50+ Lifestyles

Your Advocacy

By Jaime Long
The “Passionate Patient Advocate™”
Owner of GolderCare Solutions

The 2 Most Important Secrets to Winning the Medicare Battle

Last month, a story on local TV highlighted the plight of a Quad City family who learned after Mom died that they might lose her home to the state. Mom had received Medicaid benefits to help pay for her care at home during her last years. Now the family is facing the reality that they might have to reimburse the state for those Medicaid benefits by selling Mom’s house. The story reported how upsetting it was to the family to realize they might lose her home, particularly as other family members were planning to live there after her death.

Medicaid is a vital resource to middle-class families to help pay for their aging care. It is financed by the state and federal governments and is categorized by law as welfare. It is governed by hundreds, if not thousands, of complex and conflicting rules. One of those rules is that states are required to have recovery programs in place to pursue repayment of Medicaid monies paid on Mom’s behalf.

Most people have no idea of the full extent of all the Medicaid rules. This includes not only consumers, but also caseworkers, nursing home administrators, lawyers, doctors, and even state officials. Very few people have the time or inclination to thoroughly familiarize themselves with the Medicaid system. As a result, misinformation and misunderstanding about Medicaid are abundant.

Getting Mom qualified for Medicaid is like making your way through a maze. It’s confusing, and there are many blind alleys. In addition, because there are so many conflicts in the rules, there are many Medicaid traps. In actuality, the battle to get Mom properly qualified for Medicaid is like traveling through a maze built on a minefield. Keeping her qualified, once you get her there, is an ongoing battle.

In order to win the Medicaid battle, you have to avoid all the Medicaid traps. For those who want to be able to keep Mom’s house, that means taking the necessary steps to ensure it won’t be lost to Medicaid recovery.

There are lots and lots of other Medicaid traps as well. One that comes to mind is spending Mom down to her last $2,000 only to realize too late that she will be disqualified from Medicaid assistance for a period of time – and therefore unable to pay for her care – because of gifts or other transfers she made within the preceding 5 years. Another is making any one of a number of false moves that might force you to have to pay the costs of Mom’s long-term care out of your own pocket.

Secret Number 1: Winning the Medicaid battle and successfully avoiding the Medicaid traps is possible. Most people don’t know this. They have been bamboozled into believing the common myth that they can’t win against Medicaid. They don’t realize that by carefully and wisely strategizing they can successfully navigate around the Medicaid traps and win the Medicaid battle.

Sadly, the recent TV story helped perpetuate this pernicious myth. The implication was that in order to avoid losing Mom’s house, she needed to avoid Medicaid. Nothing could be further from the truth.

You don’t have to avoid Medicaid in order to avoid the Medicaid traps. Instead, you have to fight the Medicaid battle like a winner rather than like a loser. To win the battle, you have to have the correct strategy.

Secret Number 2: The help you need to successfully win the Medicaid battle is rare, but it is available. Handling all
of the complexities of the Medicaid system and successfully navigating around all of its conflicts requires comprehensive and sophisticated strategizing.

As stated above, most professionals don’t have an extensive enough knowledge of the system to provide you with that complete and successful strategy. Nor are they able to make their Medicaid strategies work seamlessly with Mom’s
medical, long-term care, housing, financial, insurance, legal, and accounting needs.

The key to getting a successful strategy for your Medicaid battle is to get the right help. For that you’ll need an independent advocate – one who works only for you and not for conflicting interests, like the nursing home or the state – with ready access to a multi-specialty team of experts on Medicaid and its relationship Mom’s medical, long-term care, housing, financial, insurance, legal, and accounting needs.

Jamie Long is the owner of GolderCare Solutions. You can reach Jamie at GolderCare Solutions Unlimited, LLC (309) 764-2273.