Is Medicaid Application Assistance, LLC a law firm?

Medicaid Application Assistance is NOT a law firm.  We assist in the process of filing Medicaid applications, including helping to address concerns and questions asked by Medicaid examiners in order to qualify for Medicaid benefits.  It is your right, and recommended, to obtain independent legal counsel to answer a question about a legal matter, should one arise.  We can provide you with a list of qualified counsel and we are available to work with your attorney, as needed.

How do I choose a nursing facility?

Please click on the image to be directed to a link that will assist you in choosing a long term care facility for your loved one.

My Spouse is in a nursing home - am I responsible for the bill?

When a nursing home resident's insurance, Medicare benefits or money runs out, they would apply for Medicaid benefits to pay their nursing home bills.  Be careful when admitting a loved one into a nursing home, and be sure to read the admitting agreement carefully.  Some nursing facilities may require that someone else, usually a spouse or other family member, agree to be a back-up payer of the resident's bills, especially if a Medicaid bed is not available when the funds run out.  The back-up payer would be responsible for the bills if and when the resident runs out of private insurance coverage and personal funds to pay for care.

Will I need to mortgage our home to pay for nursing home expenses?

No, you will not need to mortgage your home to pay for nursing home expenses.  Although, the State of South Carolina Medicaid program will not cover long-term care services for those applicants with home equity above the limit of $560,000 (2017), with certain exceptions.  Warning ... the proceeds received from a reverse mortgage are considered to be a resource by Medicaid, and a reverse mortgage may not always be the best course of action when considering how to pay for long-term care.

When should I apply for Medicaid?

If you are eligible for Medicaid and your remaining assets are within the allowable range, you should begin the process as soon as possible. To allow time to complete the due diligence required by Medicaid, beginning the qualification process 6 months prior to the time when benefits would be needed, is highly recommended. 

Often, a community spouse (the spouse living in the "community" and not in need of services) can keep liquid assets, subject to certain Medicaid limits.  As a couple you do not need to spend all of your assets in order to qualify for Medicaid.  It is recommended that you seek assistance in the preparation of the Medicaid application prior to the depletion of the liquid assets, as those funds could be used to secure residence in a more appropriate facility, which would not be available if there were no funds available to "get you in the door" of that facility.

Our application has been denied - now what do we do?

If you come to us with an application that has been denied because of missing or undisclosed information, Medicaid Application Assistance, LLC will assist you in obtaining the required documents and submit the information to the South Carolina Department of Health and Human Services (SCDHHS).  Medicaid will usually request missing information prior to issuing a denial.  If the application is denied for substantive reasons (which are usually known ahead of time) we will discuss the appeals process with you and recommend a next course of action - which may involve the assistance of an attorney to correct issues that are of a legal matter.  We will, of course, be available to assist in any way possible to obtain the needed qualification, but if the denial is due to a transfer that is prohibited by Medicaid, whether or not it was disclosed to us prior to filing the application, there may be little if anything that can be done but to accept the sanctioned penalty.  If acts were done in the previous 5 years which would cause Medicaid to issue a sanction, there may be ways to repair the problem, but some problems are not able to be repaired, such as the sale of an asset for less than fair market value or gifting funds that are not able to be returned to the applicant.  Full disclosure by the applicant and the family is expected so that we can work toward the desired qualification of benefits.

I think I might be able to do the applicaiton myself. Why should I engage Medicaid Application Assistance, LLC?

The application process is extremely time consuming and detail oriented - it is not just a matter of filling in the spaces on the application.  Prior to filing the application, there may be a period where your liquid assets will need to be "spent down" in order to meet the eligibility limits and a detailed budget will need to be created.  Medicaid officials require a review of up to five years of financial records and documentation of every fact.  If there are any unexplained expenses or deposits, these transactions may be treated as a disqualifying transfer of assets.  Often, Medicaid planning techniques (usually prepared by an attorney), such as trusts, transfers of real property to family members and family care agreements are often viewed as suspect unless you are able to properly explain these events.  Medicaid considers hiring a firm to help you in this process as a legitimate use of the applicant's liquid assets.  You do not need to hire an attorney to complete your Medicaid application and qualify for benefits.  Hiring our firm will save you a lot of stress and frustration, not to mention at least 100 hours of your valuable time.  The Medicaid application process can often take several months to complete, as Medicaid will ask for additional information after we have already filed the application.  That is time that could be better spent on you or with your loved one.

Can I enage an attorney to prepare the Medicaid Application?

Yes, you can engage whomever you would like to assist you with the application.  If you choose to engage an attorney for this process, Medicaid will consider his fee, and ours, to also be an allowable "spend down" expense.  You will note, however, that the legal community often quotes fees in the range of $8,000 - $10,000 (and often in excess of $10,000 for more difficult applications).  Our fees are determined based on the work involved in the application process, taking into consideration the number of open and closed accounts that need to be reviewed, any gifts made by the applicant, transfers, and circumstances that will be a red flag to Medicaid.

Unlike most attorneys, if mobility is an issue, we are available to meet you at your home. We also hold office consultations on Saturdays and Sundays (so that your family doesn't have to take time out of work), we are available to collect required documentation for you, if time is a concern and if the need is great, our clients are free to contact us after normal business hours.  We realize that the process of putting our loved ones in a nursing home does not stay within the 9-5 work day and are available to our clients, as needed.  We also offer free monthly "information" sessions to help the family prepare for the process of qualifying for Medicaid benefits.

The more important time for you to engage an attorney to address the matter of Medicaid "planning", is at least five years BEFORE you need Medicaid - so that your assets can be allocated properly in order to secure those assets before the "look back" period has begun.  Although it is impossible to know when the best time to start planning is, it is recommended that you begin to talk about this process as soon as you are of retirement age.

I would like meet with Medicaid Application Assistance to help me with the Medicaid qualification process - what are your office hours?:

We encourage you to attend a free information session that is held on the first Saturday of each month, reservations are required.  I would also be happy to meet with you to discuss in more detail the specifics of your matter. If weekday appointments are not possible, we do have weekend appointments available.  If mobility is an issue, I am available to meet at your home, and evening hours are available, only as a last resort.  Please contact me at (864) 280-2506 to schedule an appointment, or send me an email (M.Aldridge.MAA@gmail.com) and I will get back to you as soon as possible.