Applying For Medicaid: Common Pitfalls

In some cases, applying for Medicaid benefits for a loved one can be a fairly straightforward undertaking. In other cases, it can quickly turn into an ordeal.

As a quick reminder: Medicaid is a state and federal government funded health program available for certain eligible individuals. Whether one is qualified for Medicaid benefits depends on their assets and income as only individuals with low incomes who cannot afford medical care are qualified for the benefit. While Medicaid covers several health services, the most commonly known coverage is Nursing Home Coverage. If qualified, Medicaid will pay for your loved one’s nursing home coverage which not only allows the loved one to have necessary care, but also allows their families to retain financial stability and freedom.

While the Medicaid application can be done by most people, there are several issues that often times warrant hiring an experienced elder law attorney to assist. Some of the potential risks of filing the application on your own include:

• The Medicaid application is denied
• Delay in receiving a decision from Medicaid
• Failure to be properly informed of the rights of the spouse who is not in the nursing home
• Penalties
• Failure to spend down your remaining funds correctly.

There are several other possible ramifications of handling these matters on your own. Medicaid officials often put severe scrutiny on the application – requiring up to five years of financial records, proper documentation, proper reference documents and explanations for all possible disqualifying transfers.

Even in cases that seem clear cut, Medicaid officials have been known to deny applications which require an appeal or perhaps a re-application. It is helpful in both of these instances to have an attorney who has assisted in this process from the very beginning. While the cost of attorneys can often seem quite high, if having professional counsel can assist in getting eligibility faster (even by one month!) then that could provide great savings to your loved one.

Martinson & Beason has experienced Alabama elder law attorneys and staff that are ready and able to assist you in this important and difficult time in your life and the lives of your loved ones. If you are considering applying for Medicaid benefits or have questions regarding Medicaid, the attorneys of Martinson and Beason are here to guide you step-by-step through the process.