Senior Planning Services

When a Medicaid applicant owns a home – could it be successfully transferred to a child?

Post author By sps
Post date November 5, 2014

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).

Health and Wellness

Pumpkins – Building a Healthier You!

Post author By sps
Post date October 29, 2014

Don’t you love seeing the bright orange pumpkins scattered amongst the rows of green bushes on Jersey Farmlands? Pumpkins are not just bright orange decorative pieces; they have benefits that far exceed their external beauty. Pumpkins are not just about bright orange decorative pieces; they have benefits that far exceed their external beauty.
Pumpkins are rich in Alpha and Beta Carotene which are Carotenoids that convert in the body to Vitamin A. Vitamin A helps to ensure healthy skin, bones and good vision. Vitamin A also strengthens the immune system. Additionally, Alpha and Beta Carotene are potent antioxidants. Antioxidants remove destructive cells also known as Free Radicals. Free Radicals can cause tissue damage which can eventually lead to Cancer and other chronic illness. So the next time you see a bright orange ripe pumpkin, don’t just admire the color or perhaps the carvings, cook it for dinner! It will be a small step closer to a healthier you!

Medicaid Connecticut

Prepaid Funeral Contract That Was Not Set Up Irrevocable

Post author By sps
Post date October 22, 2014

In Mid-April , Senior Planning Services was contacted by an attorney who was the POA (Power of Attorney) for a resident that had been in a nursing home for about a year. At the time the case was retained, the clients had thirty five thousand dollars remaining in assets and an outstanding bill at the nursing home for thirty thousand dollars.
Senior Planning Services caseworker, Devorah, understood from reviewing the case that the client would need coverage pretty soon. After a Senior Planning Medicaid Specialist met with the client’s attorney, Senior Planning Services was given copies of the latest bank statement held by Peoples Bank as well as paperwork for an Amerprise account that had since been liquidated.
The specialist was also informed about a prearranged funeral. The client was receiving $1100 in social security income and an additional $150 from a pension.

Devorah immediately got to work. The first thing she tackled was ensuring that the skilled nursing facility’s bill was paid in full. After briefing through some of the clients information and financials, Devorah understood that the client would need to be spent down to $1600 by the end of the month. This would secure an April eligibility date for the client.

Devorah needed to move quickly and she immediately got to it . She reached out to the facility for an accurate updated bill. She forwarded it to the POA and advised him to pay the facility as soon as possible to ensure that the funds were actually out of the bank account by month’s end. In a situation like this, it’s best to get a cashier’s check from the bank, or withdraw in cash. This way the funds clear the account immediately.

Devorah then requested Pension verification from the company that was administering the client’s pension. She phoned People Bank’s back office to obtain five years of the client’s checking account history and reached out to Ameriprise to obtain statements from them as well. Then, Devorah proceeded to contact the funeral home for verification of the pre-arranged funeral and to confirm that it was set up properly according to the Title XIX guidelines. Upon receiving the verification, Devorah discovered that the prepaid funeral contract was not set up properly. Devorah had the funeral home re-arrange the contract with a list of how the funds would be allocated, and had the new contract sent to the POA to sign.

Upon receiving the People’s banks statements, Devorah discovered a savings account as well. She reviewed all statements and made certain that there were no questionable transactions according to Medicaid guidelines. She also reviewed all the Ameriprise statements to make certain that all monies withdrawn from this account were deposited to the Peoples bank account. Lastly, she filled out the application and had the POA look it over and sign. Devorah gathered all documents and organized it to be mailed to the correct regional office.

CW contacted Devorah via mail with a letter requesting that the funeral contract be written a different way. Devorah reached out to the funeral home who arranged this and sent her a corrected copy.

Devorah had it forwarded to the case worker.

The approval was granted two days later.

Senior Planning Services thanks Devorah for her outstanding work.

Case Studies Medicaid New York

NY – Retroactive Medicaid Coverage

Post author By sps
Post date October 8, 2014

Senior Planning Services was retained on 1/30/2014 by a skilled nursing facility to assist them with a case that was submitted to Westchester County back in 2013. It was an application for a young mother of two that was placed in nursing care due to an unfortunate accident at her job. The Medicaid Caseworker requested significant amounts of bank statements and verifications of cash withdrawals seen on the client’s bank statements. The nursing facility was unable to fulfill the demands of the county caseworker and therefore chose to hire Senior Planning Services to handle the case. Marcella, the Senior Planning Services Caseworker quickly resubmitted the case in full within a very short time period. Marcella was in touch with the Medicaid office weekly to oversee the progress of the case.

