In my blog post last week, I explained that John was unsuccessful in his attempts to obtain Medicaid benefits for his mom. He then ended up being sued by the facility for the amount of unpaid bills which were not covered by Medicaid. But why did his repeated attempts fail? From my conversation with John it became readily apparent that he didn’t entirely understand the Medicaid process - how detailed and complex it is. The first application he filed was denied. I asked him the reason but he couldn’t recall. It was clear, however that the level of detail overwhelmed him. John said he basically kept refiling the application at least 3 more times but he didn’t address the specific reasons for each denial. It sounded as if he was almost taking a stab in the dark, hoping to hit on the solution. That never works and so I completely understood why he failed each time. What made the problem worse is that with each passing month, John said no one approached him about the unpaid bill so he assumed everything was fine - until he received the summons and complaint. Finally, John asked me if he could appeal any of the denials. Unfortunately, I told him that there is a strict
In my blog post last week I told you about John’s call to our office. John had made several unsuccessful attempts to obtain Medicaid for his mom who was in a nursing facility. He called because he had been sued by the nursing home where his mom had been residing. The facility was looking for payment of nursing home fees totaling $100,000 with attorneys fees and costs of the lawsuit added on to that. He said that during the time he was attempting to obtain Medicaid benefits, the facility never asked for payment. He wanted to know my opinion as to whether he could be held responsible. After reviewing the admissions agreement that he signed, I told him that he could possible be on the hook. Although John admitted to me that he never read the admissions agreement, he signed it as resident representative on behalf of his mother. The agreement contained several pages of language concerning filing a Medicaid application as well as what is expected of the resident representative. The agreement also stated that the facility “encourages the Resident representative to utilize the assistance of the Facility’s Medicaid representative”. This is typically a company that the facility uses to process applications. Other language in the agreement gave the facility the right
We received a call some weeks ago from a caller named John, whose mother was in a nursing facility. He had attempted several times to qualify her for Medicaid. Each attempt was unsuccessful. After the last unsuccessful attempt he took his mother home to “regroup”. John called our office when he received a summons and complaint filed on behalf of the facility seeking payment of unpaid bills totaling approximately $100,000. I explained that we don’t handle these types of lawsuits. Rather, we file Medicaid applications on behalf of our clients. John then asked me whether, in my opinion, he could be held responsible for the unpaid bills. He told me that the facility had told him what to provide to Medicaid and never said anything about the unpaid bills while he was working thru the application process for Medicaid. He also asked me whether I could handle an appeal of the most recent denial of benefits and get Medicaid to cover his mother’s care dating back to when she applied. Next week I’ll share with you what I told him.
When we get to the end of the year, it’s time to look ahead to what numbers may change in 2024 for the government programs from which our clients receive benefits. It starts with the Social Security Administration, which announces its cost of living adjustment (COLA). Other government programs then adjust their numbers, sometimes using the same COLA as Social Security. In the last 2 years because of the highest inflation rates that we have seen in 40 years, the adjustments were large at 5.7% for 2022 and 8.7% for 2023. Inflation, has steadily declined, however, so the COLA for 2024 is a more modest 3.2%. This means that Social Security recipients will receive an increase in their monthly payment of 3.2%. Medicare numbers will also change next year. The standard Medicare Part B premium that most people pay will increase by 6% to $174.70. This follows last year when the premium actually decreased from $170.10 to $164.90. Certain Medicare deductibles and copays will increase next year. The Part A hospitalization deductible will increase by $32 to $1632 and the copay for days 61 through 90 will increase from $400 to $408 per day. Medicare covers the cost of rehabilitation in a skilled nursing but there is a copay for that
In this last post of 5 I explain the reasons why the estate administration process takes as long as it does - why it isn’t as simple as getting appointed administrator and closing out all the decedent’s accounts and distributing them in a matter of days or weeks. This week we cover taxes. We almost always must address the issue of taxes but there are different types of taxes. When someone dies we must consider estate taxes and inheritance taxes. Federal estate tax is owed on estates greater than $12.9 million (soon to increase to $13.6 million in 2024). Only a small percentage of estates ever owe federal estate tax. New Jersey no longer has an estate tax for anyone who died on 1/1/2018 or later, however, there still is an inheritance tax. This is based on the relation of the heirs to the person who died. Certain “Class A” beneficiaries are exempt from tax. They include spouses, children and grandchildren. Distributions to more distant relatives and non relatives are subject to tax depending on which class they are assigned to. Estate tax returns are due and the tax owed 9 months after death. Inheritance tax returns are due and the tax owed 8 months after death. Interest accrues on unpaid tax after
In my post last week, I covered the complications that can arise if there is no personal representative named - either because there is no will or because none of the named executors in the will are able to serve. This week I discuss the difficulties when there are no clearly identifiable heirs. We must then consult the intestacy laws which establish who are entitled to a share of the estate. The law establishes the categories of heirs and the order in which they take. Identifying those individuals however, isn’t always easy. The decedent may have had children from different relationships, some of whom he may have lost touch with. When there isn’t a spouse or children it can get trickier. More distant relationship such as aunts and uncles and cousins can be especially problematic to identify. A family member from the maternal side of decedent’s family, for example, may not have knowledge of family members on the paternal side. The family tree on each side must be identified because they have equal right to share in the estate. There is not a central database that can be consulted to identify all the heirs. Professionals may need to be hired to locate heirs. Searches must be methodical to capture all possible heirs