Medicaid is a joint federal and state health care safety net for low income seniors, children and disabled citizens. Since it is funded by both the federal and state governments, there is much variation from state to state as to what is covered and who is covered. Discover how it works with Senior Planning.
The amount of the Medicaid lien corresponds to the amount of money Medicaid had paid for the care and needs of the deceased Medicaid recipient during their lifetime.
Below we’ve provided an example to better illustrate the way it would play out in real life circumstances.
Say a deceased Medicaid recipient owned a property with $100,000 of equity. If the Medicaid recipient resided in a skilled nursing facility for 11 months, Medicaid would have paid approximately $110,000 with the average monthly Medicaid rate at nearly $10,000 a month. With this situation Medicaid would acquire full ownership of the property since they have paid more than the $100,000 of equity in the home to recover some of their losses.
If the Medicaid recipient was in a skilled nursing facility for approximately three months in which Medicaid paid out about $30,000, Medicaid would place a lien on the property for $30,000 and recover the money once the property sold. The remaining $70,000 would be left to the heirs.
Heirs may sell the home and use the proceeds to satisfy the Medicaid lien or if the wish to keep the home, they may payoff the lien with their own personal funds.
It was a pleasure to have you at our annual Networking/Healthcare Symposium. Each year we enjoy showing our appreciation to the healthcare industry, our business partners and clients – we hope you enjoyed as much as we did!
If you wish to view a complete album of the event click below:
The presentations from our seminars are available to be downloaded below:
Click here to download the Medicaid Compliance and Eligibility Power Point
Click here to download the Ethics of Self Determination Power Point
Click here to download the Advance Care Planning Power Point
We look forward to sharing with you our future events and continuing to service your facilities with the highest levels of expertise, skill and integrity.
LTC Consulting Services, Senior Planning Services & Streamline HR Management
The 2014 Oscars made history for the world of Alzheimer’s disease as Julianne Moore won the Oscar for best actress in the film Still Alice, a film about the life of a woman diagnosed with early onset Alzheimer’s. Based on the book written by Lisa Genova, the world took real notice of a disease that is reaching epidemic levels around the world; leaving us all to ask “What if?”
Moore’s character, Dr. Alice Howland, was a 50 year old linguistics professor at Columbia University when she was diagnosed with early onset Alzheimer’s. After finding that she inherited the gene from her father her three grown children had to choose if they wanted to find out if they too carried the gene. Her oldest daughter, pregnant with twins, tested positive; while her twins were negative for carrying the gene. Her son, a junior doctor tested negative and her other daughter made the decision to not be tested.
Genetic testing for Alzheimer’s does not guarantee you will or will not be diagnosed with Alzheimer’s, only if you are at increased risk. There are other factors that play into whether or not the known gene mutates into the gene which seems to create a breakdown that creates forms of amyloid plaques (consistent with all Alzheimer’s patients) in the brain.
In the beginning, Alice had a plan to end her life when she became ill. Strategically planning out the entire way to end her life once her mind was no longer working was what she thought was best. She came to this conclusion once she knew that she would die from Alzheimer’s disease. No spoiler here on whether she changes her mind or she chooses to live life to the end of her given time.
Many have different views on this idea and I don’t believe there is ever going to be an agreement on that thought. However, I can share what a woman told me about her own mother who was diagnosed with early onset Alzheimer’s.
If my mother had decided to take her life when she could still realize she was slipping away, we would have missed much joy and laughter as a family.
Most of all, we would have missed her last birthday celebration. She not only smiled non-stop at the surprise party, but she ate like a trooper, opened gifts and seemed so very ‘there’ with us.
We would hve missed quiet times sitting outside in the gazebo while looking at the flowers, the birds, and the sky (smiling).
We would have missed playing UNO and ‘wheelchair races.’ Those few memories we made far outweighed the days where she wasn’t really with us and we missed her.
Whether portrayed on film, book or in real life, Alzheimer’s disease is not easy for anyone. Deciding whether or not to test to see if you are at risk is a very personal decision; for everyone who has Alzheimer’s or someone they love who is affected, we all hope for a cure to come.
