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I just posted on another thread concerning Premiums on health care and it brought something to mind....A question...not an argument or opinion..I would have posted in the minefield it that was the thing.

First I know from personal experience in two cases that if a person is treated under Medicaid (called Medical in California)...this is not pertaining to Medicare..that after a period of time or a certain amount of Medicaid money received by the patient...the Government can come back on the estate of that person when they die and demand repayment...My Mother in Denver was one of those as was my Mother In Law here in California. This usually does not affect folks that are on Medicare and have to be shifted to Medicate for some simple follow up, etc...the ones that really get hammered are the folks that get ill and have to go into long term care and have no private long term care insurance..Medicare pays for a very small amount for a short period of time and then they are shifted to Medicaid for any long term situations...they go into a nursing home at something like $100K a year (billable) and Medicaid pays the bill...then after the person dies..if they have a house or any assets the Government can (and will) demand repayment from the estate. In order for the person to have gotten any Medicaid at all they must have very limited assets but can own a house free and clear and not have to liquidate it during their life...that house becomes a target for repayment of the Government "aid" program...here is a link to the Government discussion of the recovery program....

Medicaid Liens

Now my question...since Obamacare is a Government program does this now encompass any and all care a person receives and can they attach or demand assets at the death of the person that gets the medical benefits including what they get from day one of care? In other words is it still the same as Medicaid (Medical here) or does that change and if so, how? Since the Government is on a "seize all assets kick" I can imagine they might have found a way to really go after any assets a person that was on Obamacare might have to "repay" the assistance...I don't know and have not found anyone that really does but I can't see the administration passing up a target like this

 

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One of the things that's really sad (glad we found out before it all occurred) is that you can have a parent that has lived, mortgage free all their lives...they can be financially challenged but managing like so many do...then they get sick and have to make arrangements for long term care and anything they have after they die can be seized by the Government. Our choice with my Mother (and at her request) was to keep her out of a nursing home as long as possible...we could have brought her here and into our home but she declined saying all her friends were in Denver and she knew nobody in San Diego...she broke her neck at age 90 and was a certain candidate for a nursing home without another way..Medicare would have taken care of a year of so of the expected $80-100 K per year and then on Medicaid...her only asset at that time was her home and some small savings, etc...In that case, at her death, Medicaid could (and we were told "would have) placed a lien on her home and at it's sale they would take whatever (meaning all if they had to) of the proceeds to pay back Medicaid. We found a wonderful woman to care for her and we paid the in home care ourselves...she lived comfortably for another few years...the issue is that many folks don't know about this nasty little surprise and they have to put a loved one in a nursing home and figure the "family home" will stay in the family and find that the Government is their new "partner". I agree that "fair is fair" and the Government probably lays out a ton of money on this kind of long term care..but the folks they come after have often been law abiding tax payers all their lives (again, she was 90) and this "grab law" didn't become a law until in the 80's and many folks have no idea it's sitting there.

With so little understanding of Obama care by anyone at all I'm sure there are a ton of "surprises" like this 80's law that are just sitting there waiting to be uncovered...I can see them wanting to come after any Medicare or other benefits that the Government pays under any circumstances..not sure but never know what they might do.

I have an ex wife (nice enough gal..just "didn't understand me"..lol) and she and her Husband are living a really frugal life...she has a home her Mom left her long ago and it's clear...she and her Husband are on Medicare and Medical (as backup). She has had several long bouts in the hospital and an after care center paid by Medical...she found out not long ago the Government will file a lien on their house...they can live there but when she dies it will be a cloud on the title that has to be cleared before it can be transfered.

 

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This may be a surprise to some but both my Mother and my Mother in Law had living trusts and it did not avoid the situation about the potential for a lien...the trust had the trustor (Mom or Mom in Law) and one Trustee (in this case my Wife on the one and me on the other)....in both cases the asset (home) became titled in the name of the trust and was "protected" as long as the surviving trustee was alive and wanted to live in the home....I sold Mom's place after she passed and because she had not used Medicaid there was no issue. My Mother in Law had used Medicaid to a minor amount back several years ago in addition to her medicare (Medicaid was her "secondary" or gap insurance because she was on SSDI)....in any event my Wife got a notice from the "recovery section" advising that they were auditing all funds paid to her Mom since the beginning of any Medicaid involvement...she was fortunate that the amount did not equal an amount that would have triggered a lien or repayment requirement (don't recall the exact amount but it was under $1000 a year for just a few years).

The situation of the trust is fine if the survivor is going to live in the house...in our case my Wife is using the house as a rental and had her Mom run up big bills..as in a nursing home...trust or not....they would have filed the lien. Remember the trust ...unless an ongoing trust like where money is doled out over a specified period...dies with the trustor when they die.

We've all had trusts for many years...they do some good things but can also lead folks into a false sense of security if not kept up to date concerning law changes. Thank God we don't have much to keep track of.

There is another nasty little change in the laws that many folks are not aware of...used to be that even attorneys would advise their clients to "spend down" any assets the ill person might have so they could use Medicaid and not have to "liquidate any assets" to pay for medical expenses...it was a very common practice...Mom or Dad got very ill, looked like a long battle or a nursing home...the kids were advised to have the elder "spend down" all their savings and checking accounts and any assets besides their primary residence and therfore qualify for Medicaid...The elder would begin to gift money at the maximum to everyone in the family to get it out of their accounts as legal by law and do things like buy cars and luxuries and then give those to the loved ones...today that's a felony and any attorney that advises it be done can lose his license to practice...again from personal experience as I'd heard about "spending down" and asked the attorney (in my Mom's case) and he was really adamant about not even thinking about that "option"...just include this in my thread here in case anyone has those kinds of thoughts...it's really dangerous. I think the Government goes back something like 5 years to check for "spending down" during the 5 year period before the long term health care.