Medicare wants huge money. I have no idea how to deal with this issue and would really appreciate some advice.
My mom had a $10K Insurance policy in which I was the beneficiary. She was on Medicare and Medicaid and in a non profit nursing home. There were no charges as my mother was a charity case with only social security and no assets. I received no bills from Medicare during her last months (11 months) in the nursing home. When she was home, a large portion of her SS went to Medicaid/Medicare for her at home services. Now I received a letter from Medicare addressed to her “estate” asking for $17,600. She was in New York City. There is no “estate.” The money was used for her final internment and bills I incurred on her behalf in the years I was the sole caregiver for her. I live in CT. The bills are so high I’m still paying them and she passed 4 months ago.
I have no idea how to deal with Medicare on this issue and would really appreciate some advice.
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The first letter was a NOI - Notice of Intent to file a claim or lien against the estate unless there are exemptions, exclusions or other situations that take it into not cost-effective (to persue). It has a very specific & narrow timeframe in which to respond and return the questionnaire along with supporting documentation. If none sent, then MERP assumes amt is valid & lien claim can be placed on her estate.
Mom was on Medicaid for her at home care prior to the NH, right? That’s probably what the 17k is from. Any Medicaid paid for services - not just NH/LTC stay- can be included for a recoup. 17k is pretty modest amount to owe for care; if mom was almost a full year in a NH, the amount would be more like 100k.
If moms “estate” left no assets, then no recovery. Response to the NOI would let that be known and with documentation to support. Like you include mom last months alive bank statement that show what the balance was on month of death; her life insurance policy that clearly reads you are designated beneficiary.
I’d double check the life insurance policy to make sure that it was you as sole designated beneficiary and it’s not an asset of her estate with you as named director.
So your paying your moms debts? Even though she has died, you are paying them? If she died without assets, any debt -if they were solely hers- would be a debt of her estate and died with her. Why are you personally paying. off?
I am the sole beneficiary with no other instruction.
The bills I’m left with are in my name as my mom couldn’t get credit after my father died 4 yrs ago. Clothes, electric bills, groceries, telephones, hearing aides...the list of things I spent money on consistently is endless and it went on for years. The $10K Insurance policy, after her final plans, left little for me to pay my bills. So now before I deal with them I want my ducks in a row.
My understanding is that IF you personally were the designated beneficiary to her life insurance policy then the $ is yours & the check issued should be in your name only & you get a tax follow up on it in your name too. There are heirs who get the life insurance $ and as far as they are concerned the $ is theirs and too bad if there are debts of the deceased.
Hmmmm. It’s from CMS.... ok so maybe it’d due to Medicare being able to recoup due to “Secondary Payor Act”. Someone else posted last week on AC on similar - they got a letter from CMS regarding recovery of payments received by the now deceased individual (his granddaughter actually as she was dpoa) for MVA settlement.
Or NYC has CMS as recovery for those who are duals.
So do you mind sharing if there is a questionnaire, how ?s read? Folks will have suggestions how to answer if so. Are you still within response time frame? If so, how much time before cutoff? You need to find her last couple of bank statements, life insurance policy and funeral / burial costs receipts too. For MERP if Estate less than 3k or value of estate under 10k, it’s my understanding that it’s considered not cost effective for recovery. But you have to provide documentation or open probate.
Each state determines how their Medicaid program is to be administered under overall federal guidelines. My experience is that the insurance policy must be included in the documents turned in and the amount of the policy is limited. Those that have any ability for cash value have to be cashed out with the funds spent down.