This is the first installment of a blog I am starting. This blog concerns legal issues pertaining to seniors.

This chapter is about medical assistance.

Medical Assistance is a state-federal program to help low income Americans pay for medical expenses. In other states, it is known as Medicaid. It is one of the entitlements we hear so much about. The others are Social Security and Medicare. Don’t confuse Medicaid with Medicare. Medicare is not means tested. That means that you can be a billionaire and be on Medicare. Medicaid is means tested. A wealthy person cannot be on Medicaid.

I work predominately with seniors. One of the concerns of seniors is health care. After all, a large portion of the health care industry goes to serves seniors.

One of the specific concerns of seniors is long term care. Statistics show that one out of three seniors will live for some time in a facility, be it a nursing home or assisted living.

Medical Assistance will pay for long term care if a person qualifies. One of the things county financial workers look at is the income and the medical expenses of the applicant. Nursing homes in the Mankato area cost anywhere from $5,000 to $10,000 per month. The actual amount depends greatly on the amount of care a person needs. Most retired people do not have sufficient income to pay this amount. So, depending on assets, Medical Assistance can be a great help.

For most seniors, increasing their income is not an option. They may well be stuck with Medical Assistance. (In the interests of transparency, one of the services we provide is to help seniors qualify for Medical Assistance.)

For those folks who have an option, like being cared for at home by family members, going to a Veterans Administration nursing home, having long term care insurance, etc. here are some things to consider:

Applying for medical assistance requires a never-ending onslaught of paperwork. First, you have to prove that you were born. They want to see a birth certificate of baptismal certificate. If you have any assets, they need to see verifications of each of these. If you have unusual assets, like an interest in a oil lease in North Dakota, it can be difficult to prove how much it is worth.
Once you are on Medical Assistance, you have to complete additional forms every six months. This paperwork is not as intrusive, but it still has to be completed. The financial workers have all the time they want, but you will have deadlines on when your information must be filed. If you miss a deadline, Medical Assistance can be terminated.
Upon your death, Medical Assistance will try to recover benefits paid out. They can file a lien against real estate. They can file a lien even against a life estate. The financial worker sends you a spreadsheet. You are to fill it out and return a check for the balance of whatever is left in your estate.
Doing all this paperwork is not only time consuming, it is invasive and as a result, degrading. It starts with having to prove that you were born and doesn’t get any better.
You or your loved one is constantly having to comply with regulations. For example, it has long been axiomatic that a prepaid funeral is an exempt asset for medical assistance purposes, meaning that it is not counted against the $3,000 asset allowance. However, there was a recent Bulletin that provided that neither flowers nor music were an allowable funeral expense. How are people supposed to know that?
As indicated above, if a senior has no choice, then there is no choice and one has to jump through all the hoops above. However, if a person does have a choice, including maybe buying long term care insurance, he/she should seriously consider it.