Do you need an attorney to apply for Medicaid?
When a family member enters a nursing home and needs to apply for Medicaid, the process can be very overwhelming and stressful. On top of dealing with a major transition in life, the family must deal with the massive amounts of paperwork involved in not only the nursing home admission but also the financial side. Applying or Medicaid involves the daunting process of gathering detailed financial records for the last five years. Once you are able to gather the necessary documentation, the next task of navigating the asset transfer rules and look-back period hits you. Unfortunately, applying for Medicaid is not as straightforward as many think and there are many traps and pitfalls that can have devastating financial implications. Hiring an elder law attorney to help navigate the intricate Medicaid rules is vital to a smooth and successful Medicaid application process.
One of the most common reasons people do not hire an attorney to assist them with the Medicaid application is because the nursing home will assist with the application at no cost. Therefore, the family often decides to have the nursing home complete the application. However, it is important to understand that a nursing home receives more money per day from a resident that is privately paying than when the resident is on Medicaid. Not only does the facility have a vested interest in having a resident privately pay and prolong Medicaid eligibility, but the nursing home is not able to provide legal advice on the best way to protect assets. The nursing home is not trained on the intricate state and federal laws that allow individuals and couples to protect money and still receive Medicaid eligibility. It is important to have independent advice from an elder law attorney on how best to protect assets an accelerate Medicaid eligibility.
Legal fees to hire an attorney to represent you for the Medicaid application is an allowable expenses and part of the Medicaid spend-down. However, if you do not hire an elder law attorney from the outset of the Medicaid application process, you may not have the money do so when an issue arises. For example, many initial Medicaid applications are denied. The denial is oftentimes related to the caseworker not receiving specific information they need to process the application or the appearance of being over the resource limit. If the denial is not properly and timely appealed, the results can be financially devasting as the applicant could loose retroactive Medicaid coverage. Having an elder law attorney assist you from the beginning with the application is a way to make sure that the denial is properly appealed and that you have legal representation for the Fair Hearing.
Hiring an elder law attorney from the beginning of the Medicaid application process can give you peace of mind during a very stressful time. Having an independent advocate familiar with the Medicaid rules and process can save both time and money.
The legal advice in this column is general in nature, consult your attorney for advice to fit your particular situation.
Rebecca A. Hobbs, Esquire is licensed to practice in the Commonwealth of Pennsylvania and is certified as an Elder Law Attorney by the National Elder Law Foundation as authorized by the Pennsylvania Supreme Court. She is a principal of the law firm of O’Donnell, Weiss & Mattei, P.C., 41 High Street, Pottstown, and 347 Bridge Street, Phoenixville,610-323-2800, www. owmlaw.com. You can reach Ms. Hobbs at rhobbs@owmlaw.com