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Expanded Medicaid’s fine print holds surprise: ‘payback’ from estate after death
The Seattle Times ^ | 12-15-13 | Carol Ostrom

Posted on 12/16/2013 7:39:27 AM PST by afraidfortherepublic

As thousands of state residents enroll in Washington’s expanded Medicaid program, many will be surprised at fine print: After you’re dead, your estate can be billed for ordinary health-care expenses. State officials are scrambling to change the rule.

It wasn’t the moonlight, holiday-season euphoria or family pressure that made Sofia Prins and Gary Balhorn, both 62, suddenly decide to get married.

It was the fine print.

As fine print is wont to do, it had buried itself in a long form — Balhorn’s application for free health insurance through the expanded state Medicaid program. As the paperwork lay on the dining-room table in Port Townsend, Prins began reading.

She was shocked: If you’re 55 or over, Medicaid can come back after you’re dead and bill your estate for ordinary health-care expenses.

The way Prins saw it, that meant health insurance via Medicaid is hardly “free” for Washington residents 55 or older. It’s a loan, one whose payback requirements aren’t well advertised. And it penalizes people who, despite having a low income, have managed to keep a home or some savings they hope to pass to heirs, Prins said.

With an estimated 223,000 adults seeking health insurance headed toward Washington’s expanded Medicaid program over the next three years, the state’s estate-recovery rules, which allow collection of nearly all medical expenses, have come under fire.

Medicaid, in keeping with federal policy, has long tapped into estates. But because most low-income adults without disabilities could not qualify for typical medical coverage through Medicaid, recovery primarily involved expenses for nursing homes and other long-term care.

(Excerpt) Read more at seattletimes.com ...


TOPICS: Business/Economy; Government; News/Current Events; US: Washington
KEYWORDS: aca; biggovernment; estates; exchanges; healthcare; marriage; medicaid; medicaidestates; medicaidexpansion; medicaidloan; obamacare; subsidy
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To: Gaffer

Thank you for pointing out that many do not have any sense of responsibility toward their family-if they did, we probably would not even be discussing how best to throw mamma off the train/into the death home, not be bothered with her and keep her stuff.

We don’t do that in my large, latino family-some may think it is weird, but we consider it the Christian thing to take care of our family members if need be-I must have missed the part of Jesus’ teachings where he said to warehouse your relatives when they became inconvenient to your lifestyle. I have zero empathy for that attitude, never mind having been a case manager in a former life.

If you put your relatives out of sight and mind because you don’t want to be bothered, you deserve the bill for the misery you have caused them in later life, not to mention whatever misfortune the Almighty sends you-and to top it off, you are feeding the government beast. Flame away if you like-that is my belief...


121 posted on 12/16/2013 9:24:13 AM PST by Texan5 (" You've got to saddle up your boys, you've got to draw a hard line"...)
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To: jpsb
But now with health care they are going to get thier hands into my pocket and most likely will end up owning my home.

Well, I can't argue with what you say. I can only say that if one is thinking about what will come after they die, they should be acting now, or at least exploring the options that are available. Nothing says that you can't transfer wealth to your children before you die. You can give $12K a year (maybe even more now) to every one of them each year, tax free. I have done this several times.

122 posted on 12/16/2013 9:24:34 AM PST by Gaffer
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To: Ladysforest
... my Grandma-in-law had GIVEN my in-laws a nice house, free and clear AND fully renovated, about fifteen years earlier.

Well, there's the problem right there.

Greed isn't a genetic trait. Generosity often breeds and cultivates it.

123 posted on 12/16/2013 9:26:38 AM PST by Alberta's Child ("I've never seen such a conclave of minstrels in my life.")
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To: AppyPappy
Yes but you have to do it 5 years ahead of time.

