SHOULD YOU CONSIDER MEDICAID?
- In a nursing home?
- Planning post-discharge placement?
- Exceeding assisted living levels of care?
- Insufficient insurance to pay for care?
- Running out of money to pay privately?
When the need for nursing home placement arises, securing quality care is of paramount importance. Nursing home costs in Maryland can average $8,000 to $10,000 per month. At that rate, very few people can afford to privately fund their long-term care needs.
Long-term care insurance can be costly and may not cover the full cost of care. Medicare offers a very limited skilled nursing facility benefit and private health insurance covers little or no long-term care. Medicaid Long-Term Care is often the only option left for many families, but navigating the Medicaid eligibility guidelines can be treacherous. Prudent advice from a skilled counselor familiar with the rules can be an invaluable resource.
Hammond Law can advise you regarding how to coordinate benefits between Medicare, supplemental insurance, private pay and Medicaid. Our strategies are aimed at securing Medicaid Long-Term Care benefits for your loved one, while striving to protect their assets to the greatest extent possible, within the Medicaid rules.
Whether you have a long-term care plan in place or you are faced with an unexpected health crisis resulting in nursing home placement, do not delay meeting with the experienced, knowledgeable elder law attorneys at Hammond Law to review your situation and to make recommendations that could protect your family against unnecessary impoverishment.
OTHER TYPES OF LONG-TERM CARE PLANNING
Not every client needs to apply for Medicaid. Many families are choosing to care for aging parents in their homes. Others clients are at various stages of care, from senior housing to assisted living, are trying to figure out how to make their money last and when they can expect funds to run out. Long-term Care Planning Meetings are beneficial for these clients as well because many will have questions about the potential for Medicaid eligibility in the future and what things can be done now to prepare. Examples of services Hammond Law provides to these types of clients include, but are not limited to, the following:
- Caregiver Agreements
- Contribution Agreements
- Promissory Notes
- Life Estate Deeds
- Sustainability Calculations
- Surrogate Decision-Maker Affidavits
- Pre-Need Gifting Strategies
THE HAMMOND LAW PROCESS
Typically, the long-term care planning process begins with a brief phone consultation with an experienced member of our staff. During the consultation, we will discuss your concerns and solicit additional important information so that we can be certain we are the right firm for you. If your issue is more complex than most, a follow-up phone call with an attorney will be scheduled. There is no charge for either of these calls. At that time, we will schedule an initial long-term care planning meeting.
There is absolutely no obligation to retain Hammond Law beyond the initial planning meeting. Regardless of your needs, you will leave the meeting with a tangible plan (called "Hammond Law Homework") in place. You are free to take the plan and implement it on your own, or, if you'd like to retain Hammond Law to help with all or part of your plan, we will discuss estimated fees at the conclusion of the meeting. Some clients do not require asset protection as much as guidance and clarification about Medicaid eligibility. Our goal is to preserve the client's resources to the greatest extent possible. To that end, for clients who have little or no money left to preserve, we will strongly encourage capable family members to implement the plan on their own, using Hammond Law as a sounding board, rather than spending the client's remaining resources on legal fees.
We will email (or mail) you a confirmation letter, with the date and time of your meeting, as well as instructions for other important documents to gather and bring to the meeting. In addition to the confirmation letter, we will send you directions to our office, our fee schedule, and a detailed, Long-Term Care Planning Questionnaire. The Questionnaire is a fillable PDF file and can be completed on the computer or printed out and completed by hand. Although the Questionnaire is fairly detailed, the more thorough you are with your answers, the more in-depth the initial planning meeting will be.
Initial Long-Term Care Planning Meeting
The initial meeting usually lasts about two hours, but may run long, depending on the complexity of your matter. Regardless of the length of your meeting, the same, flat fee applies. (The flat fee will be discussed with you during your initial phone call.) Many clients will use the meeting as an opportunity to learn about the Medicaid rules and the Medicaid planning process, like a question-and-answer session. Other clients will use the initial meeting as a "working meeting," with a specific goal in mind. There is no one-size-fits-all approach to these meetings, as the facts and circumstances of each case vary widely. For those clients actively pursuing Medicaid eligibility, we will develop the framework of a spend down plan and asset protection strategy during the initial meeting and will discuss applicable fees at that time. We will provide you with various forms and other initial paperwork to begin the Medicaid planning process at the conclusion of the meeting. Lastly, we will review, in detail, our engagement agreement, which you may sign on the spot or take with you to consider.
The Medicaid planning and application process can be daunting, if not downright overwhelming. While it is our goal to educate our clients about all facets of the rules and strategies we employ, we are also dedicated to breaking the process down into manageable, easily-digestible pieces. Our highly-skilled Medicaid paralegals will meticulously evaluate the client's resources and will work with the client's representative and financial institutions to gather the documentation and verification needed to complete and file a Medicaid application. We work directly with the nursing home to coordinate the start date of benefits and to inform the nursing home of estimated cost of care payments to be expected from the client while the application is pending. Using finely-tuned checklists and frequent Medicaid planning meetings, Hammond Law will ensure that you are constantly informed and involved in the process and so that you are aware of spend down and application deadlines.
Our involvement does not end with the filing of a Medicaid application. Often, a significant amount of work is required after the application leaves our office, to ensure it is properly and timely handled by the local Department of Social Services (or Bureau of Long-Term Care Eligibility). It is not uncommon for applications to take months before a determination is made. We follow up frequently and regularly with the assigned case manager to ensure all necessary information has been received and that important legal issues impacting the client's eligibility are decided in accordance with applicable laws. Occasionally, it is necessary to file appeals to resolve disputed issues. While we attempt to avoid filing and preparing for appeals hearings to save the client time and money, we are also prepared to zealously advocate on behalf of our clients should the need arise.
Receiving a Notice of Eligibility on a Medicaid application provides a great sense of relief; however, there may remain additional work to do, in order to preserve a client's eligibility. For example, within 90 days after a Notice of Eligibility is issued, the client (or his or her representative) has one final opportunity to transfer any resources remaining in the married applicant's name above the $2,500 resource limit to his or her spouse. Hammond Law will send you a detailed post-eligibility letter, identifying the remaining assets to be transferred, the process for reporting those transfers to the case manager, the ongoing cost of care payments to be made to the nursing home, changes to the client's Medicare premiums and the annual redetermination process. Other post-approval work may include changes to the client's spouse's estate plan, beneficiary designations and/or changes to the client's spouse's real property deeds. Hammond Law will explain and assist with all of these issues.
Medical Assistance requires that eligibility determinations be updated annually; therefore a redetermination application must be submitted to the local Department of Social Services or the Bureau of Long-Term Care Eligibility each year. Hammond Law will assist you in gathering the information necessary to complete and file the redetermination. We will send you a letter approximately 1½ months prior to the filing deadline to remind you to begin gathering the documentation for the redetermination.
We're always here to help. So if you ever have a question, simply call or email anyone on our team and we will respond promptly. As a client, you will have access to all levels of support staff to ensure your request is addressed and handled appropriately.
It takes a unique blend of professionalism, knowledge, and compassion to excel in the field of elder law. Our team is comprised of attorneys, paralegals, law clerks and support staff, all of whom are experienced and skilled at delivering unparalleled service to our clients. You are our priority.