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February 11th, 2015

Getting Ready for the Medicaid Safety Net

Sanford Altman, Esq.
In the many years that I have been practicing Elder Law, only once did 1 actually hear a client say that she would rather spend her waning years in a nursing home. 1did not actually hear her say that directly. It came from her adult son who told me that she said, “I don’t want to be a burden on my children. Just put me in a nursing home.” That was about as close as 1 ever got to hearing someone express a nursing home preference. After all, who would really want to be pulled out of their home to live in an institution and pay up to $15,000 a month out of their own pockets for the privilege? The fact is that around the clock home care can cost more than a nursing home. Regardless of our wishes, when needed, we are very fortunate to have high quality skilled nursing homes right in our area whether for an indefinite stay or just for long term rehabilitation.

But what about that $15,000 per month, which is still rising? What can we do about that?

Whether for a nursing home or your own home, this is where Medicaid comes in as our “safety net”. My own belief is that, after paying taxes for all of your life, it’s only fair that the government would pay for a nursing home if you’ll need it. Unfortunately, the government does not see it that way. As most oy you’ll maybe aware, Medicaid is the only government program that pays for long term care whether at home or at a skilled facility for the long term. But Medicaid is not automatic. There are many eligibility standards as to income and assets, prohibitions against gifting your funds to become eligible, etc. If you are not already eligible financially, you can, often with the aid of an elder law attorney, have a plan put together so you can become eligible sooner rather than later. But aside from the strict financial standards, there is one area that is often ignored before you can be actually be approved for Medicaid - the documentation needed to prove your eligibility. While, in the past, the various counties’
Departments of Social Services that administer Medicaid have been very lenient about extending time after the Medicaid application is submitted for you to bring in the documents, they are now much more strict, even to the point of denying applications for failure to supply supporting documents in a timely manner.

Since the required documents are often very difficult for your family to locate, it is wise to set them aside now while you are still capable of doing so. Here are the highlights of the very lengthy list that your family will receive along with your Medicaid application:

1. Power of Attorney - this allows the people of your choice to submit the application on your behalf and authorizes Medicaid to actually speak with them;

2. Proof of Identity - birth certificate is best although a passport will suffice. A marriage certificate identifies your spouse whose finances will come into to play for eligibility (if deceased, a copy of his/her death certificate is needed). If appropriate, citizenship verification should be supplied.

3. Military Discharge papers for you and your spouse. Some small benefits are attached to this.

4. Residency - this is extremely important because each county has their own Department of Social Services and they must know that you are living in their county for them to handle your application.
However, the proof is easy. Most common is a utility bill with your name and address. Almost any bill or even a bank statement with your name and address will suffice.

5. Copies of all your health insurance cards. Both governmental and private as well as your Social Security card. Front and back are necessary.

6. Proof of income - your yearly award letter from Social Security for you and your spouse; eight weeks of paystubs if you are working; proof of any other type of income from such sources as pensions, retirement account distributions, annuities, veterans benefits or interest and dividends from stocks, bonds or bank accounts. Your best proof of your income is, of course, your tax returns for the past five (5) years with 10995. If you haven’t filed taxes, submit the 10995. Medicaid doesn’t care if your income is taxable or tax free. It still counts.

7. Resources - this is a tough one. If you ever need nursing home Medicaid, you must submit five (5) years of bank statements, brokerage statements, retirement fund statements such as IRAs and 401Ks, even if they have been closed during the past five years. This means that, if you haven’t been saving them, start saving them now. It is often difficult to do so later especially since banks are closing or being swallowed up by other banks. If you don’t have them, you probably won’t get Medicaid.

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