When spousal or parental nursing home placement is unavoidable, and once it’s realized that Medicare is not going to pay for a nursing home long-term, understanding the Medicaid Chronic Care program becomes critical.  The Medicaid Application is not a simple document to complete and benefits do not automatically roll in when needed.  The Medicaid Application is a process. In fact, it’s a very complex process involving various areas of law with conflicting rules and regulations.  Ideally the application process should be handled with the guidance of an experienced Elder Law Attorney.

Required in the Medicaid Application process is the submission of numerous documents. Identifying, compiling and cross-referencing these documents is often a burdensome and tedious procedure that takes many hours. Most adult children are not fully aware of their parents’ financial circumstances and approach the situation with trepidation.  Documents are often difficult to find or obtain.   The ill person may not be capable of providing reliable assistance.  Regardless of the difficulties, five years of detailed financial documentation, as well as certain personal documents, is required. The failure to provide ALL documents as required can result in major delays or outright refusal of Medicaid assistance. Continued follow-up with banks and insurance companies once documents are requested is critical to ensure no deadline is missed.  The failure to provide accurate information – even the result of an honest mistake or omission – can have devastating financial consequences.

The old saying about how “a little knowledge can be a dangerous thing” proves all too true for many people with regard to the Medicaid maze. Common knowledge of “what’s legal” can cause major losses as a result of wrong choices from a Medicaid perspective.  Choices regarding the financial management of bank accounts, investments, insurance coverage and gifting may be “legal” but result in a denial penalty or delay in qualification for Medicaid coverage at a rate of approximately $10,000 per month.

An experienced Elder Law Attorney knows the ever-changing rules and regulations that entrench the Medicaid system.  This Attorney will also have familiarity with various other programs and service providers from which a person may benefit. Understanding exemptions that can be used by family members to preserve assets, as well as the acceptable form and timing of asset transfers, can make a huge difference in the living standards of a spouse or child and legally protect assets, even if someone is already in a nursing home.  Remember – an Elder Law Attorney represents the Applicant. The Department of Social Services and Nursing Homes, no matter what they may imply, are not advocates for the Applicant. This is key when considering who to have assist you in completing a Medicaid Application.

With the average cost of nursing home care in northeastern New York typically exceeding $130,000 per year, the Elder Law Attorney provides not only peace of mind, but also value, knowing that your loved one will qualify for the maximum benefit at the earliest date possible.