What are the most common mistakes people make when attempting to qualify an elderly loved one for Medicaid? Matthew Bravette, one of the attorneys at Bratton Law Group, a Life Care Planning Law Firm with offices in the Southern New Jersey and Philadelphia areas, has helped thousands of clients navigate the complicated and confusing Medicaid application process. He has seen more than his share of mistakes, and one of the biggest is not working with an experienced elder law attorney, the kind you will find at a Life Care Planning Law Firm.
“Medicaid is a complex program,” Matthew said. “Planning before the application is filed, and the filing process itself, are time consuming and there are all sorts of pitfalls and land mines that you have to anticipate and know how to work around. A small mistake can set your case back months, possibly leading to large out-of-pocket expenses.”
Though Medicaid is a federal-state program, the case workers who work with the Board of Social Services don't necessarily have a duty to help an applicant establish Medicaid eligibility. They have a duty to process the application and to provide certain information within certain timelines, but they don't necessarily have to tell you if they see some glaring issue with your eligibility until the application is done being processed. At that point, they will issue a denial. “The reason the claim was denied is often something that an experienced elder law attorney could anticipate and avoid,” Matthew said.
Denials can create costly delays. Let's say it takes three months for the application to go through and be processed before a denial is issued. Whatever long-term care costs the older adult was incurring during those three months won’t be covered by Medicaid. They will be the responsibility of the applicant or spouse to pay out of pocket. Working with an experienced Life Care Planning Law Firm can increase the likelihood of obtaining Medicaid coverage, ensuring that family members get the care they need while maximizing the ability to protect funds for the well spouse (if there is one) and for future generations.
Some families who find their way to Matthew have made many of the mistakes addressed in this article series. “What brings them to me is usually some kind of family, healthcare, or financial crisis,” he said. “Maybe they have already submitted two or three applications for Medicaid, they’ve all been denied, and now the client owes tens of thousands of dollars to a long-term care facility. The Medicaid application may have been denied due to a gifting issue or a verification issue that could have been overcome.”
Income eligibility issues can be especially vexing for people attempting to navigate the application process on their own. “Income eligibility issues often require the opening and proper utilization of a device known as a Qualified Income Trust,” Matthew added. “The Department of Social Services might not tell you that during the application process. Instead, the application will eventually be denied or eligibility postponed due to failure to establish income eligibility. When you work with an experienced attorney who knows how to navigate the process, you will get far better results. Getting the right kind of help from the start more than pays off in the end.”