Medicaid and my mother.

Jinx - yeah but the caregiver option can mean that the caregiver has to do that for possibly years & years & years since there is no crystal ball. If mom is 75, and at 90 moves into a NH that means the caregiver in order to benefit from the MERP exemption has to do caregiving as their full time & only "job" for the whole run of 15 years till mom goes into and qualifies for a NH/Medicaid. And momma's house is now 15 years older too and maybe not in the neighborhood that is was back in 2013. If mom is 75, the kids are likely to be in their 40's or 50's and still with their own jobs, businesses and their own kids not even in college yet. I think it's really hard and unrealistic to expect your kids to essentially give up their life and livelihood so momma can keep her house. Or better yet for 1 of the kids to give their time and the other siblings don't. This site is filled with very not pretty stories of the daughter (usually) who after taking care of mom, now has siblings who share equally in mom's estate and to the total detriment of the health and financial well-being of the caregiving daughter.

And since we've lost that crystal ball, what if the exempt homestead asset changes for Medicaid in the future. Personally, I bet that is what is going to happen in the states in which homestead laws are not quite so sacrosanct - that the home will be exempt for a set amount of time (my guess will be 18 months) and then I bet will be required to be placed on the market via a Realtor in order for the elder to stay on Medicaid. I bet it would have to be an active real estate listing unless there is a valid exemption done within the 18 months. The states are going to have to figure out something to offset and recoup the huge costs that NH Medicaid costs and this would do it or at least do a big dent in the cost.

You are spot-on on understanding (or trying to understand) MERP is essential. Are you at all familiar with HMS and what they do? If not, google HMS MERP. yeah be concerned, very very concerned. Really taking subrogation to a new level & totally legal. I don't think most of us who have parents or spouses on Medicaid understand what MERP means and that they have to respond asap to any and all MERP letters and have to clear the potential MERP claim or lein in order to own or sell or do whatever to the property without problems later on. If HMS is your state's contractor, they are very, very good at what they do and very very through. The little old 88 yr old still bereaved over her husbands death widow is really in no position to get the paperwork done in short order with whatever documents required asap by MERP. Right now how MERP is done is so unfair to families that have just had a death and is one of the reasons why I post on what I've read on MERP on this site.

One way to preserve the house would be for one of you children to move into the house and become her full-time caregiver.

Is your mother on Medicaid now?

Read up on MERP - Medicaid estate recovery plan - to learn more. Google "MERP Medicaid" and your state name.

As Heiser has said, you all really need to speak with an elder care attorney in your state. As mom has a house, I'd look for one with experience in your city or county.
This site has lists of elder attorneys's too.

At 75 mom is still young and really you likely have time to plan out for her and her needs. Her Medicare and SS are NOT affected by whether or not she has a house. SS & Medicare are set federal benefits and mom & dad have paid into them by working. Those FICA deductions they paid underwrite both SS and Medicare. One thing you want to look into is if mom's SS is under her "pay-in" or under dad's. Usually dad's is a much higher rate as men make more $ and work longer, so do look into that. But what will matter for mom, now that dad has died, is whether or not she can manage all with the house for the possible decade plus ahead of her. You really need to figure out what realistically the house costs to maintain (taxes, insurance, yard, utilties) and what future costs are out there (like the roof is at 22 years and will need a total replacement in the near future). If they still have a mortgage, it can be alot of $$ out every month just to maintain the basics on a house. My dad died in the 1980's and my mom continued to live in the house till she went into IL a few years back. Over 2 decades of her alone in the house and it worked for her as she had a good support system and was pretty logical in decision making and had a very good retirement & health insurance from my dad which paid 100% of all her health care costs until she went on NH Medicaid. Had my mom only had SS and had to co-pay for her Medicare expenses for those decades, she would have run out of funds years and years ago rather than when she hit her 90's. You kinda have to just take the time to go through their finances and see where they stand and then look at the house costs.

Now Medicaid is an "at-need" program so if mom & dad have/had a very limited income, then they could get some Medicaid benefits. Medicaid benefits can pay for NH, or some mental health services and also food benefits. Are they getting SNAP or food stamps? if so, mom might need to be requalified since there is only 1 in the household now that dad has passed so the amount would be less. Understand?

If dad was in a NH and on Medicaid, then there will be some issues as far as your mom's exemption as the surviving spouse to the house. If dad was in a NH on Medicaid was the case, then the state should send out a letter from MERP (Medicaid Estate Recovery Program) to whatever address the state has in the Medicaid application asking about exemptions to MERP. If mom get's this, it is critically important that the MERP questionnaire be filled out properly and mailed back to the state. A MERP letter is not something to be ignored. Your mom will have the surviving spouse homestead exemption but she needs to let the state know in writing. MERP only matters if dad was on a Medicaid program that is under MERP rules. Food stamps or SNAP is not included in MERP oversight.

Now is a good time to have a realistic come to Jesus talk with all family and mom regarding what options to consider. Yeah, it's hard to do but really sometimes it just has to be done. 75 is young and if mom is in relatively good health, she in all probability will live another decade plus. Planning ahead and spending the money to do so with an attorney will in the long run be priceless. Good luck.

I'm 62 and I hope my kids will get a reverse mortgage or sell the house to help pay for my care. Don't be surprised to find out Medicaid already has a lien.

If your mother takes her name off the house, it would treated by Medicaid as a gift. If she then needs to apply for Medicaid within the next 5 years, that gift would cause a period of disqualification from Medicaid coverage, i.e., a "penalty period." In addition, she would no longer have the legal right to live in her own house (unless she signed an occupancy agreement with you).
Because the available techniques to protect the house vary from state to state, the best course of action will depend on your own state's laws. I suggest you contact an elder law attorney with experience in Medicaid planning to help you figure this out and decide how best to protect the house. Good luck!