POZ Community Forums
Meds, Mind, Body & Benefits => Insurance, Benefits Programs & HIV => Topic started by: Jeff G on October 07, 2010, 05:11:25 pm
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Welcome JR . Its great to have a place here to ask a question or two of a lawyer , and boy is the price right ;)
I have been on medicaid in the past and probably will be again once the health care reform is in place .
My question is does medicaid try and recoup what it spent for your health care after you die ?
I have been told they can come after some assets I want to leave to a family member one day but I cant seem to find out the details .
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Hi Jg,
Here's what I pulled from the CMS website:
The Omnibus Budget Reconciliation Act (OBRA) of 1993 defines estate and requires each state to seek adjustment or recovery of amounts correctly paid by the state for certain people with Medicaid. The state must, at a minimum, seek recovery for services provided to a person of any age in a nursing facility, intermediate care facility for the mentally retarded, or other medical institution. The State may at its option recover amounts up to the total amount spent on the individual's behalf for medical assistance for other services under the state's plan. 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. States have the option of recovering payments for all other Medicaid services provided to these individuals.
In addition, states that had state plans approved after May 14, 1993 that disregarded assets or resources of persons with long-term care insurance policies must recover all Medicaid costs for nursing facility and other long-term care services from the estate of persons who had such policies. California, Connecticut, Indiana, Iowa, and New York are not required to seek adjustment or recovery from a person's estate who had a long-term care insurance policy. These states had state plans approved as of May 14, 1993 and are exemptfrom seeking recovery from individuals with long-term care insurance policies. For all other individuals, these states are required to comply with the estate recovery provisions as specified above.
So basically they recoup any money they pay to a nursing home or hospital on your behalf, and maybe some of the associated costs. But remember that there is an assets cap on Medicaid eligibility of $2000. I don't think they can come after your house if your spouse is still alive. One way out of that would be to make a joint tenant out of whoever you want to leave your house to, so that when you die it doesn't become part of your estate but just passes to the other tenant. Definitely check with a local attorney if you want to pursue that. Also remember that Medicaid is administered at the state level, so the rules will vary slightly from state to state.
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Thank you for the information , it was very helpful .
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JR:
Thank you so much for being here and allowing us to ask questions. Your pro-bono services are truly appreciated.
Thank again-
Tracy :)
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JR,
Thank you so much for the very helpful information.