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One area that causes a lot of confusion with regard to Medicaid is the look-back period.

Moving a family member to a nursing home is never a simple process. Finding the right facility, coordinating the move, managing a very sick family member and dealing with all of your emotions will easily overwhelm most of us. To make matters more difficult, the nursing home is asking you to sign a very complicated admissions agreement. Here is what you need to know before you sign.

Douglas had to place his mother in a nursing home. Douglas consulted a social worker who told him that he should spend his mother’s assets down to below $2,000 and then, for a small fee, the social worker would prepare the Medicaid application for his mother and everything would be taken care of.

Douglas spent his mother’s assets below $2,000, paid the social worker $2,500 to prepare the Medicaid application and was told everything was good to go with his mother.

After about four months, Douglas had not heard anything on the status of the Medicaid application and the business office at the nursing home told him that his mother’s account was $35,000 past due. After a few frantic calls to the social worker, Douglas found out that his mother’s Medicaid application was rejected by the Medicaid office because of some prior gifts his mother had made to set up college funds for Douglas’ three children.

Because the Medicaid application was rejected, the nursing home is demanding that Douglas immediately pay the $35,000 past due account or the nursing home will evict his mother. Additionally, the nursing home is telling Douglas that he is personally liable for the payment of the bill because he signed as the “responsible party” at the time his mother was admitted to the nursing home.

Fortunately, we were able to reverse the decision by the Medicaid office on appeal and qualify Douglas’ mother for Medicaid. Douglas would have saved himself a lot of money and stress if he would have consulted with an elder law attorney with expertise in protecting assets from long term care costs this office first and retained them to complete the Medicaid application correctly. I explained that it is almost never in the best interest of the Medicaid applicant to spend down all of their money. There are legal ways to protect a person’s savings if it is done correctly.

The filing of a Medicaid application is a complicated process. There is no room for mistakes.

Brad is quoted in an article entitled "Navigating the Complexity of a Long Term Care Insuarnce Policy.  Click here to read this article.

Brad is quoted in a recent CNN Money/Genworth article entitled, "The Biggest Threat to Retirement Planning." Click here to read this article.

Brad is quoted in a recent Market Wealth article entitled "How a Parent's Health-Care Bills Could Hurt You."  Click here to read this article.

To investigate a nursing home for a loved one, you may contact the local Ombudsman program to identify facilities that can meet your needs.  It is a free consumer advocacy program.   

Brad was recently on Dr. Sam Brinkman's "Neuro Matters Radio Show.  Please use this link to listen to this interesting show. http://cdn.voiceamerica.com/health/011384/brinkman060314.mp3

It appears that Medicare Advantage Organizations (MAOs) and Prescription Drug Plans (PDPs), Medicare Part C and Part D private carriers, also come into the fold as entities that parties will have to deal with regarding Medicare secondary payment subrogation rights as these private carriers begin seeking reimbursement for payments made for services in which Medicare is a secondary payer.

What the Supreme Court giveth, Congress can take away. The federal Medicaid statute has long required that Medicaid agencies recover from third parties legally liable for health care items or services to the extent that the Medicaid program had paid for those items or services. 42 U.S.C. § 1396a(a)(25)(H). States also were required to have individuals assign to the State the individual’s right to payment for medical care from any third party. 42 U.S.C. § 1396k(a)(1)(A).