The Types of Long Term Care Facilities and Why It Matters – Part 2
In my blog post last week I addressed the differences between types of facilities and the confusion I see when someone tells me the type of facility they are looking at for a loved one - or they think they are looking at. This matters, for example, when someone has a long term care insurance (LTCI) policy. I am often told that Mom or Dad has an LTCI policy, followed by the question “that will cover the cost of care, right?” There isn’t a one size fits all answer to this question. Maybe yes, maybe no. It depends on what the policy says. In other words, what type of coverage did they buy? LTCI may cover care at home, in an assisted living facility (ALF) or in a nursing home (NH). It may cover one, two or all three of these. The more it covers the higher the premium. More coverage may have originally been purchased and then reduced when a policyholder was faced with an increase in premium. The amount of coverage - as defined in terms of a maximum daily rate and a length of years at that maximum rate - may be different for each type of care. For example, the home care maximum daily rate may be 50%
The Types of Long Term Care Facilities and Why it Matters – Part 1
Searching for care options for a loved one can be very confusing. When you add to the mix the possibility that there may not be enough money to cover the cost of that care - in other words when government benefits such as Medicaid may be needed - it adds another element of complexity to that search. As I have previously written, many people don’t recognize the difference between nursing homes and assisted living facilities and even sometimes independent facilities. That is because there are many facilities that take in residents who need more than one type of care. Sometimes there are two separate buildings on the same grounds. Other times there may be one building with separate wings for the different types of care offered. For example, in one location there might be a nursing home but also an assisted living facility. It could also be that assisted living type care is offered as well as independent living. Adding to the confusion may be that many people assume that a “memory care” unit, where residents who need higher levels of care reside, is a nursing home, probably because residents who reside there need nursing home level care. These units, however, are located within an assisted living facility so
Is There Ever an Easy Medicaid Application? Part 4
In last week’s post I continued to tell you about a Medicaid application which our client characterized as easy but turned out to be not so much. One check deposited into an account we were aware of, then led us to 2 other accounts in another bank that we had not been told about. But that didn’t end the search, however, because when we received the statements for these accounts, we had to identify where all money deposited into and withdrawn from these accounts went. Thankfully, there were very few transactions during the time the accounts were open so we were able to document those. That left the opening deposits and the closing withdrawals. The first account was opened before the beginning of our 5 year look back and it was closed and then deposited into the second account. That left the withdrawal of the balance in the 2nd account when it was closed. We went back to Jane’s family to get answers but they had no clue. The closing balance was $5500. In the end we had to accept that we could not account for this money, resulting in a 1/2 month Medicaid penalty. Not so terrible by itself. The damage, however,
Is There Ever an Easy Medicaid Application? Part 3
Continuing the topic of my last 2 blog posts, I was discussing a snag we hit with a Medicaid application - the discovery of at least one account of which our clients had no recollection. When we identify the bank in these situations, that has always been enough for the bank to locate any and all accounts even when we don’t have the account numbers. For some reason, in this case, the bank came up empty. As I stated last week, client tax returns with 1099s will give us the account information. Unfortunately, in this case the clients hadn’t filed a tax return in many years because their income was low enough and they didn’t keep the 1099s. So what to do? Since financial institutions generate 1099s for any account that earns interest and must report it to the IRS, we asked a family accountant to obtain a tax transcript. Once we received it, we were able to identify account numbers for 2 client accounts which we forwarded to the bank. They were then able to find the accounts and produce statements showing all activity for the years in question. The accounts were closed 2 years into our 5 year look back, however, there were some transactions that had
Is There Ever an Easy Medicaid Application? Part 2
In my post last week I began to tell you about an “easy” Medicaid application that suddenly became not so easy. A deposit in one of the applicant’s known accounts led to the revelation that there had been at least one other account unbeknownst to the applicant’s daughter. What this means is that there was other money during the 5 year look back that had to be traced and documented. Because the applicant already spent down the rest of her assets and we had filed the Medicaid application, timing was critical. The failure to provide the required documentation could result in the application being denied for “lack of verification”, meaning it is incomplete. Since the client was already accruing costs in a nursing home, a Medicaid denial acts as a “double whammy”. Not only is there no Medicaid coverage but it also means the facility will continue to bill at the higher private pay rate. So, now the problem was how to get this information? We knew from the check image what bank to contact. In most cases, the bank can search its database if given the check copy. For some reason, in this case the bank could not find it. In part that may have been because the check
Is There Ever an Easy Medicaid Application? Part 1
When I speak with people for the first time about the Medicaid application process - specifically about the 5 year look back and the amount of documentation required - they often tell me that in their case it should be easy. “Mom never had much,” they’ll tell me. But is that necessarily true? Maybe yes, maybe no but we won’t know until we go through the Medicaid process. A recent case in our office illustrates this point. Jane was in a nursing home. Her daughter called about getting Jane on Medicaid. When I asked some questions about her finances, I was told that Jane only had 3 accounts over the past 5 years and it should be a very straight forward application. We sent Jane’s daughter a checklist of the documents needed. There was not much left to spend down so we filed the application within a couple of months when the remaining funds were spent. That’s when the problems began. We discovered money had been deposited into one of the accounts early in the 5 year look back time period. I knew this was going to be a problem and sure enough, the Medicaid caseworker picked up on it as well and asked for the source of the deposit. The daughter had