Hospitals and care communities often look to assist their clients to file for Medicaid in the most inexpensive way. In some cases, social workers within the institution or outside “specialists” can be brought in to keep the cost for the family down.
(Note!! In a ruling issued January 15, 2015, Florida’s Supreme Court determined that certain Medicaid planning activities performed by non-lawyers constitute the unlicensed practice of law.This ruling will help eliminate such Medicaid planners from the marketplace where their actions are unregulated and have resulted in harm to Medicaid applicants including the denial of benefits, negative tax consequences, loss of assets, and exploitation. The full opinion is titled The Florida Bar Re: Advisory Opinion — Medicaid Planning Activities by Nonlawyers (Fla., No. SC14-211, Jan. 15, 2015).
This system breaks down, however, at least from the resident’s or patient’s perspective, if the application has any complicating factors whatsoever. For instance, if the applicant has made any gifts or given any money or property away in the last five years (including gifts of cash or other financial accounts) then filing through an outside vendor who does not understand the law regarding asset transfers and who cannot give legal advice will greatly hurt the cash flow of your community. That’s because gifts cause Medicaid penalties and it’s not enough to simply identify them. Often there are strategies to cure these penalties or make them disappear. How that is done is a legal question and requires an in depth analysis, far beyond anything that can be provided by a national provider.
In addition, if the applicant has paid any private caregivers without having a written care contract in place or owns a farm or rental real estate, then a more in-depth consultation is required.
When applying for a married couple the process is quite complicated and again requires a specific line of inquiry to determine whether or not further spend down is needed or whether the spend down has already been met. In addition assets like IRA’s or retirement plans for instance are treated as income not assets under certain circumstances. Understanding these nuances can be the difference between getting your client qualified while affording the patient or resident the protections they enjoy under the law.
As always, if you have questions or need guidance on a particular situation, feel free to contact us so that we can help you determine whether this is a simple filing which can easily be handled by you or even an outside vendor or whether this is a situation that requires a more in-depth analysis.
