Medicaid | Cooper, Adel & Associates

Bad Advice from the State on Medicaid

Written on April 4, 2013 by Cooper, Adel & Associates in Medicaid

By: Attorney Nathan Simpson

A recent case from Florida illustrates the danger that comes from not using an attorney when making an application for Medicaid, and instead relying on the advice government workers. In Garcia v. Dept. of Children and Families (Fla. Dist. Ct. App.,3d, No. 3D12-834, Jan. 30, 2013), the state had given a family bad advice while they were doing a Medicaid application. Because of that advice, after giving a Medicaid approval, the state then demanded the family repay the state, saying benefits should not have been approved. After a court battle the family prevailed. However, the battle could have been avoided if an Attorney had been involved from the beginning. The attorney could have advised them of the Medicaid rules and regulations, making sure that a situation like this did not develop.

Don’t rely on the county to give you Medicaid advice. Contact an Elder Law Attorney who can help you navigate the maze of Medicaid rules, while preserving what you have worked your entire life to earn.

DISCLAIMER – Every case is different because every case is different. This blog does not give legal advice. This blog does not create an attorney client relationship. You are not permitted to rely on anything in this blog for any reason. This blog is an entirely personal endeavor. Every person’s situation is different and requires an attorney to review the situation personally with you.
No attorney-client relationship is created by this site.

The use of the Internet, this blog or email for communication with this firm or any individual member of this firm does not establish an attorney-client relationship. Before we represent any client, the client and the attorney will sign a written retainer agreement.
If you do not have a written, signed retainer agreement with us, we are not representing you and will not be taking any action on your behalf.

The World of Medicaid to be explained

Written on March 26, 2013 by Cooper, Adel & Associates in Medicaid

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Heartland of Centerburg Nursing and Rehabilitation will present Attorney-at-Law Liz Durnell, Medicaid specialist with Cooper, Adel & Associates. The public is invited to attend a FREE informational session on the complicated world of Medicaid and Long Term Care. If you or someone you love can benefit from this FREE session or just want to be prepared for the future, don’t miss this session on Tuesday, March 26th 2013, from 6:30-7:30pm. The address is 212 Fairview Avenue in Centerburg. Light refreshments will be provided.

DISCLAIMER – Every case is different because every case is different. This blog does not give legal advice. This blog does not create an attorney client relationship. You are not permitted to rely on anything in this blog for any reason. This blog is an entirely personal endeavor. Every person’s situation is different and requires an attorney to review the situation personally with you.
No attorney-client relationship is created by this site.

The use of the Internet, this blog or email for communication with this firm or any individual member of this firm does not establish an attorney-client relationship. Before we represent any client, the client and the attorney will sign a written retainer agreement.
If you do not have a written, signed retainer agreement with us, we are not representing you and will not be taking any action on your behalf.

Bad Advice from the State on Medicaid

Written on March 5, 2013 by Cooper, Adel & Associates in Medicaid

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By: Attorney Nathan Simpson

A recent case from Florida illustrates the danger that comes from not using an attorney when making an application for Medicaid, and instead relying on the advice government workers. In Garcia v. Dept. of Children and Families (Fla. Dist. Ct. App.,3d, No. 3D12-834, Jan. 30, 2013), the state had given a family bad advice while they were doing a Medicaid application. Because of that advice, after giving a Medicaid approval, the state then demanded the family repay the state, saying benefits should not have been approved. After a court battle the family prevailed. However, the battle could have been avoided if an Attorney had been involved from the beginning. The attorney could have advised them of the Medicaid rules and regulations, making sure that a situation like this did not develop.

Don't rely on the county to give you Medicaid advice. Contact an Elder Law Attorney who can help you navigate the maze of Medicaid rules, while preserving what you have worked your entire life to earn.

DISCLAIMER – Every case is different because every case is different. This blog does not give legal advice. This blog does not create an attorney client relationship. You are not permitted to rely on anything in this blog for any reason. This blog is an entirely personal endeavor. Every person’s situation is different and requires an attorney to review the situation personally with you.
No attorney-client relationship is created by this site.

The use of the Internet, this blog or email for communication with this firm or any individual member of this firm does not establish an attorney-client relationship. Before we represent any client, the client and the attorney will sign a written retainer agreement.
If you do not have a written, signed retainer agreement with us, we are not representing you and will not be taking any action on your behalf.

Is there a program that will offer you or your loved one in-home care?

Written on February 6, 2013 by Cooper, Adel & Associates in Aging, Medicaid

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By Attorney Elizabeth Durnell

Yes, the program is called PASSPORT. The State of Ohio offers this program through Medicaid to pay for up to 20 hours a week of in-home care to a person who meets certain health and financial requirements.

To meet the health requirements for PASSPORT, a person must require assistance with two of the activities of daily living. These include getting in and out of bed, bathing, cooking, dressing, going to the restroom, and mobility, just to name a few.

The financial requirements differ based on whether the application is for a couple or a single person. For a single person, they are allowed to keep $1500 in cash assets and exempt assets such as their home, one car and an irrevocable burial contract. For a couple, the same rules apply, plus the healthy spouse may keep half of the couple's resources with a maximum of approximately $114,000 and a minimum of approximately $22,000.

