Should you hire an attorney for a Medicaid application?

Does the Medicaid application process intimidate you? The application can be very overwhelming if you’ve never completed the process before. Terms like “five-year lookback” and “spousal benefits” can make you realize that you don’t really know much about Medicaid. That’s when an elder law attorney can be a valuable guide for you and your family. Read on to see why hiring an attorney might be the best solution.

Legal fees are permissible as part of the Medicaid spend-down.

Legal fees are a common part of the Medicaid spend-down. You are permitted to retain the assistance of an elder law attorney to provide advice and assistance with the process. If you do not hire an attorney in the beginning then you may not have money to do so when a problem arises after the funds have already been spent-down to the nursing home.

In the case of Mulherin v. Department of Public Welfare, 935 A.2d 40 Cmwlth 2007, Pennsylvania’s Commonwealth Court permitted reasonable legal fees to be paid without interfering with retroactive Medicaid eligibility. Securing legal counsel and proper advice is not just a luxury for the wealthy, this case permits anyone to be able to afford a capable law firm at any stage of the Medicaid application process, particularly if long-term care benefits have been denied. Clients retain our firm because we save them time and money, and legal fees are a proper and allowable spend-down item.

Do you trust the nursing home to advise you on how to protect assets and qualify for Medicaid long-term care benefits?

Nursing facilities receive much more money per day from private pay residents than from those who successfully qualify for Medicaid long-term care benefits. Why would the nursing facility advise you about exempt assets, exempt transfers, or spend-down strategies?

The longer you pay their bill privately, the more money they make per day. We wrote a in-depth article about Nursing home working with people on their Medicaid application. It’s just not their job to provide legal advice on how to legally protect assets and accelerate eligibility for Medicaid long-term care benefits. Furthermore, there are estate planning strategies which are the practice of law, and which only attorneys can advise and implement.

At Gerhard & Gerhard, P.C., we work for you at as an elder law attorney, not the nursing home, and give you independent advice about the legal ways to protect your assets and qualify for Medicaid long-term care benefits.

The law firm handles the paperwork and saves you time.

One of our major goals is to save you time whenever possible. When applying for these benefits, the caseworkers at the County Assistance Offices tend to request financial statements going back 5 years and require you to supply other supporting documentation to verify that the information on the application is true. Some caseworkers even request copies of checks of $500 and over.

We review the financial records you have in your possession, identify what we believe the caseworker will request, and help you obtain what you are not able to locate. If we can save you time and obtain this paperwork for you, then we will do so. The caseworker will set a deadline to receive this paperwork or they will deny the application. They are required to make a decision within a certain time period, generally 45 days. Our office will do all we can to help meet that deadline. If you have missed the deadline and find your application denied on appeal for “failure to provide verification,” then please call us; we would be glad to help.

The law firm guides you through all stages of the application process.

We have traveled this path of applying for benefits many times with our clients. We are working on Medicaid applications in our office on a daily basis. It’s what we do.

We know what papers to file, when to file them and where. We follow-up with the caseworker reviewing the application at the County Assistance Office on an ongoing basis and communicate with you regularly so you are aware of the status of your case. When necessary, we are able to contact a supervisor at the County Assistance Office or legal counsel for the Department of Human Services. We are often able to resolve issues ahead of time, avoiding a denial of benefits and the need for an appeal. Another goal of ours is to compress the time period where the application is pending so you can get back to focusing on the caregiving, and not spend all your time on these financial matters.

Have a legal team on standby to handle appeals.

If an application for benefits is denied, many times there are things that we can do in order to ultimately have the case approved. Our law firm will provide options to deal with a problem, and appeal denied cases as appropriate by requesting what is called a Fair Hearing with the PA Department of Human Services Bureau of Hearings and Appeals.

We are able to assess the merits of your case, based on our years of experience. Many can be resolved before the hearing since we continue to work with the County Assistance Office and DHS legal counsel while an appeal is pending. If benefits have been denied and you are on appeal then there is a major financial threat to be taken seriously, and we recommend that you have legal representation.

In conclusion – why wouldn’t you hire an attorney for Medicaid application?

As you can see, having an advocate on your side can save you time and anxiety. During an already stressful time, why wouldn’t you hire an attorney who is an expert in the Medicaid process? You can rely on us to be on your side every step of the way.

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We've been working with people just like you for years to help navigate the long term care system and qualify for Medicaid long-term care benefits. Let us clear things up and help you feel confident about your and your family's future.