Do you know Medicade, Long Term Care, will take all you have?

[Miigwech]

OK. You are really ill and need long term care because your loved ones can't take care of you at home any more. The Laws steps in and takes over all of your assets to pay for your care ... in fact, if you have too many assets you will be denied. IS THIS REALLY HOW WE WANT TO TREAT OUR SICK OR ELDERLY?

[BigmanPigman]

1. Yes, I did know that.

Have seen it too. I tried to tell others but they blew me off like, "That won't happen to me" or "If this were true I would already know about it". Oh well, I warned them.

[Miigwech]

6. Folks need to listen.

[Igel]

2. Yes.

More in some states than in others.

Back in the '80s a friend's mother was basically told that she could go into a nursing home at state expense, but in the end they'd come for her resources to the extent necessary to cover her care. She objected, but her sons couldn't take care of her. They didn't want her to move in--it would be disruptive. They didn't want to sell her assets and hire somebody to help. No, they wanted the state to take care of her, socializing the costs and keeping the profits private. So to speak.

She was in a home that would have cost over $20k for over 10 years, and lost her $60k house. Her sons were irate that the care wasn't free and they wouldn't inherit anything as a result.

It makes sense. You become a ward of the state, you forfeit your assets.

[Doremus]

18. Some people can't be caregivers for any number of good reasons including work commitments,

lack of transportation, lack of temperament. Some people have no family to be caregivers.

No, it isn't right that the state can seize someone's assets because they had to avail themselves of a social safety net. I'm old enough to remember a time when the government did NOT take advantage of someone's ill fortune and allowed their estate to transfer to whomever was supposed to receive it. I also remember a time when ambulance rides were included in our taxes and not billed separately for $800 and up.

Of course, that was before 40 years of rethug rule turned the country into a money and power hungry dystopia. Apparently you've been assimilated.

[Trailrider1951]

20. Amen, Doremus

At 67, I remember a time in this country when we had affordable health care, before it was corporatized, beginning in the Nixon Administration. See this: https://en.wikisource.org/wiki/Transcript_of_taped_conversation_between_President_Richard_Nixon_and_John_D._Ehrlichman_%281971%29_that_led_to_the_HMO_act_of_1973:

With the sale of my last real estate holding, a house in Texas, I have now no assets, except for my retirement savings and my little mobile home on rented land. I still have my health and mobility. When the time comes, I intend to spare my children of the burden to care for me, and retain my dignity by taking matters into my own hands. I never thought it would come to this.

[CountAllVotes]

77. Retirement accts.

You may want to check into the status of your retirement account(s).

I have an IRA and it is bankruptcy protected as are many other retirement accounts.

Please check into this (or maybe you know already).

Best of luck and yes, many, myself included, are right there with you.

It is a sad and disgusting state of affairs to think that a person that works their entire life ends up having to get rid of all they have (well just about that is) in order to qualify for Medicaid.

[pnwmom]

38. But there is no reason that a person with plenty of assets

should go onto Medicaid, as an indigent, so their heirs can inherit more.

I am glad there is a safety net for people who have run out of assets and need to pay for nursing home care. But I don't think that people with assets should be able to hand them over to their heirs, and make the rest of us pay for their nursing home care.

[Doremus]

98. "Make the rest of us pay for their nursing home care."

Honestly this sounds like a RW talking point. Sorry if that offends you but frankly I'm offended that such a cold hearted sentiment normally found in Repuke101 is expressed so cavalierly in a discussion among Democrats.

First let's just make it clear that the wealthy, or people with "plenty of assets" as you say, for the most part do not send their elderly family to nursing homes. That's for the unwashed masses like most of us. If the estate is large, there is sufficient capital to hire in-home round the clock medical care for their loved one until their demise. This is the gold standard of elderly care.

The rest of us have to rely on family to do what they can with whatever meager income/cash we might have. Sometimes care is provided in a nursing home, sometimes there is a family member able and suited to the chore of providing the care at home.

There was a time when government didn't shove its hands into dead folks' estates. Society didn't think it proper to send bills to unfortunate people who needed to avail themselves of emergency rescue squads, etc. Why? Because most people worked their entire lives, paying into the tax base in multiple channels over many decades all along the way. Should they be stripped of the few things they were able to accumulate during their lives? I think it's beyond heartless. Non-wealthy people demanding it are probably suffering from Stockholm Syndrome, imo.

The recent $2 trillion tax cut to American billionaires was more than the entire Medicaid budget. Give that a thought and then tell me why that guy down the street who died shouldn't be able to give his kids the house he worked his whole life to have.

[shanti]

73. She should have

signed her house over to her kids when she had the opportunity.

My mother has a modest mobile home, but it is jointly owned by all three of us kids, same as her bank account. She did this years ago. She also purchased LTC (through my own job!) for herself that would cover someone coming in to care for her at home, as she was adamant about not going into a nursing home when the time came. Well, she has dementia now at 87, and we are using the LTC program. We are hoping that it will be enough. For now, she has someone coming in twice a week for a few hours. However, if she were to need fulltime care, the funds wouldn't last that long. We really have no idea what we'd do if they were used up. Nursing home care costs about $35,000 a year and up!

I might be wrong, but thought I had read that Medicare was to be revamped about 2020 to where they would cover in home care too. With all of the Boomers getting older, this is getting to be a huge issue.

