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Medicaid Myths Debunked with Schraeder Law
Episode 902nd October 2023 • Looking Forward Our Way • Carol Ventresca and Brett Johnson
00:00:00 00:36:47

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We are joined by guest Larae Schraeder, an attorney specializing in elder law and Medicaid eligibility and planning. Schraeder shares her expertise and personal experiences while discussing the intricacies of Medicaid and the importance of proper planning for long-term care.

Larae emphasizes the need for strategic preparation when it comes to potential long-term care or assisted living needs. She advises individuals to gather and retain financial documents, such as bank statements, during hospital stays and to consult and receive advice on preserving assets.

The topic of spending down to the $2000 asset limit for Medicaid is discussed, with Larae highlighting that it may not always be necessary but steps can be taken to meet the criteria.

Larae discusses the importance of transparency when filling out Medicaid information, particularly regarding gifts that have been made. There can be debates over eligibility, especially when it comes to defining what constitutes a gift.

Medicaid, a program that includes federal funding but is administered by individual states, is then explored. Larae explains the various benefits covered, including the SNAP program, health insurance for children, assistance with Medicare premiums for older adults, and long-term care for adults who meet certain criteria.

The parameters for qualifying for long-term care benefits in Ohio are outlined, including residency, meeting income limits, and having restricted assets. Larae also highlights the importance of strategic asset planning to prevent impoverishment for families stuck in the middle, who have too much to qualify for Medicaid but too little to afford necessary care.

The discussion then shifts to the challenges faced by facilities and the limitations they may have in providing legal advice regarding preserving assets. Larae cautions that qualifying for Medicaid does not guarantee the ability to keep assets and leave them to chosen individuals after death.

Larae explains the Medicaid estate recovery program in Ohio, where assets are reported to the state upon the Medicaid recipient's death. Schraeder assures listeners that estate recovery constitutes a small portion of the budget spent on Medicaid programs and is not a significant source of revenue.

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Recorded in Studio C at 511 Studios. A production of Circle270Media Podcast Consultants.

Copyright 2024 Carol Ventresca and Brett Johnson

Transcripts

Larae Schraeder [:

completely spent down to the $:

Brett Johnson [:

We are Looking Forward Our Way from Studio C in the 511 Studios in the Brewery District just south of Downtown Columbus, Ohio. Hi. This is Brett, our guest today, has provided us some great information over the past year, given the complexity of Medicaid, its rules, regulations, and paperwork, we knew that Larae Schraeder from Schraeder Law was the expert to call for assistance in this important decision and discussion.

Carol Ventresca [:

Larae, thanks for joining us. Thanks for having me. I'm happy to be back. Lorey, thank you so much for coming today and talking to us and bringing your expertise. we have all known individuals who cannot afford their long term care. there and it's such a complicated process. You opened your law practice inspired by a belief that many need an advocate, particularly older adults. So, thank you so much for coming today. Let's start though, with an overview of your background. and how you have structured your firm to meet these needs in our community.

Larae Schraeder [:

Yes. After several years in financial services, I had the opportunity to go to law school, which I had wanted for some time. I was still helping care for my grandparents who were in their nineties. And they were living with my mom because they felt so strongly about not being in a facility. And during my time in law school, I realized that this was something that was very important to me. I still felt I would likely pursue corporate law, but given the opportunity, to focus full time on those who are older and who had these concerns. am I gonna lose my house? What's what's gonna happen to me or to my spouse? that when I left law school, I started practicing part time to help families with those challenges. While I was a student, my grandmother did end up needing long term care in a way that was not met, at our home anymore. And so, unfortunately, I saw the whole Medicaid spin down process and she spent the 2 years in a facility, and other people are going through that and it's scary. She was fortunate enough to have an advocate, but not everybody does. And this is a changing area of law. There aren't a lot of practitioners who are willing to do it. This is not a topic, regularly covered. It's not on the bar exam. This is just an area that, people choose to specialize in later, mainly when they have a passion or have been otherwise exposed. And so that was true with me. And I've continued to dedicate my practice to estate planning, but also with a special focus on elder law and including Medicaid eligibility and planning.

