Assisting Living Medicaid is Still Not Retroactive (Part 1)
There are some very important differences in the Medicaid regulations and coverage for nursing home vs. ALF Medicaid. ALF Medicaid is a community based “waiver” program. It is not part of the basic Medicaid coverage that all states must agree to provide when they accept federal funds. Rather, this is additional coverage that they can choose to offer or not. So, what do I mean when I say that ALF Medicaid is not retroactive but nursing home Medicaid is? Let’s say I apply for Medicaid on June 15 and I want Medicaid to start paying for my care on June 1. I must meet all the eligibility requirements as of May 31 in order to be eligible for coverage on June 1. However, it may take 6 months or longer for the State to review my application and approve it. If my application is not approved until December and I am in a nursing home applying for “nursing home Medicaid” then the approval will be retroactive to June 1. I can even seek coverage back another 3 months to March, again, if I have met all financial and other eligibility requirements as of February 28. On the other hand,
Sobering Story About Lack of POA
June is a month for celebrations. Whether it’s friends or family it seems there is always a prom, high school or college graduation or wedding to celebrate every year. It’s the good stuff in life. While I certainly don’t want to ruin the party, this week I do want to share a call we received last week. Monica called concerning her son, Jay who is 22 years old. Two weeks before he his college graduation he was in a serious car accident. After being hospitalized for a few weeks he is now moving to a long term care facility. Monica explained that he sustained a brain injury and doctors have told her he has a long road to recovery. She called us because Jay does not have a financial or medical power of attorney. Monica and her husband are running into problems making decisions on his behalf - both financial and medical - and right now Jay is not yet competent to execute any documents on his own behalf. Guardianship for Jay is the only option. I have written in this blog a number of times about why you want to avoid a guardianship. (See 10-14-12 post.) It is
Anatomy of a Scam
As far as scams go, it is not one that will cause anyone to lose their life savings. Maybe calling it a scam is not entirely accurate. At the very least the letter Joan received was misleading and confusing. As part of an asset protection plan we placed Joan’s home into a trust. We prepared a deed which Joan signed and we recorded it with the Register of Deeds in the county where the home is located. Once we received the deed back we sent it to Joan. A few months later Joan received a letter from the “Local Records Office”, in connection with the “recently recorded deed” to her home, which of course was the one we recorded. The letter stated that for a $100 fee they would send her “a copy of the only document that identifies Joan as the property owner” as well as a “complete property profile”. The letter does not explain what this profile is exactly. Joan called us confused as to whether she needs what this company is offering. She does not. I have received similar calls from clients for years. These services have been around for quite a while. They are required
Dad Gets Knocked Off of Medicaid (Part 2)
Last week I was telling you about John’s dad who was about to be knocked off of Medicaid. His mom had recently died. Her will stated that should Dad survive Mom her estate would pass to him. Included in the estate was the marital home which she was able to keep as an exempt asset when he applied for Medicaid. That’s because she continued to make it her home. The company John hired to file the Medicaid application advised them to remove Dad’s name from the deed. So why was he now about to lose Medicaid? Because he was about to receive the home under her will. Since he is in a nursing home and not living in the marital home it is now a countable asset for him. The State of New Jersey gave him 2 very unappealing options. Option 1 is to sell the home and turn over all the proceeds to the state and remain on Medicaid. If, however, Dad dies and it turns out that the amount in Medicaid benefits he received is less than the money John turned over, there will be no refund. The state gets
Dad Gets Knocked Off Medicaid
John called because his dad, who had been receiving Medicaid in a nursing home for several years, had just received a notice that his benefits were being terminated at the end of the month. He told me he had hired one of the companies that does Medicaid applications because it was less expensive than having an attorney do it. Everything worked out fine and they were able to get his dad approved. So why was he calling? When I asked him he said that his mom had died a few months ago. As soon as he told me that, I had a pretty good idea the reason why. Sure enough, John told me that his mom, who had been living in the home in which John and his sibling were raised left an estate which included the home and a few bank accounts. Her will left everything to his dad and alternatively to John and his brother. They had removed Dad’s name from the deed to the home leaving Mom as the sole owner. Since Dad survived Mom, however, her will directed everything be left to him. Once Medicaid learned that he would be receiving a few hundred thousand
New Jersey Issues Updated Medicaid Penalty Divisor
The last time New Jersey updated it’s Medicaid penalty divisor was two years ago. The divisor is the State’s determination of what the average daily cost of nursing home care is across the State of New Jersey. Although it is supposed to be updated annually the last adjustment occurred 2 years ago. What is noteworthy here is the jump in the divisor by almost $90 from $332.50 to $423.95, effective for applications seeking benefits from April 1, 2017 forward. On a monthly basis that computes to $12,895, which is more in Iine with the actual cost of care in Northern New Jersey. For many years the divisor was below the actual cost of care in a nursing facility. Why is this correction so important? Because the divisor is used to calculate a Medicaid penalty, the waiting period for Medicaid benefits that New Jersey imposes for transfers for less than fair value that occur within the 5 year lookback period – that period of time for which an applicant must provide detailed records of assets so Medicaid can scrutinize whether those assets have been spent down correctly. Let’s say I have gifted $50,000 to my children a year before I