[NightWatcher]

3. Which is why you transfer everything out of that person's name first.

I've had multiple relatives have to do this very same plan.

Why wait till you're damned near dead, I've a plan in place to do similar if I should ever have a nasty relapse like I did 6 years ago. There's no way I'd saddle my wife and child with my burden.

[BigmanPigman]

8. You have to do it in increments so plan ahead

and keep up to date on current laws, especially with taxes.

[pnwmom]

39. Some people do that. Our family did not make that choice when a relative

needed nursing home care. She paid for her own care at a nursing home till she ran out of the money from the sale of her house, and then Medicaid took over till her death.

Her heirs were left with nothing, and didn't expect otherwise. They never suggested she hand her assets over to them. The important thing was that their loved one had good care, and she did.

[Laura PourMeADrink]

52. That is true, but then you also have people who want

To leave their heirs what they worked so hard all their lives for. I have heard my mom say a zillion times, "we don't want the government to get it."

[Drahthaardogs]

54. If you want to leave an estate, you buy Long Term insurance

I purchased a plan when I was 30. It will basically pay for 5 years of nursing home care. That should give my wife plenty of time to work things out. I also hope I will die within those 5 years.

[Laura PourMeADrink]

59. Ya, think I read that the average stay in a nursing home is 18 mo.

You obviously are an astute financial planner - buying when premiums low. I think the vast majority of people have no clue until they have to deal with it for parents. I bet if you polled people they don't even know that Medicare doesn't just pay for it all. Then the point comes and they are shocked.

[pnwmom]

62. There used to be an estate tax that could take quite a bite, even if all you owned

was a house in a major city that had appreciated over the decades. But that's not the case anymore, unless you have assets in the tens of millions.

But paying for nursing home care is like paying any other bill over the course of your life. It's not going to the government.

[yellowdogintexas]

89. Estate taxes vary widely from state to state

the federal estate/inheritance taxes don't kick in unless your assets exceed a significant amount of money More than most of us will ever have

State taxes are another whole ball game

[pnwmom]

94. True. But nursing home bills are not taxes, they're a combination of living costs and personal care.

And people with assets shouldn't expect taxpayers to take care of their nursing home bills until they've run through their assets.

[Flaleftist]

66. You might want to check on the specifics of the law.

I recall reading that the assets must be transferred X amount of time before the individual is placed in care (I think it might be as much as 2 years). So if you sell/transfer ownership of your house or other assets a month before, they can still come after the assets.

[kskiska]

97. I know someone who did that.

When his father had to move into a home they asked him why his father had no assets. Nick told them his father went to the track every day.

[SWBTATTReg]

4. Yes, and this is a very sad thing. I wasn't aware that they took all of the assets. Don't they ...

leave some e.g., exempt a certain amount of money, $5000 or so? And perhaps differs on a per state by state basis too?

[pnwmom]

40. Each state has its own rules for Medicaid. nt

[highplainsdem]

46. I think that sometimes if an heir was a caregiver who kept the patient from needing Medicaid for a

while, they might be entitled to keep at least part of an inheritance, but I'm not sure exactly how the rules work or if it varies state to state.

[exboyfil]

57. You can set up a funeral trust

That is what I did with my grandma when she went into Medicaid. I only had a couple of days to pull it off, and it actually worked pretty well (no guarantee on it since I picked a funeral home in my grandma's hometown out of the phone book).

The trust was active for ten years. They covered everything they promised.

[SWBTATTReg]

71. Thank you. Good suggestion! I'll definitely look into, and see what rules the state of MO has ...

on such things, if any.

[yellowdogintexas]

91. This is Oklahoma's setup.

If you put someone in a nursing home or other facility, there is a limited amount which will be covered by Medicare. Then you use up all your residual available assets. Then you sell your house and anything else you want or need to sell and use that up. When you use that, and are down to just your social security check, you can get on Medicaid. The facility will start the application process ahead of time so the approval for Medicaid is seamless with the end of benefits. SOmetimes the facility has its own real estate agent who specializes in marketing these homes.

Your personal possessions, such as jewelry, furniture, and other items are not included I have several valuable items which came to me from my aunt which were not part of the Medicaid settlement.

Medicaid covers Nursing Home care, and pays the Part B Medicare premiums and deductible. After deductible is met, Medicaid pays the co insurance.

When Medicaid is set up, the patient is allowed a cash allottment from his/her Social Security benefit which is used for personal expenses at the nursing home like hair cuts, new clothes, snack foods, etc. This can be allowed to accumulate.

Transferred assets to family members must take place 5 or more years prior to application for Medicaid. Assets can be protected in a variety of ways, such as transferring the deed to your home to your child/children, or gifting funds to children, etc. Trusts are also exempt if established within the state's guidlines.

So Medicaid does not swoop in and take everything but you do have to divest yourself before Medicaid can be approved. I learned that KY and OK were very similar.

[Hoyt]

5. Been that way for decades. In most states, you can keep your home

if there is a reasonable chance you can return home. But, most states will take it when you pass.

While it’s ugly, I’m not sure someone with assets should keep them — for heirs —at expense of other needy citizens when the end is near, or at the expense of education, welfare, healthcare for others, etc.

One can buy long-term care insurance, but it’s expensive.

Another reason I’m for euthanasia.

