Any Medicaid experts here?

[Rain Man]

Okay, this is an awkward question, but I'll pose it.

I have an older relative who's got a long history of making bad financial decisions. He's a senior citizen and has basically backed himself into a financial corner. He's making payments on two properties that aren't producing any income for him (and which have very low market value), and he owns another property that's apparently got a lien on it for some significant amount relative to the property's value. I have the impression that each of these properties would sell for less than he owes on them, or are breakeven at best.

So he's basically spending all of his income on these loan payments, and he's not buying things like medicines that he needs. His house is falling down around him because he can't do basic repairs, and he's eating junk food every day because it's cheap. Again, he constantly makes bad financial decisions.

I've suggested that he look into Medicaid to get some help. He alternately claims that he's not eligible because of all of the real estate that he owns, and then also says that he won't apply because they'll "take all of his stuff".

I don't know much about this topic since I've never looked into it. Can someone answer these questions for me?

1. If he owns real estate, but it's worth less than he owes (or if it's got a lien on it), does it count as assets in terms of Medicaid eligibility? It's not really an asset for him in net value, and in fact it's a big liability because he's making payments on properties that are not worth the cost. But does Medicaid consider the debt when determining eligiblity, or just the raw asset?

Obviously, the smart move would be to dump them for whatever value he can get, but again ... he constantly makes bad financial decisions so he refuses to do the smart thing.

2. He claims that Medicaid will "take his stuff". I'm looking up information, and it appears that you have to sign your assets over if you want long-term care (and that's a reasonable thing in my opinion). It appears that basic Medicaid coverage doesn't require signing over your assets, though. Is that correct? It's only for long-term care or assisted living? And does 'signing over your assets' include your home? I know that your home doesn't count as an asset when determining eligibility.

3. If you need long-term care and sign over your assets, does that somehow negate the debts on those assets? Would he still owe payments on the remaining mortgages and the lien on the third property? Or would that go away somehow when they received the assets?

Thanks in advance. If you respond knowledgeably, there won't be any money, but when you die, on your deathbed, you will receive total consciousness.

[Fat Elvis]

If he is in Missouri, then he won't qualify for Medicaid since he (I assume) doesn't have children under the age of 18, and he doesn't qualify for a disability waiver.
https://www.healthinsurance.org/missouri-medicaid/

Missouri has not expanded Medicaid (MO HealthNet) under the Affordable Care Act (ACA). Non-disabled adults without children are not eligible for Medicaid regardless of how low their income is, and parents with dependent children are only eligible with incomes that don’t exceed 22 percent of the poverty level. Only Texas and Alabama have lower Medicaid eligibility caps, at 18 percent.

[Fat Elvis]

Originally Posted by Randallflagg

This will seem extreme, but from my "limited" experience, it may be necessary to see an Attorney to inquire about a non voluntary power of attorney. It's a rash step that shouldn't be taken lightly. "relations" with this relative will be irrevocably broken. However, if it's the only option left - might be a necessity.

The other option, unfortunately, is to leave him/them to their own devices and allow the chips to fall where they may...

There's no such thing as "non voluntary power of attorney". What you are talking about is guardianship. And there is really no better way to **** someone over the rest of their life than to get them under a guardianship.

Guardianships are usually pursued with the best of intentions, but if something happens to the guardian, that person has been legally declared incompetent and has no civil rights under the law. A prisoner literally has more rights than a person under guardianship.
Missouri recently passed some laws regarding Supported Decision Making which is an alternative to guardianship that you might want to look in to.

Quite frankly, it just sounds like your father unfortunately isn't very business saavy...and that isn't grounds for guardianship.

[Rain Man]

Originally Posted by ChiliConCarnage

I am not a medicaid expert and as others have mentioned it can vary quite a bit state to state.

I have some experience with this through helping a parent. In my experience, it can be quite difficult to get and stay on medicaid. I can't imagine that they'd let someone who owned 3 homes on and I seriously doubt they'd be interested in trying to calculate the real value of the assets. We had to renew every year and I can't imagine they want employees trying to figure that sort of stuff out.

In my experience, they won't "take" anything from a living person. If you own assets that preclude you from joining they simply turn you down. Your father would need to sell the assets and eventually reduce assets to below the level they allow (typically 2k) before he could join.

If you gain assets in excess of the approved level they kick you off the program until you're back under the amount. So say if your parents are living at home they can stay there but if they end up in a nursing home or whatever, they'd expect you to sell the asset and they'd kick your parent off medicaid. Then you'd cover the bills for the nursing home from the sales proceeds until you got near to being under 2k or whatever and you'd apply to join medicaid again.

