Medicaid Isn't Just a Form
What you need to know before you need it.
As a death doula, sometimes I have clients with needs that extend beyond what I provide. For example, I’m hearing from a lot of people who need assisted living or long-term patient-centered health care for themselves or a loved one.
They try to budget these costs with everything else they require to live a full and (as much as possible) independent life. That’s where Medicaid can help, but many people don’t know how to qualify and feel a bit overwhelmed.
What is Medicaid?
Medicare doesn’t cover everything my clients need. This includes nursing homes, in-home health care, or other medical/supportive care and services.
Most of the time, these are elderly clients who need help right now. Through taxes, they have paid into a system for fifty or sixty years. They believe they should now be able to utilize benefits, receive quality care, and not go broke.
That’s not too much to ask, right?
That’s what Medicaid does. But it’s complicated.
To Get Started
See for yourself what is required to file an application and qualify for Medicaid.
If you understand the technicalities of healthcare and have experience applying for government programs, have at it. You can certainly tackle this yourself. Especially if you have some time.
Everyone else with an immediate need – call an experienced attorney*.
Legal professionals help make sense of burdensome and confusing paperwork. They also explain the complicated reasoning behind some of the questions. This isn’t an easy process.
Applying for Medicaid funding requires attention to detail and an understanding of the information you’re providing.
Does Medicaid Pay for Death Doulas?
No, death doulas like me are not covered by Medicaid, Medicare, or insurance. We are private pay only.
I can’t speak for other end-of-life doulas, but thanks to grants and donations, I use a sliding scale and won’t turn anyone away.
Benefits of Hiring an Attorney
Here are some benefits of hiring a professional attorney to help get qualified for Medicaid.
Expert Advice
Eldercare attorneys do this for a living. They successfully navigate a bureaucracy and use that knowledge to get the best possible outcome for their clients. An experienced lawyer also knows the rules and regulations in your state.
If there are ways to legally obtain and keep benefits, an attorney who specializes in Medicaid will identify those ways for you.
Avoiding Penalties
Unless work or experience requires it, most of us have no clue about Medicaid rules and regulations. For example, name an exemption to the gifting rules.
Umm…what the hell are gifting rules? Exactly.
An attorney explains them.
Many people dump their assets in reckless ways, thinking that will help them qualify. Here’s something to think about - if you make a transfer of assets that’s a no-no, the penalty might be that you don’t get any Medicaid benefits for a certain period of time.
Who wants that?
(You’d need all your fingers, toes, and a math degree to figure out some of these penalty time frames. It’s a mess to calculate. I’ve tried.)
Timing
Many experts suggest you get everything in order five years before long-term health care is needed. Unfortunately, few people work things out that far in advance. Most of us get hit with a need for health care and then determine a way to obtain it.
Or not.
Most of my clients don’t do this in advance because life almost always gets in the way. Therefore, when they need these benefits, time is of the essence.
A solid attorney helps plan a strategy to get this hammered out sooner rather than later.
Spouse Protection
Sometimes people find themselves in a situation where they need long-term care, but their spouse is healthy and doing fine. Or perhaps one woman has veterans’ benefits, but her wife never served in the military.
A lawyer will devise a plan for you to qualify for Medicaid but still retain enough assets so your partner continues living in the house. They still buy groceries, pay bills, that sort of thing, without jeopardizing your benefits.
Proper Reorganization
Sometimes a person rearranges their assets in a way that allows them to live independently, keeps their money in the family, and still qualifies for Medicaid.
This is the best-case scenario, right?
For example, some families create a personal care agreement. They pay a relative who’s also a caregiver and, at the same time, they “spend down” to qualify for Medicaid.
Medicaid helps pay for respite care for that caregiver when they need a break or a good night’s sleep.
Attorneys help determine whether this approach and many others may work for your family.
What’s the Process?
Unless you’re five years out with time to research and understand the process, a reputable attorney is a good choice.
They look over your income and assets, ask questions about recent financial transfers that might be a red flag, and suggest a plan of action. This helps you qualify for Medicaid much sooner than if you go it alone.
Check online forums for local recommendations, read reviews, and ask around.
Not all elder care attorneys are knowledgeable about Medicaid. Some are experts in probate issues. Others specialize in estate planning and will preparation. You want an attorney familiar with Medicaid regulations in your state.
Costs
Yes, it costs money to hire an attorney. Of course, the hope is that they’ll save you money down the road. This is money you won’t have to spend on co-pays and other items Medicare won’t cover.
You want a good lawyer who will help you retain as much of what you own as possible. All while qualifying for needed long-term care.
Plan Ahead
Starting the process now means far less stress ahead for yourself and your loved ones. Making advance care directives that include ways to pay for the care you’ll need, before you need it, is one of the best gifts you can give yourself and those who love you.
(*I am not a lawyer, nor do I work for lawyers. I don’t get any commission or even theatre tickets for referrals. I simply meet with attorneys and recommend those who work well with others. Especially if they have excellent reputations. This post is the result of recent questions and needs from loved ones and clients.)