It depends. The attorney who helped us with my mother assures us that by putting all her assets in a revoccable trust and keeping only $2000 available to her, her estate is protected and also protected from probate. As her retirement funds are paid into that $2000 bank acount, I move the excess into her Trust, from which I pay all her bills and supply all her needs. I am assured by the attorney that (in CA) she is still eligible for MediCal, should she further decline and need skilled nursing care. She is currently in Assisted Living (private care) which I pay for out of her Trust. He said that MediCal would be available to her immediately after setting up the Trust 1 1/2 years ago, should we need it. We haven't. She turned 100 in August. They have raised her rent, however, because she now needs more care than when she entered the facility.

124 posted on 12/16/2013 9:28:00 AM PST by afraidfortherepublic
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To: GOPJ; afraidfortherepublic; MrB; Mr. K; Liz
RE :”The way Prins saw it, that meant health insurance via Medicaid is hardly “free” for Washington residents 55 or older. It’s a loan, one whose payback requirements aren’t well advertised. And it penalizes people who, despite having a low income, have managed to keep a home or some savings they hope to pass to heirs, Prins said.
.....
One more thing about Obamacare that hurts white people more...’

The way medicaid works now (prior to this) is it doesnt pay at all if the patient has assets or exceeds an income threshold, so the hospitals and nursing homes have to sue to get the money if the patient doesnt pay.

What relatives did in the past was to transfer their $$$ or set up a trust so the taxpayers would get stuck with their nursing home bills later on.

125 posted on 12/16/2013 9:29:14 AM PST by sickoflibs (Obama : 'If you like your Doctor you can keep him, PERIOD! Don't believe the GOPs warnings')
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To: afraidfortherepublic

Here is where pre-planning factors in. NOT pre-paying, as that can bite you in the butt as we found out with grandma-in-law, but pre-planning you get to ask all these questions. For example, does this funeral allow the family to provide it’s own casket or do we HAVE to select from the ones you offer? Some states may have laws in place, and it’s best to look into that stuff a head of time. Some funeral homes may have policy different from what the state law allows. Ask many questions.

Like embalming for example. In NY we don’t have to have that done, unless it is going to be a public viewing. If it is a small family only viewing, no embalming required. Many states are that way. This saves us about $900. Our family is tiny, and Pop only has a few friends, so we won’t have a viewing at all except that a couple of family members may take a moment to “visit” once Pop is casket-ed. That saves over $1000. of charges for a tiny family viewing. I opted out of the limo ride for Pop, and he will go in the SUV “lead car” instead. Saved $300. on that.

Like I said, nitty-gritty. But it will be nice, it will be dignified and have a graveside service with clergy, and it will be paid for in full. My father never thought a minute to provide for his own final expenses, so it falls on me.


126 posted on 12/16/2013 9:39:53 AM PST by Ladysforest
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To: mdmathis6
And that is how you get to single payer...make it so nobody qualifies for any sort of “market plan” because their income is deemed too low. In a few years as the insurance companies go bankrupt, more folks get hearded into Medicaid, even richer or more well off folks, as Medicaid is the only “payer left” in the Obamacare system!

Single payer is not pure government healthcare, it is a front for a healthcare monopoly.

The monopolists (new world order) provide financing for the government as well as all medical institutions.

New world order is famous for these sorts of arrangements which are very difficult for most people to understand.

Take your typical local hospital. The hospital corporation itself, i.e., the brand name, may well be a non-profit corpporation. Doesn't that sound ever so charitable and lovely ?

But one has to get into its financial details to understand how the money moves around. First, the building and all its equipment are all financed by corporate bonds. Ding, new world order's Wall Street branch of its global bond syndicate earns on this deal. Oh, and dicates the terms of the deal, and routinely gets NWO social engineering included in the laws and regulations that govern how hospitals must function. Wanna be a hospital ? It's on NWO's terms and you need to go to them for financing.

The equipment is purchased from NWO's medical equipment industry, so those companies are profiting - and they love to see prices rise.

