Mom’s in the Nursing Home – Should the Nursing Home Handle the Medicaid Application?

By Marissa B. Marshall, Esq., CELA on June 10, 2019

The answer to this question is a resounding NO! It can be expensive for a nursing home business office to handle the application for Medical Assistance (Medicaid) long-term care benefits. While the nursing home is permitted to assist its residents with Medicaid applications and to handle appeals before an administrative law judge, they are not permitted to provide legal advice. You should consult with a certified elder law attorney who is familiar with Medicaid long-term care benefits and the application process to ensure that you are not spending more money than needed. That consultation can help you avoid financial disaster.

Here at KMA, we have worked with our local nursing homes for years and get along with them well. Many times, the facilities will advise residents and their families to seek legal counsel from an elder law attorney. This is often when there was gifting within the past five years, or when they encounter other difficult situations. They know that we do not recommend risky strategies that end up causing problems with Medicaid applications. A consultation with a certified elder law attorney makes sure that you spot issues ahead of time, avoid mistakes, and know that you have done all that you can do to protect assets as permitted by law.

Clients came to our office for help when the nursing home advised a married couple to “spend down” half of their assets and the nursing home would handle the application process “for free.” Unfortunately, one client was the community spouse who spent down his retirement account, which was actually an exempt asset under PA law, and did not need to be spent down at all. This client spent way more money than was necessary.

In another instance, the nursing home advised the family to cash in all of the life insurance policies for their cash surrender value. While the cash surrender value is a countable asset, in most situations, we can protect the life insurance policies by transferring them to the community spouse. By cashing in the life insurance, the family lost the increased value of the death benefit.

Consulting with a certified elder law attorney will ensure you are taking advantage of the opportunities to protect assets and get approved for Medicaid benefits as quickly as possible. We can help by advising:

  • How the community spouse can protect his assets
  • How to legally transfer an asset to a trust for a disabled child or to a child caregiver
  • How the community spouse can avoid impoverishment and have enough income to pay the bills
  • How to legally avoid Medicaid estate recovery payback
  • How to legally transfer certain assets to the community spouse to protect them
  • How to “fix” a penalty due to gifting within the past five years
  • How to make sure that you are protecting what you are permitted to keep

Don’t rely on the nursing home to file your Medicaid application. Your best bet is to retain the services of a knowledgeable elder law attorney who can provide advice about your rights and responsibilities.

Kreisher Marshall & Associates, LLC, has two certified elder law attorneys, Marianne E. Kreisher and Marissa B. Marshall, who have the expertise to ensure you are receiving all benefits available and taking advantages of the various strategies to protect your assets. Attorneys Kreisher and Marshall offer home, hospital, and nursing home visits and offer evening consultations by appointment. Call (570) 784-5211 ext. 2 or email info@columbiacountylaw.com.

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Posted in: Seniors