Brett Johnson [:

what is Medicaid and what's its goal? And then I know it's part you know, it it's health care, but how does it help those that are most vulnerable.

Larae Schraeder [:

Medicaid is a very broad term. There's federal funding, but programs are administered by the states. And each state has different rules. So I think that's one thing to keep in mind, especially when you're comparing notes at the family table at Thanksgiving, because everyone's experience would be different, even by county within Ohio. Medicaid is a broad program. It includes many, such as the snap, supplemental nutrition assistance program, and health insurance for children. Assistance with Medicare premiums for older adults. But it also includes significant, forms of long term care for adults that meet the criteria. that may be in a skilled nursing facility, but we also have separate programs available to people in assisted living that can't afford their care. or people who are living at home and they need, people to come to their home a few hours a week, to provide assistance, and they'll stay in the community. So long term care Medicaid is, the area where I focus. but again, it's just one part of the state budget. and the state area of expenditure because it also includes health care, right, their doctor visits, their prescriptions, etcetera. So that's the area that I have focused on. But when you say Medicaid, there's so many different programs you can't tell, without really understanding and looking under the hood. what someone is actually receiving in terms of benefits.

Carol Ventresca [:

And and also it is a program that is open to individuals based on some criteria. And as you mentioned, Ohio's criteria is different. It's not like Medicare where, you know, 65, everybody's eligible.

Larae Schraeder [:

Tell us a little bit more about those parameters and, what's going on with Ohio. Sure. The you have to be a resident of Ohio. which when we're talking about moving older parents, you know, maybe to be closer to children or vice versa, occasionally a consideration, but usually it's easy. Most people are living here and there's no question. The other major areas of qualification are income. There are limits set to the amount of income that an older adult can receive. and keep to re in order to, collect long term care benefits. Another area is assets. What do they have in the bank? What do they have in their name? What is titled to them? Because long term care Medicaid has restrictions on the asset limits. in addition to the income. And you have to need care. You have to be sick enough. So I summarize it sometimes with family saying you have to be broke enough and you have to be sick enough. And there are ways, to become eligible financially if you aren't automatically broken off. There are many families that are stuck in the middle. I call it middle class math. They have too much to automatically be eligible for Medicaid. and they have far too little to pay for the monthly care that they need in a facility or even at home if they need caregivers to come. And so there are strategies that, attorneys and others can use to help a family, be strategic about what to spend it on. And so that's one of the areas where I focus is understanding all of the assets that a family has, what income that they have, and then what things can be moved around lawfully order to maintain the most for the family so that, you know, a spouse isn't impoverished just because one needs care. that didn't work so well, and that's why some of the rules in the past have changed because we don't want to bankrupt the spouse that needs to continue living living in the community just because their spouse needed to go to a facility if that's

Carol Ventresca [:

Sorry. Often one spouse is definitely afraid of going on Medicaid because they are still believing

Larae Schraeder [:

that the other spouse will have nothing. Right. And there are spousal and poverishment rules to try to prevent that from happening now. We don't need two people right, cared for by the state if we can let 1, continue to have enough to be sustained in the community. And it is certainly harder for a family to meet the, requirements of living at home when it comes to property taxes, right, from a rural community, compare to living, you know, in in some of the suburbs of our, suburbs of Columbus that have a higher tax basis because the rules are set across the state in terms of how much a a couple can keep or how much an individual can keep. Those are those are set. and dollars don't always go as far. right, in every community.

Brett Johnson [:

When should an individual consider applying for Medicaid? What determines eligibility Is there a checklist? There there is a list if you work with someone.

Larae Schraeder [:

I I hand a family a list of the documents that would be needed for them to gather. generally 5 years worth of bank statements, 5 years worth of, you know, documentation. And I'd like to say it's daunting, but doable. there is quite a process. And I will say as a taxpayer in Ohio, I appreciate the rigor involved in making sure someone hasn't tried to cheat this them. A lot of schemes, you know, well, what if I just transfer the, you know, house to the kids and just pretend, like, what if I just put it under the mattress? Like, someone has already thought of that. Yes.

