Expanded Medicaid’s fine print holds surprise: ‘payback’ from estate after death

Well yet another surprise from at least one State's new "expanded" Medicaid program.

It appears that Washington State can go after your estate for medical expenses after you die.

The story says this may not be something "new" and may be part of some existing law or Federal laws ?

Confusing. And Washington State officials are reportedly scrambling to see if this can be changed.

And the story also points out that the people "helping" with sign ups and enrollments are not aware of this outrage.

Unreal.

It seems we hear new surprises dang near every day.

As thousands of state residents enroll in Washington’s expanded Medicaid program, many will be surprised at fine print: After you’re dead, your estate can be billed for ordinary health-care expenses. State officials are scrambling to change the rule

It wasn’t the moonlight, holiday-season euphoria or family pressure that made Sofia Prins and Gary Balhorn, both 62, suddenly decide to get married.

It was the fine print....

She was shocked: If you’re 55 or over, Medicaid can come back after you’re dead and bill your estate for ordinary health-care expenses.

The way Prins saw it, that meant health insurance via Medicaid is hardly “free” for Washington residents 55 or older.

Expanded Medicaid’s fine print holds surprise: ‘payback’ from estate after death

As Prins began searching for answers, she found that even those trained to help people sign up for insurance under the ACA weren’t aware of this provision, nor were some government officials.

“People will think this is wonderful, this is free insurance,” Orient said in an interview. “They don’t realize it’s really a loan, and is secured by any property they have.”

Even states that are now limiting estate recovery, she warned, can change the rules again if budget problems become more intense.

Hmmm

reply to post by xuenchen


Oh that's rich... Wow... Just unbelievable. They are determined to destroy wealth from anyone below TRUE wealthy levels within a generation or two at this rate. This will take care of the back end very effectively.

Lets see.... As part of Obamacare, the Medi- programs are, in most states, being radically expanded. They catch everyone who doesn't fall into the exchanges, Military Tri-Care or other similar coverage. So, essentially the Middle Class and below as primary targets to be hit and pushed into that level of care.

....seemingly unrelated... we see now that those who use the Medi- programs may well see anything left to pass on to children, taken in paying back expenses? Bad enough as that has existed to some degree in normal times. With Med- Programs in dramatic expansion??

...........So... This is not Government supplied, taxpayer funded medical care? It's simply deferred cost unless you have absolutely nothing left to take??

The rich are the only ones who won't be touched by this, since you won't see Daddy Warbucks standing in line at the local Medicare/Medicaid offices to apply any time soon. Damn...the idea of Middle Class inheritance could die in major ways here though.

I hurt myself today
to see if I still feel
I focus on the pain
the only thing that's real
the needle tears a hole
the old familiar sting
try to kill it all away
but I remember everything
what have I become?
my sweetest friend
everyone I know
goes away in the end
and you could have it all
my empire of dirt

I will let you down
I will make you hurt

I wear this crown of thorns
upon my liar's chair
full of broken thoughts
I cannot repair
beneath the stains of time
the feelings disappear
you are someone else
I am still right here

what have I become?
my sweetest friend
everyone I know
goes away in the end
and you could have it all
my empire of dirt

I will let you down
I will make you hurt

if I could start again
a million miles away
I would keep myself
I would find a way

This has zero to do with Obamacare and everything to do with the State of Washington Medicaid system and has since at least 2005.

Mods, I know this is a lot of text but it is the whole picture.

greinerlaw.com...

Second, you need to provide enough assets for the security of yourself and your loved ones because they too may have a similar health or financial crisis. Some people may want to leave assets to their children. A long term illness can seriously jeopardize such desires.

[snip]

To qualify for Medicaid, applicants must pass some fairly strict tests of the amount of asset they can keep. Any asset which a person is not allowed to keep must be liquidated and the money used to pay the cost of care.

To understand how Medicaid works, we first need to review what are known as ‘exempt’ assets or assets which the applicant gets to keep. Exempt assets are those which Medicaid will not take into account (at least for the time being). In general, the following are the primary exempt assets:
In order for the State and federal government to pay the cost of Long Term Care, a husband and wife can keep the following assets: i. A primary residence, consisting of a house or mobile home but the equity in that residence cannot be more than $500,000. ii. All of the personal furniture, furnishings and belongings in the residence. iii. A car of unlimited value if used for primary transportation. iv. $42,000 worth of ‘other property’, which may include real estate or investments or bank deposits. v. Small Life Insurance Policies if dedicated for burial vi. Certain Qualified Annuities. vii. Assets which have been shifted into Safe Harbor Trusts

A single person is allowed to keep only a maximum $2000 worth of assets, the Safe Harbor Trust accumulation, and a small insurance policy which has been pre-arranged to pay
burial costs: no house, car, investments or annuities are allowed.

This is why the couple decided to get married instead of remain single which is what this article was about. The rules are very unfair to a single person. Better to have a spouse d keep a large amount of assets than to be single and keep $2,000.00 worth of assets in the US.

reply to post by StoutBroux


Very good point.

But the problem is that people have been led to believe the new Medicaid expansions would allow people to have "access to" insurance in that form (the form of Medicaid as opposed to a regular paid for policy).

The fact remains that nobody was told these details about the "spend down" and possible estate attachments.

With Jan 1, 2014 right around the corner, it seems these "details" have been suppressed until the final hours of decision making by people.

This should have been announced 2 or 3 years ago, not now.

