Medicaid Planning

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Medicaid Estate Recovery in Missouri…

Medicaid Estate Recovery in Missouri…


Under Missouri law, MO HealthNet (aka Missouri’s Medicaid Program) can make a postdeath claim against the estate of a benefit recipient.  (RSMo. 473.398).  This is known as Medicaid Estate Recovery.

This blog article discusses Medicaid Estate Recovery in Missouri, how it works and exceptions.  For starters, Missouri courts have recognized the state’s right to pursue an accounting to recovery property to satisfy its claim.  The Family Support Division (FSD) will sent a notice to the person handling the deceased person’s affairs.

There are exceptions to the right to estate recovery.  One is if there is a surviving spouse of the decedent who received Medicaid benefits.  The other is where a surviving child under 21 years of age or surviving adult child who is blind or permanently and totally disabled.  Additionally, no recovery is allowed where the benefit recipient was under the age of 55 when they received MO Healthnet benefits.

Estate recovery claims are not subject to the six month nonclaim period like other creditors or to the one year deadline for filing a claim.  However, if not probate proceeding is filed within one year of the recipient’s death, the estate recovery is time barred.

A MO Healthnet Claim is a claim of the seventh class (RSMo. 473.397), so it is allowed after payment of court costs, administration expenses, exempt property, the family and homestead allowance, funeral expenses, taxes and debts to the United States and the reasonable cost of a tombstone.   Basically what this means is that the Medicaid estate recovery, if valid, is paid after all of the above is paid first.  Those expenses can be significant and as a result can ultimately reduce the value of Medicaid estate recovery claim.

The standard of proving the claim is low.  Missouri Department of Social Services (MoDSS) does not have to produce written records.

Proper Medicaid planning can help ensure not only initial eligibility for Medicaid but also protect the estate, as best as possible, against estate recovery.  Our office assists clients with this type of planning and offers clients a free consultation to see if they are a good candidate for Medicaid Planning.


Two Important Statistics Related to Aging in America

Two Important Statistics Related to Aging in America

1.  The life expectancy of today’s senior is roughly a decade longer than the previous generation of seniors.

2.  Over the next 25 years, the senior population is expected to increase 70%.

In a nutshell, the future holds that there will be more seniors and they will be living longer….and the need for estate planning and long term care planning for Medicaid and VA benefits are set to increase significantly.



Caring for Mom and Dad as they age…

Probably one of the best things about being an estate planning and elder law lawyer is that I get to work with and help seniors.  I am often dealing with the adult children of elderly parents as they are suddenly dealing with a crisis with Mom or Dad or a slow evolving process of needing to help them out as they age.

There are two main issues for us to discuss if you are helping an elderly parent.  The first issue we need to discuss is whether Mom and/or Dad have their estate planning in place and updated.  Do they have a will?  Is there a trust?  Have their assets been transferred into the trust?  Is there a recent power of attorney allowing you to make decisions for them (if they want you to do that)?  The cutoff for completing estate planning is competence.  Once a person loses competence, we lose a lot of ability to proactively complete estate planning for them.
There are alternatives.  Without a power of attorney, we’ll have to file a petition for guardianship to have the court appoint you as the legal representative.

We usually see outdated or incomplete estate planning with older clients and that’s why it’s especially important that we tackle this issue first.  Because going forward, those documents have to be done before it’s too late.

The second issue is whether Mom or Dad should stay at home, can move to an independent living facility (the next best thing to being at home), should go to assisted living or must go into skilled nursing.  This largely is going to hinge on their medical condition and whether Mom or Dad wants to move.  If they are going to a facility the question then becomes how are they going to pay for that?  It is one of the unfortunate quirks in our healthcare system that physical ailments (such as heart problems / strokes) are paid for nearly in full by Medicare, regardless of age, but diseases such as Alzheimer’s and other forms of dementia are not covered when they require more extensive and prolonged care for their patient.

Depending on the type of facility, there are a few different ways to pay for long term care.  The first is private pay.  Next and best is long term care insurance.  Then there are government programs such as VA Aid and Attendance and Medicaid.

VA Aid and Attendance is available to veterans and surviving spouses of veterans who have served one day in a war time period, had 90 days of active duty and were discharged honorably, are in need of the “aid and attendance” of another person with the activities of daily living and have limited assets and income.

Medicaid is a federal program administered through the states and is much more stringent in the amount of assets an individual can have (in Missouri, less than $1000.00).

No matter what the circumstances, you will need a competent estate planning and elder law attorney to guide you through the process.  Estate planning and elder law has a lot of moving parts and they are constantly changing.