When Applying for Medicaid, One Size Does Not Fit All
As State budgets continue to tighten hospitals and care communities often look to outside vendors to file Medicaid paperwork on behalf of their residents or patients. There are national companies who offer these services "for the purposes of evaluating and assisting you with your options."
In many cases, working with outside vendors can be a smart alternative when you are handling a large flow of applications. This system breaks down, however, at least from the resident's or patient's perspective, if the application has any complicating factors whatsoever. For instance, if the applicant has made any gifts or given any money or property away in the last five years (including gifts of cash or other financial accounts) then filing through an outside vendor who does not understand the law regarding asset transfers and who cannot give legal advice will greatly hurt the cash flow of your community. That's because gifts cause Medicaid penalties and i'’s not enough to simply identify them. Often there are strategies to cure these penalties or make them disappear. How that is done is a legal question and requires an in depth analysis, far beyond anything that can be provided by a national provider.
In addition, if the applicant has paid any private caregivers without having a written care contract in place or owns a farm or rental real estate, then a more in-depth consultation is required.
When applying for a married couple going through a division of assets, the process is quite complicated and again requires a specific line of inquiry to determine whether or not further spend down is needed or whether the spend down has already been met. In addition there are state to state differences in the way some assets (IRAs or retirement plans for instance) are treated. In some instances in Kansas they may be exempt while in Missouri they may be countable.
Understanding these nuances can be the difference between getting your client qualified while affording the patient or resident the protections they enjoy under the law.
As always, if you have questions or need guidance on a particular situation, feel free to contact us so that we can help you determine whether this is a simple filing which can easily be handled by you or even an outside vendors or whether this is a situation that requires a more in-depth analysis.