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The Five Steps Critical Steps To Take When Mom’s Medicare Runs Out

If you're reading this, it's because you’ve already received the call. The social worker at the rehabilitation facility said, “Mom’s last covered Medicare day is in two days from now. If she stays here, it’s going to be $310 a day”. That’s over $9,000 a month! She’s going to go broke quickly if she has to pay that. Mom’s not safe to go home alone and home health care is even more expensive. You thought about keeping her at your home, but you aren’t a caregiver and you have a full-time job anyway. What do you do?

Fortunately, we’ve helped hundreds of families - just like yours - protect everything Mom spent her life saving and still get her the care she needs. Forget everything you think you know about Medicaid because it is achievable and it is for Mom - even if you think she has too much money. That’s why we prepared this informative guide on the steps you need to take now to help her protect everything!

Appeal, Appeal, Appeal!

I know what you’re thinking - I’m not an attorney, I don’t know anything about appeals! That’s probably true. However, even if you were an attorney, this is a different type of appeal. When Medicare issues a decision to end service, you have the right to an immediate and independent medical review of that decision if you disagree with the decision to discharge. Once you are issued the discharge notice - which is formally referred to as a Notice of Medicare Non-Coverage or NOMNC - you’ll be able to request the appeal. The nursing home provider must issue this notice at least two calendar days before the Medicare covered services end. Once you receive this notice, you must file your appeal request with your Quality Improvement Organization or QIO. That information will be located on the discharge notice provided to you by the nursing home. Your request for the appeal should be made as soon as possible. Make sure you make a list of reasons why you think the decision is improper and include them in the appeal.

Locate Legal Documents

What type of legal documents are important at this stage? Powers of attorney and healthcare surrogacy/medical power of attorney documents are needed. When loved ones are in nursing facilities, things can change in an instant. Without those documents, you won’t have the ability to make decisions for Mom if she ends up unable to make them herself. At that stage, your only option would be to pay thousands of dollars for a guardianship. If you don’t have - or can’t find – these documents, an elder law firm like the Family First Firm can help prepare them for you and get them executed. What if Mom can’t physically sign? As long as she understands what she’s doing, we can have a notary sign for her at her direction. By getting these documents in place, Mom will have an agent who can act for her and protect her interests. Additionally, you will avoid the need to file a guardianship later with the courts.

Once you find the power of attorney, check for some extremely important information. Documents signed before 2013, signed outside the state of Florida or pulled from the internet generally do not contain the language you’ll need to utilize some of the best protection options here. Examples of things you need to look for include: checking for whether there are places for the signer’s initials next to special powers or if it contains phrases like “personal services agreement”, “qualified income trust”, or “ability to contract”. Again, this document can be updated if it’s lacking the necessary information.

Finally, collect any Last Will & Testament documents, prenuptial or postnuptial agreements, or any other legal documents. This might seem odd as you may feel like they don’t apply, but they may prove to be very important in the upcoming steps.

Gather Financial Documents

As you may be aware, Medicaid has a limit on both monthly income and assets owned by the person applying for benefits. The Medicaid office has ways of searching through public and private records to locate any assets which may be able to be used for care. You can’t sneak assets past them. However, when you take advantage of some of the best asset preservation options, you can protect Mom’s legacy and still get Medicaid. In order to do this, you need to know every asset that she has. One missed account or property can result in a denial of benefits. Make sure you collect the following (if applicable):

  • Driver license or government issued identification Social security card. 
  • Health insurance card(s).
  • Proof of medical insurance premium.
  • Long-term care insurance policy. 
  • Current proof of gross income (directly from an income source, often referred to as an Income Benefits Verification Letter and for Social Security the Annual Award Letter).
  • Current proof of life insurance cash and face value.
  • Current proof of irrevocable burial/funeral contract.
  • Statements for all financial accounts for the last 3 months for all assets including checking, savings, IRA’s, annuities, CD’s (include all pages- even if the page is blank).
  • Proof of mortgage and/or rent.
  • Proof of homeowner’s insurance, property taxes, and utilities.

Additionally, if mom is a veteran or a widow of a veteran, make sure she has:

  • Certificate of Release or Discharge from Active Duty (DD214).
  • Marriage license.
  • Death certificate for Veteran with cause of death listed.

These documents are required to file for Medicaid. The sooner you collect them, the sooner you can begin the application process. It can feel daunting, but we can help, and acting swiftly can save Mom tens of thousands of dollars in monthly private pay fees.

Calculate When Mom Will Run Out of Money

Why is this important? Well, some people may not be worried about running out of money. If you’re lucky enough to be in this position, it’s good to know. How do you do this? Take the total amount of money mom has and divide it by the monthly cost of care. Here is an example:

Mom has $208,000 and the facility costs $9,575 per month. This means that Mom will be completely broke in a little over 21 months. The average stay in a long-term care facility is just under three years. Of course, this can vary based on age and health circumstances. However, knowing how much time Mom has before she’s broke can help you figure out the next steps to take. Do you apply for Medicaid or just pay at the facility? If Mom has millions of dollars, it may not be necessary for her to apply for assistance. If she doesn’t, it may make sense to move to Step Five.

