You Can ‘Cure’ a Medicaid Penalty Period by Returning a Gift

Anyone who gifted assets within five years of applying for Medicaid may be subject to a penalty period, but that penalty can be reduced or eliminated if the assets are returned. 

In order to be eligible for Medicaid, you cannot have recently transferred assets. Congress does not want you to move into a nursing home on Monday, give all your money to your children (or whomever) on Tuesday, and qualify for Medicaid on Wednesday. So it has imposed a penalty on people who transfer assets without receiving fair value in return.

This penalty is a period of time during which the person transferring the assets will be ineligible for Medicaid. The penalty period is determined by dividing the amount transferred by what Medicaid determines to be the average private pay cost of a nursing home in your state.

However, Congress has created a very important escape hatch from the transfer penalty: the penalty will be “cured” if the transferred asset is returned in its entirety, or it will be reduced if the transferred asset is partially returned (although some states do not permit partial returns and only give credit for the full return of transferred assets). 

Partially curing a transfer can be a “half a loaf” planning strategy for Medicaid applicants who want to preserve some assets.  In this case, a nursing home resident transfers all of his or her funds to the resident’s children (or other family members) and applies for Medicaid, receiving a long ineligibility period. After the Medicaid application has been filed, the recipients return half the transferred funds, thus “curing” half of the ineligibility period and giving the nursing home resident the funds he or she needs to pay for care until the remaining penalty period expires.

The person who returns the money needs to be the same person who received the gift; otherwise, it is not really a return of the original gift. But many people will have spent the gifted assets and no longer have any money to return. If the person who received the transfer no longer has the funds to cure, other family members could give or loan that person the funds to do so. 

Returning the funds will likely mean the Medicaid applicant will have excess resources that will need to be spent down before the applicant will qualify for Medicaid. The experienced team at Wenzel Bennett & Harris has helped many families  take the necessary steps to successfully cure a Medicaid penalty and obtain Medicaid benefits. Call us at (989) 356-6128 to schedule a Long-Term Care Consult to learn more about how you and your loved ones can qualify for Medicaid.

According to a recent national study, nearly a quarter of Americans aged 50 and older say they – or a loved one – needed long-term care in 2022. The findings further suggest that seniors and their caregivers could benefit from more consumer-friendly information and guidance about long-term care services, a need researchers say will grow exponentially in the future.

Finding Long-Term Care Causes Wide-Ranging Emotions

Results showed that people looking for long-term care experienced a range of emotional responses in searching for a provider:

  • 53 percent of respondents reported feeling anxious about the process 

  • 52 percent described feeling frustration

  • 23 percent said they were confident during the process of long-term care for themselves or their loved one

  • 23 percent of respondents felt “at peace” about the choice they made for long-term care

  • Only 14 percent of respondents reported feeling happy

Respondents Want to Feel Prepared When Deciding on Long-Term Care

Researchers found that respondents want advice for seeking long-term care when it comes to the following:

  • 92 percent wanted to know what types of long-term care services are available
  • 90 percent wanted more information about paying for long-term care
  • 90 percent said advice and support on long-term care would have been helpful to them
  • 88 percent needed help understanding whether their personal or health care needs require long-term care
  • 88 percent of those surveyed also said they needed help choosing a long-term care provider
  • 86 percent said having someone to listen to them when seeking long-term care services would have been important to them
  • 84 percent of respondents wanted help deciding whether to pursue in-home care or community-based services (i.e., nursing home care)

Paying for Long-Term Care

A large number of respondents reported needing more information about how to pay for long-term care.

Of the people who were surveyed, 63 percent said it was extremely important to have additional details about the various types of care options available. Meanwhile, 69 percent said it was extremely important to have further details about the cost of care and their payment options.

To learn more about long-term care services and options, it is often helpful to work with an elder law attorney in the community who can help you assess the benefits and services available to you and create a plan for how to pay for long-term care. At Wenzel Bennett & Harris, P.C., we offer a consultation called a “Long-Term Care Consultation” in which we meet with clients to help create a plan for long-term care. If the client has a need for care in a nursing home or skilled care at home, we will work with the client and their family to explain how the Medicaid program works , review the clients’ assets and income, and assist the client in obtaining Medicaid benefits, where applicable. Many families are surprised to learn that they may qualify for benefits they weren’t aware were available to them. In addition, we help clients to make sure they have a good plan in place should it become necessary for them to have long-term care in the future. This often includes having Powers of Attorney for both financial and health care needs, so that appropriate agents are granted the authority and have the information needed to obtain benefits in the future, should that become necessary. If you or a family member would like to schedule a Long-Term Care Planning Consult, please contact our office at 989-356-6128.

If you have specific questions about your situation or would like to learn more, reach out to the team at WBH here.

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