MEDICAID RECIPIENTS AND THEIR FAMILIES KEEP CONTROL

MEDICAID RECIPIENTS AND THEIR FAMILIES KEEP CONTROL

By: Craig Riffel, Attorney and CPA

This is a true story. A lady was physically assaulted by her boyfriend. The boyfriend was arrested but the boyfriend (not the lady) obtained a restraining order against the lady. During this process, the lady was told by a police officer if she returned to the home she (not the boyfriend) was renting, she would be arrested because boyfriend also lived there. So, she stayed away from her home. At the hearing, the judge explained to her she did not have to abandon her home at any time, and the information she received was completely inaccurate. The judge told her, “Don’t get your legal advice from a police officer.”


The same applies to Medicaid. I started writing articles about Medicaid and related issues because I realized most people are either completely unaware of Medicaid and how it works, or are planning and making decisions based upon false information. Frequently, people will question me about Medicaid. At some point in our discussion, they will make statements which they believe to be true but which are completely inaccurate. When asked where they received their information, they often tell me they heard from a friend; overheard it at the local co-op, beauty/barber shop, restaurant, etc.; or received it from their family attorney, accountant or investment advisor.


My advice to them is the same as the judge told the lady. Don’t get your Medicaid advice from a friend or anyone not specifically trained in Medicaid planning. I teach Medicaid seminars to attorneys, accountants and investment advisors for several national companies and the Oklahoma Bar Association. I can tell from my teaching experience most attorneys, accountants and investment advisors know little more about Medicaid than you do. Also, beware of the local DHS caseworker. Although they are involved in evaluating Medicaid applications, they never participate in Medicaid planning. Therefore, they often give incorrect advice about how to protect assets.


Just recently, I have encountered several individuals operating under these Medicaid myths. First, I had both a prospective client and several investment advisors tell me when a person qualifies for Medicaid, they loose control over their care and the state controls their care. This is false. The only difference between a person paying for their own care and Medicaid paying for their care is who is paying the bill. 


When a person qualifies for Medicaid, the family still controls the care of the Medicaid patient. The family, not the state, selects the nursing home for the individual, decides which medications the individual receives and handles all medical treatments. This makes common sense. If the state made these decisions, the potential liability would be enormous. Anytime the family disagreed with a chosen treatment, the state would have liability exposure. Therefore, all of these decisions for Medicaid patients are made by their family in the same manner and way families of private-pay patients make these decisions. 


Second, some prospective clients and investment advisors incorrectly assume when a person is on Medicaid, the nursing home in which the individual resides may not accept them. This is also false. In order for a nursing home to receive Medicaid money, it is prevented from discriminating against a Medicaid patient in any way. If a nursing home is Medicaid approved and has an available bed, it must take the individual. Most nursing homes, especially in rural areas, are Medicaid approved. Most nursing homes would not survive without Medicaid. Only those nursing homes which are only private-pay (usually only located in the metropolitan areas) can refuse to accept a Medicaid patient. 


Third, some individuals incorrectly assumed the level of care a Medicaid patient receives is inferior to that of a private-pay patient. Again, this is false. Because of the nature of my practice, I frequently visit nursing homes. Most people in nursing homes are on Medicaid; and yet, all patients receive the same level of care. In order for a nursing home to receive Medicaid money, it is prevented from discriminating against a Medicaid patient in any way. 


Fourth, some prospective clients incorrectly believe they cannot retain their current health insurance if receiving Medicaid. This is also false. Not only will clients be allowed to retain or obtain health insurance of their choice, they will be encouraged to do so. As an incentive, Medicaid allows clients to deduct their health insurance premiums from any payment they may be responsible to pay the nursing home. This practice puts another source of payment of medical costs before Medicaid.


Fifth, other individuals incorrectly think once a person qualifies for Medicaid, the patient’s spouse either looses all of their assets or is subject to constant control and monitoring by Medicaid. This too is false. Before a person qualifies for Medicaid, the assets of both the patient and spouse are counted in determining eligibility. However, once a person qualifies for Medicaid, a separation in assets occurs which prevents Medicaid from controlling or monitoring the spouse’s assets. After qualification, the spouse is free to do whatever the spouse wishes with his or her assets. Beware where you get your legal advice. 


For more information about Medicaid, Medicare, Veteran’s benefits, Social Security disability, estate planning or asset protection planning, or how to become a community partner, visit Senior Resources and Benefits, LLC (“SRB”) at www.srbllc.com. All legal services for SRB provided by the law firm of Mitchel, Gaston, Riffel & Riffel, P.L.L.C. with website at www.westoklaw.com. Any additional questions or inquiries can be directed to Jeremy Nichols at Senior Resources & Benefits, LLC at 3517 W. Owen K. Garriott, Suite Three, Enid, Oklahoma 73703, (580) 794-0042, or at his email address of jnichols@westoklaw.com. Senior Resources & Benefits, LLC has offices in Alva, Enid, Fairview, Oklahoma City, Ponca City, Tulsa or Woodward, Oklahoma.