Someone mentioned DPOA but you won't get power of attorney over anyone if they are of sound mind and competent without their approving it.

Yeah, they're not mentally incompetent. They just don't know how to manage money. It sounds like I just need to convince them to sell the properties, but that's a tall order.

Originally Posted by Fat Elvis

If he is in Missouri, then he won't qualify for Medicaid since he (I assume) doesn't have children under the age of 18, and he doesn't qualify for a disability waiver.
https://www.healthinsurance.org/missouri-medicaid/

Wait, what? That's weird. I talked to someone who signed people up, and she said nothing about this.

[Fat Elvis]

Originally Posted by Rain Man

Yeah, they're not mentally incompetent. They just don't know how to manage money. It sounds like I just need to convince them to sell the properties, but that's a tall order.




Wait, what? That's weird. I talked to someone who signed people up, and she said nothing about this.

The person you talked to probably assumed that your parents were seeking services under the Missouri Aged and Disability Waiver. From what you've said, they wouldn't qualify for the waiver. You might contact your local Area Agency on Aging and see what support options are available.

[TrebMaxx]

I have a similar problem with my wife's parents. They are just stubborn and will not take any advice.

[Rain Man]

Originally Posted by Fat Elvis

The person you talked to probably assumed that your parents were seeking services under the Missouri Aged and Disability Waiver. From what you've said, they wouldn't qualify for the waiver. You might contact your local Area Agency on Aging and see what support options are available.

Ah, yes. That's exactly who I talked to.

I'm starting to think that it's a futile effort unless I can get them to sell these properties, but I don't think I can get them to sell the properties when I think they're underwater on the mortgages. It's a conundrum.

[KS Smitty]

Originally Posted by Rain Man

Ah, yes. That's exactly who I talked to.

I'm starting to think that it's a futile effort unless I can get them to sell these properties, but I don't think I can get them to sell the properties when I think they're underwater on the mortgages. It's a conundrum.

Is there someone his age that he would listen to for financial advice? A "Local" that could steer him in the right direction?

[Rain Man]

Originally Posted by KS Smitty

Is there someone his age that he would listen to for financial advice? A "Local" that could steer him in the right direction?

Unfortunately, no. He doesn't listen to anyone.

[Fat Elvis]

Originally Posted by Rain Man

Ah, yes. That's exactly who I talked to.

I'm starting to think that it's a futile effort unless I can get them to sell these properties, but I don't think I can get them to sell the properties when I think they're underwater on the mortgages. It's a conundrum.

Yeah, that's a tough one. The best thing you can do for them is let them know that you love, respect, and value them no matter what. Hopefully, they will come around and seek your help/advise on their own terms and timelines

['Hamas' Jenkins]

Rainman,

This may be complicated, but if you could find a list of all the medications that your relative takes, I could review them to see where he might be able to save out of pocket regardless of his insurance. There are times where it is cheaper to pay cash price than to use insurance, and there are several medications with coupon/savings cards or apps you can use on your phone to defray the cost.

[crashcourse]

always wondered if medical has the same thing dental does--student dentists who need the practice on somebody at a much cheaper price--ought to be a few doctors out there. other thing is to see if he's eligible for VA based on income even if he has no disabilities if he served and he's poor he could get in

[Yosef_Malkovitch]

Originally Posted by crashcourse

always wondered if medical has the same thing dental does--student dentists who need the practice on somebody at a much cheaper price--ought to be a few doctors out there. other thing is to see if he's eligible for VA based on income even if he has no disabilities if he served and he's poor he could get in

This is a really good idea. Check with local law schools to see if there is a student clinic. Where I went to school, we ran a tax clinic giving advice and helping people fight the IRS. We charged very little (or nothing at all, depending on the circumstances).

Other schools have other kinds of legal services clinics. You might be able to get some help that way.

[dlphg9]

Have you considered insurance fraud?

[oldman]

Medicare premiums for Parts A (hospital) and B (medical) are taken directly from your SS check if you are eligible. If you are 65 and not eligible (or don't draw) SS, you are billed directly. Part D covers your scripts and that's pricey. My wife and I pay a combined $240 or so for parts A&B and we have a Medicare advantage plan for the stuff Medicare doesn't cover and drugs. The drug coverage is based on tiers and money spent. Most generic drugs are at little or no cost on our plan, but if you fall in that donut hole, cover your ass.

[Rain Man]

Originally Posted by dlphg9

Have you considered insurance fraud?

I actually cashed in on my life insurance policy years ago. I hated to set that car on fire, though.