Brett Johnson [:

As we joke, right, many rules are made because someone has already broken them before they were even rules, but yeah, the same is true, the true for Medicaid.

Larae Schraeder [:

your question about when should someone apply, I would say it's best to plan in advance for the possibility. Because then if you don't need Medicaid, it's okay. You've got a plan. ideally, plans happen more than 5 years before care is needed, but nobody knows when that day might come. that you might need care and not have enough money to independently pay for it forever. other families are more strategic saying we see it as a possibility. We would like to wall off some of our money. There are options in terms of trusts, where or other gifts that can be made, far enough in advance. that the family is not penalized for making those gifts, and it is an opportunity to ensure that, certain assets are protected. You know, if you had a a family farm that's been in the family for generations. I'm the 9th generation from Ohio, 7 from the same farm as an example where I grew up Like, that would really matter. You wouldn't wanna just lose and say, oh, we'll just sell the house and use the proceeds to pay for the nursing home. Like, sometimes there are things that really matter. And so the sooner you plan, the more options you have. And I kind of joke that there's 2 kinds of planning, right? There's crisis planning when you're I've said this with the state planning, right, when you're already horizontal,

Brett Johnson [:

and then there's the vertical planning when you're upright and making your own decisions and signing your own documents. Right.

Carol Ventresca [:

So let's go back and take a little bit more detail on this process. Somebody's going to apply for Medicaid. they may or may not have planned ahead, but they're what exactly is the process? It sounds like a paperwork nightmare and if they don't have a Loray to help them, what is going to happen? Many facilities will, have social workers that will help with the application.

Larae Schraeder [:

It is a little bit of a conflict of interest at times because they're incentivized to get money and to get it faster, and they can't provide legal advice about what can be lawfully kept, what can be lawfully transferred, and what can't. And so it is an option to have an application prepared for free generally by the facility. it's just they they can't necessarily help you preserve some things that may be available to you without you knowing. So that is one thing. It also doesn't necessarily provide all of the peace of mind to the spouse about what will happen to them, right? Because the facility is there to to get the applicant approved, and some of the downstream consequences are where I find the biggest surprises are still coming. What I mean by that is, qualifying for Medicaid is 1 set of rules. You can still have a house if you're married. You can still have a car if you're married, but nobody really has versation to say, oh, yeah. Guess what? you can't really die with those things and be on Medicaid and leave them to whomever you would choose. especially if it's just you. Right? So qualifying for Medicaid doesn't mean you get to keep it and leave it to San Johnny, right, when you're gone. And so the state does have an opportunity to recover against those assets that they might let you keep while you are still alive if you need them and if you meet other criteria. And so the nursing facilities are again in a place of eligibility, and they're seeking getting you on benefits. They can't really talk to you about the or math of what happens when you die if you have received benefits and you still have things that the state has a has an interest in Right? Because Johnny could have moved into that house and oops found out from the state later on that,

Carol Ventresca [:

they they he didn't have the right to it. That's right. That's

Larae Schraeder [:

when Elaine may be placed on those assets. Again, if there's a surviving spouse All the rules are different. it's very different than if it's just a child. It's even more different if it's a grandchild instead of a child, what someone may be able to keep or transfer And so those are not those are very nuanced things that not every facility is prepared to counsel on nor, can they, right, without the unlawful practice of law?

Brett Johnson [:

Right. So you're you're all kind of saying you probably need a lawyer. Without it being self serving, of course, but it sounds as though they're just to to lay out both sides of the coin -- Mhmm. -- to have a lawyer to understand, okay, doing this, yes, doing, you know, it everybody's kinda self serving in that situation. a lawyer can maybe be in the middle of explaining.