Contact the Family First Firm for Help!

No matter what time of day it is, email us at intake@familyfirstfirm.com with the subject line “EMERGENCY”. We’ll respond quickly and get you scheduled for one of our earliest appointments. Often, this is within 24 business hours of when you reach out. To make it a little bit easier, we’ll waive our usual fee, so you can get the answers you need at no cost.

I’m sure you’re wondering why you should call it an “emergency”. If you’re anything like most of our clients, you already recognize that Mom needs to protect her nest egg and get Medicaid to pay for the facility. However, the process of protecting assets in a legal way can be exceedingly daunting. So much so, that in 2015, the Florida Supreme Court issued a ruling that only lawyers can engage in the practice because too many non-attorneys were messing it up by creating unnecessary taxable events and making costly mistakes at the expense of their client.

We’ve helped hundreds and hundreds of families protect Mom’s assets while getting her Medicaid. We’re proud to say that we’ve gotten every case approved that we’ve ever filed. No matter how complicated or complex the case is - we have a team that can handle it all. We’ve heard of people trying it on their own, often with disastrous results. But is this really something you want to DIY? Is it worth the risk?

Email us at intake@familyfirstfirm.com with the subject line “EMERGENCY” and we’ll take this off your plate so you can rest easy, knowing that Mom’s life savings are protected and her Medicaid eligibility is assured.

Things To Consider When Hiring An Elder Law Attorney

ACCESSIBILITY

We're virtually everywhere! We provide our clients with the option of an in-person or a virtual experience. Distance should never be a barrier to the highest quality legal representation.

AFFORDABILITY

How much is all this going to cost? Can't afford a consultation fee? No problem, our law firm will provide a complimentary client needs assessment for you. Additionally, our firm only charges a flat rate fee for legal services and that includes everything you'll need from beginning to end. That means you won't have to worry about being billed hourly for calls, emails, or visits with our team.

EXPERTISE

Why do I need an elder law attorney? In an age of specialization, ensuring the best quality of life will depend on having an attorney with an updated wealth of knowledge about elder law. You have unique financial goals and objectives, and we dedicate ourselves to protecting your assets through innovative solutions. We’ll assess all your obstacles and opportunities to guarantee you get the best experience we can.

RESPONSIVENESS

How long does this take? While we've had cases approved in 13 days, on average our Medicaid cases are approved within 60 - 90 days. We pride ourselves on getting your case approved as quickly as possible.

RESULTS

Why should we hire your firm? We have a 100% success rate getting our clients Medicaid approved! While we have to give the usual lawyer disclosure of “our past results are no guarantee of future results,” we’re still proud to say that of the thousands of Medicaid applications we’ve filed, we’ve gotten each and everyone approved. Whatever you do, beware of non-attorney "Medicaid planners" who are unlicensed to practice law. They can create havoc with costly mistakes! Non-attorney "Medicaid planners" are not regulated by the Florida Bar thus there is no protection to the consumer.

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CHOOSE WHO WILL MAKE YOUR DECISIONS

What will happen if you become incapacitated and can no longer make decisions? Someone will have to step in and make decisions for you. It might be your spouse, but what if he or she is also incapacitated or there is another legal issue? Without an estate plan, the government can take over. Fortunately, an estate attorney can ensure that won’t happen. Your attorney can create a healthcare directive and power of attorney, so you can choose who will be in charge if you’re incapacitated. These documents will even give you control over how the decisions are made. You want to live and die with dignity, and that’s possible with help from an estate lawyer.

DO YOU NEED A WILL OR TRUST?

Are you looking for an “estate attorney near me” to create a will or trust, but you aren’t sure which is the right choice? Your estate lawyer will help you determine which document allows you to reach your goals. First, you must understand the qualities of each. Wills determine how property is distributed after death. They must go through probate and can be contested. A living trust is private and doesn’t go through probate. The document can go into effect when the creator becomes incapacitated, and it is also used to distribute property upon death. Due to the complexity of both documents, you should consult with an estate planning attorney before choosing one.

WHAT HAPPENS IF YOU DON’T HAVE AN ESTATE PLAN?

If you pass away without a will or trust, the court will distribute your property based on the Laws of Intestacy Succession. The law determines the order your assets are distributed to your descendants. If the court is unable to locate any surviving relatives, the property will be transferred to the state of California. Instead of leaving it up to the courts, you can take control of your estate with help from an attorney. Your California estate planning attorney will ensure that your property is distributed based on your wishes.

AVOID PROBATE WITH AN ESTATE PLAN

Probate is long, stressful, and expensive. Probate lasts around a year, even if no one contests the validity of the will. If there are legal challenges, the process can take longer, and your descendants won’t receive the property until it’s over. An estate lawyer from Senior Citizen Lawyer can go over options to avoid probate. Options include gifting your assets, creating a living trust, or owning joint property.

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