In the world of Texas Medicaid eligibility, the words “gift” and “penalty” go together like “sunshine” and “lollipops”. In almost every case where there is a gift within the look back period you will find a penalty that prevents a person from obtaining Texas Medicaid benefits. I regularly speak with families that heard from someone, somewhere, at some point in time that a certain type of transfer or gift is acceptable. In every instance that I can remember this advice was given by someone that is not even a lawyer, or in the few instances where it is from a lawyer, it is not from an experienced Texas Medicaid Attorney. And that is usually the beginning of a long line of mistakes before they find their way to me.

So let’s get the record straight on what you need to be aware of before making that gift you’ve been thinking about. And if you have already made that gift and your family member needs Medicaid benefits within the look back period then run, don’t walk, to a Medicaid Attorney.

First – any transfer of any asset for less than fair consideration within the lookback period (up to 5 years) of applying for Texas Title 19 Medicaid benefits creates a penalty period of ineligibility. Say it with me out loud – any transfer of any asset for less than fair consideration within the lookback period of applying for Texas Title 19 Medicaid benefits creates a penalty period of ineligibility.

Now that we understand the rule, let’s go over some basics.

You will notice all types of transfers are included in the rule. Be it writing a check to a friend or family member, handing them cash, signing a deed over to someone etc. As it says, any and every transfer for less than fair consideration is included in the scope of the rule. A simple way to look at it is if the person gives away an interest and access to property, you are at risk for your transaction being labeled a penalizing transfer and resulting in a period of ineligibility for Texas Title 19 Medicaid benefits.

One popular transaction that comes up often is taking a joint account and removing the Medicaid applicant’s name from the account. This is a gift. The Medicaid applicant had unrestricted access to the full value of the account on one day and after his or her name was removed from the account they no longer had access to the account. This transaction results in a period of ineligibility.

Another popular question concerns Medicaid penalties and annual exclusion gifts. For tax purposes, each person is allowed to gift a certain value to any person tax free. That is where the annual exclusion gifts end, for tax purposes only. In the context of a Texas Title 19 Medicaid application, a gift that you made which is tax-free can very well be (and almost always is) a gift subject to penalties for Medicaid eligibility purposes.

Another example is special occasion gifts such as birthdays and graduations etc. There is no exclusion for these types of transfers no matter how noble or small they may be. Any and every gift is subject to the penalty period of ineligibility rules whether it is $5,000 or $500.

But I Heard About Such and Such Exception

You may be right, there are a few very narrow exceptions of transfers that do not create a penalty, however the burden is on you and your Houston Medicaid Attorney to establish by the evidence that you qualify within one of the specific exceptions. If you do not prove your case you are left with a penalty, and that is what this article is about. We will review some of these exceptions in detail in future articles.

One final word; if you are considering a strategy of stonewalling the Health and Human Services Commission by denying information, then think again. You bear the burden of proving your eligibility. If the law presumes a transfer is a penalty and you do not prove otherwise your loved one will be denied benefits.

So how much can you give away without creating a penalty?

If you are outside the look back period then you can give away as much as you want. If you are within the look back period then you really can’t give away anything. The best thing you can do is to speak with a Houston Medicaid Attorney to find out what your options are to structure transfers to avoid them being labeled as “gifts” in the first place.

TexasTitle19.com is your connection to an experienced Houston Medicaid Attorney who can help you find the right nursing home, get the best care, and pay for it all without going broke. We are currently focused on Harris and Montgomery Counties, including the areas of Houston, Conroe, The Woodlands, Spring, Tomball, Humble, and Katy. We also provide consulting services throughout all of Texas.

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