2016 VA and Medicaid – Changes and Trends #2016VA #2016 Medicaid

            This week I thought I would discuss some changes and trends that are – and in the future may – make it more difficult to qualify for two programs that provide critical benefits to pay for long term care, the VA’s Aid and Attendance and New Jersey’s Medicaid program.

            A year ago I told you that the VA had proposed new regulations that would severely restrict the ability of wartime veterans and their spouses to qualify for a pension that can provide as much as $2120 a month that can help cover long term care costs (See Blog Post 2-9-15).  The biggest change that has been proposed is the imposition of a 3 year look back which would work similar to Medicaid’s 5 year look back.  Whereas now, with proper planning and restructuring of assets, an applicant with assets in excess of the VA’s asset limit of approximately $80,000 can immediately qualify for benefits, a 3 year look back would act as a 3 year waiting period for those same benefits.

            Rumors circulated for months that these changes would occur in February, 2016.  Now word is that these changes could be coming in March, 2016.  For anyone with assets in excess of $80,000 who may want to apply for the VA benefit while avoiding this 3 year waiting period, the message is clear.  Do your planning now before any changes are implemented.  The window of opportunity may be closing.

            Let’s turn to Medicaid.  I have been filing Medicaid applications for clients for 20 years but have noticed a disturbing trend in recent months.  New Jersey appears to be more willing to deny applications for what it terms “lack of verification”, forcing us to file appeals in order to continue to fight on  our clients’ behalf for these critical benefits.

            As I have written on many occasions in this blog, New Jersey’s Medicaid caseworkers conduct extensive and exhaustive searches of the 5 years of financial statements provided as part of every application.  What they do is provide us with a laundry list – several pages long – of checks and deposit slips that they want to see copies of.

            In some cases, the agent under POA acting for the Medicaid applicant can easily and quickly obtain the requested documentation.  In other cases they can’t, often because the financial institutions aren’t very cooperative.  Increasingly, the State is denying applications because this detailed documentation is not being provided quickly enough.

            So, what New Jersey Medicaid does is deny the application because it is incomplete.  “Refile the application when you have everything together”, the State says.  But, they say this 6 or 9 months after the original application date.  Refiling means the loss of most of those months which New Jersey will never have to cover, leaving families with a huge nursing home care bill they never anticipated.