Q:

What is Elder Law?

A:

Elder law is any legal issue that affects someone who is at least 65 years old. Some people draw the line at age 55. Many attorneys limit “elder law” to Medicaid planning and applications. But issues of housing, discrimination, disability, health, family relations are all parts of Elder Law. I limit my practice to issues about estate planning, probate, guardianship, asset protection, and Medicaid.

Q:

What is a MERP Claim?

A:

A MERP claim is a claim for reimbursement by the State of Texas for costs of care for a nursing home patient who entered the home at age 55 or older. There are certain other persons who face MERP claims.

Every patient or the patient’s agent must be given notice of the possible claim on applying for Medicaid benefits in those programs subject to a reimbursement claim. The State must prove that it meets all the preconditions for reimbursement at the time of its claim. It is often wise to require the State to prove it met the conditions for reimbursement quickly when a claim is received. There is a time element to proving defenses.

Q:

Does a Medicaid Estate Recovery Program Claim Have to Be Paid?

A:

A Medicaid Estate Recovery Program (MERP) claim does not have to be repaid if the probate estate is less than $10,000.00. There are several other reasons that deny the State from recovery including as stated above that the State does not meet the requirements to recover.

In most situations, the only asset with substantial value is the homestead. If a Ladybird was used to transfer title then the State will not be able to recover. Currently, the State of Texas may only recover reimbursement out of a patient’s probate estate.

The most common reason that the State does not get repaid is that the nursing home patient’s spouse is still living. The State cannot require a spouse to repay the reimbursement claim from the sale of the house. The same is also true if a child of the patient is under age 21, or is disabled or blind is living in the house. A third basis is if a sibling of the patient is living in the house, owns a portion of the home and lived there for at least one year prior to the patient’s admission to the nursing home.

There are several other situations where the State cannot enforce its claim. Please call me to set up an appointment if you have received a claim.