The hospital may be host to a medical corporation that runs the heart surgery business in a separate wing. Now that group is a for-profit. It takes on much of the liability of doing the operations, it contracts with local doctors, which also have their own businesses, to provide the services. Allowing doctors to make pretty good profits has kept them on the same side as new world order all along. Doesn't hurt that new world order financial elites established, endowed and oversee the premier universities and medical research; thus doctor's minds are shaped in medical school to think within new world order's medical industry bubble.

So the whole "non-profit" hospital arrangement is really just allowing all the capital expenditure - which runs in the hundreds of millions for many hospitals - to be done with tax-exemption. NWO makes a concerted effort to avoid taxes, which makes sense; their strategy is to get government to collect taxes from the sheeple and then spend as much of that money as possible on NWO operations. NWO doesn't spend money on taxes, taxes are a source of revenue for them.

There will also be separate non-profit foundations set up to take donations from sheeple who manage to acquire some wealth and want to "give back". This allows those wealthy donors to gain some tax advantages when they donate, while allowing some flexibility in how its actually used.

The really neat NWO trick is that the (NWO-controlled) insurance industry wrote Obamacare. The insurance companies and government officials can blame each other publicly, but behind the scenes members of Congress are simply acting on the orders transmitted to from NWO via staffers, which are guided by "experts" at some powerful "foundations". NWO is all about monopolies, and the ulimate monopoly is to have government mandate that everyone buy a "government" product or service, and then what is actually happening is a monopoly or oligopoly is actually providing the "government" product or service. This is the case with the infamous "single-payer" deathcare systems of the nations belong to new world order's British Commonwealth.

Notice that ALL these "obamacare" plans are being sold by insurance companies, and the biggest companies are best able to maneuver, doing things like setting up subsidiaries to sell just obamacare products, and culling out of the normal customers large swaths of policies they can cancel "because of obamacare". Sorry customer, your cheap policy that only provides coverage you need won't be renewed. You need to buy a policy that provides coverage you don't need. Sorry, it's the damned "government's" fault.

The best way to screw someone is set things up so they don't know they're being screwed. Second best is so that they think someone else is screwing them instead of you.

Statism is simply a front for new world order, which is the biggest of the big money people. The government is simply a puppet show for the sheeple so they can throw tomatoes at it. Those concentration camps and guards that we fear so much will actually be working for a private shadow government.
127 posted on 12/16/2013 9:41:38 AM PST by PieterCasparzen (We have to fix things ourselves)
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To: Ladysforest

All good tips.


128 posted on 12/16/2013 9:45:51 AM PST by afraidfortherepublic
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To: Gaffer

I do distinguish this from medicare, which everybody is forced to use, and which we supposedly paid for during our working years.


129 posted on 12/16/2013 9:53:11 AM PST by CharlesWayneCT
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To: jpsb

This is not medicare at 65 that you are required to take.

This is something you can CHOOSE to sign up for. With that choice to take taxpayer money, you have to also agree to pay it back when you die rather than pass it on.

This is not an argument over whether there should BE such a program. The program exists. The argument is whether someone who chooses to take taxpayer money should later complain when they are asked to pay it back rather than leave their money to their children.


130 posted on 12/16/2013 9:55:16 AM PST by CharlesWayneCT
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To: Alberta's Child

Sad but true. My MIL expected everything would go to her because she was the only child. She never discussed it with her mother, and since her mother had always picked up the slack in their life, she expected to have the whole pie once she convinced her mom to sign herself up as a resident in the nursing home.

She is still resentful of us for having the house. She makes up fake reasons for not coming over to holiday meals when invited - so I stopped inviting her a few years ago. Now she complains that she doesn’t get invited.

My husband takes care of her house, mowing, snow shoveling, plumbing issues, car problems, etc. His dad passed away a few years ago, but he was doing all this while his dad was still alive too. I don’t like going over there because she whines constantly. My husband blames his dad for not setting his mother up better - I can’t seem to get him to understand her own responsibility in the whole thing. Bah!

She could never have afforded this house anyway - taxes here are very high for such a small house, and it needed much updating. *Sigh*, still needs a roof.


