TONI SAYS: Son loses mom’s house because of poor Medicare/Medicaid choices

By Toni King


I have a client, Joshua, who just received a bill for his mother’s long-term care paid by Medicaid in the state of Texas, with care provided at her house instead of a nursing home during the last few years of his 80-year-old mother’s life. No one informed him that the state was running a tab of all healthcare expenses that Medicaid paid and wanted to be reimbursed after his mother died.

Medicaid says the $65,000 medical bill that Medicaid must be paid in full. Joshua recently received a document from MERP (Medicaid Estate Recovery Program) saying that Medicaid wants the money used for his mother’s care back and is filing a lien against the house that his mother owned, which Josh now lives in.

Americans need to be aware of their state-specific Medicaid rules when receiving “extra” health care, especially if you or your family member owns a home. Thanks, Chuck – an elder care attorney and Toni Says reader.

Hello Chuck:

Everyone should know about the MERP (Medicaid Estate Recovery Program) for their specific state by visiting The website says, “State Medicaid programs are required to recover certain Medicaid benefits on behalf of a Medicaid enrollee. For individuals age 55 or older, states are required to seek recovery of payments from the individual’s estate for nursing facility services, home and community-based services, and related hospital and prescription drug services.”

During a Toni Says consultation, confused adult children are shocked to discover their state has taken a lien on their parents’ house because of long-term care health care costs that the state paid.

Chuck, I am sure your client was astonished to find out that the state of Texas wants the $65,000 that Medicaid spent for his mother’s care returned, even though the care was at home and not in a nursing home.

All claims against an estate, including MERP claims, must be paid before the property can be distributed as specified in a will. The state does not, however, require an heir to sell the deceased recipient’s homestead (house) if the claim can be paid by other funds. But if not, then the heir may have to sell the house or the state will file a lien against the house, such as your client is experiencing.

The letter sent to the enrollee’s estate states that the amount recovered by Medicaid will not exceed the value of the estate’s assets, if any. If there is no money or assets in the estate, then there is nothing to recover.

Readers, now you know how Medicaid’s Long Term Care services operate.

My advice to readers whose loved one is receiving Medicaid benefits would be to explore your options and work out a schedule with family members to take care of your loved one. This way you can protect all that they have worked so hard to accumulate.

Toni’s advice:

  • Seek the advice of an Elder Care Attorney that can assist with proper Medicaid planning for the specific state that your parents live in. Keep in mind: No one wants their adult kids or grandchildren to be their caregiver and take care of their activities of daily living such as bathing, dressing, bathroom problems, etc.
  • Do not rely on advice from well-meaning friends, who are not an expert in the Medicare/Medicaid arena.

Readers, it is important to understand that traditional long-term care insurance plans offer more flexibility and options than Medicaid. Medicaid long-term care is available for those living on a limited income.

Toni King, author of the Medicare Survival Guide Advance edition, which is a simple guide that puts Medicare in “people” terms, is on sale at Email questions or schedule a “Confused about Medicare Workshop” for your organization or company by emailing [email protected] or call 832/519-8664.