Ask Jaleh: Reasons For Medicaid Planning.
Video Summary
Reasons for Medicaid planning. Medicare or long-term care insurance benefits may be unavailable or insufficient to cover the costs of nursing home institutionalization.
While Medicare and HMOs may pay part of the nursing home care for the first 100 days, they will only pay for quote unquote skilled care, and a three-day hospitalization requirement must be fulfilled before any days of care and coverage will be allowed. The first 20 days full expenses will be paid by Medicare or Medicaid. And for the next 80 days the patient must pay a sizeable per day coinsurance amount.
Nursing homes in metropolitan areas of Florida normally charge $250.00 per day or more simply for room and board. Thus, the Medicare and HMO coverage will not pay the entire bill. Further, because of the narrow definition of skilled care, the national and Florida average for Medicare and HMO coverage is 10 to 20 days and not the full 100 days allotted. Long-term care calls for long-term money management to provide essential health and quality of life services and wears over and above that furnished by the Medicaid benefits. The burden of costs of catastrophic medical care is especially poignant in cases of married couples. Community spouses who do not plan ahead, often live in poverty to keep an ill spouse in a nursing home.
If you have any questions regarding skilled nursing care and/or Medicaid planning, please give us a call here at Waller and Mitchell at 727-847-2288.
- Published in Medicaid Planning, Videos
Ask Jaleh: The Medicaid Application Process.
Video Summary
Medicaid Application Process. A Request for Assistance, which is also commonly referred to as an RFA form is generally used to apply for most Medicaid programs. With this form, the applicant must file permission steps to allow DCF to check Medicaid, medical and financial records, a form to specify which program is being applied for, and also a doctor’s statement showing the medical necessity of the applicant.
Following receipt of the RFA, the applicant will be notified by a letter containing a request for records the applicant needs to assemble in order to complete their application. Most records requested are bank statements and other financial records tending to show the financial status of the applicant, such as estate planning documents.
After all information is assembled, the case will be decided and a letter will be sent to the applicant informing them of the grant or denial of aid. Usually the decision letter is sent within 45 to 60 days of the application date. It is important to note that it is always best for a lawyer – your lawyer – to handle this process from start to finish, rather than attempting to complete this process individually or through a family representative. Organization and proper presentment of information is necessary, as is the knowledge of laws, rules and regulations, in order to successfully complete this process.
Also, it’s very important to know that the date of your application is key to determination, since in most instances the grant of benefits will be retroactive to the first day of the month in which the application is processed. If the applicant is eligible for one day of the entire month, then entitlement is good for the entire month applied for. Also, the Institutional Care Program entitlement date is the date in which the institutionalization began and the applicant is otherwise eligible. Another component of the application process is verification of U.S. citizenship. Another component is verification of residency in the state of Florida at the time of the application.
What types of financial records must be gathered to ensure complete financial disclosure for the Medicaid application process? Such types of documents include: VA benefits forms and letters, pension benefits, life insurance records, security statements, bank records, deeds, accounts payable such as notes and mortgages, tax bills such as real estate tax bills from the preceding year, vehicle registration, title papers, insurance information such as homeowner’s insurance, disability insurance, life insurance, funeral records, burial accounts, funeral and plot contracts as well as funeral deeds, prenuptial and postnuptial agreements, powers of attorney, utility bills, receipts and other records showing current utility needs, HOA statements and dues, leases annuities, personal services contracts are also very important to include. It’s very important to note that the list I just provided is not an exclusive list of all the documents that must be provided in the Medicaid application process.
If you would like us to help you with your Medicaid application process, we would be honored to do so. Please give us a call at Waller & Mitchell, 727-847-2288.
- Published in Medicaid Planning, Videos