Given the odds that you or a spouse will need some type of long-term care in the future, and the extraordinarily high cost of that care, there is a good chance that you or your spouse will need to rely on Medicaid for help paying for long-term care. If that comes to pass, you need to be aware of the potential repercussions that reliance may have on the estate you leave behind when you die. To help ensure that you are prepared, the Medicaid planning attorneys at Legacy Care Law Firm explain the New Hampshire Medicaid Estate Recovery Program (MERP).
Long-Term Care Costs in New Hampshire
According to the Administration for Community Living, someone turning 65 today stands a 70 percent chance of needing some type of long-term care (LTC) at some point before the end of their life. If you are married, that means that there is an extremely good chance that you or your spouse will eventually need LTC services. Nationwide, the cost of LTC hovered around $100,000 for 2022. Unfortunately, New Hampshire residents pay, on average, considerably more for LTC with an average cost for a year in a nursing home running just over $144,000 that same year. The average cost for an assisted-living facility in 2022 was almost $73,000 while a home health aide charged, on average, just over $74,000.
As a retiree, you may depend on Medicare to cover most of your healthcare expenses and rely on private health insurance or your savings to cover what Medicare doesn’t pick up. Unfortunately, Medicare will not cover the cost of a LTC facility nor will most health insurance plans. Unless you purchased a separate long-term care insurance policy or you can afford to cover the cost using your retirement savings, the only option left may be Medicaid.
Medicaid Eligibility in New Hampshire
Not surprisingly, many older adults rely on Medicaid to cover the high cost of long-term care services. Medicaid, however, uses both income and asset limits when determining eligibility. For 2023, an individual applicant cannot have income of more than $2,742 a month and may not have countable resources valued at over $2,500. Certain assets, such as your home (up to $688,000 in equity as of 2023) are exempt, meaning they do not count toward the asset limit when determining your eligibility for Medicaid in New Hampshire. While assets such as your home are exempt for the purpose of determining your eligibility for Medicaid, they are not exempt from the New Hampshire Medicaid Estate Recovery Program.
New Hampshire Medicaid Estate Recovery Program
Like most states, New Hampshire has a Medicaid Estate Recovery Program (MERP). The goal of a MERP program is to recover funds from the estates of deceased individuals who received benefits from the Medicaid program while they were alive. In New Hampshire, MERP is administered by the Department of Health and Human Services Estate Recovery Unit (ERU). The ERU is authorized to try and recover funds from participants of the following programs in New Hampshire:
- Old Age Assistance (OAA)
- Aid to the Needy Blind (ANB)
- Aid to the Permanently and Totally Disabled (APTD)
- Medicaid for Employed Adults with Disabilities (MEAD)
- Granite Advantage (GA) (formerly called New Hampshire Health Protection Program (NHHPP))
- Breast and Cervical Cancer Program (BCCP) Medical
New Hampshire is one of several estates that uses an expanded definition of property for the purpose of the MERP program. All property held by a Medicaid recipient, including probate property, property held in joint tenancy, as tenants in common, or as a life estate, and property held in a living trust if such title was established on or after July 1, 2005, is subject to recovery by MERP.
As part of their recovery efforts, the ERU can even put a lien on your home for the value of services you received while alive. There are, however, some important restrictions to the reach of the MERP program. For example, while the ERU can go after just about anything in your estate, that authority does not extend to the estate of your spouse. In addition, they cannot put a lien on your home if any of the following people reside in the home:
- A spouse
- A child under 21 years old
- A disabled or blind child of any age
- A sibling who has an equity interest (ownership) in the home and has lived in it a minimum of one year immediately preceding the Medicaid recipient’s nursing home admittance.
Can I Do Anything to Prevent the New Hampshire Medicaid Recovery Program from Taking My Estate Assets?
The best way to ensure that you are eligible for Medicaid if you need the benefits and to protect your estate assets is to consult with an experienced Medicaid planning attorney long before you need benefits. Because Medicaid also uses a five year “look-back” period when determining eligibility, it is best to incorporate Medicaid planning into your estate plan while you are still relatively young and unlikely to need to qualify for benefits in the near future.
Contact Our Medicaid Planning Attorneys
For more information, please join us for an upcoming FREE seminar. If you have additional questions about the New Hampshire Medicaid Estate Recovery Program, contact our incapacity planning attorneys in our North Andover, Woburn, and Beverly offices at (978) 969-0331. Our Salem and Nashua, New Hampshire office can be reached at (603) 894-4141.
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