I had not thought about an irrevocable trust. I looked it up and it looks like that works but you have to do it before the 5 year lookback period:
How Can a Trust Help You Avoid Nursing Home Costs? | Kiplinger
I have known people where they did not do that, and when the house sold after the person died, they only had to pay back a portion of the money, not the whole amount of the sale. So maybe if the house was not put in a trust, then the kids could get together and get a mortgage to pay off what the estate owed to Medicare. I would talk to a lawyer if you want to leave the kids the house, no matter what you do about a trust, it would be much better to talk to a lawyer now.*
*I would involve the kids in these discussions, and maybe they could as a group start a bank account and start saving for this possibility--each contribute the same amount each year, to have a head start on paying back the Medicare money if they need to. Or if they don't need to, a bank account that they could use to fund expenses to the house.



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