Senior Planning Services is the premiere Medicaid application company in the states of NY, NJ, PA and CT. We have been privileged to successfully process thousands of Medicaid applications on behalf of our clients. Our unique vantage point allows us to identify trends that have been occurring in regard to Medicaid’s enforcement of rules and policies. The following is a recent trend that we have identified.

When a Medicaid applicant owns a home, there are circumstances in which the asset is exempt and may be transferred without jeopardizing Medicaid eligibility. In the past, the applicant’s home could successfully be transferred to a child if the following two criteria were met:

 

1. The son or daughter has lived in the home of the applicant for a minimum of two years prior to institutionalization

2. There is a signed doctor’s note stating that the applicant was kept at home (as opposed to a facility) due to the care of the child who lived with the applicant.

Senior Planning Services has noted that the above referenced criteria have become less liberal. Medicaid may now disallow the transfer on the basis of any of the following:

1. If the child had a job that would impede their ability to fully care for the applicant, the Board of Social Services may request documentation in order to determine whether or not
the care was supplemented

2. If the applicant’s medical records do not reflect a need for care, a doctors note may not suffice as proof that there was a need for care.

Although we have seen numerous cases approved without the additional scrutiny, we have also seen cases where the additional requirements were enforced. If the Medicaid applicant meets the criteria of the more stringent interpretation of the policy, educating them to provide this information when applying may help facilitate faster Medicaid approvals.

Senior Planning Services is the most comprehensive and efficient Medicaid application company in the industry. The fact is that many long term care facilities absorb financial losses caused by preventable errors. Slow Medicaid approvals preceded by long pending periods, Medicaid penalties and worst of all Medicaid denials rob facilities of untold sums of revenues. Very often, the root cause of the aforementioned issues are based on actions or inactions attributable to the Medicaid applicant.
For a free Medicaid consultation contact Senior Planning Services at 1855.S.Planning (775-2664).