The Medicaid Caseworker had left for vacation for several weeks and after doing a thorough investigation, Marcella was informed that the case was forwarded to a new caseworker in the Medicaid conversion department. Marcella proceeded to contact the new caseworker who was thoroughly confused about the case and seemed to have not had the slightest clue about the case. It was getting frustrating, but Marcella was not giving up. She phoned the Medicaid caseworker’s supervisor who said that he was unable to locate the case and that it had been misplaced.
Marcella contacted the supervisor of the nursing home eligibility unit and confirmed that she would see to it that our client would receive retroactive Medicaid coverage dated back to April 2013. Marcella then resubmitted the Medicaid application in May 2014 with proof of prior submission. After working with the supervisor for several weeks, Marcella received the most wonderful piece of mail on 7/3/2014-the case was officially approved with coverage from April 2013!

The nursing home could not be more grateful for Senior Planning Services’ persistence in the process. The client’s husband was thrilled with the news and was delighted that he can now focus on raising his two children without the worries of paying exorbitant nursing home bills.

Medicaid New Jersey

Can the Community spouse keep the home when the second spouse is getting onto Medicaid?

Post author By sps
Post date September 17, 2014

I recently received a call from Samantha who posed a question to me. What would happen to her home should her husband, Nicholas be approved for the Medicaid benefit?

Samantha and Nicholas have been married for fifty-three years. Nicholas was a former general contractor and Samantha was a teacher. They were hardworking individuals who extended themselves to provide for their two children. After years of putting away money, the couple purchased a home and diligently paid their mortgage every month until it was finally paid off. Unfortunately, Nicholas was recently diagnosed with Parkinson’s disease and is in need of a higher level of care. When Samantha heard that she will need to spend down some of their assets for Nicholas to be eligible for Nursing Home Medicaid, she became concerned about what would happen to their home. Would she have to move? It was Samantha’s dream to be able to leave her home to her children. She was afraid that applying for Medicaid for Nicholas would inhibit her ability to do so.

I was delighted to be the bearer of good news, and informed Samantha that according to NJ Medicaid guidelines, a community spouse may keep the home. However, Nicholas, the spouse in need of Medicaid, would have to have his name removed from the deed. The full ownership would now be under Samantha and the home will no longer affect Nicholas’s eligibility. Samantha was relieved, thanked me for my time and will be working with Senior Planning services to get Nicholas approved for Medicaid.

In our next blog we will discuss other situations relating to a home in connection to Medicaid.

*Please note that there are other asset preservation concerns that one should take should the community spouse pass away.

Medicaid Connecticut Medicaid New Jersey Medicaid New York Medicaid Pennsylvania

Medicaid Spend Down and Special Needs Trust

Post author By sps
Post date September 16, 2014

In order for an individual to be eligible for Medicaid, there are financial standards that need to be met. Many Medicaid applicants will have to spend some of their assets in order to meet Medicaid’s financial threshold. There are a few excludable resources that are exempt from the Medicaid Spend down. These assets can be kept by the Medicaid applicant and will not impede Medicaid eligibility. An individual’s personal possessions, a prepaid irrevocable funeral trust and a special needs trust for a disabled child, are just a few excludable resources when applying for Medicaid.

Today we will discuss utilizing a special needs trust with the excess “spend-down” money. When a Medicaid applicant has a disabled child a special needs trust allows the transference of assets from a parent to the child without jeopardizing the child’s government benefits.

Special needs trusts are also referred to as “supplemental care trust” these trusts supplement the disabled child’s supplemental security insurance (SSI) and Medicaid benefits. The money in a special need trust may only be used for specific items or services. The trust is meant to supplement, and not pay for basics such as food and shelter. Some things that may be purchased through a special needs trust include:

Home modifications to assist the disabled,
Medical treatments and equipment not already covered by government assistance programs.
Education and recreation equipment
Computers
Musical instruments
Sports equipment
Travel expenses
Prepaid funeral

When a parent creates a special needs trust for a disabled child, He/ She chooses a trustee. A trustee is an individual or institution who manages the assets in the trust. The trustee’s responsibility is to follow the terms and guidelines outlined in the trust as well as transferring the funds from the trust to the beneficiary or disabled child. A trustee can be a family member, attorney, bank or anyone that one chooses to assign as a trustee.

The trust is an excludable resource for government benefits for both the parent applying for adult Medicaid and the disabled child receiving SSI and Medicaid benefits. The trust restricts the beneficiary (or Disabled child) and parent access to the assets in the trust. Only the trustee would have accessibility to the funds and therefore it’s considered an unattainable asset for both the parent and disabled child. It is for this reason that it will not impede Medicaid eligibility for either.

One should consult with a competent elder care attorney for advise on if and when such planning strategies are advisable.