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ESTATE RECOVERY IS HERE: HOW
DOES IT APPLY TO YOUR CLIENTS
AND THEIR FAMILIES
Coldwell Banker Woodland-Schmidt
P. Haans Mulder, JD, MST, CFP®
Cunningham Dalman, P.C.
321 Settlers Road
Holland, MI 49423
(616) 392-1821
phmulder@holland-law.com
Background
• Attorney and Partner at Cunningham
  Dalman, P.C.
• Have a Masters in Tax (MST), CFP®
  and specialize in estates/elder law and
  business planning.


                              Serving the Holland area since 1900
Background
• Cunningham Dalman, P.C. has been
  serving the lakeshore since 1900.
• We have 15 attorneys specializing in all
  areas of the law.




                              Serving the Holland area since 1900
Overview
 • Discuss the Medicaid rules and process.
 • Cover the what, who, when, where, and
   how’s of Medicaid.
 • What is estate recovery and why is it
   important to your clients and their families.


                               Serving the Holland area since 1900
Overview
 • What types of assets does estate
   recovery apply to.
 • How it might impact your business.
 • How do your clients and their families
   protect against it.


                             Serving the Holland area since 1900
What is Medicaid?
 • It is a state and federal program that
   pays for medical treatment (including
   long term care).
 • Oftentimes confused with Medicare.



                             Serving the Holland area since 1900
When does Medicaid apply?
 • Historically, it only paid for nursing
   home care.
 • In certain counties (that have the MI
   Choice Waiver program), it will pay for
   care in someone’s home or in an
   assisted living facility.

                             Serving the Holland area since 1900
Who does Medicaid apply to?
 • Applies to people who are 65 years or
   older, blind, or disabled.
 • Must satisfy the medical requirements
   (level of care assessment).
 • Need to meet the income and asset
   tests.

                            Serving the Holland area since 1900
Who does Medicaid apply to?
 • A patient’s monthly income cannot
   exceed the monthly cost of the nursing
   home ($6-7,000 in this area).
 • For the Waiver program, a patient’s
   income (not a spouse) must be less
   than $2,022/month.

                            Serving the Holland area since 1900
Who does Medicaid apply to?
 • The asset test requires that a single
   person cannot have more than $2,000
   in countable assets.
 • A patient can keep his or her home (as
   long as its not in a trust) as well as a
   vehicle.

                             Serving the Holland area since 1900
Who does Medicaid apply to?
 • Asset test allows a married couple to
   keep their home (again, if it’s owned
   properly), a vehicle, and one-half of
   their other assets (up to a maximum of
   $109,560).


                            Serving the Holland area since 1900
What is estate recovery?
 • It is a process that the State of Michigan
   gets reimbursed for the Medicaid
   services it has paid for.
 • It does not put a lien (i.e. Medicaid lien)
   on exempt assets during a patient’s life
   or force a sale.

                              Serving the Holland area since 1900
What is estate recovery?
 • It applies to people age 55 years or
   older who have received Medicaid (i.e.
   long term care) services.
 • Covers Medicaid services back to
   September 30, 2007.


                            Serving the Holland area since 1900
What assets does estate
recovery apply to?
 • It only applies to assets that have to be
   probated.
 • That has the potential to include all
   assets (house, bank
   accounts, investments, vehicle, person
   al property, etc.).
                              Serving the Holland area since 1900
What assets does estate
recovery apply to?
 • But…the only assets that are typically
   left are: bank account, personal
   property (including vehicle), and a
   patient’s house.
 • The house will be the most significant
   asset, but do not lose
   sight of the others.
                             Serving the Holland area since 1900
What effect might this have
on your business?
 • Estate recovery might incentivize
   patients to stay at home longer.
 • Patients might be more likely to sell
   their house and have more liquid
   assets for their care.


                              Serving the Holland area since 1900
How do people protect
against estate recovery?
 • The most effective way to protect the
   house is with a “ladybird deed.”
 • The house remains an exempt asset
   during the Medicaid recipient’s life.
 • The costs and hassle of probate are
   avoided.
                            Serving the Holland area since 1900
How do people protect
against estate recovery?
 • What about other assets besides the
   house.
 • The patient should make sure those
   assets avoid probate (i.e. having a
   trust named as owner, naming a
   beneficiary, etc.).
                           Serving the Holland area since 1900
Some other things to be
concerned about
 • When a single person is on
   Medicaid, he or she can keep the
   house.
 • However, he or she will not be able to
   use Social Security and other income
   to pay the house expenses.
                             Serving the Holland area since 1900
Some other things to be
concerned about
 • This typically means that a child or
   beneficiary must pay these expenses.
 • Children should protect their right to be
   reimbursed by executing and recording
   a mortgage against the house.

                              Serving the Holland area since 1900
Some other things to be
concerned about
 • This gives a child’s reimbursement
   claim higher priority than the State of
   Michigan’s estate recovery right.
 • A child will get paid when the house
   sells.

