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Elder Law Newsletter: Preplanning for Medicaid Benefits - a Critical Step in Caregiving

Chambliss Law Firm Monthly Editorial – October 2019
10.04.2019

Preplanning for Medicaid Benefits - a Critical Step in Caregiving

by Sally Brewer

As if day-to-day caregiving for your parents is not stressful enough, the financial obligations of skilled care will push you to your limits. Consider this your wake-up call for your parents' financial plans and personal financial responsibility.

The current average cost of care in a nursing home in the Chattanooga area is $7,000 - $10,000 a month. This is for "skilled nursing care" due to a chronic condition such as Alzheimer's disease. Unless you can afford this high cost of care, you will likely turn to government benefits such as Medicaid (TennCare in Tennessee) for help. However, don't expect the Medicaid eligibility and application process to be a walk in the park. With rising long-term care costs and boomers now retiring in droves, TennCare is amending their rules and regulations several times per year with impoverishing effects to recipients and their families.

There has never been a more critical time to preplan for Medicaid benefits!  In 2019 alone, we've seen numerous regulation updates and clarifications, a new application form, a new online portal system, denials with Medicaid's Incurred Medical Expenses (IME), formerly 'Item D Deductions', and a devastating blow to the community spouse's ability to protect their hard-earned retirement accounts (forcing a spend down of these assets). After applying, it takes an average of three months to receive your approval or denial notice. So although preplanning for Medicaid can seem daunting and perhaps costly in your eyes, a consultation with an elder law attorney generally costs less than one month of private pay in a skilled care facility and may reduce stress levels, minimize future costs, and offer a smoother application process.

Here are a few tips to get you started if you find yourself preparing now to enter Tennessee's Medicaid system, riddled with complexities, technicalities, and seemingly insurmountable guidelines:

Steps to Prepare for TennCare

  • Learn about the basic benefits, resource limits, eligibility criteria, and evidence requirements at www.tn.gov.
  • Review this list to gather important asset information (Medicaid has the right to know about the last five years)
  • If your assets or income exceed Medicaid's allowance, research appropriate ways to "spend down" without giving assets away or attempting to hide assets (refrain from taking advice from inexperienced individuals since regulations change often); Chambliss often helps with maximizing assets in terms of how resources are spent down to obtain government benefits
  • Be aware that the most common reason for a denial of benefits is insufficient evidence
  • Get expert help from a trusted source who handles Medicaid on a daily basis and is aware of amended regulations
     

If you are interested in planning ahead with a seasoned professional and analyzing your own situation, Chambliss can help! Our dedicated elder law team has years of combined experience in this field and is knowledgeable and passionate about ensuring clients maximize their rights.