Larae Schraeder [:

I'll give you a perfect example. One family I'm helping currently started working with a facility to have the application prepared. the facility in working with the local job and family services office through their county. communicated that they are not eligible. They simply own one extra empty parcel of land adjoining their home. And it is being treated as a separate parcel. Therefore, not their primary residence. Therefore, they're going to have to sell this land that they've had for 40 years. Like, wait. Wait. Wait. Wait. Wait. Right. I'm really glad they found their way to me because I was able to simply provide, right, the support for them to not have to sell this land and liquidate the proceeds and spend it on mom's care. So that one thing alone, yes, there are differences if that land is down the road across the road, right, not connected. But in this case, they were eligible to keep it. And I had to go toe to toe, which I have in family services, in order to change this, They needed an advocate because they were otherwise stuck with selling the land. Mhmm. But for a neighbor who said, I've talked to somebody, and I think you should too. I think you can keep this, but, like, that made an enormous difference in the outcome, especially for the spouse who will continue to live there. Everyone thinks that,

Carol Ventresca [:

this is gonna just happen overnight. And hopefully a lawyer will make it, more expeditious, but maybe not. How long should someone prepare that to

Larae Schraeder [:

to deal with this process? Again, I'm going to say years in advance is the first answer.

Carol Ventresca [:

Right.

Larae Schraeder [:

completely spent down to the $:

Carol Ventresca [:

the facility knows what assets there are. So they would know whether an individual is a pain customer resident

Larae Schraeder [:

long long before short before they actually run out of of funding. And sometimes adult children in particular are chipping in order for mom or dad to be down the street. And so I don't know how transparent it always is, that someone is nearing the end of their assets or the end of the tolerance for their children or in laws, right, to to keep supporting their care or subsidizing their care, especially when there's some optimism that someone may be able to return home and that may not be panning out. And so I think that's why the dialogue is really important with the facility about the possibilities as well a professional

Brett Johnson [:

who can can help navigate this path. Obviously, there are people that are denied Medicaid. What leads to that denial and what should they do to get the decision reversed if they can?

Larae Schraeder [:

Certainly. there's an appeals process. where, job and family services, right, is contacted. You can represent yourself, right, or you can be represented by a family member or a chosen agent if there is someone that you have named while you still had the capacity to do so. And and I think it's a matter of understanding. An example where things are muddy is when gifts have been made is a gift to a church, considered, you know, something that's disallowed? Well, usually, yes. If you are broke because given away your money, that's not something that is going to, you know, help l ability and debating, for example, what is a gift? You know, was that gift made with the intention of qualifying for Medicaid? No. I was tithing or I was simply giving my grandchild a wedding gift. But the rule that says, you know, you can't give away or sell something without getting back something that's fair market value in exchange, that feels like a gift. So that would be an example of where you know, eligibility sometimes is questioned. People are denied, and you're you're going through an appeals process to say, wait. Let me just prove to you. I had no idea I was going to have a stroke. However, if that person instead had Parkinson's, then they're making big gifts. Like, wait, you might have had some inclination that you might have, you know, need more care than you were getting currently and that you might run out of assets. So those are where there's gray area. It's just not like a simple black and white.

Carol Ventresca [:

Lorraine, there are, challenges that Medicaid clients face from what I've heard from some family members particularly looking for the availability of their providers. Have you been hearing the same issue from your clients

Larae Schraeder [:

Certainly, health care is a concern, and it is part of the long term care Medicaid program. There are restrictions because not every provider accepts every form of Medicaid, and it is helpful when your client can maintain the secondary insurance that they already had. If they have UnitedHealthcare, keep it. Medicaid can be a 3rd prior. So Medicare would continue to be 1st for someone over 65. And then their standard health insurance that they had before they needed care should be my recommendation has generally been to keep that enforced. because the list of providers that may accept, you know, that Aetna plan, that medical mutual, right, those are usually much broader. especially for specialists. You'll find more specialists than than providers that take only Medicaid if there's someone over 65 that just has Medicare and Medicaid. So providers matter. So for

Carol Ventresca [:

someone like me who is on the traditional Medicare plans, and I have a supplement It's that supplement you're saying. Yes. Interesting. Now, if it's an advantage plan, then Medicaid Cade is the 2nd?

