The Medicaid process can be a complex process and often times quite overwhelming. We see countless families come to us in fear after their Medicaid application has been denied. Without proper legal guidance, on what could be the single most important financial decision you make toward protecting your loved one, you could jeopardize your application and their future care. Below are three simple and common reasons for Medicaid denials.
- Applicant is “over-resourced”. This seems like a no-brainer but in practice many innocent caregivers decide to take on the Medicaid application themselves as a goodwill gesture for their loved one, not fully understanding the eligibility requirements. You follow directions from the unassuming caseworker and submit what appears to be an “easy” application for benefits. Then – the wait begins. Months roll by and the Board of Social Services says very little about eligibility but requests a mountain of financial supplementation to justify all numbers and figures. After months have passed, and the nursing home bill has accrued $60-80K or more, the application is denied because the applicant was over-resourced, meaning they have too many assets, sometimes by just a few hundred dollars! The horrible ending to this story: an unhappy long-term care facility that needs to get paid! (How will you be able to pay? Will they be discharged?)
- Applicant missed a deadline. You would think this is impossible. How could anyone let this happen? The truth: it’s actually pretty common (and maybe the system is designed that way!). When you receive a response from your assigned case worker, they will allow approximately 15 days for you to provide responses to their inquiries. Sounds simple enough, however, case workers are notorious for asking for volumes of documents and small verifications that require you to write banks, title companies, timeshare brokers, and so many other entities to try and prove that the applicant has no other assets than what is stated in the initial application. 15 days is nothing to actually collect this data and extensions are not easily granted. The result? The application is denied for failing to timely respond.
- Applicant response not received. This happens frequently; where the applicant supplies documents timely and mails them in for processing. The unsuspecting layperson doesn’t realize that this overworked, understaffed entity loses lots of packages. At Bratton Scott, we always photocopy the contents and send it certified or via courier to ensure tracking and confirmation, because otherwise you assume they received it and the application is denied.
Enlisting the help of a life care planning professional and a seasoned elder law attorney can help make the process go much more smoothly. At Bratton Scott, we have helped countless seniors apply and get approved for Medicaid. Our services are permissible expenses from your loved one’s funds and those funds may ultimately protect you from potential financial ruin. Contact us today, 856-857-6000 for a consultation on how we can help your loved one receive hundreds of thousands of dollars in government benefits.