131 posted on 12/16/2013 9:56:39 AM PST by Ladysforest
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To: Ladysforest
Get this-my Grandma-in-law had GIVEN my in-laws a nice house, free and clear AND fully renovated, about fifteen years earlier. My MIL still lives in that house. Greedy.

Food for thought: you go in for a heart op. you're told that you need rehab afterwards; MC pays 21 days, after that, its some ridiculously high $400 per day.

Comes day 19 or so, none of the staff is talking about you leaving. You're kept medicated and aggravated by dealing with the pokings, proddings, not-so-hot food, your underwear is missing, etc. You start asking about going home. Oh, you really think you're ready ? Doctor's not here today. Etc.

As the weeks roll by and the bill starts adding up, you get angry, want to go home. But your getting angry is a "medical issue". Combative patients get a little sedation to "help them sleep" and "relax". Gee, this patient can't make it at home alone, he's getting alzheimer's; he can't communicate well and gets disoriented and combative. The social workers recommend that he stay in rehab indefinitely.

Now the billing department starts the paperwork, contacts the relatives, explains the plight of "poor old patient", how much care they will need at home, how difficult patient is, could have a heart attack any day. All relatives need do is just sign this form and all will be taken care of; we're here to help.

In truth, a few days of rehab would have been fine and patient would have been back in their home for 15 more years living a great life. Relatives would only have had to yank dear patient out of rehab. Would help, when patient gets home, if they had a little help, like shoveling snow, lifting heavy objects, etc.

MC is actually an insurance plan that seniors pay for every month. Wow, so you pay a payroll deduction during your working life, then you pay an insurance premium when you get old. MC is not free. MC does not cover everything 100%. And you're liable for the part of claims from your "providers" that MC does not pay.

Don't forget, new world order looks at government money as THEIR money that their government collected from you, their subject on their behalf. So all the cash MC takes in and pays out - that's all NWO money in their eyes. So NWO is requiring that everyone sign up for MC when they reach a certain age, or face much higher premiums if they sign up later (it's been this way for a long time). All the MC money, after all, gets paid out to the healthcare industry, which is a NWO-controlled industry. It's simply a way to get those pesky "little-people" to pay; they keep not wanting to pay for the medicine that NWO performs on them.

The preferred NWO "liquidation" of a person, after a lifetime working in the service of NWO:

Families often do not get along well; younger people tend to favor not helping out their elders. In which case, the medical industry helps themselves to all the elder's assets and their estate, in exchange for "managing" the "end-of-life" phase. In this phase, all the patient's assests are turned over; as long as the person can be profitably kept alive by the medical industry they are; after that, NWO's palliative care steps in.
132 posted on 12/16/2013 10:10:54 AM PST by PieterCasparzen (We have to fix things ourselves)
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To: Gaffer

I agree.
I got my Grandpa’s tools, my Grandma’s books, and some seeds for the hollyhocks.
Oh, and a jar of dirt from the farm.

That is all I want.


133 posted on 12/16/2013 10:12:19 AM PST by redgolum ("God is dead" -- Nietzsche. "Nietzsche is dead" -- God.)
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To: gdani
I haven't seen anyone advocating anything illegal.
Nor did I accuse anyone of doing anything illegal. Legal and ethical are two different animals. Ethical is a more stringent set of requirements than merely "complying with the letter of the law". The fact that you, along with many others are ignoring the distinction, is but another facet of the systemic problems with our culture, that, dare I say it no election will ever fix. It is a problem of the soul of our culture. No grandstanding here either, just an observation.
134 posted on 12/16/2013 10:21:07 AM PST by JadeEmperor
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To: afraidfortherepublic

I forgot to mention - a “code word” for funeral homes. When you, a grieving family member, call the funeral home to come and collect your deceased loved one, the person you speak with at the funeral home will ask you if you want them to “Prepare” the remains.

You automatically respond, “Yes”. You figure that means to get the remains dressed or something similar, right? It is code for embalming.