[erronis]

117. Amen. However the term "euthanasia" has been tinged inappropriately. (I hate word police!)

A quick look got me this concise definition of Active, Passive, Voluntary, Involuntary, and Assisted Suicide.
http://www.bbc.co.uk/ethics/euthanasia/overview/forms.shtml

We need the ability to take ourselves out to the woods and be gone without fanfare or brouhaha.

A couple of good articles:
https://www.washingtonpost.com/local/social-issues/at-94-she-was-ready-to-die-by-fasting-her-daughter-filmed-it/2019/11/03/41688230-fcd9-11e9-8190-6be4deb56e01_story.html

https://compassionandchoices.org/end-of-life-planning/learn/vsed/

[Hoyt]

118. +1. "We need ability to take ourselves out of the woods . . . .without fanfare."

Excellent way to put it.

To me it would lessen fear of cancer or similar diseases, and especially having family to have to go through all that. (I’m old enough that people won’t say, “He died so young.” Might have something to do with way I feel.)

Will read articles when I can. Thanks.

[Raftergirl]

7. Thats not completely correct.

Medicaid does not take over paying for one’s care until you have spent down all your assets.

What they can do is claw back funds, for instance from the sale of a home, to repay what they have paid out for one)s care.

But, they cannot count one’s home if a spouse is still residing in it.

As soon as my in-laws go through all their money at the $26k/month skilled nursing home, they will go on Medicaid. Once we sell their home (they haven’t let us yet so likely won’t happen until they die,) Medicaid will claw back the amount of money they paid to the nursing home from the sale of their home.

[Frustratedlady]

14. Surely not $26K/monrh? Good grief!

I have recently been in Skilled Nursing as well as the nursing home section and it was $6.5K/month. I thought that was bad enough.

The nursing home I was in has 70% of their residents on Medicaid. The rest of us were paying full price. Once they have exhausted their savings and sold their property, the home gets their SS payments of which the residents can keep $50/month.

That nursing home has closed one wing and is refusing to take Medicaid residents.

[pnwmom]

33. That's for 2 people. It's not unusual to cost more than $100K a year. nt

[Frustratedlady]

50. Oh, my goodness. I thought $78K/year was bad enough.

At that rate, it wouldn't take long to wipe out an estate.

[Blue_true]

110. Having a live in practical nurse would be cheaper than $100,000 per year. nt

[Blue_true]

109. $100k for two people or one? I am guessing one.

Here where I live in Florida, it tops out at $60,000 per year per person. In some parts of the country, it is considerably more expensive.

There is a reason why old people come to parts of Florida. Some are fleeing Florida for Central America, where quality managed care is much less expensive.

[pnwmom]

119. Average of $100K a year for one.

Higher in some parts of the country. Semi-private a little less.

On average beneficiaries in the United States can expect costs to average:

Room Type
Daily Monthly Annually

Semi-Private Room
$245 $7,441 $89,297

Private Room
$275 $8,365 $100,375

https://www.seniorliving.org/nursing-homes/costs/#:~:targetText=With%20the%20average%20annual%20costs,cost%20of%20assisted%20living%20options.

[Blue_true]

120. Those are big numbers. nt

[Raftergirl]

34. Yep.

The $26k is the cost for two people in a Memory Care unit. It was only $8k a month when they were in Assisted Living.

It’s pretty unusual to have both parents in their 90’s still living and both needing skilled nursing care, but it is what it is.

[Blue_true]

111. What is the difference between "memory care" and assisted living?

Also, generally, what part of the country do you live in?

Where I live, $312,000 would pay for a highly skilled live in nurse.

[Raftergirl]

127. Upstate NY

We tried the live ins but they kept firing them. Then they went into assisted living but demanded they be brought home. Tried the live ins again and they fired them again.

Then there were falls every other week and several hospitalizations and we convinced them to try another assisted living place. But MIL needed more care because of her dementia so we moved her into the memory care unit after she fell in the middle of the night, broke her arm and needed surgery. But my FIL freaked out from being alone (there were calls to his kids, cousin’s kids, even acquaintances at all hours of the day and night.) He is pretty much blind so we had gotten him Alexa, but we had to take it away because of the calls. Then it was decided to move him into the memory care unit with MIL. He is 94 with a lot of medical issues - just not dementia - so higher level of care needed anyway.

[Blue_true]

129. Thanks.

Earlier today I met an 82 year old man and his wife. Seemed like decent people that had a refreshing perspective on life and aging. 94 years old is truly a long life, I hope that you and members of your family are taking any free time that you have to listen to stories about their life while the FIL still remember them. For a person that has been with another person for so long, it is understandable that your FIL would freak out with your MIL not around him constantly. Even if they met in his early forties, they should be beyond a golden anniversary, that is special.

[Raftergirl]

131. They've been married

71 years!

We know everyone’s story going back from before their parents immigrated here.

My mom is 90 but fit as a fiddle. Even has a 76 yr old boyfriend. She has stayed really active - unlike my in-laws, who after my FIL retired when he was still in his 50’s - sat down on their sofa and never got up again. They really atrophied. Their world became very, very small.

[highplainsdem]

44. It isn't unusual for memory care to cost $100,000/year or more.

[Blue_true]

113. What is the difference between "memory care" and other care? nt

[highplainsdem]

114. Alzheimer's units require more assistance, plus more security.

[Blue_true]

116. Thanks. nt

[Blue_true]

108. Managed elder care here in my part of Florida starts at $1600 per person per month and

Go up to around $5,000 per person per month. $26,000 per month sounds really high, that must be care that includes routine Doctor visits each week.

