Understanding The Medicaid Process
Are you or a family member facing a nursing home admission and confused with the many rules of Medicaid? Is there fear that many of the assets you worked hard for throughout your life will be lost? At the time, it may seem like there is no hope. However, Heritage Elder Law & Estate Planning focuses on saving your assets while still getting you and your loved ones the skilled nursing care they need.
In most cases, our experienced Medicaid lawyers can save a married couple 90% of the assets when one spouse enters a nursing home. If the client is single, we can typically save 50% of the assets.
There is no need to be frightened when navigating this process. Call our firm to schedule a free, no-obligation consultation to learn what your options are and how we can help ease your burden.
First, the benefits associate does a triage to collect initial information on income and assets. An initial meeting is typically scheduled during this phone call and the prospective client is sent a detailed planning worksheet to complete before the meeting by email or regular mail.
During the initial meeting, the potential client meets with one of our experienced Medicaid attorneys and ideally brings the completed worksheet. The attorney will collect any additional information needed, identify the problem and then step out of the meeting to do calculations to determine which option is best for the family. Then the attorney returns to the meeting, explains the Medicaid process and presents the client with the possible strategies available to fix the problem. If the client signs the Medicaid Fee Agreement, a document collection meeting is scheduled at that time.
The document collection meeting is usually the next meeting scheduled, and the attorney or benefits associate will collect any additional information or documents still needed at that time.
Follow-up meetings usually consist of status updates, document signings or the spend-down, depending on how complex the case is.
Following the spend-down meeting, our team will submit the Medicaid application to the County Assistance Office (CAO) and get one of three responses: approval, denial or pending.
If the application is approved, we check the start date to make sure we agree with it, and if we do not, we appeal.
In the case of a denial, we identify the issue then appeal. For a case with a pending status, our staff will reach out to the client and obtain any documentation we do not have. We then resubmit the application, and a new decision is issued by the CAO.
If documentation is not received by the deadline, we are given a denial and appeal it, scheduling a fair hearing. Heritage Elder Law & Estate Planning will represent the client at the fair hearing and usually enter into a stipulated agreement with the CAO. We will talk to the client, discuss the deadline of the stipulated agreement and ask that the client provide documents to us so we can provide them to the CAO so it can issue a new decision.
Once we receive the final decision, we send the client a closing letter.
Discuss Your Options With A Skilled Elder Care Attorney
With so much on the line, it is vital to work with an attorney who understands the myriad considerations that could affect your eligibility. Contact our office by calling 724-897-7781 or by emailing us today.