Medicaid Applications Are Serious Business
Medicaid services received through New Jersey’s MLTSS program provide for long-term care for those who are clinically and financially eligible. Although the application itself is only a few pages long, the process is daunting and mired with pitfalls for those who have never attempted to navigate this process. Here are a few pitfalls:
Those with income exceeding $2,742 per month must fund a Qualified Income Trust. How do most applicants discover this? By receiving a denial letter. When? Months (and thousands of dollars in nursing home fees) after applying.
Gifts given within five years of applying for Medicaid create an ineligibility period. What if there was a method to resolve this unintended consequence?
The Medicaid applicant’s primary residence is exempt, meaning it is not counted towards Medicaid eligibility. What happens, though, if the Medicaid recipient dies while still owning the residence? What if that same Medicaid recipient has a disabled child or a child who cared for her for two years prior to filing the application?
BEWARE PREDATORY PRACTICES
These are just a few of the issues that only elder law attorneys can address. However, in the past decade predatory Medicaid applications companies have proliferated with the goal of benefitting financially from those in dire need of guidance as they face the mounting costs of long-term care.
Admittedly, there are legitimate companies helping seniors qualify for Medicaid. In fact, when there are no real legal issues and the application is straightforward, the team at NJELC highly recommends them. Sometimes, it’s not worth bringing a gun to a knife fight. However, as soon as there is a potential hurdle: real estate, gifts, theft, a spouse, an estranged spouse, a business, or anything that may hinder eligibility; then, an attorney needs to be involved.
Thankfully, the state of New Jersey is finally addressing the widespread problem of both private, non-legal companies and nursing homes themselves aiding in the Medicaid application process. Most importantly, New Jersey specifically addresses the widespread problem of nepotism in the industry. Yes, the company that you entrust to care for your loved one is also “helping” you apply for Medicaid. Think about who benefits from an arrangement where the seller of services is also advising you on how best to spend your money. Do you ask the IRS how to maximize your tax deductions?
NEW JERSEY TO THE RESCUE
A bill introduced in mid-February, S-3606, would prohibit non-attorneys from charging to provide Medicaid application assistance to families. A second bill, A-5194, would require anyone providing Medicaid application assistance to disclose their relationship to the long-term care provider. These two bills aim to address an unregulated and unlicensed industry that has long been accused of financial elder abuse, consumer fraud, bad advice, and withholding money-saving advice which has cost families significant financial loss. Moreover, most of these companies have been flagrantly committing the unauthorized practice of law.
At NJELC, we are committed to putting our clients first. While we welcome introductions from nursing facilities and assisted living communities, we are very clear that our loyalty is to the client. Nursing homes and assisted living communities send their families to us because we get the job done in an organized, friendly, and complete manner. We help families qualify for Medicaid along with our other services: Medicaid planning, estate planning, guardianships, and estate administration.