So, everyone, if you have decided to forgo embalming, remember that code word when the time comes. ASK if you are unsure, and make sure to state clearly that you do not opt for the embalming procedure.

I got my recent updated line item quote in writing, and had it put on record at the funeral home we will be using.


135 posted on 12/16/2013 10:23:14 AM PST by Ladysforest
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To: Gaffer

“This stipulation/rule/whatever you want to call it is NOT a byproduct of Expanded Medicare. It has been there for decades IIRC.”

And that’s the problem. Before obamacare, medicaid had an asset qualifier, which meant there would essentially be no estate upon death.

But obamcare now looks ONLY at income, so there could be quite a large estate that the government confiscates at the time of death. And the really bad part is that obamacare essentially FORCES people onto to Medicaid (which is some of the worst insurance in the world) whether they want to or not.


136 posted on 12/16/2013 10:30:46 AM PST by catnipman (Cat Nipman: Vote Republican in 2012 and only be called racist one more time!)
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To: AppyPappy

According to the article, current income is the only criterion for Medicaid, assets don’t count anymore.


137 posted on 12/16/2013 10:30:46 AM PST by OK_Sam
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To: PieterCasparzen

After my grandma-in-law had gone through 2/3 of her cash stash paying for assisted living, they suddenly decided she needed to be in the full care (or whatever that is called) at twice the daily cost. I guess they wanted to make sure to get every last dollar, and they sure did.

She died about eight months after her own money was exhausted. Prior to that she had been doing really well. Creeps me out.


138 posted on 12/16/2013 10:33:48 AM PST by Ladysforest
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To: afraidfortherepublic

Everybody here is missing the point, namely, people are essentially being FORCED onto Medicaid by obamacare whether they want to or not. And Medicaid is practically the world’s worst health insurance.

If your income is too low you are forced to either take Medicaid against your will, or you must pay the FULL exchange policy rates, typically $600.00 per person per month, plus $6,000.00 out of pocket, which would usually be impossible if your income is that low.

This is extremely bad news for those who would be willing to pay SOMETHING for decent insurance. And do remember the reason the exchange policies are so overpriced in the first place is because of obamacare itself.

So all the people being FORCED onto Medicaid against their wills are simply another class of people being completely fuched by obamacare.


139 posted on 12/16/2013 10:37:05 AM PST by catnipman (Cat Nipman: Vote Republican in 2012 and only be called racist one more time!)
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To: Ladysforest

The situation you describe happens all the time.

The sheeple are clueless when it comes to keeping vultures away from their assets.

Also clueless about passing down family wealth.

Also clueless about keeping money IN the family through marriage.

Of course, NWO has absolutely no morals, but that’s a different story.

It’s why new world order treats sheeple with such disdain, because they make such mistakes, allowing their assets to be “snookered” away from them.

Don’t forget, NWO are the “evolution” people - they believe they have a right to enslave anyone dumb enough to be enslaved. NWO are the original “survival of the fittest” people.

After all, what is the point of saving up $500,000 in one’s life...

if instead of passing it on to your heirs (who could perhaps use part of it to pay for the education of a gifted grandchild, or perhaps use part of it to set up a family member in a small business)...

you simply allow it to be grabbed by non-family members who are lazy crooks and scam artists.

For $12,000 per month, you could stay at the finest hotels.

Stand with a stopwatch and keep a log of all “care” provided by the staff. Try some of the “food” that is provided. Ask if there is a doctor available in the building. See how many times a registered nurse comes into the room. Tally up the cost of the equipment used in their personal “care” regimen.

Nursing homes would be overpriced at $2,000 per month. Sounds like $10,000 worth of scam.

Made possible only by government regulation, which keeps out all competitors. Every nursing home is legally required to be run the same way.

Do you see how the post-WWII cultural shifts were required to put this massive scam into place ?


140 posted on 12/16/2013 10:37:12 AM PST by PieterCasparzen (We have to fix things ourselves)
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