It is up to each state to develop and disseminate information to help the public understand the rationale and necessity for Medicaid estate recovery, as well as the rights of both the State and the recipient. See entries in column 4.

Good choices in estate planning require a clear and accurate understanding of the various options for financing long-term care services, including qualifying for Medicaid and accepting -- or avoiding -- the consequences of Medicaid estate recovery.42 However, if a better understanding of Medicaid rules results in more people sheltering more assets and increased dependence on this taxpayer-funded program, then Medicaid -- a perennial and major budget concern for state and Federal governments -- will inevitably pay an ever increasing share of the nation’s long-term care costs. Specific Federal guidance is provided on recoveries when recipients are enrolled in capitated plans where Medicaid spending is not directly tied to the cost of services provided.

The trust can be set up to allow you to live in the home for the remainder of your life while also enjoying the associated tax deductions. States are advised to tell applicants about the potential for Medicaid estate recovery during the eligibility determination process.

Long-term care insurance is relatively new and still evolving.

Mortgages, unpaid tax or public utility bills, child support arrears, burial costs, or other debts may be paid before the Medicaid lien and reduce the amount that is actually recovered. States may use the narrow Federal definition of “estate” and limit Medicaid estate recoveries to only those assets that pass through probate. 41: 34-42 for a discussion of the factors that influence estate-planning behavior. What Is Legacy Planning and Why Is It Important?

No matter whether the resources are countable or not, once the state finds out there is a surviving spouse it will not pursue estate recovery. What Are The Legal Requirements of a Will? If the long-term care Medicaid recipient received benefits after age 55 and had surviving children under 21, the state will not pursue a claim. For example, see Roger, Schwartz, and Sabatino (November 1994); or Wilcox, M.D.

Fossett, J.W. When home equity becomes part of the estate, it is subject to Medicaid estate recovery.

Explanations for variations between surveys are speculative. For an overview of the program, see http://www.hhp.umd.edu/AGING/PLTC/partnership_post.pdf. McCall, N. and Korb, J. Federal guidelines suggest two specific kinds of property for the hardship exception: homesteads of modest value and income-producing property, such as farms or family businesses that are essential to the support of surviving family members.

Surviving spouse. We recommend you consult a lawyer or other appropriate professional if you want legal, business or tax advice. Before family members even finish grieving, one of them receives a letter from the Medicaid estate recovery program (MERP) requesting repayment of every dime the state shelled out for the senior’s care.

Not surprisingly, a web search on “Medicaid estate planning” yields thousands of results offering advice on a variety of strategies to qualify for Medicaid while preserving assets and savings for heirs. 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.

(August 1995).

(2001). An irrevocable trust can protect your assets against Medicaid Estate Recovery. However, when they die, the government may try to recover what it spent through Medicaid estate recovery. (1986). State practices are reported in Schwartz and Sabatino (November 1994); Sabatino and Wood (September 1996), Table 9; and North Carolina Department of Health and Human Services (1998) State Medicaid estate recovery programs.

For details, see http://www.hhp.umd.edu/AGING/PLTC/partnership_post.pdf. Post-death liens prevent the estate from being settled and the property distributed to the recipient’s heirs before all claims against it, including Medicaid’s, are satisfied. Much of the original enthusiasm for mandatory estate recovery was based on the results in Oregon, where estate recovery was implemented in the 1940s as part of a comprehensive program to help senior citizens keep enough money to meet their own needs and protect their assets from unscrupulous uses by others.8 An extraordinary jump in Medicaid savings was predicted if all states were to follow the Oregon model.9 A more recent study estimates that one state (Nebraska) could increase Medicaid savings fivefold if it adopted all of Oregon’s estate recovery practices.10 However, it is clear that the much-vaunted savings have not become a reality. For this reason, implementing Medicaid rules against a background of non-Medicaid law carries the potential for lack of legal clarity, competing claims to property of deceased Medicaid beneficiaries, and inconsistent outcomes.16 Despite such legal and practical obstacles to fully implementing an estate recovery program that uses the broad definition of “estate,” it is clear that states could increase Medicaid recoveries, possibly by substantial amounts, by collecting from assets that individuals could otherwise shelter from recovery (i.e., by shifting them out of the future probate estate into a form outside the State’s Medicaid recovery orbit). The option to disregard assets from eligibility is based on section 1902(r)(2) of the Social Security Act. Things You Can and Can’t Do With Power of Attorney, lawyers and they also do not provide legal, business or tax advice. Through this program, the government may force your home to be sold so that it can recoup some of its money.

Ohio Department of Human Services, accessible at: http://jfs.ohio.gov/ohp/bltcf/reports/er/ER_D.pdf. Partnership Insurance: An Innovation to Meet Long-Term Care Financing needs in an Era of Federal Minimalism.

This avoidable decline in health status may lead to higher medical costs later on.40.

For many seniors, Medicaid provides them with the life-saving nursing home and in-home nursing care they need to live comfortable, dignified lives.

During the lifetime of the surviving spouse (no matter where he or she lives). They are most affordable for younger, healthier people whose long-term care expenses are typically many years in the future.33. Sabatino, C.P. http://www.flsenate.gov/Statutes/index.cfm?Mode=Constitution&Submenu=3&T... http://www.dhhs.state.nc.us/aging/estate.htm, http://www.longtermcarelink.net/reference/ref_medicaid_recovery.html, http://www.hhp.umd.edu/AGING/PLTC/index.html, http://www.hhp.umd.edu/AGING/PLTC/partnership_post.pdf, http://www.hhp.umd.edu/AGING/PLTC/chapter8.pdf, http://www.cms.hhs.gov/medicaid/eligibility/elig0501.pdf, http://www.hhp.umd.edu/AGING/PLTC/Partnership.pdf, http://rockinst.org/publications/federalism/medicaid_managed_care/MedicaidandStateBudgets2004.pdf, http://jfs.ohio.gov/ohp/bltcf/reports/er/ER_D.pdf, http://www.ago.state.co.us/PRESREL/presrl2003/prsrl98.htm, http://aspe.hhs.gov/daltcp/reports/estaterec.htm, http://aspe.hhs.gov/daltcp/reports/estreccol.htm, http://aspe.hhs.gov/daltcp/reports/liens.htm, http://aspe.hhs.gov/daltcp/reports/MAliens.htm, http://aspe.hhs.gov/daltcp/reports/hometreat.htm, http://aspe.hhs.gov/daltcp/reports/spouses.htm, download the latest version of the