Larae Schraeder [:

No. The Advantage Plan could still be maintained as the 2nd. Okay. Well, you would still have Medicare advantage plan paying, and then Medicaid would come behind it. Right. So and that is preferred because, again, the list of providers available to you would be significantly broader than if you were only only having Medicaid as your only option.

Carol Ventresca [:

Wonderful. Oh. Okay. Great. That would that's a easy fix. for something that's become huge.

Larae Schraeder [:

And so while it may be harder to work with job and family services to say we need to keep some of the income order to pay for this medical care, and keep the premiums paid. it it's usually to the best Ventresca of the client than just saying, we'll just put you on you won't have to worry about any medical expenses moving forward. Right. And it and for the state, it's to their advantage because it's not increasing the cost of it within Medicaid. Right. Fewer services than need to be rendered actually by the Medicaid providers that, again, they're only paying that bill. Yeah. Okay. You mentioned job and family services.

Brett Johnson [:

Is that the umbrella over Medicaid? Or I I I mentioned a couple of different agencies Mhmm. who I guess potential here you're gonna have to work with. I can maybe be familiar with the agency's names.

Larae Schraeder [:

Yes. So job and family is is the organization that is involved in eligibility for, for for individual that is seeking long term care services. So the money from Medicaid flows through that agency. They're they're the ones that assess eligibility. Alright. If someone is to, To to be assessed medically, there's a different agency. And for us, that's a central area agency on aging -- Okay. -- that would ensure that someone is medically wiring the care that is being sought. So that's a combination of agencies, but for the most part, when you say Ohio Medicaid, it's the job and family services is the face most families during the application process and during the renewal process.

Brett Johnson [:

Okay. I think that's important to know. Right. Who you're dealing with in in the names, in that way, cycle, where did they come from? sort of thing. So okay. Nothing. And renewal is every year, just like Medicare. Correct. And there was there was a hiatus during COVID because the public health emergency.

Larae Schraeder [:

And there's now a process in place that the public health emergency has ended, and people who may have lost eligibility during the public health emergency, had to be maintained on the roster. And so there's now an enormous renewal effort, if you will, to to assess eligibility because that is a process that did not for quite some time. And then you can imagine over that number of years, changes happen for several families in income, in assets, etcetera.

Brett Johnson [:

Yeah. Well, you had mentioned earlier to the potential. You you gave scenarios a potential fraud of that giving away money. Whether you tried or not to fraud, you just did and didn't think about it. Okay? So I I can imagine the amount of fraud occurring in Medicaid is there and probably increasing just because I wanna be a part of, you know, that sort of thing. It's just that you see the opportunity and whether it's intentional, unintentional, whatever, but do you have tips on how to fight fraud? And is there a legal responsibility to report fraud?

Larae Schraeder [:

as an officer of the court as an attorney, there is a duty. And if someone comes to me and suggests they have a lot of money on the deed of the mattress, That's obviously something that I can't unhear.

Brett Johnson [:

Right. He can't go la la la la and walk away. Right? Yeah. Yes.

Larae Schraeder [:

Exactly. We're yes. Let's just pretend that you gave that away 4 month 4 years 11 months ago. Right? When it was in the we'll just wait a month and magically everything will work out when it was really, you know, 2 weeks ago. Right? Those those just aren't those things. I haven't seen a lot of fraud. What I have seen though is some fraud under the guise of confusion, right, or fear. I have an extra bank that somebody doesn't know about because I'm really afraid since I'm still living in my home that there will be an emergency. And so this is the the the account, right, that I share. with job and family services, and this is the one that I have for an emergency. And I'm like, I cannot represent you unless we move forward and find a way for this to be above board. and let's make you eligible. Right? Let's take care of some of the spend down that you need to do. Let's take care of the things that we can do maintain your eligibility and you don't have to live in fear that someone's gonna knock on your door. Mhmm. And so I have helped clients with that as needed. But again, it wasn't done intentionally, but it still is, right, of represent a misrepresentation.

