Recent Trends with Medicaid Applications – Part 1
I have been saying for some time that Medicaid benefits are much more difficult to obtain now than at any time I can recall in the last 25 years I have been filing applications on behalf of clients. There are a number of reasons for this and a number of ways in which the State has made it more challenging. First the reasons. Demographics certainly have something to do with it. The population in this country continues to age. The average age of Americans continues to climb as people are living longer. That means more individuals needing long term care and consequently more potential Medicaid applications being filed. At the same time the funding for Medicaid, which like all government programs comes from tax revenue, has come under pressure. More applications means needing more money but since the pandemic trillions of dollars have been spent in stimulus checks and extending unemployment benefits. Even before the current crisis state and federal budgets have been running at a deficit. In New Jersey, our State public pension fund is underfunded after years in which the State reduced contributions to apply public monies elsewhere. It only stands to reason that this budget crunch could affect other programs like Medicaid. While I certainly have no inside knowledge
Another Word About QITs – Part 5
In my last post on this topic (4/4/21) I told you about a case involving a qualified income trust (QIT) that was not used correctly causing the denial of a Medicaid application which we had filed. I appealed and the judge reversed the denial excusing the technical mistakes made by the trustee. Instead of depositing the whole amount of Social Security into the trust, transferring back to the applicant the $50 personal needs allowance she was entitled to and sending the rest to the nursing home, the trustee subtracted the $50 before depositing the rest of the income into the QIT bank account. Additionally, in one instance the trustee mistakenly deposited the Social Security into her own bank account. She realized her mistake when she wrote a check to the nursing home from the QIT account and the check was returned for insufficient funds. She quickly corrected the mistake but only in the month after the check was received. As I explained in my previous post, a decision by an administrative law judge can be accepted, rejected or modified by the State. In our case that is exactly what the State did. The judge found that the mistakes made were excusable because of the current pandemic. The State
Estates Left Unattended – Part 3
This 3rd post of 3 is about estate administration which was begun but not finished by an executor who died. As I explained last week, I first had to petition the court to be appointed administrator. The estate consisted of a house and investment accounts. There were several issues that needed immediate attention. Because the real estate taxes had not been paid for more than a year, there was a tax lien on the property. The town had sold the lien to an investor at a tax sale. Investors buy the liens and then continue to pay the taxes. When the homeowner sells the home or otherwise pays the taxes, the lien holder must be paid back with interest. The bigger payoff for the lien holder, however, is the possibility of foreclosing on the property after a waiting period which is usually about two years. In this way, it is possible for an investor to pay a small fraction of the fair market value for the property which can result in a huge profit when the property is resold. My concern as administrator was that a $350,000 asset could be lost to the estate if the lien holder obtained title to the property. In that case, the estate would get nothing
Estates Left Unattended – Part 2
In my post last week I explained that while probating a will is not necessary in each and every instance, when there is a need - because there is an asset that can’t be administered any other way - there is a danger in not attending to this need. The risk is that some or all of the assets can be lost for ever. We see this time and again in our office. Currently we have a case in our office of a client for whom we prepared a will, who then passed away. Her executor, a friend who was also the sole heir of the estate, decided he did not want our help in administering the estate but rather preferred to handle it himself. Except that he didn’t finish the job before he died. The assets included a house and several bank accounts which he did not transfer into his name before he died. He also never paid the inheritance tax that he owed as a Class D beneficiary. By the time his family called us for help it was almost a year after he died. As it turns out, the executor also never executed his own last will and testament so New Jersey’s intestacy laws predetermined which
Estates Left Unattended
When we get a call from family members when a loved one has passed away, they typically ask how quickly they can or need to probate the will or otherwise begin the estate administration process. The act of probating or “proving” the will - presenting it to the county Surrogate and seeking appointment as the executor named in the document - can be done at any time. The actual appointment by the Surrogate cannot be issued earlier than 10 days after death. Sometimes there is no need to probate - or at least there doesn’t initially appear to be a need. That typically can be the case when a spouse dies leaving a surviving spouse. Because many married couples hold their assets jointly with right of survivorship, these accounts automatically pass to the surviving co-owner by operation of law. No probate of the will is necessary. Other assets may have a payable on death (POD) or transfer on death (TOD) designations such as retirement accounts, life insurance policies and annuities. This designation also overrides what is in the will. This can result in many cases where probating the will is not necessary or at least not yet necessary until an account solely in the name of the decedent without
Another Home Based Medicaid Option – Part 3
In the final post of 3, this week I again discuss the Personal Preference Program, a home based Medicaid program. As I explained last week, once an applicant is approved through the usual Medicaid application process, a consultant is assigned to the case to determine a budget that is then used for the services, support and goods that will enable the Medicaid recipient to complete his or her activities of daily living. So what exactly can PPP pay for? It can cover the hiring of individuals to perform personal assistance (ie. a home aide). This person can even be a family member or neighbor. The aide need not be hired thru a licensed home health agency, although an agency can work as well. The program can also pay for cleaning services, errand services, laundry services, equipment, small appliances and technology that increase the Medicaid recipient’s independence. Examples include a microwave oven or a washing machine to name a few. Funds can also be used for transportation of the Medicaid recipient and his or her employees and the purchase and installation of vehicular modifications that are related to achieving accessibility. The purchase and installation of environmental modifications are permitted expenses as well. As with most government programs there are a myriad