young woman in panic
This could mean that current residents will lose Medicaid benefits.
On September 1, 2016, DHS changed the rules about how it treats assets in a Revocable Trust. As a result, more applicants will be denied benefits. Also, current recipients will lose their benefits.
DHS treated a home in a Revocable Trust as an Exempt or Non-countable asset. This means that the home’s value would not be used as an element to disqualify an Medicaid applicant from benefits. This made sense because a home in a Revocable Trust retains homestead rights. A couple or an individual could qualify even though the home was in the name of a trust.
Now DHS treats the family home as a countable resource if it is in a Revocable Trust. What does this mean?
Current Residents:
Married Couples | Individuals |
Potential loss or denial of Medicaid benefits if the home, together with other countable assets, exceed the certain limits. | Loss or denial of benefits as an individual is only allowed $2,000 in countable resources. |
Deed the property from trust to individuals or couples.
Married Couples | Individuals |
If property is deeded to both individuals and the non-institutionalized spouse dies first, then DHS can place liens on the home for the cost that it incurred. | After 12 months of the stay in a nursing home there is a strong presumption that the individual will not return to the home and resume residency.DHS will treat the home as a countable resource. This will require the sale of the home and spending down the funds to regain Medicaid eligibility. |
Married Couples | Individuals |
Steps to prevent liens:The healthy spouse should maintain the home as his or her primary residence.In addition, considerations should be taken to further protect the home. This may involve making the healthy spouse the sole owner and Estate Planning to prevent the property from reverting to the nursing home bound spouse.Care should be taken to determine how deeds are created. There may be a need to have the healthy spouse place the property into an Irrevocable Trust to avoid probate and for Medicaid Asset Planning. | If the individual in facing liquidation of the home, there are two choices.1. Sell the home then use the proceeds to pay for care until the resources dip below $2,000; or2. Sell the home, give some of the cash to a family member. This creates a penalty period and some of the funds will be used to fund a Medicaid qualified promissory note or annuity to pay through the penalty period.Result of option 2?35-45% of the proceeds might be saved for the family. |
There is substantial risk that an individual in Medicaid payment status will become ineligible. The directive to the caseworkers is to give the family a 10-day notice and if the home remains in the Revocable Trust, then an individual will become disqualified and a couple may exceed their resource allowances.
What Should a Nursing Home Should Do Today?
The worst case is to wait for the 10 day notice.
This can likely mean that the nursing home resident will become ineligible for benefits. A recent email from the DHS’s top attorney, said:
For several years OAC 317-35-41.1 said that home property held in a revocable trust retains its exempt character. As of 9/1/16, this is no longer true, with OAC 317-35-41.1 being amended to conform to 42 U.S.C. § 1396p(3)(A)(i). DHS Medicaid eligibility workers have been given the following instructions:
Effective September 1, 2016, home property in a revocable trust is considered an available resource. When a client’s (Medicaid recipient’s) home property is in a revocable trust, the worker informs the client, or his or her representative, that the home property exemption does not apply unless the property is removed from the revocable trust. The worker provides the client or his or her representative with Form 08AD092E, Client Contact and Information Request, giving the client 10-calendar days to provide proof the property was removed from the trust.
(1) When the client does not remove the property from the trust and the value exceeds the resource limit per Schedule VIII.D of the Oklahoma Department of Human Services Appendix C-1, Maximum Income, Resource, and Payment Standards, the worker denies or closes the SoonerCare (Medicaid) benefit.
(2) When the client:
(A) lives in the home and provides proof the home was removed from the revocable trust, it is excluded as home property;
(B) does not live in the home or a nursing facility and does not plan to return home, the client must take steps to convert the property for use in meeting his or her current needs per (b)(1) of this Section; or
(C) lives in a nursing facility, refer to Oklahoma Administrative Code 317:35-5-41.8 for the home property exemption time frame
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