After living in a NH in MA for several months using MassHealth funds and keeping monthly $ to under $2000, a retirement investment fund started sending quarterly reports out of the blue to us, making her have way above the $2000 monthly limit. What to do? Report to Mass Health, the NH, or both ? Elder lawyer is assisting us, Thanks!
Something to mull over… LTC Medicaid (the program that is paying her custodial costs in the NH via Mass Health) tends to look at resources based on a monthly system. So their assets at the end of each month is supposed to be at or under the asset maximum. & their income - $ paid to them for the month, like SSA - is too within your States $ limit. Most States use $2,829 max per month of income and 2K max for nonexempt assets for an individual. The month the payment is deposited it is “income” and then every month subsequently it is an “asset”.
So if she or you as her POA can find something to use that $ for that is a legit expense for her and uses almost all the lil windfall of $ so that things are bought and paid for and clear her banking within the month…. then Voila! She ends her month within income & asset limits.
If this is a smallish lump sum of $, she may be able to buy in full a preneed funeral / burial policy. All States allow for these but the $ amount and how they have to be structured is very State specific. In general a good Funeral Home will know how these have to be done to be ok. There are insurance agents who sell these but you have to do your own research to are sure what they are selling is within LTC Medicaid regulations for your State. There may be dental care she needs and is not covered by Medicaid, so she spend the $ to get this done. Or she buys a fancy expensive piece of DME aka durable medicine equipment that is more specialized then what Medicaid will provide for. A lot of what she / you as POA can do is interdependent on how much $ this is. If it’s 15K I bet you could find a way to deposit it on the 2nd of the month and find stuff to buy and get it paid for by EOM. But if 50K that imo she is stuck with having to do a spend down via private pay for care till she’s once again impoverished. Run your plan by her caseworker too.
Fwiw on things that pay quarterly or annually, so this will be regular but smaller $ amt she is getting from now on, you may want to have the $ amount presented to the caseworker as an amortized amount that is income every month to her. It could be that once amortized by month (& not a bigger lump sum) if it not too too much $, it even once added to her other mo income (like SSA) is under the income max, so not a problem at all. Ideally a CPA would do a document for the amortization. But if this is a serious amount of $$$ that each & every month take her always over resourced she either goes private pay or get an atty to do a Miller Trust or pooled Trust like what Alva mentioned.
This isn’t an unusual situation….. it happens often when they get an inheritance from a now deceased but was well intentioned family member who has no idea how this totally causes problems for those on LTC Medicaid and have to stay basically impoverished.
Also if the $ is somehow being paid as an annuity (like it’s from a tort type of lawsuit settlement $), those can be problematic. If the $ is structured this way, post an update.
Glad you went to the attorney. Would have been my recommendation.
When all is said and done I hope you will come back to tell us how this all worked for you and what was done with your attorney's help. It will help others on this forum.
Wishing you the best of luck.
: )