Medicaid is not "free" and it is not "insurance"

[Jersey Devil]

This post is not intended to argue one way or the other on the Senate HCR bill, just to try to clear up some of I what I think are misunderstandings by many concerning the nature of Medicaid.

First of all, Medicaid is not "insurance". You cannot buy it, pay premiums for it or contract for it. It is medical care established by the federal goverment and optional for the states (though all states now have it) and is need based, though need, no matter how poor someone may be, is not the sole criteria to be eligible for it. Not all poor people are elibigle for it unless they fall into one of the areas specifically covered by Medicaid (treatment for HIV, nursing home care, etc.).

Second, it is not "free". Though you receive medical care if eligible, you by law must promise to repay for Medicaid when and if you are able to do so. You might think those were empty words, because after all, how could poor people repay for costly medical care? Well, I have seen on many occasions people who were in fact forced to repay Medicaid. They list your treatment, render a "bill" at some point (which is really just notification of the amount owed) and file it as a lien against you. Then, if you inherit Mom or Pop's home, or if you win the lottery or if you have an accident and sue and recover damages you find out a lien has been filed against you and you cannot sell the property, collect the judgment or cash the lottery check without paying back Medicaid. This happens quite often with elderly people in nursing homes after they have exhausted their savings and become eligible for Medicaid when $8.000 or more is added to the lien each month. Except in the case of a surviving spouse (or dependent child) in NJ all of that money must be paid back from, for example, the sale of a home.

But it not only negatively impacts those who have been on Medicaid who want to sell or dispose of property. It also prevents them from buying property. Let's say a person is poor but then obtains an education or job training and a few years down the raod is in the position to actually buy a home. Well, no, because before buying most lenders require a lien search be done on the buyer and if a Medicaid lien turns up they will reject the buyer for bad credit.

I hope this post doesn't sound patronizing and I realize that most probealy know the difference, but Medicare and Medicaid are so different they probably should not be discussed in the same sentence.

[Desertrose]

1. Wow. So help with strings attached,eh?

I shouldn't be surprised, should I?

[dkf]

2. I thought Medicaid is run by the states. No?

[Jersey Devil]

4. Yes and no

If it a federal program administered by the states and paid paritally by the states and partially by the federal governemtn, though not in equal proportions in each state, which is one of the reasons Nelson was holding out - to get (and he did get it) Nebrtaska's Medicaid paid for in higher amounts by the federal government.

[gateley]

3. Thanks -- eye-opening. nt

[Xipe Totec]

6. And scary n/t

[DJ13]

5. I and my lawyer fought the state of California over Medical reimbursement in the early 90's

My father spent his remaining 2 years in a nursing home after a stroke.

They were legally entitled to only claim against an estate valued above $60,000 at the time, and his house was only worth $40,000.

Didnt stop them from trying to seize it for reimbursement, so I hired the former Founding Dean of Texas Tech Law School and we went to arbitration and won.

Screw Medicaid.

[Jersey Devil]

7. I've seen many sad stories

For instance, about 5-6 years ago I represented a man (I am a lawyer) who owned a home with his sister, both single and well over 65. Due to Parkinson's she had to go to a nursing home where she exhausted her savings (not huge but over $200,000) and then went on Medicaid/ She lingered there for several years before passing away.

Well, when he went to sell the house Medicaid wanted half the money. We were able to whittle it down a bit by getting them to deduct her 1/2 of the taxes, insurance, utilities, maintenance, etc. paid by her brother durng the time she was in the nursing home, but they wound up with almost 2/3 of her half anyway.

I have seen this many times.

[frazzled]

18. Medicaid paid for the last 7 months of my mother-in-law's life

We had to put her into a nursing home situation when she was 92. By the time she was about to turn 95, she had exhausted all her financial assets. There was no home in question (she had sold it years earlier and had been living in a senior living situation; the savings out of which her nursing home fees were paid came partially from that). My understanding is that you can have no assets to receive Medicare. I'm somewhat surprised in your example that the poor woman even qualified for it.

At any rate, after the Medicaid kicked in my m-i-l was permitted to stay in her same (private) room at the nursing home (probably out of their good grace); she was hospitalized a lot in that last 6 months or so. That was paid for too. After her demise, neither my husband nor his sister had any financial liability whatsoever for what was extremely expensive care. Of course, they didn't inherit anything either. But they were happy to be able to give their mother the best possible care during the end of her life, without it bankrupting themselves and their families to do so. It was a godsend.

[CountAllVotes]

8. Screw Medicare.

Shouldn't it be "screw Medicaid"?

As the OP wrote the two names, Medicare and Medicaid do not belong in the same sentence. They are two completely different things.

Medicare does not pay for nursing homes. You do and if you don't have the $$$ for it then this is where MEDICAID comes into the picture.

They put a lien against the estate and are entitled to collect back every cent they can find.

So, it isn't such a sweet deal is it?

When my mother fell ill and needed 24-hr. care in a private facility, she paid the bill, not her private supplement to Medicare nor Medicare insurance.

She did not qualify for Medicaid so that was a mute point in her case. Pretty damn sad for someone who worked their entire life and paid into the system and died having insurance. She was a retired FEDERAL employee I might add. And this is what everyone is so hot to get?

People need to know the difference between these various plans that are out there.

My condolences re: you father btw. This is not the type of "change" we need. We need a complete overhaul and a system that covers everyone equally, not this "if you have this then you get" type of crap.

:kick: & recommend.

[DJ13]

9. Yes, you're right. Medicaid.

Thanks!

[CountAllVotes]

10. see ...

it is so very easy to get the two confused and yet they share absolutely nothing. :(

[dkf]

15. How is the long term care in the bill being provided?

Anyone know?

[Armstead]

11. Also the "Make Mother go broke and lose her house so we can qualify for Medicaid" syndrome

That's the position many families are thrown into by the current system. An elderly parent gets old, requires expensive ongoing nursing care not covered otherwise, and tghe family has no choice but allow her to slide into poverty to qualify for Medicaid.

[Jersey Devil]

12. And it is a federal crime for a lawyer to give advice to beat the debt

If a lawyer gives advice to transfer ownership of a home to someone else in order for the owner to avoid a liability for debts like Medicaid that may be upcoming (as in the case of Mom or Pop starting to lose it mentally and the son/daugher bringing them to a lawyer to see if anything can be done to preserve their property), then the lawyer has committed a federal crime if he knowingly helps them develop a plan to avoid Medicaid reimbursement.

Isn't that nice?

[mzmolly]

13. The new bill expands coverage BASED UPON INCOME, alone.

Do you have a link to the assertion that Medicade reimbursements must be repaid if you win the lottery or inherit a home? I'd be especially interested in knowing what the new legislation says in this regard.

I'm out for a bit :hi: have a nice day all.

[Jersey Devil]

14. Too complicated to list

There are many statutes on the subject in each state. In NJ real estate is subject to a Medicaid lien unless it is inherited by a surviving spouse or dependent child under 21 years old.

In the case of some judgments the lawyer must submit a certification that the person does not have a Medicaid (or welfare lien) or the lawyer himself becomes responsible for the lien.

The state also makes a check before sending out lottery checks. There is no special law for this since all of a debtor's property is fair game for a lien.

[mzmolly]

16. Sounds like it depends upon the state?

Thanks for sharing.

[tonysam]

19. If you have to repay Medicaid, then who in the hell would want

this so-called health care reform? This is ludicrous.

That's NOT health insurance reform! It is no more than a damned loan.

[Raine]

17. THANKS

for the info.