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What Is Medicaid Recovery And How
Can I Avoid It?


What Is Medicaid Recovery And How Can I Avoid It?When an Oklahoman receives Medicaid assistance to pay for his or her medical care, Medicaid keeps track of the amount that they spend on this person. When the patient dies, and their estate goes through Oklahoma probate, the Oklahoma Medicaid administrator is going to file a claim against the estate for all of the money that Medicaid spent for this person. For example, If I am admitted into a long-term care facility and am qualified medically and financially such that Medicaid begins paying $6,000 a month for my long-term care assistance, when I die, the cost of the long-term care will be computed and a claim will be made against my estate for that amount. If I was incapacitated and in long-term care for 10 months and Medicaid had paid $6,000 a month for my care during that time, Medicaid would file a claim against my probate estate for the sum of $60,000.

It is possible to avoid, or at least minimize, Medicaid recovery by holding your assets in such a way as to avoid Oklahoma probate. Currently, Medicaid in Oklahoma does not make claims against assets that do not flow through probate. Now, this could change in the future, especially given the number of people who are needing long-term care and the limited funds, but right now, we can avoid Medicaid recovery by avoiding assets going through probate. Of course, this requires some planning on your part and likely requires assistance from a Certified Medicaid planner. We are here to help you with such tasks. Just give us a call.

What Are Some Of The Common Reasons That Medicaid Is Denied In Oklahoma?

This is a somewhat difficult question because the facts that surround Medicaid applications vary drastically, but here are a few things that I have seen that have led to a denial in a Medicaid application. First, there are many Oklahomans who own mineral rights, and sometimes they fail to recognize that those mineral rights are assets in the eyes of Medicaid, even if those minerals are not paying any income at all. Therefore, the applicant will turn in his or her request for services and it will appear that they are financially qualified, but if the Medicaid worker finds that the patient owns mineral rights, the application will almost certainly be denied. The family may have believed that those minerals would not be a problem because they haven’t received any money from them in the last couple of years. But these type of situations often do become problems because the Medicaid worker is usually not qualified to value mineral rights as a general rule, and the Medicaid worker will probably be compelled to deny the application.

Another common problem arises when life insurance has cash value. If, for example, I have purchased a whole-life insurance policy and it contains the sum of $3,000 in cash value, I will not be financially qualified for Medicaid because I will have more than the allowable amount of countable assets. Lastly, retirement accounts can be very problematic when qualifying for Medicaid. If I am the incapacitated member of a family living in long-term care and my wife has $200,000 in her IRA, we will be disqualified from Medicaid assistance unless we get some professional help. Fortunately, a Certified Medicaid Planner can help you with such a problem. If you are applying for Medicaid, or are denied Medicaid, with one of these issues, please reach out to us as quickly as possible.

If I Am Denied Medicaid Assistance, Should I File An Appeal Of That Denial Or Should I Just Reapply?

Usually, but not always, my answer to this question is going to be that you should file an appeal. This does mean that you are going to need some assistance, probably from a well-qualified attorney. Filing an appeal has a significant advantage and it works like this: When you file for Medicaid assistance, the Medicaid worker can backdate eligibility as much as 90 days prior to your application. Therefore, if you file your application on April 1st of this year, the Medicaid worker can cover the long-term care expenses back to January. When/if you are later denied Medicaid coverage and file an appeal, you are generally going to be able to retain the same application date and therefore, the same beginning of services date. But if you abandon your application and then reapply later, it is practically certain that you will have lost several months of coverage and someone has to pay for that care. Therefore, usually I recommend that you file an appeal instead of starting a new Medicaid application.

Why Might I Need Help Obtaining Medicaid Coverage? Isn’t It Just A Matter Of Submitting An Application?

Some people who have no money and no assets do not need any legal assistance to apply for Medicaid. However, those are usually not people who are researching the best way to handle their family financial affairs. So, I am going to presume that you or your family member has assets and that you’re trying to decide whether to engage a Certified Medicaid Planner to help you protect as many assets as possible.

The general approach that most Medicaid planners use is to never apply for Medicaid until the patient is financially and medically eligible for Medicaid. This means that the Medicaid planner will need to have a comprehensive knowledge of every asset, every debt, and every source of income for the husband and wife, if it’s a married couple, or the single patient if he or she is unmarried. We want to do our planning before Medicaid begins nosing around giving us the risk of a denial and subsequent serious delay or the expenses of an appeal.

Fortunately for you, there are many protective steps that can be taken for the patient who is going into long-term care. It is not necessary to impoverish the spouse who is not going into care, for example. But in order to give that spouse the best possible life, we need to do our planning before Medicaid becomes involved. Therefore, if you actually have assets that you would like to protect, it is important that you reach out to a Certified Medicaid Planner and engage their services to get prepared for the time of application.

Will A Family Attorney Who Has A General Practice Be Able To Provide Me Quality Medicaid Planning Advice?

I began my career as a general practitioner, so I can speak from experience when I say that a general practitioner has pros and cons. One of the pros of being a general practitioner attorney is that you will be exposed to multiple types of cases at once. A major con, however, is that it is difficult to become an expert in any single field of practice. If an attorney focuses on a specific branch of law, they can develop extensive skills and will be much more reliable and useful in that field.

If you would like superior work on your Medicaid case, then you should reach out to an expert, preferably a Certified Medicaid Planner. Treat your finances with the same respect that you treat your physical body. If you have liver cancer, I urge you not to put your life solely in the hands of a general practice physician. Find yourself an expert. Likewise, if you are going to be seeking Medicaid assistance for long-term care, I urge you to put your life in the hands of an expert, not a general practice attorney. In either of these cases, you might have a good outcome, but success is much more likely when you are in the hands of an expert.

What Is The Most Common Misconception When It Comes To Medicaid Planning?

In my experience, the most common misunderstanding concerning Medicaid revolves around the revocable living trust. The revocable living trust is a useful tool that will usually help a family avoid probate and sometimes even guardianship. Unfortunately, however, it has absolutely no value at all when it comes to planning for Medicaid assistance. Everything in your revocable living trust is completely unprotected from being considered by Medicaid. This can become quite problematic because families have been lulled into a false sense of security when they created their revocable living trust, and when the time came to apply for a Medicaid, they had no idea that they were completely defenseless. This leads to them being shocked to find that half of the family assets will be lost to long-term care expenses. Avoid losing all your money to the terrible expenses of long-term care. Seek out a Certified Medicaid Planner and ask for some guidance well in advance.

For more information on Medicaid Recovery In Oklahoma, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling (405) 754-4166 today.

Terrell Monks, Esq. - Estate Planning Attorney, Edmond City

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