Medicaid in NC: What are my mom's financial obligations and who is responsible?

dunazee: Do not use your financials on your mother's care.

Seek Elder Law Attorney directions.

Medicaid is a welfare program. It is not an insurance. I don’t know how Medicaid works in North Carolina, but here in California, once you pass away you have to repay the $$ received through your estate.

I’d say get off that puppy as quickly as possible.

Medicaid is a federal and state program for people who are poor (no income) and people with very limited income. Many people believe that Medicaid is a “free” program, but this is a misnomer. My daughter works as a supervisor for the New Jersey Medicaid program for the DD/nursing home and she told me that the state needs an account of every penny that the patient receives. The State of New Jersey also looks into the trust fund of the patients to make sure that money isn’t funneled into the trust as a way of hiding funds as some people do this thinking the state would not know this. If Medicaid finds out that a patient has assets, they WILL try to recoup the money they spent on the patient.

I have Medicare Advantage and I love it because I have zero copay at my PCP and zero premium, plus it comes with many, many other perks like $70 ever quarter for OTC products, $200 a year for eyewear, they also pay for someone to come in and prepare meals, run errands, laundry, and many more. When I had Original Medicare they were paying 80 percent while I was responsible for paying 20 percent for my medical bills and there were no perks. I’m curious as to why you want to switch back to Original Medicare.

Medicaid is a very complicated program and it varies from state to state. You need the advice of an elder law attorney from your state who has experience in the way Medicaid works.

Sorry you are having to deal with this. It is all so frustrating, complex and takes lots of time to navigate. Given the move from one state to another, part of the issue herein is likely different State Law and Rules with regard to both the Trust as well as the new State's requirements in terms of some of the paperwork. That said, Federal law and rules also apply. The set up of the Trust may be tripping the Federal law/rules; the 5-year look back provision if (based on description provided) was set up post sale of the home and the sales proceeds were put into that Trust instrument.

The "paperwork" issue is sadly not surprising, in that YES most states require original bank and other statements; so much easier if you can set up all accounts to be on-line, so that you can download all statements. I had to do this for my mom, and yes downloading monthly bank and other statements for 5 years (60 total per account) was a huge time consuming task, but each was saved with a clear name (such as 23 01 01 X Bank January 2023 Statement -- year, month and date) for each one to try to keep track of each download for each month - tedious). Each had to be uploaded to our State's Medicaid portal (your State may have something similar, one has to create an account to do this, and things like the POA get uploaded too so that you can "act on her behalf" within the portal - tedious.

Given that two States are involved, it would be best to hire a competent elder care lawyer licensed in the State you are now trying to get her qualified in. Some States have residence rules, like having to have lived in the state for a year or so before one can qualify. Talk w/your local LCTF business office people, ask for the person(s) there who interface with your State's Medicaid office and speak w/them. Ask for them to give you the names of 2-3 top notch elder care lawyers licensed in your State and w/whom they deal with. PS: most of these folks all know each other and they ofter work together because some residents are under State guardianship whereby the lawyer acts as their guardian as appointed by the State Court. Most will give you a packaged price, but it will likely not be cheap. Pay the attorney from the Trust. Are you a Trustee of the Trust or who is? If revocable, the Trust may have to be revoked. OR the funds in the Trust (if not revocable) may be on the hook to pay for her nursing home care until which time she has spent down to the state's asset limit (different that the prior State).

Have the attorney review any paper work, do NOT sign anything in the nursing home contract w/o the lawyer reviewing as there often is trick language, to trick you into signing that you personally agree to be financially responsible OR to "take custody of the person" if Medicaid is NOT approved; DO NOT SIGN/AGREE TO ANY OF these trick questions that you are responsible provisions in the paperwork as it is a contract and there is no do over.

So sorry this is all so complex and you did not have proper information. Not sure if there is any recourse for the lacking or bad prior legal advice? Was the former attorney an "elder care attorney?"

A long while ago, my mother had a legal issue and "hired" my cousin who had just graduated from law school. Yes, he was a lawyer and passed the bar; but he had no real experience in a real estate matter my mom had at the time. All to say all lawyers are NOT all equally qualified or competent. But you are sadly also having to navigate two State legal systems, so what was done in the first State may be something that does not work in the new State.

Good luck with this and hope this can be unraveled.

Stop using your funds to pay your mother's expenses.

Also, folks, I really appreciate the helpful answers and moral support. Thank YOU!!

They are your mom's bills and not your obligation. How many months is she denied because of the trust? You should be informed about the number of months.
Is that money recoverable from the new owner of the trust? She signed away money that protects us taxpayers from paying for her. Did an attorney set up the trust with bad advice?
Last, once on an Advantage plan, there is no turning back. Make sure you know about this when you enroll.She might be able to switch if she moves to another state and you check on this. But wait, she cannot private pay.

DO NOT SIGN anything without the advice of an Elder Law attorney.

I think at this point you need to talk to an elder lawyer. You cannot be held responsible for your Moms debts.

Was she admitted to the LTCF "Medicaid pending"? If so, the Medicaid will pay starting from the date of the application.

What sort of lawyer set up the trust? Did s/he know that mom was concerned about Medicaid eligibility? I don't know about NC, but here in NY, it would have needed to be an irrevocable trust.