Are There Really Any Easy Medicaid Applications?
July 25, 2011
Ben calls us with some basic questions about his mom’s long term care needs as she is very close to needing nursing home care. The subject turns inevitably to Medicaid as I explain the complexities of the program and how people get tripped up by it with often disastrous consequences. Ben then makes a statement I hear often. “The nursing home social worker will help me with the application. She says Mom’s situation is very simple.” But how do either of them know if that’s really true? Is there really such a thing as an easy Medicaid application?
A trend we have noticed in recent months in many county offices (Medicaid applications are processed on the county level) is the high turnover of staff and the severe understaffing of offices. Many offices are filled with inexperienced and overworked employees – a bad combination. That’s when mistakes happen. If you’ve been a reader of this blog for even a short time you know how many things can go wrong with a Medicaid application and it’s almost never in your favor.
The family doesn’t know the ins and outs of the Medicaid rules. Completing a Medicaid application is more complicated than preparing the average tax return. That’s why you hire a good CPA. The nursing home is not any more equipped to handle it either. It’s just not the business they’re in and it can cost the applicant and the nursing home tens of thousands of dollars if they make a mistake.
The reply I hear so often is “I looked at the application form. It’s only 8 pages and looks pretty straight forward”. For the most part that’s true. Except that it’s not the application that’s really the problem. It’s all the documentation you must provide and the follow up scrutiny. Going through the Medicaid process is sort of like undergoing an IRS income tax audit, only worse. Why? First of all, most people have some basic knowledge of income tax just from the fact they have been filing returns for many years. Most people who file a Medicaid application, however, do it only once. They know next to nothing about the laws and regulations (or even worse they think they know and are flat out wrong).
Secondly, the tax auditors are so much more experienced than Medicaid caseworkers. They generally know the tax laws, or at least how to interpret the laws in the government’s favor (which is why you don’t walk into an audit on your own). You can’t really blame the Medicaid workers. They are thrown into the job, usually with next to no experience, and try to do their best. But, in so many cases it’s the blind leading the blind. When the caseworker says an asset is countable how do you know it really is? If he/she is wrong you wouldn’t know it.
So, let’s go back to my original question. Is there really any easy Medicaid application? If for the past 5 years you literally never had any assets and only a checking account and lived on Social Security and a pension then, yes, that would be a painless application. But, that’s a pretty rare occurrence.
If you’ve got more assets than that, it is impossible to say it will be an “easy” application until an elder law attorney who knows the rules and regulations really scrutinizes all the transactions in every document provided to Medicaid before you file the application, not after. That’s the best way to insure you’ll have a painless Medicaid experience.
Is Your Long Term Care Plan Stuck in a Time Warp?
July 18, 2011
The amount of change in the last 15 years is incredible and the pace of change has quickened. Nothing stays the same forever, and forever is not as long as it used to be. We are starting to see this in the senior market, beginning with how the term “old” is viewed by seniors themselves and by the businesses that serve them. The generation turning 65 today is the Woodstock generation. The term senior citizen doesn’t seem to fit and may itself become a relic before long.
If you ask anyone turning 65, they’ll tell you they don’t feel like seniors. They also don’t act like seniors, certainly not like ones of past generations. Growing up with sex, drugs and rock and roll, many of the recently minted seniors, the oldest of the baby boomers, still think of themselves as young and are generally healthier than their parents were at that age.
65 now is not what it was 20 or 40 years ago. People are living longer, more active lives and that will have an impact on what services new seniors will require and demand in the marketplace. For example, traditional senior centers in some areas are closing for lack of funding and lack of participation. Many are too sedentary. You are more likely to find younger seniors at a health club than a senior club. They are more likely to be playing basketball, softball, tennis, golf, even adventure sports, than playing board games, cards and bingo. This change will affect many senior communities, including active adult communities and assisted living facilities.
It usually takes society time to adjust to change. We’ve heard about how the Social Security and Medicare will run out of money within the next 10 to 20 years. The retirement age for Social Security has been raised gradually from the traditional 65 and probably will continue to climb. The notion of retirement in 1935, when the Social Security program was created, did not contemplate 20 or 30 years or more of retirement but that has become the norm. In 1935 people weren’t living with chronic ailments for years like we are now, thanks to advances in modern medical science. In fact, the average life expectancy in 1935 was less than 65 years of age. Social Security was designed with the expectation that a large segment of the population would never collect benefits. That’s generally how insurance works, at least if the insurance company wants to remain in business.
