I was in the process of buying my father's house, fast forward to February he had stroke. He lived in PA, but at the time he was in my house in NJ. He did not have NJ Medicaid, therefore Medicare paid for a facility. Once he was approved for Medicaid he was able to have a decent facility because the other sucked big time.
My father passed away on 10/09, I received the estate probate letter and spreadsheet for what Medicaid paid for my father, they are even charging for Medicaid in 2013/2014.
The facility was paid for 3 months and 9 days, according to the Medicaid spreadsheet, they paid 5,500 per month, I requested the payments from the facility, but it's been a week and have not heard from them.
Can I request these directly from NJ Medicaid?
I find it really odd that Medicaid is paying this high amount, almost like a private pay cost.
They just sent us a spreadsheet with what it was billed and paid (same amount) the spreadsheet has a lot of hidden locked lines (for whoever knows excel) something does not sound right here.
- dad applied for & received benefits from Long Term Care Medicaid program then, & got better & left.
- applied for & on Community based Medicaid program. Community is entirely different application, it’s a waiver program. Usually medical “at need” only, no or sm financial “at need” requirements. Tends to pay for IHHS / in home health services (w/small copay) or day program, like PACE, that does health care as well as more traditional meals & activities. PACE is Medicare & community health Medicaid usually for payment stream.
- whatever State he was in back then opted to have premiums State paid for Medicaid as his HEALTH INSURANCE to be able to have recovery done after death on $ amt of premiums. Isn’t super common. How to deal with these not at all my wheelhouse.
- the person on file 2023-2014, it’s not him.
States can go back 10 years on recovery. Unusual but allowed. Entire “lookback” on assets can be 10 years from date of application filing under federal law. Most States - as each administer their Medicaid programs uniquely but under federal guidelines - choose a 5 yr lookback, some 3 year lookback as just waaaaaay way too cumbersome for caseworkers or data systems aren’t retentive. But 10 years either pre or post is the federal benchmark for how the Public law that funds LTC Medicaid was passed.
On another note, if he still has his home in PA, but died & on Medicaid in NJ even with a valid will dealing w/probate in my not an attorney opinion but been an Executor X 3 will be a beast….& co$tly. $$$. I don’t think it’s at all DIY and you’ll need probate attorney’s for both States. If you can, look for a firm licensed in both States and optimum try to find one with a bar card in both PA & NJ probate courts where he lived. One States hopefully will allow his will to be posted as a foreign will so any actions needed to be done on those assets in that state (foreign) will be ok by a filing from the attorney from the other State in whatever ends up being viewed as his county & State of residence at day of death.
I had this my first time, it was mineral rights / O&G asset & fairly common as lines cross State boundaries; probate court signs off on a request for that asset to move jurisdiction; not a big deahl. I’m guessing that home as an asset this will be a big deahl & more complicated & $$$ to deal with; plus whole aspect of that home - if he still owned it at DOD - is an asset of his estate subject to an attempt of estate recovery by LTC Medicaid rules. It’s atty work.
He did die with a valid will, right? Please pls tell us he had a will!
Now if he did not fully legally transfer his house over to you and beyond any Medicaid lookback, b4 his eligibility, my gut feeling is it is going to be really sticky even for experienced with Medicaid and MERP attorneys to get thru all this. May not be worthwhile….
Be on lookout for mail from tax assessor in PA (maybe delivers to the old house??). Why? well if he became a resident of NJ to be eligible for NJ Medicaid eventually that will surface for PA. If PA had a homestead, I bet assessor removes it & resets his prop taxes to when he “left” PA so house has zero exemptions. Could end up being a year or two re$et$. Property if taxes not paid will go up for tax sale. Taxes could be huge $ increase past due plus forward a year or 2 or 3 to get thru probate, deal w/MERP, etc. Plus pay utilities, insurance.
Elder keeping home while in a NH on LTC Medicaid & dealing with post death stuff, MERP exemptions, probate etc. can b done but whomever POA / Executor will need wallet to pay for all an unknown period of time on property they do NOT own and may end up not owning. Runs risk, which not everyone is comfortable in doing.
is it an informational letter with an “our condolences…... but there’s $ owed” OR is it’s a NOI aka Notice of Intent to file claim/lien?
and does it have a questionnaire attached to it?
which State sent this letter? Like State where his house is? OR state the NH was in? It sounds like they are different. & it sounds like you did NOT get around to buying his house at the time he went into the NH, is this accurate?
And Is it actually from “the State” or is it actually an outside contractor? If it’s this who is the OC?
and
to whom is it addressed to.?
and
does it have a respond by date? Are you beyond the response date as of today?
fwiw asking for more Medicaid details from the Nh is a waste of time.
Why? Because the NH in this drama is just another vendor that was paid by a Medicaid program. Not trying to be harsh to you, but asking for more details from the Nh beyond what you’ve lready gotten can’t really go anywhere as they don’t have anymore info.
In this case you already know they got 3 mos and 9 days paid to them by whatever the state has as its room&board custodial care day rate under the LTC skilled nursing facility Medicaid program. Which is significantly below private pay rates. If that is the exact period of time in the NH that bill is accurate. The grayed out areas probably are the ICd-10 codes specific to their care plan, and the info details as to the NH and their payment stream.
right now what is the status on his house? Like if you went onto courthouse records, what is its title? And roughly its last tax assessor value? Is it accurate? Who is paying property costs? Did he leave a will naming executor and in the will are you solo to inherit it?
dealign with this can be done but it’s a puzzle with interlocking pieces. Yiur answers will help in figuring out juts wtf has happened and likely to happen.
I would wonder if this 5500 included his contribution, SS and any pension. Yes u can call his Medicaid caseworker and ask for a recovery letter. I had to do this because I was selling Moms house and wanted to make sure Medicaid lien would be covered. The amount on the recovery letter is what the lien will be. Now if Dad was on Medicaid in PA, I would think that he would have to pay for recovery there too. Since you said the paperwork shows 2013/14, maybe the States combined what was due. I would ask NJ about this.