[airplaneman]

24. Yes claw back is worse than insurance

If you buy insurance they don't expect back every penny including the premiums that you paid back. I don't plan to let this happen to me i'm with the take the matter in my own hands crowd.
-Airplane

[TalenaGor]

9. I'm dealing with that very thing right now

My mom is in a nursing home..... She gets social security of $1,009 a month...
They take 1,000 of that.... They leave her with $9 to pay any and all bills she has.... And she does get medical bills....

[enough]

10. We need to consider who/how these costs should be paid.

Costs for long term care are astronomical and can go on for years. If a person is going into long term care and eventually dying, what is wrong with using that person’s assets to pay for that? Who should pay?

I’m old enough for this to be a personal issue for me. I don’t feel offended by the idea that whatever assets I have at the time should go into paying for this at least to some significant extent. Is it right for me to divest my assets now in order to put the expense of my end of life care onto my fellow citizens?

I have no problem at all with my taxes going to long term care for people who don’t have assets to use. But if I do have assets why shouldn’t they be used to pay for my care? Are we proposing some right to pass assets on? If so, at what level?

[A HERETIC I AM]

13. You really do need to stop being so reasonable.

Logic and rational thinking very often gets ridiculed on this board.

Of course, you have been here long enough to know that, so I apologize for pointing out that which you already know.

[pnwmom]

36. I agree. And when a relative of ours had to sell her house and spend down the rest of her

assets in order to pay for permanent nursing home care, and to qualify for Medicaid, no one in the family had a problem with this. We were grateful Medicaid would pick up the bill so she could continue in the nursing home (which was a good one.)

She didn't leave any assets to her heirs, but least her heirs were able to see her well taken care of in her final year.

[Blue_true]

115. I agree. If a person has assets that can pay for his or her care, those should be used. nt

[Vivid Lizard]

11. Yes Indeed

My wife and I went through learning the ins and outs of the State medical care mess regarding both her and my mom's care. And yes, all her assets would have needed to be exhausted before the state (California) would step in.

Then, any monthly Social Security or retirement she got would go to the state, except for a small stipend.

One important point is that any assets / cash given away to family members (or anyone for that matter) within "X" number of years prior to needing state care can be grabbed back by the state from those recipients. At one time in California I believe it stretched back 3 years, not sure about now.

I don't remember though if the non-taxable yearly amount given as a gift ($9,999? $14,999?) counts.

Luckily, in a sense, both of our moms passed away before needing to dive into that quagmire.

As a side note, both stayed at care houses to save money. We did a lot of research and found them to be a nice setting (more "homey&quot and easier on their mental health IMHO. Plus, most of these homes are run by Filipino families, and the food was OUTSTANDING!

[Skittles]

15. welcome to DU, Vivid Lizard

we are appreciative of personal testimonies here

[dhol82]

19. Just as an FYI, in NY state it goes back at least five years.

Not sure if it might be longer now.
A woman I know of gave her nephew a wedding check for $7,000. The state knocked on the newlywed’s door to claw it back when she died.
True story.

[Coventina]

43. A nephew?!?! I hope he told them to stuff it!!

That's outrageous!

[dhol82]

47. Nope. She owed the money to the state. Tough luck to the nephew.

[mopinko]

12. back in the day, there were "old folks homes" where they did it just like this.

iirc, they called them legacy homes.
you basically signed over your estate, and they took care of you as long as you lived.

[A HERETIC I AM]

16. That basically describes the system of Masonic homes all across the country.

The same sort of endowment present with Shriner's Hospitals.

They get their money from endowments bequeathed by members of the lodge.

[mopinko]

17. i think it was pretty common w all those groups.

i have a bil that spent time in mooseheart when his parents hit some hard times.

[iluvtennis]

21. My sister was a social services eligibiltiy worker and told me this years ago. Gov't will

take care of medical needs but in the small print of the document it says the gov't has a lien on your property/assets.

My sister knew of case where after the woman passed away, the gov't took control of all assets to cover the costs they paid for 18 years of hopitalizations and medical care. The woman's surviving daughter was left with nothing from her mom. So, sickening.

[marybourg]

35. Disgraceful! That woman had a god-given right to

give her assets to her own daughter. The taxpayers should have been happy to pay the older woman's nursing home care for 18 years,- about $1,725,000 - so that she could do so! I'm sure you would do so happily. And for the other 1.5 million currently in nursing home also, of course.




I haven't posted in a week and a half, and I was trying to not post any more, but the incredible nature of this OP and far too many of the responses just broke my resolve. I'll try to do better next week.

[iluvtennis]

41. Keep posting please

[PoindexterOglethorpe]

65. If the gov't paid for 18 years of care,

they deserved the reimbursement. The surviving daughter was fortunate she wasn't herself on the hook for whatever it cost.

[TexasBushwhacker]

122. Sorry, but no one is entitled to an inheritance except a spouse

I have one brother, Rick, who "borrowed" thousands of dollars from our mother over the years. Whenever she asked him about repayment, he would wave her off and say "Take it out of my inheritance". So she did. He didn't get a dime. She split her small estate between his daughter, my other brother and me.