With people living longer, more active lives does that mean long term care services are no longer necessary? Of course not. While we can put off the aging process we can’t avoid it – at least until someone figures out that whole cryogenics thing. It just means we are more likely to face significant declines in our health later, perhaps at 75 or 85. Everything is stretched out over a longer time frame and we’d better be prepared for it. We have to stop thinking about retirement and long term care as it was 75 years ago. Most people have a plan that fits 1935, as if they are caught in a time warp. It’s time to replace it with one that works in 2011.
What’s Your “88 Plan”?
July 11, 2011
It seems more and more to me, that dementia and Alzheimer’s Disease are everywhere, but then, maybe as an elder law attorney I am more tuned to it. In the last month three notable celebrities died or were diagnosed with dementia and/or Alzheimer’s, actor, Peter Falk of Columbo fame, “Rhinestone Cowboy”, singer, Glen Campbell and NFL football Hall of Famer, John Mackey.
Mackey was a tight end for the Baltimore Colts in the 1960’s and early 1970’s after having played his college ball with some great Syracuse teams in the early 1960’s. He later became the first president of the NFL Players’ Association and was instrumental in efforts to secure pensions and other benefits for retired and ailing players. Football is a violent sport and like many players Mackey began to suffer from dementia. In his last years he needed to be cared for in an assisted living facility.
Mackey played in the days before athletes made millions. His wife, Sylvia, therefore, had to go back to work as a flight attendant to pay their bills and because they needed the health insurance. As the disease progressed, however, the Mackeys realized what many of our clients come to learn, that traditional health insurance won’t cover long term care. That’s when Sylvia Mackey and other wives and children of former NFL players pursued the NFL and its Players Association to establish the 88 Plan.
Named in honor of John Mackey, whose uniform number was 88, the plan provides up to $88,000 a year to cover long term care for former NFL players with dementia. Much has been written about the connection between football and brain injuries although the NFL still insists there isn’t any higher incidence of dementia in football players than there is in the general population. Maybe the 88 plan is just the NFL recognizing what I have been saying for a long time, that long term care is a big problem in this country and the owners and players are doing what we all should, implementing a plan to solve the problem.
The Mackeys’ story is instrumental. It’s a story of a wife who suffered along with her husband, supporting him physically, financially, emotionally and psychologically the best she could. It’s also a lesson about being unprepared. The Mackeys didn’t have a plan, but they were lucky. They convinced John Mackey’s former employer to come through with the “88 Plan”. The question then is, “who’s going to provide your 88 Plan?” Chances are you’ll have to do it yourself so the sooner you get started the better off you’ll be, unless you’re thinking the NFL is going to help us all out – just as soon as they figure out how to solve their lockout and save the coming season. Yeah, right.
Reading the Will – An Urban Myth?
July 4, 2011
There is an amusing Direct TV commercial which takes place in an attorney’s office that highlights a practice that doesn’t exist any longer in New Jersey (if it ever did) and, to my knowledge, isn’t practiced in most other states. The attorney is conducting what is known as “the reading of the will” in the presence of the heirs.
In the commercial, present are an elderly woman we presume to be the widow, the very attractive young blonde “soul mate” and the son. The attorney recites the clause in which the jet, private island, and family business are left to the soul mate, to the disgust of the widow. Finally, the Direct TV collection of movies is left to the son, who proceeds to carry on in celebration. Funny, but is there any truth to any of it?
No, not really. While I can’t say I have had any client take that much interest in passing on an inheritance that includes their TV service, reading a will aloud isn’t a requirement and I’m not sure, outside of Hollywood, it ever really was required by law.
But what about the idea that the widow gets nothing, or at least that’s the inference that the commercial leaves us with. Of course, we don’t know what else the Direct TV subscriber’s will says, but most, if not all states, have a law to protect the “kept in the dark” spouse. The law is known as the elective share. It says that the surviving spouse is entitled to a minimum amount of the estate even if her spouse’s will cuts her out entirely, unless she knowingly waives that right. So the poor “Direct TV” widow, if she lived in New Jersey, for example, could be entitled to as much as 1/3 of her husband’s estate, regardless what the will says.
In that case, the son might not be celebrating quite as much if he only receives 4000 movies, the other 2000 being left to the widow. It doesn’t make for as amusing a commerical, although I’d hate to think about how messy it could be deciding who gets what movies. Sounds like that family may be headed for a court battle.
