Certainly, public benefits should be available to those who qualify without having to resort to hiring an attorney. Unfortunately, this aspiration and the reality of the Medicaid rules are far apart. The eligibility requirements are defined in a conflicting set of state and federal laws, regulations, bulletins, and practices that make it impossible even for attorneys to fathom unless they specialize in the field. Your case may be simple and may not require the depth of knowledge needed to plan for a more complicated estate. However, you cannot be sure of that without first meeting with a specialist. Again, a lot’s at stake, and given the cost of nursing homes, it’s not difficult for a qualified attorney to save the client more than the attorney’s fee.
Free Application Services
Yes, the nursing home provides application assistance at no charge. In addition, in the majority of cases, there is no risk in using these services if you’ve checked it out with an attorney ahead of time. However, there is a great risk in using the nursing home’s services without first consulting an elder law attorney. We have seen countless examples of incomplete or improper advice leading to significant lost planning opportunities for clients, no matter how well-intentioned the advice giver may be. Rectifying the situation may cost more in legal fees than would have been the case with a proper plan.
In any event, the nursing home and the resident’s family often have conflicting interests since their private-pay rates are typically $2,000 a month more than they receive in Medicaid reimbursement. In other words, every month that a resident pays privately rather than receives Medicaid coverage is additional money going to the nursing home and less preserved for the resident’s spouse and family.
In addition, to the extent that the application raises legal issues, it makes sense to have an elder law attorney prepare the application. This would be the case, for instance, if a trust were involved or if you were seeking an exception to the usual penalties for transferring assets.
Medicaid as Welfare
Medicaid serves a number of different populations, including poor recipients of Supplemental Security Income (SSI) and disabled people receiving Social Security Disability Income (SSDI). No one would argue that when Medicaid was created it was meant to be the main system of paying for long-term care for older Americans. But in the absence of any other program to fill that need, Medicaid has become the nation’s long-term care financing system by default. Medicaid planning permits nursing home residents to be covered by the program under its rules. Congress can change the rules, and often does.
Consulting with an attorney permits seniors and their families to understand the rules as they are and the options available to them. It does not require them to take any particular steps. It can be vital to preserving the financial security of a healthy spouse continuing to live at home.