[StarfishSaver]

125. Exactly.

It's wonderful when people can pass money on to their children. But it's just as good that they have the money to pay for their care and then can rely on Medicaid so that they're not passing on debt to their children or requiring them to deplete their assets to take care of their parents.

I just don't understand the mentality behind complaining that Medicaid requiring their parents to use their own assets to support themselves before the government steps in is somehow taking something away from the heirs.

First, as you say, they're not entitled to jack squat unless the parents want to give it to them. And second, the parents can only leave what they have left after they use their money in their lives. Why do people think the government is supposed to subsidize their parents who have assets so that they can get more of their assets after they die?

I don't get it.

[Ilsa]

22. Yes, and states keep lengthening the look-back period.

The look-back is the era before a person needs long term care. The patient's money distributed during that time will be sued for by the state.

[jimmimac43]

23. I know a little about this

I'm glad to see that there have been some sorta knowledgeable responses. I work for my state's department of social services, as you have guessed, as a ltc eligibility case worker. Well not any longer, I've been promoted. Yeah me! The most contentious part of the job is working through bad information that applicants and their representatives have been given by well intentioned sources.

State's are not seizing assets. We do make sure that applicants are asset compliant. We also make sure that applicants are not writing large checks to friends and family to become compliant. I don't know of a state that takes homes. We will place a lien on a home.

As far as income goes, applicants are permitted a personal needs allowance. In my state the allowance is now $82/mo. It may not seem like a large sum but I see clients that run into asset compliance issues at benefit renewal time because the money just accumulates month after month.

The key is financial and wealth transfer planning. If you care about passing on generational wealth then plan for it. There are strategies and elder law attorneys.

It is not the system that is disrupting transfer of what wealth we have, it is human nature. People have their reasons for not beginning the transfer of wealth sooner. One reason is that they are afraid they will never see their heirs again once they have the money. For people that think this way it ain't getting better as they get older.

Me personally, I don't think the state and fed should participate in someone's wealth transfer plans more than they currently are. As stated, there are strategies. Research them or pay someone that has. This is all of our money. It is not unlimited. Why would we want to spend it to cover the cost of care for anyone that has the means to pay for it on their own?

[klook]

69. Sound advice - thanks

I am at an age when it’s time to fine-tune planning for my Golden Years, and will be meeting with advisors after the holidays to get my ducks in a row.

I appreciate your perspective as someone in the biz from the state side.

[shanti]

74. Thanks for laying this out

My mother was astute enough to transfer her bank account and house deed to her kids years ago.

[KentuckyWoman]

25. It will take half of some of what you have.

Generally the first 100 days are covered in full by Medicare after at least 3 inpatient days in hospital.

If Medicaid kicks in along with Medicare after that, then the patient doesn't have a lot to start with. State laws vary, but generally for every check you write to satisfy Medicaid, you can draw an equal amount to the estate. Some assets are not included. A living spouse or disabled dependent cannot be left destitute.

The feds set the basis, the states tinker a little with the rules. They aren't always followed. Financial abuse is unfortunately a possibility if there is no strong patient advocate.

My advice if you are the advocate, don't hesitate to contact an eldercare attorney in your state for help.

[USALiberal]

26. It is nice they cover the cost after you run out of money. nt

[JoeOtterbein]

27. K n R

MFA!

[AJT]

28. I don't see a problem with this. The cost of a nursing home is

around $10,000 a month. If you are in a nursing home you pay for it until you run out of money, then you pay what you can(social security)and the state is covering the rest(in WI it's title 19). It is actually good that after you run out of money the state will cover it.

[shanti]

75. $10,000 a month

is a pretty high end nursing home.

[iamateacher]

79. $14,000 here in the mid-Atlantic states

[shanti]

82. Seriously

I don't know how people do it.

[iamateacher]

128. They use up all their assets and go on medicaid

If you have a spouse, some assets remain, but yeah...going through it now with a parent.

[elleng]

29. Glad my car's only worth $1000!

[KWR65]

30. It is fair that people contribute to their health care costs

It isn't free to provide medicaid or long term care and the users of it should pay for it after they have passed with their estate. If you have no money in your estate after you have passed then your estate doesn't owe a dime.

[pnwmom]

31. Not exactly. For a married couple they leave assets for the spouse. However, yes,

for a single person, nursing home care isn't covered by Medicaid until you've run out of your own assets.

The person in the long term nursing care still gets their care paid for by the government. The one who will be hurt by this is anyone hoping to inherit their assets.

But why should taxpayers pay through Medicaid for nursing home costs of people with plenty of assets, just so their heirs can inherit more?

[mountain grammy]

32. My friend's mother had a stroke at 96

until then she was healthy, living alone in her own home, which my friend and her siblings had put into their names about a decade earlier.

Mom is now in a nursing home where she'll turn 100 in December. The nursing home is $8,000/month mom is in a wheel chair, but can feed herself and use the bathroom with help. She can't speak. All her pension and SS, about $2500/mo go to the nursing home.. all savings have gone to the nursing home. Medicaid will pay the rest because now she is indigent.

The three siblings split the sale proceeds of the house, about $100,000 apiece. Should it all have gone for mom's care? I don't know.

[El Supremo]

106. I've been involved with this in Colorado.

First of all - $8000 a month? That is really high.

Second, I sold Mother's house and put it into an annuity for her. How were you able to split the proceeds among the children? Your mother would not be on Medicaid, which sucks.