This undoubtedly will shy many people away from the system entirely.

The original "Intentions" have been knifed away already.

reply to post by xuenchen


Simple...sign every asset, every dollar and every brick of property you own over to your kids NOW.

They can't steal what isn't yours to lose.

Found this from 1993

aspe.hhs.gov...

Highlights of the 1993 Estate Recovery Mandate:

States must pursue recovering costs for medical assistance consisting of:
•Nursing home or other long-term institutional services;
•Home- and community-based services;
•Hospital and prescription drug services provided while the recipient was receiving nursing facility or home- and community-based services; and
•At State option, any other items covered by the Medicaid State Plan.

At a minimum, states must recover from assets that pass through probate (which is governed by state law). At a maximum, states may recover any assets of the deceased recipient.

WHOSE ESTATES ARE SUBJECT TO RECOVERY?

Recoveries may only be made from the estates of deceased recipients who were 55 or older when they received Medicaid benefits or who, regardless of age, were permanently institutionalized. However, states may exempt recipients if their only Medicaid benefit is payment of Medicare cost sharing (i.e., Medicare Part B premiums).

If a state has elected to impose TEFRA liens12 on recipients’ homes, then it must also recover from the estates of those recipients. States may impose liens on property of Medicaid recipients of any age if they are permanent residents of a nursing home or other medical institution, and if they are expected to pay a share of the cost of institutional care.

reply to post by xuenchen


I usually agree with you and S&F most of your stuff and I appreciate all you do to keep people informed of the ills of Obamacare. This hasn't been hidden nor is it part of Obamacare. Denying of ignorance is all encompassing and should replace the rose colored glasses and partisan spectacles.

reply to post by MysterX

At least in the US, don't forget about the Gift Tax. And if you give it to your kids, here's hoping they don't just sell it all and leave you homeless and penniless.

reply to post by MysterX

true, the important thing to remember is to forget writing a will. It goes through probate and can be seized when the will is probated. With a life estate, you can give your property to your children and it does not go through probate.

Its simple......the system will get EVERYTHING in the end......
Ya cant take it wit you......

grumpydaysleeper
reply to post by MysterX

 

true, the important thing to remember is to forget writing a will. It goes through probate and can be seized when the will is probated. With a life estate, you can give your property to your children and it does not go through probate.

That's a good idea.

Other names are "Living Trust" and maybe "Beneficial Interest".

Typically, your estate, is liable for all expenses you incurred while you were living. If you owe money on a car, it will be repossessed. You have equity in your house and die, the hospital may put a lien on it to recoup what they are owed.

There ain't no free lunch (for your heirs) just because you die!

MysterX
reply to post by xuenchen

 

Simple...sign every asset, every dollar and every brick of property you own over to your kids NOW.

They can't steal what isn't yours to lose.

Missouri does this.

In Missouri, you have to make sure that your assets have been held by your children or others for three years prior to any benefits claim in order for the state to not be able to make a claim on you after your death.

reply to post by xuenchen


this is nation wide I believe ..

A friend has family in Idaho that has to pay back as well... I'm dead serious

they've been married for 40+years....

reply to post by Komodo

It didn't used to be. Some states did and some states didn't. It depended on them.

ketsuko
reply to post by Komodo

 

It didn't used to be. Some states did and some states didn't. It depended on them.

yes....

gonna be a interesting ride to say the least

reply to post by ketsuko


Missouri also allows your property and assets to be held in Family trust for those named. *IF* it's that way, the court stamps it and off you go. What is in trust is beyond the scope of probate or other direct process to take.

Unfortunately, my recent experience with Missouri Probate court was learning that for how it should have happened. Let's just say the directions for number of signatures and manner of witness really matters ...and there is no will, let alone a trust, if that part is messed up in any way.

reply to post by StoutBroux


Agreed and this is nothing new, and not localized to any one state. Most states have this provision.

The sooner people realize that *nothing* is free, the better off they are.

The sooner people realize that Medicare is *required* by age 65, the better off people will be.

I have had this discussion in multiple other threads, about personal responsibility, wills, and the like. This has come up in discussion about gay rights. They don't understand it works the same way, straight or gay. Get your things straight, before you die, before your assets are compromised.

My parents (divorced) both asked all the kids what they wanted from their estates, and my mother wrote us all a check dividing the estate funds evenly. This was 5 or so years before she died.

My father and mother both, realizing their advancing age, sold everything except their most personal assets, clothing, etc., so there was nothing left for the government to take.

In order to do this, this is why a lot of parents end up living with their children. They can give them money to help pay for their care, food, etc., from their Social Security benefits. The rest will usually go for their medication and health care, and possibly then some. Medicare only covers 80%, the remaining 20% is out of pocket or you have to buy a supplemental policy.

Medicaid, on the other hand, you must be nearly destitute in the first place to qualify for it. No income, on welfare and food stamps, etc. Medicaid works on a sliding scale, and co-pays are usually in the 1-10 dollar range. Co-pays for meds are about the same. With Medicaid, you cannot have assets, you are required to sell off everything, or have already reached that point by the time you apply.

So much knee jerk reaction, when really, it all comes down to lack of knowledge.

Most people figure it out when the government signs them up for Medicare. From there, they realize what they need to do. The rest, young folks, sit in amazement at their keyboards, not understanding why nothing in this world is really free.

reply to post by stirling

Then there is the death tax. Lol.