However, the exempt assets are not protected from the Estate Recovery Program. This Program is run by the State Attorney General's office and was created so the State of Ohio can recoup some of the money spent for a person's care. The State has the right to place liens on the exempt property to recover some of the money paid on that person's behalf.

There is good news, however. If you have too many assets to qualify today, it is not too late to protect some of your assets through the use of trusts and other estate planning tools so that you can qualify for benefits in the future.

Also, if you were a wartime veteran or the widow of a wartime, you may qualify for a VA benefit that you can use to help pay for in-home care. But you must coordinate the applications for benefits, because the rules to qualify for VA are different than the rules to qualify for Medicaid.

To find out more about this great program, please contact the Elder Law Attorneys at Cooper, Adel and Associates, for a free consultation.

DISCLAIMER – Every case is different because every case is different. This blog does not give legal advice. This blog does not create an attorney client relationship. You are not permitted to rely on anything in this blog for any reason. This blog is an entirely personal endeavor. Every person’s situation is different and requires an attorney to review the situation personally with you.
No attorney-client relationship is created by this site.

The use of the Internet, this blog or email for communication with this firm or any individual member of this firm does not establish an attorney-client relationship. Before we represent any client, the client and the attorney will sign a written retainer agreement.
If you do not have a written, signed retainer agreement with us, we are not representing you and will not be taking any action on your behalf.

Will Medicaid Make You Sell Your Home?

Written on January 10, 2013 by Cooper, Adel & Associates in Medicaid, Nursing Home Planning

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By: Attorney Nathan Simpson

One aspect of Medicaid that many people are not familiar with is how the home is treated. Many do not realize that Medicaid places value limits on homes. If a home exceeds these value limits, an applicant cannot qualify for Medicaid. This means that a person with nothing other than their home could face a situation where they are not qualified for Medicaid and sell their home to cover the Nursing Home bills.

It does not have to be this way. By working with an Elder Law Attorney, you may be able to protect your home from a Nursing Home spend down. Even if you or a family member is currently in a Nursing Home, it is never to late to discuss strategies to protect your life's work. Contact us today.

DISCLAIMER – Every case is different because every case is different. This blog does not give legal advice. This blog does not create an attorney client relationship. You are not permitted to rely on anything in this blog for any reason. This blog is an entirely personal endeavor. Every person’s situation is different and requires an attorney to review the situation personally with you.
No attorney-client relationship is created by this site.

The use of the Internet, this blog or email for communication with this firm or any individual member of this firm does not establish an attorney-client relationship. Before we represent any client, the client and the attorney will sign a written retainer agreement.
If you do not have a written, signed retainer agreement with us, we are not representing you and will not be taking any action on your behalf.

Son Held Responsible for Mother’s Nursing Home Bills

Written on August 20, 2012 by Cooper, Adel & Associates in Aging, Asset Protection, Medicaid, Nursing Home Planning, Planning

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By Attorney Nate Simpson

Earlier this month, the Superior Court of Pennsylvania held that in Pennsylvania, a son liable for his mother’s nursing home bills. Health Care & Retirement Corporation of America v. John Pittas, 2012 PA Super 96 (May 7, 2012). This Pennsylvania case could mark the beginning of a change in the way states cope with the rising costs of long-term healthcare.

John Pittas' mother was injured in a car accident, and following her rehabilitation, she went into a nursing home from September 2007 until March of 2008. During the time she was in the nursing home she accumulated a bill of over $90,000. Pittas' mother withdrew from the nursing home in 2008 and moved to Greece, leaving the bill unpaid.

Under Pennsylvania’s “filial responsibility” law, the nursing home brought a lawsuit against her son, even though there was a pending Medicaid application. The Superior Court held that under state law, her son was responsible for the bill based solely on the fact that she was his mother. Under Pennsylvania law, a child is responsible for their parent's medical bills if their parent is indigent, and the court determines that the child can afford to pay the bills. This law is particularly onerous since it permits a private company (e.g. nursing home), rather than a state agency, to sue the child for the debts of the parents. The law also allows the nursing home to choose which child it sues, and did not require the court to consider the pending Medicaid application.

A majority of states currently have these types of statutes on their books, but up until now they have rarely been enforced. Ohio is one of over 30 states that currently has a filial responsibility law on the books. Ohio Rev. Code Ann. 2919.21 Ohio's law places responsibility on children to provide for their parents. Ohio is different than the Pennsylvania law in that the Ohio Revised Code makes it a CRIMINAL offense to fail to provide adequate support to your parents. As budgets around the state tighten, we could see a change to follow the example set by Pennsylvania to also permit private parties, such as nursing homes and care facilities, to sue children civilly for the unpaid costs of care for their parents. Pennsylvania borders Ohio, and it is not a stretch to imagine the State government getting ideas from its neighbor. In 2005, the National Center for Policy Analysis released a paper arguing for increased enforcement of these laws in order to reduce the strain on state budgets. http://www.ncpa.org/pub/ba521/.

