You may be wondering if I enroll in Medicaid under the Affordable Care Act, can I lose my home or assets when I pass away?
In short, the answer is yes however that is a reality for all Medicaid programs. In 1965, each state was been permitted to recover costs from the estate of deceased recipients who were over 65 years of age when they received benefits and who had no surviving spouse, minor child or adult disabled child. In 1993, there were two significant changes to estate recovery. First, estate recovery went from being permitted to being required for states to recover the cost for long term care in a nursing home or at home and secondly, the age from which the recovery can occur dropped to 55.
Some states allow recovery of all assets owned by the decedent or that he or she had an interest in. In New York, however, estate recovery is limited to only asset that pass through the recipient’s estate by Will or intestacy. This means that assets owned jointly, or with a beneficiary or owned in a trust cannot be collected against in New York State, as of now.
Nothing does in fact change for seniors over 65 who apply for and receive Medicaid to pay for long term care. The ACA however does 3 things that will potentially subject more people between the ages of 55 and 65 and their assets to the Medicaid program:
1) The ACA requires most Americans to have health insurance or pay a penalty which is $95 or 1% of the household income as of 2014.
2) The narrow eligibility for Medicaid has been expanded in states including NY to allow more adults to access Medicaid.
3) Perhaps most significant is that the strict income and asset eligibility rules have been modified so that there are no longer asset tests.
These three factors allow more adults on to the program with unlimited assets so for those that are unaware, those assets can in fact be claimed against and recovered by Medicaid upon their passing.