Third, my sister, on Medicaid, got a small allowance for personal use. So the governments did not get 100% of her pittance of PERA disability insurance. We were going to put her inheritance into a trust for her benefit but she died before she could get her share of our mother's estate. So my niece got 2/3's of it while I got 1/3. I had already spent all of that on my sister's and mother's legal fees.

[mountain grammy]

107. It's an excellent nursing home and she does need round the clock care

since she can't walk..

This is not my mother, but my friends. What my friend and her two siblings did was have their mom sign the house over to them. They did it at least ten years before she was sick, so at the time of the stroke she owned no property.

The three siblings sold the house after mom went into the nursing home. Two years drained all her retirement savings, around $200,000 and now they take her pension and SS payments. Yes, I think she gets to keep a couple of hundred a month. She is now on Medicaid.

[marybourg]

112. Good children would have used

the money for their mother's care. Maybe that $300,000 would have been enough to place her in a better home, where they only take patients who can self pay for 2 or 3 years, then the home puts them on medicaid. That's what good children do.

[sarisataka]

37. It is more nuanced than that

And insurance is available which can allow you to shelter assets but it is not cheap.

Like all other medical care however, you are expected to pay up to your ability to do so.

[rampartc]

42. this is how we have been treating our sick and elderly for decades

and, it is better than this "conservative" alternative ...

"BATON ROUGE — Nursing home eviction notice warnings to be sent Thursday are likely to create a panic among the 37,000 Louisianans and their families who could be victims of the state's budget crisis...."

https://www.thenewsstar.com/story/news/2018/05/09/nursing-home-eviction-notices-start-panic/593627002/

[Liberal In Texas]

45. Yep. Known it for a long time.

A system that makes you give up your house and everything you've worked for is wrong.

Just wrong.

Edit to add:
Make sure the funeral expenses get paid in advance out of whatever proceeds are derived from the sale of the house and other property before the nursing home gets paid. Otherwise, the "heirs" will have to come up with it.

[StarfishSaver]

48. I don't have a problem with a system that expects people who can afford it

to pay for their own care before it steps in and uses taxpayer money to take care of them.

Medicaid is a safety net, not a windfall. It's set up so the community can ensure people are cared for even when their private resources run out. It's not to ensure that heirs can inherit those resources intact while the community foots the bill.

I don't understand why people have an issue with that.

The complaining sounds an awful lot like wealthy people fussing about the "death tax," seeming to assume that inheritance is a birthright that the state must protect to its own detriment.

But it's actually an even weaker argument because at least the people arguing about the estate tax are resisting giving money to the state out of their inheritance after their benefactor dies and all of the deceased person's expenses have been paid out of their resources. This argument
doesn't object to paying out something, but demands that taxpayers pay their loved one's expenses, so that their resources remain untouched and they can get their money after they die.

[Vinca]

49. If you need Medicaid for long term care you're probably already broke from medical expenses.

Only the wealthy can afford to be sick in this country and keep their 25 bathroom mansions.

[cbdo2007]

51. It is your final months/years...you don't need anything but care.

Americans are obsessed with their money and having money and passing money to their kids and being on a boat or something stupid.

If you need long term care you don't need all that money. Your kids have their own money. You won't need anything but basic care so stop worrying about your bank account and let the govt take over. That is how it happens all over the world and you are going to be fine.

[StarfishSaver]

58. There's also a sense of entitlement operating

If my parents need to spend their savings for their care - or anything else they want - who am I to complain that they didn't leave it to me? It's not my money and I'm not entitled to it unless they decide to give it to me and they don't spend it on something else before they go.

[Drahthaardogs]

53. That's why people need to buy Long Term Care riders

If they don't want to have the state take it all.

[emmaverybo]

81. You need to think about the expense of long term care insurance vs. a facility. AARP studies show

that the average length of stay in assisted living or nursing care facilities for elderly—so not talking younger folks with debilitating illnesses or disabilities—is something like iirc 18 months.

There is also insurance you can get for home health care though it is limited.

Licensed care small group homes can be a good alternative, but check out carefully. Some mom and pops ops are terrible. Some are great if 24/7 nursing on site not needed. Of course the elderly person will have to have a level of self-care and mobility.

The taxes we would pay to cover good quality LTC for everyone, undocumented immigrants included, would be frightening. It is true that other countries provide it to citizens and documented immigrant workers, and refugees, but people who can afford it, get much better care. As here, the state care homes can be a horror. Not always, but can be.

[Drahthaardogs]

87. You get enough to cover 3 to 5 years

IF you want to leave anything to your heirs. If you don't, no reason to buy it.

There was a local guy who lost both parents to cancer. Neither had health insurance and after the state paid for their care, they took the farm.

That's sad, but obviously the parents were okay with it.

[emmaverybo]

90. My point being that with the premiums being so high, and the fact that elderly who end up using

it—and there’s strict eligibility criteria to have it kick in—only live between 11and 18 months on average. So you might better put those assets you’d spend on premiums in investment. Then pay for your care if you need to. You might never need to. I am not talking about going on Medicaid, but the pros and cons of carrying LTC. If your job provides it for you at lower premiums, you could lock in young. Some employment will provide at group rates for parents.

