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You try to do the right thing. Take care of an elderly parent. You supplement their income, make sure their needs are met, and put your life on hold to provide elderly care. You try to keep them in their homes and not commit them to a nursing home.Then when they pass away the state comes in to take the only thing they ever owned of value and worked a life time to acquire, THE FAMILY HOME. My mother passed away and now my heart is broken all over again.

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Thanks, igloo572, for once again taking the time to provide such useful information.
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MERP - Medicaid Estate Recovery Program:
States may file post-death liens or claims against the real and personal property of persons who were permanently institutionalized and those who received Medicaid services through a federally required program called MERP. Medicaid is a joint state and federal program that is needs based and after the person who used the program dies and there is an estate, then the state has the option to recoup or recover some of the costs through MERP.

Post-death liens or claims are often and usually a part of the probate process.
The laws of some states (e.g., California, Pennsylvania, Rhode Island, Washington and Wisconsin) specify Medicaid as a creditor and establish its standing relative to other claims against the estate, while other states regard Medicaid as a creditor under provisions for “reasonable and necessary medical and hospital expenses for the last illness of the decedent.” Some state laws (e.g., those of Florida and Texas) protect the decedent’s home by placing certain interests of survivors ahead of the claims of others, including Medicaid. For Texas, MERP is a class 7 claim – which means there are 6 other categories that get paid first when probate is being settled. Because of this, MERP is low in TX.

How MERP gets done and what you can do, depends on the state. All states have MERP exemptions. Many, many people qualify for the exemptions BUT you have to let MERP know within a very specific time-frame that you will file for an exemption. If you don't, you are probably out-of-luck. Each state has the rules or regulations on their website - the feds require that they do. But you have to be proactive to protect your interest and file the needed paperwork.

Medicaid estate recovery gets to the heart of the issue of who should pay for long-term care -- the public through the tax-supported Medicaid program, or users of long-term care through their personal resources, including those remaining after death. Amounts collected from Medicaid recipients' estates are not insignificant in absolute terms. They do, however, pale next to total Medicaid spending for long-term care. This is not surprising, given that Medicaid is available only to those with very limited resources. Nevertheless, the wide state-to-state variation in recovery rates and estate recovery practices suggests that program efficiency could be improved and greater amounts could be recovered. A lot of states are doing this by giving the MERP contract to HMS - which does compliance and duplication for CMS (Center for Medicare and Medicaid Services). I would think that HMS is going to be rather aggressive in MERP as they are an outside contractor.
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Mspine57: I'm sorry for your loss. I understand the constant demands of taking care of a parent and trying to keep them home. Unfortunately, when medicaid gets involved, they can come back and want to be reimbursed for their costs. Medicaid is taxpayer funded and it provides help and assistance to keep an elder at home or to cover their costs in a nursing home. Many of these elders have no assets and the costs to tax payers mount daily. The system is kind in the respect that it does help those in need. Without Medicaid so many elders would suffer and be neglected. The system is unemotional. It gives what it can and it tries to recapture funds where it can. Nevertheless, I appreciate your grief. As you said, "You put your life on hold" and I can so relate to that. You can't explain what you give up to those who have not had the experience. I'm sorry you lost you mom and then the family home. God Bless You for your genuine efforts and your loving spirit.
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There are exceptions that can protect the primary home. A surviving spouse is able to keep the home. Also a primary caregiver who has lived in the home as his/her primary residence for at least two years prior to the time the person entered a NH can protect the home from spend down. The role of the caregiver has to be deemed essential to have kept the home owner out of a NH while they lived there. So caregivers who lived with the home owner (only residence) and gave 24-7 care for at least two years may be able to protect the home from seizure. But someone who worked 8 hours a day while caring for the home owner may lose the house. Someone who visited several times a week or less would not be able to protect the home from Medicaid.

I've read that the laws vary from state to state and legal assistance may be required to keep Medicaid from taking the home.
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Thanks, Fixer. Everyone whose parents are on Medicaid should understand this.
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Found this on the medicaid.gov website: "Estate Recovery: State Medicaid programs must recover from a Medicaid enrollee’s estate the cost of certain benefits paid on behalf of the enrollee including nursing facility services, home and community-based services, and related hospital and prescription drug services. State Medicaid programs may recover for other Medicaid benefits, except for Medicare cost-sharing benefits paid on behalf of Medicare Savings Program beneficiaries."
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Medicaid can also apply to persons livng in their own homes. It might cover such things as adult day center care, in-home housekeeper, visiting nurse, etc. The state can recover the costs they paid out from the estate, which would basically be the home since other asset were probably liquidated before Medicaid kicked in.

So, yes, it is entirely possible for the state to take the proceeds of a home sale (up to the amount the state paid) after the Medicaid recipient dies, even without an NH stay. Different states pursue this at different levels of aggressiveness, but it is an opton for all states.

I am very sorry for your heartbreak,mspine57.
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I put this info up somewhere on this post but couldn't find it but if you go to alz.org and look toward the right side where their is a list and hit, "caregiver," it will take you to another page under, "caring for alzhemiers." This list has some information about medicade, medicare, Ethical and Care issues and etc. Hope this help someone.
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I agree with lildeb. How can this be if she was at home and not in a nursing home. Was this something agreed to before hand? If not then you need to fight it. By what program allows the to do this? Get an explanation and go on the medicaid website and do your research.
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I don't understand why Medicade took the house for she was living at home unitl she passed was she not? Hopefully, someone that knows more about medicade rules will help. My mnl has only medicare and not sure if they will take her home which we live in when she pass. We both swapped houses a long time ago but never changed the names on the deeds. Hubby has a POA in her Will. I am so sorry for what have gone through and some.
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mspine, this is such a huge issue. With the rising cost of healthcare coupled with longer lives, more estates are being taken to take care of end-of-life medical expenses. In the future I imagine there will be no such thing as an estate for anyone except the most wealthy. Unfortunately, universal healthcare is a long way off in the US.
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