Medicaid choice results in loss of mother’s home

Dear Toni: I’m an elder care attorney and have a client, Joshua, who just received a bill for his mother’s long-term care paid by Medicaid in Texas. His 88-year-old mother’s care was provided at her house instead of a nursing home during the last few years of her life. No one informed him that the state was running a tab of all health care expenses that Medicaid paid and wanted to be reimbursed after his mother died.

Medicaid says the $65,000 medical bill must be paid in full. Joshua recently received a document from the MERP (Medicaid Estate Recovery Program) saying that Medicaid wants the money and is filing a lien against the house that his mother owned, which Joshua now lives in.

Americans need to be aware of their state-specific Medicaid’s rules when receiving “extra” health care. — Chuck

Dear Chuck: Everyone should learn about the MERP for their specific state by visiting medicaid.gov. The website says “State Medicaid programs are required to recover certain Medicaid benefits paid on behalf of a Medicaid enrollee. For individuals age 55 or older, states are required to seek recovery of payments from the individual’s estate for nursing facility services, home and community-based services, and related hospital and prescription drug services.”

Adult children are often shocked to discover their state has taken a lien on their parents’ house because of long-term health care costs that the state paid.

All claims against an estate, including MERP claims, must be paid before the property can be distributed as specified in a will. The state does not, however, require an heir to sell the deceased recipient’s homestead if the claim can be paid by other funds. But if not, the heir may have to sell the house or the state will file a lien against it, as in Joshua’s case.

The letter sent to the enrollee’s estate says that the amount recovered by Medicaid will not exceed the value of the estate’s assets, if any. If there is no money or assets in the estate, then there is nothing to recover.

My advice to readers whose loved one is receiving Medicaid benefits would be to explore your options and work out a schedule with family members to take care of your loved one. This way you can protect all that they have worked so hard to accumulate.

Toni’s advice

■ Seek the advice of an elder care attorney who can assist with proper Medicaid planning for your specific state.

■ Do not rely on advice from well-meaning friends who are not experts in Medicare and Medicaid.

Traditional long-term care insurance plans offer more flexibility and options than Medicaid. Medicaid long-term care is available for those living on a limited income.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.