Pitfalls to Avoid When Applying for Medicaid Long-Term Care

The day you dreaded has come. You have made the decision to move your elderly parent to a nursing home. You know it is the right decision and that she will get good care. But you are worried about the cost. She does not have monthly income sufficient to cover the bill. You can’t afford to pay it for her either. You’re going to have to apply for Medicaid. What if she doesn’t qualify? After all, she does have retirement income that was supporting her decently.  It covered her living expenses when she was at home but it’s not enough to cover the nursing home bill. And she does have some assets – a home, a car, a small savings. . .  Will she loose the house?  She had wanted your brother to inherit that house.  He needs it.  If she’s not accepted for Medicaid, how will you care for her?  She can’t continue living alone.  She could live with you, but she needs someone with her at all times. You can’t quit your job to stay with her.  How would you keep up with your own bills? It’s frightening.  These thoughts and worries keep you awake every night.  

The Medicaid system is complex and confusing – and full of traps for the unwary. Unfortunately, there is not a lot of accurate information available. Even the people in the business office at the nursing home don’t fully understand it. But here are some things to keep in mind when applying for long-term care benefits through Medicaid that can make the process easier:

It May Be Possible to Fix Issues that Currently Disqualify You

First, keep in mind that, although it may appear that you don’t qualify due to income or assets, Medicaid does allow for some deductions and exemptions. Once these are properly handled, it is possible that you can qualify, even if you were previously denied or don’t currently meet the guidelines.  However, it is important that you do not file a Medicaid application until you know that you qualify.  Doing so could result in your application being rejected, which could make it difficult to get qualified later.

Don’t Let the Nursing Home File Your Application!

Most nursing homes will file a medicaid application for you for free.  While this may seem like a good option, it can be a disaster.  The nursing home cannot and will not properly analyze your income and assets to determine if you qualify for medicaid.  And if you don’t qualify, they cannot advise you on how to become qualified.  Nursing homes merely process the application and wait for the response.  If your application is rejected, then you are out of luck.  Getting a rejection from Medicaid can make it difficult, if not impossible, to later qualify and robs you of your ability to do the pre-planning that would have resulted in an approval.  It is crucial that your planning be done BEFORE filing your application to avoid this.

Don’t Sell, Gift or Transfer any assets!  

Medicaid has a 5-year “look back” period – meaning that if you transfer any assets within the 5 years immediately prior to application, you will incur a penalty and may be disqualified completely.  Medicaid does allow for some exemptions.  There are proper and legal ways to exempt certain assets and re-direct some income for the benefit of the applicant or a spouse remaining at home. But these actions must be undertaken very carefully if the penalty is to be avoided.  If you have already transferred assets, don’t despair!  Usually, these transfers can be fixed and you can still qualify.

Get Advice

If you are concerned about whether or not you will qualify, don’t try to handle it alone.  Consult a Medicaid attorney. A Medicaid attorney can guide you through the Medicaid application process to ensure that you receive all deductions and exemptions you’re entitled to and get your claim approved quickly.

Although the process can feel overwhelming, confusing and frustrating – and can cost you money unnecessarily if proper planning is not done – with good guidance, the planning and paperwork can be done quickly. So even if you are facing an immediate need, help is available.

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