Brett Johnson [:

Or misinformation they got from somebody going, yeah. You can do that. do you have 2 books?

Carol Ventresca [:

Right. Basically. Yeah. You know, and it's it's out there. Of course. Yeah. You know, I we've recently went through the budget process here in Ohio. And I this whole sort of comes to play because Medicaid is such a huge part of our state budget. And therefore, everyone assumes it's fraudulent because it's so big. Well, and that's not true. And as you mentioned, fraud could be a mistake, not an intentional infraction of the rules. I I wish that we could help individuals learn more about Medicaid upfront and understand what it's for. It's not there to keep people from working. It's not there to, take care of people who really could buy their own insurance There is a lot of, a lot of layers that are that are protecting the program, those dollars and this vulnerable population. And because we only hear snippets when everybody's fighting over every dollar in the state budget, We get a lot of really bad press on Medicaid when it's been a phenomenal program, keeping not just older adults safe whether in their home or a facility, but also making sure kids are eating. Yep.

Larae Schraeder [:

And what I have seen is far greater demand than availability of givers and resources and Medicaid beds. Right. I don't see people who shouldn't be receiving benefits that aren't sick enough that aren't broken enough. What I what I find is that there's such a need and there aren't enough hours available for someone to receive home services as an example. And So I I think it's just been the opposite of my experience. I don't, you know, observe many families that should not should not be seeking benefits who are. The other thing I have not experienced personally would be people coming to me to save millions years in advance. to wall it off in a trust so that they can just be on the state goal when the time comes. What I have found is that, you know, if planning is done correctly, funds could be there to supplement, the care provided to that resident of the facility. not just, you know, a new lift chair every now and again, but some kind of music therapy or, you know, regular personalized care. And and I think that's what really matters to me. It's not about protecting the next generation. It's about ensuring that that person can have the care that they need or expect. So an example I will give you personally was my grandmother. When she went through Spend Down, and received at the time it was $45 a month was her personal allowance. It's now 50.

Carol Ventresca [:

Woah. Inflation

Larae Schraeder [:

Right. It's now 50, but that $50 didn't go very far. No. She got her hair done every week with a wash -- and set at the local beauty shop. And when she moved to a facility, she had it done there, but it was $35 plus tip, maybe 40 at break, but the time she had left there a few years later. And that was per week. And so for her to have her hair done, even when the she was mildly confused, it was still a meant the world to her. She felt like a new person, right, when she came out of that salon with her hair done. And that was the sort of thing where her money had to be spent down to private pay for a few months in full. Her money was gone. And then, right? No. Options would have been just to chop off her hair. She never had a pixie in her life. Right? Those are the choices our family was able to provide supplemental care for her so she could have a few basic things that mattered. But That's what planning in many cases has been about for me. Like, how do we make sure that that person that has maybe a few teeth missing or or wiggly and their nineties, but they're still mostly their teeth. I wanna make sure that we don't just pull all their teeth and hand them dentures. Right. Let's get them to the dentist. you know, that Medicaid would provide some basic dental care. Right? Is it the care that you would want for yourself or for your parents? And so to be able to have funds available, and I would if it were me, I would prefer that those funds be mine that in some way, shape, or form, I have, you know, got a little pot that could still be used to supplement my care, especially in the situation where I can't begin to pay for the full bill for my care, but can I pay for a few things that based on my pride, I still would like to be able to do so that someone doesn't have to write a check for me. We talked

Carol Ventresca [:

early on about what happens when an individual passes away. there can be some surprises and people again need to educate themselves on these issues ahead of time, not just the individual on Medicaid, but family members because they are likely going to be affected. So there are steps that relatives or estate administrators take and it's called an estate recovery plan. Can you give us a little bit of an overview on that and tips on how to ensure that there are no legal ramifications concerning the survivors when the Medicaid patient passes?

