien before Medicaid could put one on the property. My brother w POA had told me i’d have to fight Medicaid for my money. I decided he’ll no! Mom is of sound mind & contacted an Atty. Fortunately, I had documentation of every penny I loaned her. In the end, a settlement was reached. I did agree that the loan would not be paid until mom passes. Get your documentation in order. A friend told me 2 things about loaning people money. He said, “Family will f*#k you first” & “If the Ioan is more than $5, it’s business.” I’ll never forget that!
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Was the debt documented? By a Promissory Note, or other agreement? I would think you'd need written validation of the debt for it to be considered as a valid paydown.
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lsudvm91 Mar 2022
In my state, verbal agreements are legal.
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I agree with AlvaDeer, it is imperative that you speak with an attorney -- elder care lawyer -- experienced with Medicaid in YOUR STATE! The legal terms of the settlement as well as what if any legal documentation you have for said loan (your debt to a family member) really should be reviewed by an attorney. Questions like was the outstanding debt to your family member (the loan) disclosed at the time you applied for Medicaid? If not, why not? Is your family member willing "under penalty of perjury" to attest to and sign any required legal affidavits and bank statement to affirm the funds were received as a loan from you? And further, can/will your family member be able to produce receipts of what the loaned funds were spend on at the time they were loaned?

Also, just your receipt of the settlement payout could trigger your responsibility (duty to inform) to immediately inform your state Medicaid office within X days of this payment or you may be penalized in some way. That is, I would not wait on this much less -- as AlvaDeer stated -- rely on advice from this forum. You need real legal advice here from an attorney or guidance from your state Medicaid officials.
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Have you prepaid your funeral? Good way to spend down.
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I would review the medicaid paperwork and speak with a medicaid social worker. I established a special needs trust for my family member and placed the money there. In my case, the attorney advised that the money can only be used to directly benefit the beneficiary of the trust (which in your case would be you), and that at death, the money and whatever else is in the trust would go to the person or persons designated in the irrevocable special needs trust. However, I strongly suggest you speak with the medicaid Caseworker and see what their thoughts are regarding the loan payment.
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In the '70's I was a Minnesota Financial worker, and I know many things have changed (we NEVER put liens on patients' houses!), but I would suggest you first discuss this situation with your financial worker. S/he can check the manual and/or discuss with her supervisor. Depending upon the nature of the debt, it may/may not be allowed. This is a fast and free way to start checking into this, so that is what I'd do. It's good you are thinking ahead.



ivosr. Depending upon
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Before you do anything, speak to an attorney that has worked with Medicaid before and its rules and exceptions to rules etc. I would not go ahead with it unless you talk to someone well versed in the subject. Don't trust your own knowledge because there can be so many if ands and buts to the rules. Nice of you to want to pay back your family member, but in this case you have to be the priority. You could get the info if you just go to Medicare and ask what are acceptable spend downs without telling them what you are specifically about, just that you want to be sure not to affect your current Medicaid. But, anything you get from them or the attorney must be in writing and signed. I would think that maybe the attorney could be paid from the spend down, but I really don't know and would ask before you do anything.
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tvoqbo: You need to pose your query to an elder law attorney.
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Katefalc Mar 2022
Correct. This could be “ tricky”
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It could be done but Medicaid has very strict guidelines on documenting this 'loan'. And the money that was loaned cannot be used for shelter, food, or healthcare.
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