[Drahthaardogs]

100. Everyone says "You're better off saving yourself for it"

But I don't know anyone THAT disciplined. My premiums are $42/month. I feel it's worth it. I have enough coverage for about 5 years

[emmaverybo]

105. Oh that's not bad. And of course the cost will be going up. So I can see the point.

[lark]

55. It's Medicaid, please change your OP as it's confusing.

[Recursion]

56. It's a back-door inheritance tax (nt)

[StarfishSaver]

60. No, it is not

Why do people think that the state must pay their parents' medical and living expenses so they can get their money when they die?

Why should taxpayers be required to foot the bill for expenses for people with meana while they hoard their money to leave to their heirs?

[pnwmom]

64. I don't know why this is so hard for some here to understand.

Why should a couple making a middle class wage have to pay higher taxes so that people who own million dollar houses can pass on the house to their kids when they go into a nursing home?

[Fiendish Thingy]

67. The dilemma is when there is a surviving spouse

The spouse shouldn't have to lose their home or assets for the other spouse's care. Although I agree someone shouldn't get to hoard cash while the state covers long term care, it's not cut and dry, it's complicated when there's a surviving spouse.

Edited to add:
Here in BC, long term care is subsidized based on your annual income, with minimum out of pocket cost of $1100 and maximum of $3300CDN per month. There can be wait lists for care depending on your location, and the govt. cover interim care homes if needed.

Nothing about selling your house or liquidating your estate.

[StarfishSaver]

70. Medicaid has spousal protections

People can also arrange to transfer assets to their spouses in order to legally qualify for Medicaid without decimating their spouse's inheritance or leaving them without means. But it needs to be planned carefully and in advance.

But the principle remains that if an individual or couple has the means to pay for their living and nursing care expenses, they shouldn't be relying on Medicaid.

To quote the great Don Draper: "That's what the MONEY'S for!"

[pnwmom]

63. No, it's not. In a nursing home, in addition to the nursing care, you're paying

for all the other things you'd normally have to pay for -- rent, food, utilities. There's no reason someone with assets shouldn't pay for their own costs. Why should taxpayers pay for long term nursing care of people with assets, just so the nursing home resident has more left over at the end to hand to their heirs?

[NickB79]

61. Jesus, this whole thread is depressing as hell

I used to joke that once I became a burden on my family, my "retirement plan" was a handgun with a single bullet. The future my daughter will have to grow up in will be too brutal to survive without the resources I've acquired to pass down to her.

[StarfishSaver]

68. I assume you also acquired assets in order to pay your expenses a d support yourself

Why should taxpayers have to pay your expenses while you're alive so you can give your assets to your daughter when you die?

You should first use those assets to support yourself - just like you do now - and if you run out, appreciate the fact that government will step in and ensure you don't have to depend on your daughter to take care of you and, if she can't or won't, leave you to beg for charity or live in the street.

[mr_lebowski]

85. We should have legal euthanasia available for people who decide they don't want their resources

depleted and want to pass them on rather than living a life under the care of others at great expense, don't you think?

[StarfishSaver]

93. I have mixed feelings about that

[NickB79]

123. If your long-term plans involve assisted living, have a payment plan in mind, definitely

But after watching my grandmother linger on for 3 yr with dementia in one, my plan is to die at home. Any way necessary. Thankfully that's still 40 yr off.

[StarfishSaver]

124. I'm sorry

That must have been so difficult.

[Bayard]

72. Yes, they will

It happened to both of my disabled sisters, and my parents. They waited just a bit too late to put their homes in my brother's name. Its all they had, no other assets. They had never had much of anything. Already on Medicare and Medicaid for years. My sisters had to go into nursing homes, my folks into assisted living. None of them lived that long afterward, which I'm sure the government appreciated.

Bitter, yeah. Not that my brother and I ever thought we'd get anything other than a few mementos, nor wanted it. We just hated the indignity and depression they felt at the end of their lives by being left penniless.

[StarfishSaver]

78. I know that must have been painful, but the alternative without Medicaid would have been worse

They probably would have quickly run through all of their assets and then been at the mercy of relatives, charities and meager government programs. Medicaid is a wonderful, valuable safety net, but it's a last resort that doesn't and can't take care of people who have resources to pay for their own care.

[catbyte]

76. Yep. My husband of 30 years & I almost had to get a divorce to protect our assets

when he had to enter a nursing home before his death.

It's horrific. It's inhumane. It's America.

[liberalmuse]

80. A friend of mine is taking care of her mom full time.

But the entity in charge of ensuring her in-home care is appropriate (if sending an oversight worker once a week to fall asleep on the couch is considered oversight, so be it) has a hold on not only her mom's assets, but hers as well. Sadly, her mom hired a crooked Mormon lawyer who "lost' a large amount of her money. I specifically mentioned religion because I've learned never, ever to do business with Mormons or even rent/buy property from them as I've been screwed by them 100% of the time. Growing up, I've also watched my single working mom with 3 kids get screwed out of wages time and time again by her Mormon employers. The only way the shady lawyer would step aside without a big fight was to force them to comply with his rules when they transferred power of attorney. She can't even buy groceries without asking permission for access to her bank account which they've locked down. She owns a house and had a large sum of money at one time, but it's not hers to do with what she pleases anymore. I'm not sure how someone on Medicare (not medicaid) and SSI, things her and her husband paid into ended up with all their assets essentially taken away.