Larae Schraeder [:

Certainly, there is a program that when the Medicaid patient passes, there's mandatory reporting to the state about the assets owned in the name of that Medicaid recipient. Recovery is not due immediately upon death. There are many situations in which recovery is delayed. And that is primarily driven on whether the spouse is still living and whether there's a special needs child or something along those lines There may be really good reasons why the the delay may occur. and some families don't understand that. So if dad was on Medicaid and 20 years later, mom dies and mom never needed care, even when mom goes, there still has to be a reporting. And sometimes families are surprised because they're like, lot. Mom died. Mom didn't receive care. This is fine. I'm like, I know, but we have to go back and tell them because maybe your dad did. And sometimes people don't even know that the state maintains records. based on, you know, date of birth and Social Security number. And so when we handle a probate estate in particular, we are constantly working with Medicaid. State recovery at the attorney general's office to inform them of the passing to make sure that the beneficiaries who do receive benefits have full confidence that someone's not gonna knock on their door years later to say, hey, guess what? Part of the house is really mine. Right. And so it's a it's an important process. So my understanding recoveries are around 2%, right, off the budget spent on some of these programs. And so it is not a significant part. It is not a moneymaker. But at the same time, it does feel fair that if somebody did die with certain assets that are no longer being used by a spouse, where there is a duty of care that they would be available to to help recover and offset. Medicaid, estate recovery cannot take anything above and beyond, that which the state has paid out. Right. And as I mentioned, the state generally pays out far more than they're ever able to collect. but it is simply something that exists in Ohio.

Brett Johnson [:

Is that automatically kicking a probate situation? Or because you you mentioned that. Mhmm. That if any, like, mom or dad were in Medicaid,

Larae Schraeder [:

kind of expect that a probate's gonna be kinda kicking in? If there's an asset to be probated, Okay. If there is something, a house, a car, a bank account, right, if there is something, then before beneficiaries receive anything, Medicaid has to give the nod to say yes. that's fine. Go ahead and distribute it. Right? There is no debt owed for this person, or please write a check for the following because this is the amount owed. These are first in line. They're they're they're toward the top. Toward the top. Yes. Yeah. We we we'll even bearing people first. That's the first. Right. Right. Right. But whoever paid for the funeral, Right? But but, yes, Medicaid does have have priority over, you know, as we joked about Johnny, you know, getting getting money. And so mom and dad have to pay for their bills if they're due. Okay. And just because something passed directly, not through probate,

Carol Ventresca [:

but it passed directly to

Larae Schraeder [:

a a relative doesn't mean the state isn't gonna figure that out and come back. That's correct. There are databases and systems in place to ensure that direct transfers are also on the radar, because those assets are also subject to a state recovery for the most part. And again, having someone who, is a professional to help you understand which things are available, which things will be available, things should be available and what should not be available is very important process because, especially with Retirement accounts as an example. Rules continue to change about what you can have when you go on Medicaid. So it's, necessary to continue to understand what you can. have or not have when you off Medicaid. And so just continuing to have that dialogue, especially like I said, decades sometimes pass, right, between between people. So it's the best policy is no surprises. Right. And

Carol Ventresca [:

and really good documentation.

Brett Johnson [:

Yes. Sounds like it. Yeah. Yeah. Delete. That never hurts. Looking at all the log boxes and all the folders. I think that's where I think. Yeah. Exactly. So as we always do, you you know, provide our guests with that opportunity to provide any last words of Winston, do you have any other suggestions or advice for our listener?

Larae Schraeder [:

Plan plan plan. Knowledge, you know, as I've said before, is helpful, but unless you take action, that knowledge that you've gained isn't isn't going to do you any good. I will say it's also not as scary when you have a guide. And so finding someone that you can work with that will, make it less scary and help you or your family navigate that forest,

Carol Ventresca [:

is is the best advice I can give. Lorey, thank you so much. I can't tell you how how exciting it is to be able to provide information clearly and concisely for Our listeners because needless to say it's a it's a confusing situation and scary, very scary. So thank you to Lorraine Schroeder from Schroeder Law for joining us today. Listeners thank you for joining us, and do not forget check our show notes for contact information and resources, which are also on our website at looking forward our way.com. We're looking forward to hearing your feedback on this and any of our podcast episodes.

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