So what can be done? For children, it is important to make sure that you are helping your parents plan for future long-term care expenses. There are many options available which will enable your parents to preserve a parent’s assets while also protecting their children from civil or criminal actions. This includes long-term care insurance, sound financial planning, and well as securing Medicaid benefits in a timely manner so that medical bills are not left unpaid. It is important to note that if you help your parents plan ahead and PROPERLY qualify for Medicaid, your parent's bill will be paid by Medicaid and you will not be liable. The bottom line is that you can help your parents to preserve their assets and also avoid filial liability, but planning is essential.

If you or a loved one are concerned about future long-term care costs, an elder law attorney such as Cooper, Adel & Associates can help guide you through the process.

Medicaid Confusion

Written on May 1, 2012 by Cooper, Adel & Associates in Medicaid

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By Kyle J. Thompson

The Medicaid program that is run in the state of Ohio is a very confusing program Both to those who are trying to apply for it and even those who run it. Recently there was confusion over the bidding process that takes place between health care providers. The healthcare providers claim that the Department of Job and Family Services miscalculated the scoring that was used on the individual bids placed by the healthcare companies, thus providing an incorrect assessment of their bid and in some cases disqualifying them outright.

The confusion on this scoring procedure within Medicaid and the Department of Job and Family Services highlights an issue and brings up a very interesting question. If the D.J.F.S can make such errors on this important issue, can anyone be 100% sure that their case is correctly determined? I find that it is imperative for anyone considering applying for Medicaid to get outside help – you could be missing out on the help that you really need.

Medicaid Standard Utility Decrease

Written on March 22, 2012 by Cooper, Adel & Associates in Medicaid

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By Heather Chapman

Effective April 1, 2012, the Ohio standard utility allowance applied for determining benefits for Medicaid and Food Assistance will decrease from $599 to $533 per month. This applies mostly for determining the monthly allowance for the community spouse when the other is institutionalized. This change will affect current and future eligibility for food assistance, nursing home and waiver cases, but will mainly just mean an increase in the patient liability that the institutionalized person must pay each month. For anyone that has a case affected by this change, a notice should have already been sent out for those that the mass automatic change caught, all others will go through a manual desk audit and have notices sent out no later than March 14, 2012. Food assistance cases should only experience a decrease in the amount that is received for the Ohio Direction Card.

The utility allowance was originally increased when the the cost of utilities was high and people were struggling to keep their bills paid. Even though gas prices and utility fees have steadily increased since 2009, the decrease was passed to help tax payers and not the individuals needing the assistance.

As of January 1, 2012, the Social Security cost of living increase of 3.6 percent was a long awaited relief for the more than 60 million Americans struggling to make ends meet. The first automatic increase since 2009. Now for Ohio residents receiving Social Security, the much needed income will be offset by the decrease in the utility standard providing little help in today's economy.

The requirements and standards for eligibility continue to change and will become a long term point of contention with politicians in ways to balance the budgets. Their solutions for the future is leaning towards massive Medicaid cuts. In order to help your long term care and planning for yourself or your loved ones, seek the advice of a legal professional, particularly one with elder law experience, who is equipped with the knowledge and updated requirements for Medicare eligibility.

Medicaid Appeal: Spouse Can Keep the Family Business

Written on March 13, 2012 by Cooper, Adel & Associates in Medicaid

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By Attorney Nathan Simpson

This past week our firm won an important State Hearing, allowing community spouses to keep their family businesses while their institutionalized spouse receives Medicaid benefits. We hate to see any client lose assets due to an unforeseen medical emergency, and it was wonderful to be able to help someone preserve their means of support. This got me thinking that the hearing process is something that many people may not be familiar with. When the Department of Jobs and Family Services issues a decision in a Medicaid case, you can appeal that decision to a State Hearing. Getting the help of an elder law attorney can help greatly in emerging successful from the hearing.

However, many attorneys only operate within the framework set by the County, and will back down when the County tells them they cannot do something. At Cooper, Adel & Associates, we fight for our clients. Individual caseworkers do not set the rules when it comes to Medicaid. They must follow to the rules set by State and Federal Law. We push back when a caseworker makes an incorrect decision, ensuring that the Department of Jobs and Family Services follow State and Federal Law, and allowing our clients preserve the maximum assets while getting the benefits they deserve.

If you need an attorney who will fight for you during the Medicaid application process, please contact the elder law attorneys at Cooper, Adel & Associates today.

Pay for your funeral now?

Written on December 12, 2011 by Cooper, Adel & Associates in Medicaid

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By Attorney Elizabeth Durnell

As an Ohio Medicaid Attorney, I have discovered that the one thing that every one of my clients should have is a burial contract.

If done properly, the burial contract will be exempt from a nursing home spend down.

Some people hesitate to pre-pay because they have had a bad experience with one funeral home and the quality of their services. Others have seen that funeral homes go out of business and then the family is stuck paying a second time for the same burial.

In addition to the spend down exemption, another benefit of some burial contracts is that they can be used at any funeral home in the country, which will help to avoid these possible pitfalls.

If you are interested in understanding more about how a burial contract works in conjunction with Elder Law planning, please contact Cooper, Adel, and Associates for a free consultation.

Category Archives: Medicaid