                              Serving the Holland area since 1900
Some other things to be
concerned about
 • You should make sure the Medicaid
   recipient has signed a financial (also
   known as a general durable) power of
   attorney.
 • That way, the agent can execute the
   mortgage.
                             Serving the Holland area since 1900
This is subject to change so
you have to stay informed…



                   Serving the Holland area since 1900
Stay informed by receiving
our monthly newsletter
(register by emailing
laura@holland-law.com)


                  Serving the Holland area since 1900
Questions……




              Serving the Holland area since 1900
Thank You
 P. Haans Mulder, JD, MST, CFP®
 Cunningham Dalman, P.C.
 321 Settlers Road
 Holland, MI 49423
 (616) 392-1821
 phmulder@holland-law.com
 mary@holland-law.com
 www.holland-law.com

                             Serving the Holland area since 1900

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Estate Recovery Presentation

  • 1. ESTATE RECOVERY IS HERE: HOW DOES IT APPLY TO YOUR CLIENTS AND THEIR FAMILIES Coldwell Banker Woodland-Schmidt P. Haans Mulder, JD, MST, CFP® Cunningham Dalman, P.C. 321 Settlers Road Holland, MI 49423 (616) 392-1821 phmulder@holland-law.com
  • 2. Background • Attorney and Partner at Cunningham Dalman, P.C. • Have a Masters in Tax (MST), CFP® and specialize in estates/elder law and business planning. Serving the Holland area since 1900
  • 3. Background • Cunningham Dalman, P.C. has been serving the lakeshore since 1900. • We have 15 attorneys specializing in all areas of the law. Serving the Holland area since 1900
  • 4. Overview • Discuss the Medicaid rules and process. • Cover the what, who, when, where, and how’s of Medicaid. • What is estate recovery and why is it important to your clients and their families. Serving the Holland area since 1900
  • 5. Overview • What types of assets does estate recovery apply to. • How it might impact your business. • How do your clients and their families protect against it. Serving the Holland area since 1900
  • 6. What is Medicaid? • It is a state and federal program that pays for medical treatment (including long term care). • Oftentimes confused with Medicare. Serving the Holland area since 1900
  • 7. When does Medicaid apply? • Historically, it only paid for nursing home care. • In certain counties (that have the MI Choice Waiver program), it will pay for care in someone’s home or in an assisted living facility. Serving the Holland area since 1900
  • 8. Who does Medicaid apply to? • Applies to people who are 65 years or older, blind, or disabled. • Must satisfy the medical requirements (level of care assessment). • Need to meet the income and asset tests. Serving the Holland area since 1900
  • 9. Who does Medicaid apply to? • A patient’s monthly income cannot exceed the monthly cost of the nursing home ($6-7,000 in this area). • For the Waiver program, a patient’s income (not a spouse) must be less than $2,022/month. Serving the Holland area since 1900
  • 10. Who does Medicaid apply to? • The asset test requires that a single person cannot have more than $2,000 in countable assets. • A patient can keep his or her home (as long as its not in a trust) as well as a vehicle. Serving the Holland area since 1900
  • 11. Who does Medicaid apply to? • Asset test allows a married couple to keep their home (again, if it’s owned properly), a vehicle, and one-half of their other assets (up to a maximum of $109,560). Serving the Holland area since 1900
  • 12. What is estate recovery? • It is a process that the State of Michigan gets reimbursed for the Medicaid services it has paid for. • It does not put a lien (i.e. Medicaid lien) on exempt assets during a patient’s life or force a sale. Serving the Holland area since 1900
  • 13. What is estate recovery? • It applies to people age 55 years or older who have received Medicaid (i.e. long term care) services. • Covers Medicaid services back to September 30, 2007. Serving the Holland area since 1900
  • 14. What assets does estate recovery apply to? • It only applies to assets that have to be probated. • That has the potential to include all assets (house, bank accounts, investments, vehicle, person al property, etc.). Serving the Holland area since 1900
  • 15. What assets does estate recovery apply to? • But…the only assets that are typically left are: bank account, personal property (including vehicle), and a patient’s house. • The house will be the most significant asset, but do not lose sight of the others. Serving the Holland area since 1900
  • 16. What effect might this have on your business? • Estate recovery might incentivize patients to stay at home longer. • Patients might be more likely to sell their house and have more liquid assets for their care. Serving the Holland area since 1900
  • 17. How do people protect against estate recovery? • The most effective way to protect the house is with a “ladybird deed.” • The house remains an exempt asset during the Medicaid recipient’s life. • The costs and hassle of probate are avoided. Serving the Holland area since 1900
  • 18. How do people protect against estate recovery? • What about other assets besides the house. • The patient should make sure those assets avoid probate (i.e. having a trust named as owner, naming a beneficiary, etc.). Serving the Holland area since 1900
  • 19. Some other things to be concerned about • When a single person is on Medicaid, he or she can keep the house. • However, he or she will not be able to use Social Security and other income to pay the house expenses. Serving the Holland area since 1900
  • 20. Some other things to be concerned about • This typically means that a child or beneficiary must pay these expenses. • Children should protect their right to be reimbursed by executing and recording a mortgage against the house. Serving the Holland area since 1900
  • 21. Some other things to be concerned about • This gives a child’s reimbursement claim higher priority than the State of Michigan’s estate recovery right. • A child will get paid when the house sells. Serving the Holland area since 1900
  • 22. Some other things to be concerned about • You should make sure the Medicaid recipient has signed a financial (also known as a general durable) power of attorney. • That way, the agent can execute the mortgage. Serving the Holland area since 1900
  • 23. This is subject to change so you have to stay informed… Serving the Holland area since 1900
  • 24. Stay informed by receiving our monthly newsletter (register by emailing laura@holland-law.com) Serving the Holland area since 1900
  • 25. Questions…… Serving the Holland area since 1900
  • 26. Thank You P. Haans Mulder, JD, MST, CFP® Cunningham Dalman, P.C. 321 Settlers Road Holland, MI 49423 (616) 392-1821 phmulder@holland-law.com mary@holland-law.com www.holland-law.com Serving the Holland area since 1900