If you are “spending down” your assets to qualify for nursing home Medicaid, you should hire an experienced Elder Law Attorney to guide you through the process. I’ll give you five reasons that you will find quite fair and objective. But first let me give you the most important reason that is not on the list:
So avoid the stress, aggravation and hassle of dealing with the Medicaid department. And more than that save time and money. After all when you are paying a nursing home over $10,000 per month or $2,500 a week, time is money!
1. You need a Medicaid plan of action. Medicaid is a very complicated process. It begins with a “Medicaid certified bed” in a nursing home. Without that bed certification Medicaid will not pay and the nursing home may try to transfer your loved one to an undesirable nursing home.
Once you have secured the Medicaid bed then you can consider Medicaid “spend down” of assets. What are assets? They’re more than cash on hand! Assets can include gifts you made within the past five years! You may be dealing with “divestment” and a long “penalty period” during which Medicaid will not pay for the nursing home. Your plan must address the divestment issue.
“Spend down” raises the questions of what can you spend the money on and what can you do with “excess assets”? It takes a long time to learn about it, put it all together to execute the plan and then get the documentation for the application. Most likely you will miss something. The rule at the Medicaid office is that the first application is denied (after months of it sitting in the office). Time is money. You are paying $10,000+ per month and you don’t have time or money to waste.
Think about that. How long would it take to find out what options you had in spend down and then to complete the spending? In our experience it often takes two to three months. It’s easy for 12 weeks to slip by and that is $30,000 in nursing home bills.
So here’s a tip: When you are interviewing an attorney or other to hire to help with the application, ask them how soon can get this application in? In some cases an attorney get you coverage for medical costs incurred even before you hired the attorney!
2. You must get the application done right the first time. The fact that Medicaid is complicated means that the application complicated as well. The worker must be very demanding of the applicant. That means a) the worker will be very detailed in demanding proof and documentation, and b) if the application is not complete and done right, it will be denied. The workers do not have time to wait until an applicant gets everything right. And, they don’t have time to teach applicants how to complete the application. In other words “they didn’t tell me that” is no defense. We have seen applications denied months after they were filed.
3. The third reason is also a variation of the first. Medicaid has loopholes that work for you and against you. How many seniors have somebody do their taxes? Almost all. Why? It’s because they want it done right, filed on time and they want to be sure to get all their deductions. A Medicaid application is much more complicated. Allow me to give one example. Most people think of assets as money in the bank and they are right. But for Medicaid there is more. Many do not think of life insurance as a cash asset.
Life insurance may be a “countable asset” for Medicaid and it may not. Term life, of any value, is not an asset because it has no present cash value. Of course, that must be proven. Whole life insurance is an asset to the extent of the cash value of the policy. But, life insurance is exempted if the face value is $1,500 or less, regardless of cash value. That loophole may work for you and against you. You must not only disclose the policy, but disclose the cash value by a statement from the insurance company. The Medicaid worker will not take your word for it. You must get a letter from the company and that may take weeks to get. A Medicaid worker need not wait weeks for you to get the letter. The rules say they need only give you 10 days to get the statement. If it is not in: application denied.
4. The fourth is a variation of the third. Knowing Medicaid’s loopholes can save you thousands of dollars in spend down. When we speak of Medicaid’s loopholes we usually refer to those that save applicants tens of thousands of dollars for their families. I’ve said and written many times that a spouse of the applicant can save everything and when there is no spouse we have 75% and more of all savings.
5. All of the above urges you to get help with your Medicaid application. But why choose an experienced Certified Elder Law Attorney? In a nutshell you need the fastest, most knowledgeable there is. Nobody knows the loopholes better or can get an application in faster. Where some lawyers take months you can expect weeks. Your application must be done right the first time. Want a referral? Just give us a call at (248) 356-3500.
Till the next time friends,
Jim