#1 ObamaCare Clusterf*ck: After 55, Medicaid is a loan you pay back from your estate
11-22-2013, 12:02 AM
- Join Date
- Jun 2008
This refers to Medicaid in NJ. Not sure about other states.
ObamaCare Clusterf*ck: After 55, Medicaid is a loan you pay back from your estate
The Division of Medical Assistance and Health Services (DMAHS) is reinforcing and updating guidelines that were issued in Medicaid Communication No. 00-16, dated August 10, 2000, governing the recovery of correctly paid Medicaid benefits from the estates of deceased Medicaid clients or former Medicaid clients. The following is a list of important points to remember when determining eligibility and discussing this topic with applicants, clients, authorized representatives and families:
• Medicaid benefits received on or after age 55 are subject to estate recovery. This is specifically stated and acknowledged on the authorization page of the PA-1G Medicaid Application Form.
• DMAHS has an immediate right to recover from the estate unless there is a surviving spouse or child(ren) who is under age 21 or who is blind or permanently and totally disabled. Should any of these exceptions to DMAHS’ right to recover from an estate no longer apply (e.g., death of surviving spouse, attainment of age 21 by surviving child, or death or termination of disability of blind or permanently and totally disabled child), DMAHS has a right to recover from any remaining estate assets at that time.
• Estate recovery in New Jersey includes payments for ALL services, not merely services for institutionalized clients. There is no limitation on the type of service for which DMAHS can recover its payments from estates including managed care (HMO) capitation fees. However, effective January 1, 2010, Medicare cost-sharing benefits paid under the Medicare Savings Programs such as “Buy-in”, Specified Low-Income Medicare Beneficiaries (“SLMB”) or Qualified Individuals (“QI-1”) are not subject to estate recovery.
• The estates of deceased clients who were enrolled in various Title XIX Waiver Programs (such as ACCAP, GLOBAL Options, CCW, etc.) ARE subject to recovery. The only current exceptions are HCEP and JACC, which are State- funded programs through other State Departments.
• The client’s primary residence, while exempt for eligibility purposes, is considered part of the client’s estate, and therefore is subject to recovery. It is also important to reinforce with applicants, clients and families that any interest that the client had in any property at the time of death will be considered part of the decedent’s estate, and therefore subject to recovery.
• Annuities are required to be disclosed upon application and recertification for Medicaid. For those annuities which are determined not to be subject to asset liquidation, the State of New Jersey must be named as the remainder beneficiary in the first/primary position for the total amount of medical assistance paid on their behalf. In the case where there is a community spouse and/or a minor or disabled child, the State must be named in the second/secondary position as remainder beneficiary. The State or its eligibility agencies shall require verification of the State being irrevocably named as the remainder beneficiary in the correct position and the State needs to be notified of any contractual changes in the annuities’ income or principal. The remaining benefits of an annuity not subject to liquidation prior to eligibility determination are payable to the State (primary or secondary position) regardless of the age of provided services
• “Estate” for Medicaid recovery purposes is now defined by law to include any real or personal property and any assets in which the client had any legal title or interest at the time of death. Included for your reference is a copy of the pertinent regulation. Please note that the definition of “estate” appears at N.J.A.C. 10:49-14.1(e)2 and is quite comprehensive; also note that the term “other arrangements” used in that subsection includes testamentary trusts and annuities.
• Please remember that in the process of estate recovery, DMAHS will file a lien against the estate to recover all payments for services received on or after age 55 (except for annuities).
• No distribution can be made to heirs or creditors from the estate other than for reasonable funeral expenses, costs associated with the administration of the estate, debts owed to the Office of the Public Guardian for Elderly Adults, and claims with preference under federal or state law (e.g., IRS liens) that may be superior to Medicaid’s (e.g. filed prior in time) without first satisfying the Medicaid program’s lien.
And what's so reprehensible about ObamaCare is that they force you into Medicaid. No options if that's how the eligibility plays out; if you want to risk a piece-of-crap policy so you can pass on your house to your kids, you can't do that. Yet another path to downward mobility! Of course, this only applies to the poorest, ObamaCare being ObamaCare....
11-22-2013, 12:11 AM
It just keeps getting worse.
How do you like this shit Lanie?
11-22-2013, 12:14 AM
- Join Date
- Jun 2008
The above article is an important one because so many people will be pushed into Medicaid and there was money for Medicaid expansion in the ACA.
The one below talks about how bad the outcomes for Medicaid actually are:
Four Reasons Why The Oregon Medicaid Results Are Even Worse Than They Look
For years, lefty health policy wonks have insisted, against all the evidence, that expanding Medicaid would save hundreds of thousands of lives, and that, therefore, opponents of the Medicaid expansion are guilty of a form of mass murder. So it’s been interesting to watch their reaction to the Oregon Medicaid study, which found that the $450 billion-a-year program “generated no significant improvement in measured physical health outcomes.” They’ve desperately scoured the study to trumpet any silver lining they can find. But the reality is that the Oregon findings are even worse than they look. Here’s why.
1. 40 percent of those who ‘won’ the Oregon Medicaid lottery didn’t bother to sign up
According to the authors, “only about 60% of those selected [to join the Medicaid program] sent back applications.” Indeed, of the 35,169 individuals who “won” the Oregon Medicaid lottery, only 10,405 enrolled, in large part due to this indifference from the supposed Medicaid beneficiaries, and also because a number of individuals failed in the end to meet the Medicaid eligibility requirements.
In a real randomized, controlled clinical trial, the kind that drug companies must conduct to get past the FDA, you would have to count these individuals as part of your study cohort, in what statisticians call an “intention-to-treat” analysis. That is to say, you have to compare being uninsured to the total group of people who were offered Medicaid, including those who didn’t send back the forms.
If the authors had done that, the study would have had a much larger sample size, and a much smaller difference between Medicaid and uninsurance—in either direction....
4. Medicaid will cost $7.4 trillion over the next decade alone
Paul Krugman, captain of the Medicaid deniers, tried his best to play up the Oregon results, concluding this way: “Above all, you should bear in mind that if health insurance is a good idea—and you are nuts if you let this study persuade you otherwise—Medicaid is cheaper than private insurance. So where is the downside?”
The downside is that taxpayers will spend $7.4 trillion over the next ten years on this failed program. The burden is on Medicaid’s partisans—and proponents of Obamacare’s expansion of the program—to explain why middle-class taxpayers should pay more in taxes to support a program that, at best, makes no difference in its enrollees’ health. These taxpayers, after all, are themselves struggling with high medical bills....
11-22-2013, 12:28 AM
Out of control seems like an understatement.
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