This country does not take care of its old or young if they don't have a trust fund or a company where they reap all the profits while paying their workers substandard, barely livable wages. The GOP has stolen the futures of 3 generations that i know of in my lifetime, and unfortunately, many more to come if our collective keeps voting these crooks into office. I guess a country built on one shameful action after another is going to have trouble becoming honorable and just.

I apologize if anyone was offended by my rant. I'm on one this week. Sometimes it gets to me and I have to lose some built up pressure by venting.

[Miigwech]

130. So much crap, financial and emotional ruin to wade through.

[Quackers]

83. Yes. It happened to my mom. She died 1 year ago today. We've basically just turned over

Her house to the state.

[Desert grandma]

84. The Aid and Attendance VA benefit can help

Veterans and their spouses are eligible for a benefit known as "Aid and Attendance". It basically pays a benefit for assisted living/nursing home care or home health care to a veteran/spouse through their financial power of attorney. (Most often a child or other relative.) There is an income eligibility requirement, however, it is reasonable. My 92 year old mother recently moved to an assisted living facility. It costs $5000 month. She made around $2500 monthly (pension and SS income) and will get $1200 monthly from this VA benefit. We are renting her house out for another $1200 monthly, which almost covers the cost of care. VA also operates skilled nursing homes for veterans in most states.

[Peregrine Took]

86. The Little Sisters of the Poor have homes for moderate and indigent seniors

across the country.
You don't need to be Catholic to be accepted there. All are welcome.
They took in my 94 year old sister in law, wheelchair bound with very limited vision.
She had been a retired secretary and 'worked until she was almost 70.
Through various health crises she wound up in an independent home in a really bad situation as her pension and SS weren't enough to cover her expenses and they were going to put her out.
She is a very private (and can be difficult) person who did a lot of covering up of her situation.
Finally, the home called her brother and told him of her plight. It took tons of work on his part to unearth her financial situation (electricity was cut off, telephone service, too, no record keeping, running up big meal bills (delivered to her room costs more) etc. and its not easy to sort out someone's financial situation when they are so secretive.
Anyway, we started calling around to various homes and no way could she afford even the lowest priced ones.
At last we thought of the Little Sisters Home, and bottom line, they took her in. She has been there 2 years and, while still crabby, she likes it there - especially the care givers who treat her so well
She signed over her SS and pension to them and, in return they give her the care equal to a full service 24 hour nursing home.
We put her on Medicaid, too.
Here is a listing of their homes across the U.S.
I can't say enough good things about them and what they do for her - too numerous to mention but includes all medical care including driving her to her outside medical specialists, giving her all her meds at various times required, day and night, 3 meals, help to the bathroom, showers, etc.
http://www.littlesistersofthepoor.org/locations/u-s-homes-2/
P.S. She can leave anytime she wants -no lifetime commitment.
Oh, and she has a very nice private room with many call buttons.

[doc03]

88. Yep you get a job save for retirement then

before you die the nursing home takes it all. America what a country.

[StarfishSaver]

92. Do you think nursing homes are supposed to provide free care so people don't have to spend

their "retirement" money on their own living expenses?

Travel and hobbies are wonderful things to spend retirement savings on. But when people reach the point where they need to have nursing care, why shouldn't they use their retirement money to pay for that before expecting the state or nursing facilities to pay for it so they don't have to spend their retirement savings?

[doc03]

99. I don't know. What about countries that have national health care do they have to

give up everything they worked for in their last days? I know people that were worth millions that transferred everything over to
their family a few years before they died. Their family walked away with millions and us taxpayers paid the bill. Is that fair? What if you do that and you end up passing away 4 years and 11 months later? My best friend's dad transferred his 200 acre farm over to his children a few years ago. We paid the nursing home and they ended up with $2,000,000 for gas drilling rights and they are now taking in a monthly royalty check for several thousand plus they still have 200 acres. Another friend of mine was in excellent condition when he had a motorcycle accident and ended up a vegetable in a nursing home for 3 years his family was left broke.

[StarfishSaver]

104. We're not a country that has national health care

You're talking about issues that go far beyond Medicaid.

[pnwmom]

95. Who should pay for the costs of nursing home care? Should the nursing home provide it for free?

Should people with assets pay for their own care? Or should middle class taxpayers pay more in taxes so people with assets can get free nursing home care, and leave their houses to their heirs?

[doc03]

101. read my post #99

[Scurrilous]

96. If not all you have, a nice chunk.

My mom died at 96. She lived in her own house right up until the end. For the last year of her life, Medicaid sent someone every day for two hours to help her bathe. We finally closed on her home last month and Medicaid took 30 thou off the top.

[liberal N proud]

103. Every dime.

[Texasgal]

121. This is nothing new.

It's been going on for a long time.

My parents are elderly and getting to the point of needing more care. My siblings and I have done alot to try to keep them in their home, but we all realize that we may have to place them in a facility at some point.

Both of my parents did pretty well financially in their lives but me, nor my siblings have any aspirations of receiving any financial windfall. Our main concern is to to make sure that they are both well cared for until the end.

[StarfishSaver]

126. That's how I feel.

And fortunately, Medicaid helps to ensure that, if they no longer have the assets to take care of themselves, our parents can still get quality care for the rest of their lives. And this happens without burdening their families and draining their children's resources.

Before Medicaid, people were forced to use up their assets and then rely on their children and families to pay for their care or take care of them themselves, or to seek out charity or live in destitution.