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Medicaid Spend down "Die at Home or Assisted Living"


Medicaid Spend down "Die at Home or Assisted Living"


   I really need some advice.  Ive been doing days and hours of research, and really need some community input.    Both of my parents are 90 and still live at home, and they dont want to leave.  Their only income is social security  (about $2200) with no pension and no VA eligibility.  Im a 32 year veteran and my brother retired at 20, or parents taught us well i guess.  


Im familiar with medicaid spend down, 5 year look back etc.  What I cant decide is... should we keep them at home or move them out now.  What is better for their quality of life in the next 5 years, living at home, but being generally broke, or cashing out of their home (sell or HELOC) and using that money NOW to offset costs. Im spending $5k a year keeping them in that house, but will never see that money back if they go on medicaid. 


Their health and ability to stay at home has suddenly become harder.  In the next few months we will need to make some critical decisions but need some input.  Everything I search for online regarding medicaid spend down and protecting home assets etc are all law firms.  


Question:  How do we properly and legally use the equity in their house to cover expenses now and for the next  5-8 years, knowing they will both end up needing medicaid but at different times.  


Problem:  my parents are both low income, and their one and only asset is their house  ($250k of equity).  No savings, no car, no investments.  My brother and I have been assisting them for years at around $200-500 a month with home repairs, home maintenance and other non routine expenses that they cannot afford.  My fathers hygiene is terrible, and my mother is too old and frail to help.  She can cook and clean, but is unable to help with weekly hygiene (bathing).  He can use the bathroom and is mobile, but dont know how long.  Ive purchased and installed every type of grab bar, walker, shower chair, fall alarm, nanny cam, toilet rails etc I can think of.    My 57 year old brother is a homeless veteran insterstate truck driver.  He keeps stuff at their house, but its not his legal residence...... or should it??  He uses his nearby work address for his VA meds.. but legally has no home.  He sleeps in his truck or his GF house when he's home.


Im not even sure medicaid is the right answer for my father or both of them.  I keep reading that Medicaire  (Care Plus) which they use now, would rather keep them at home.  


Sorry, this is some many questions and such a complicated subject.  I dont mind paying an attorney $500 for legal advice, but need some input.  


I see my options as: 

    1.  Keep them at home, they borrow against the house, or I loan them money each year

    2.  My brother somehow legally moves in and becomes their primary caregiver... we keep loaning/giving them money and my brother inherits the house.  (he's broke and lives in that semi truck) 

    3.  time for mom and dad to sell the home, get $250k cash and move closer to me.  Then live where?  My mother in law already lives with us.  She 84.  Im near Miami, parents are in Orlando.


My end goal is to improve their quality of live now  (home hygiene care), reduce their stress taking care of that house, and minimize our long term financial losses, knowing my brother really could use that house, or the equity from it.  He gets a small Army reserve pension and drives trucks full time, but is terrible managing money or managing his life in general. But can drive a truck.  






0 Kudos

I understand and feel your pain. I was the executor for my parents' estate and the "responsible party" to manage their finances and care for the final 20 years of their lives. They each died in their late 80s over the past few years. I gave up my inheritance share in their house to one of my siblings to live with them and provide daily hands on care. It worked out great, but ultimately they each needed to enter a nursing home for the final year or two of their lives. I was able to keep the house (worth approximately $300k) in the family without any Medicare liens and we were able to sell it to settle their estate.

I had good advice from a professional Estate Planner and highly recommend you consult one as well. I don't know how responsible your brother is, but think if you could work out a similar deal with your brother it may be your best solution.

Best of luck!

John D


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