Materials Referenced:
NIH – Alzheimer’s Genetics Testing
JOYCE APPERSON, RN, GCM
Joyce Apperson is a Registered Nurse and Geriatric Care Manager with 15 plus years of experience working with advocating for seniors. She is the founder and President of Caring Connection, Inc., which provides in-home care and geriatric care management in Harford County, Baltimore County and Cecil County in Maryland. Joyce currently serves on the Harford County Advisory Board on Aging. In addition to writing articles here for the Caring Connection’s blog, Joyce has been a regular contributor on senior care topics to the County Gazette and an advisory board member for her local Area Agency on Aging.
In recent times, Medicaid applicants have been experiencing delays in receiving Medicaid determinations. These delays impose real challenges to the Medicaid applicants as well as to their healthcare providers. The Health Care Association of New Jersey ( HCANJ) a non profit organization that represents long term care providers and the individuals they serve, recognized this challenge in a very real way. HCANJ has been instrumental in bringing this challenge to the front of the state assembly. As a result of their efforts, a bill was proposed named “Uncompensated Pending Medicaid Beneficiary Payment Relief Act,” (A-3928). This legislation dictates that should ninety days pass after a Medicaid application is submitted without a Medicaid determination, Medicaid would be required to grant payments to nursing homes for up to fifty percent of the estimated amount due for uncompensated services.
“Protracted delays in Medicaid application approvals force individual nursing facilities to carry hundreds of thousands and some even a million dollars or more worth of uncompensated care,” said HCANJ Vice President and lobbyist John Indyk. “It is a cash flow problem that makes this legislation a top priority for HCANJ.”
Senior Planning Services has helped countless individuals in obtaining Medicaid eligibility and have processed thousand of applications in the State of New Jersey alone. The data that Senior Planning Services has accumulated depicts the everyday challenges that Medicaid applicants face when applying for Medicaid benefits. It is for this reason that Neil Stern represented Senior Planning Services and gave testimony at the Assembly Health and Senior Services Committee hearing. Aside from Mr. Stern’s testimony, the committee also heard testimony from various leaders in the healthcare industry. Senior Planning Services is proud to continue playing a lead role in making things better for Medicaid applicants and healthcare providers.
If you would like to read a press release on the hearing that is posted on The Assembly Democratic Office Website, click Here.
All content in this post is for informational purposes only.
Naomi, a Senior Planning Services caseworker, related her experience in trying to obtain Medicaid coverage for an individual who had no family support and was homeless for a period of time. Additionally, he had poor memory and gathering necessary information changed a simple caseworker into an investigative detective. Ultimately, Naomi achieves the impossible: a Medicaid approval.
In mid April, Senior Planning Services retained a case from a nursing home for Gregory Slate who needed Medicaid coverage dating back to January. According to Medicaid guidelines, one may be able to obtain retroactive coverage three months back so long as at the time of the coverage request date the individual had met all the Medicaid guidelines. Being that Greg was homeless for a short time, we were under the assumption that he would meet the financial criteria . After speaking with the skilled nursing facility where Greg resided at, it was confirmed that Greg had also been clinically evaluated and that medically he had met the Medicaid requirements. Naomi understood that for Greg to remain eligible for retroactive coverage the application needed to be submitted before the end of April. This implied that Naomi had about two weeks to open the case with Medicaid and submit necessary information. There was just one problem: Greg could not recall where he banked and had no documents to establish identity or citizenship.
Naomi quickly filled out an application with the limited information and submitted it to Medicaid to open the file. Simultaneously, she sent out request letters to all the established banks in the area with the hopes that one of the banks was the one where Greg’s accounts were held. Sure enough, Naomi received a response and was able to obtain the five years of bank statements for Greg’s application. She also had to obtain a birth certificate for Greg to establish identity and citizenship, but once again, Greg’s memory fell short and he was unable to recall the name of his mother. With extensive research into the previous facilities that Greg had been at, Naomi was able to track down a distant family member who had the information necessary to request a birth certificate from vital statistics. There was much back and forth with the Department of Vital Statistics but eventually the birth certificate was received and a copy was sent to Medicaid.
Once the five years of bank statements had been received, Naomi carefully reviewed them. Greg was over the Medicaid asset limit due to his Social Security money accruing. Naomi reached out to the Medicaid case worker to explain the situation and ask for retroactive coverage despite the fact that he was over the resource limit. There are guidelines that the caseworkers can sometimes fall back on if an exception is needed. After much negotiation with the case worker at the Board of Social Services, Greg was approved for Medicaid with the retroactive coverage he needed to cover the nursing home bill.
Names have been changed to protect the privacy of those involved.
