Buyer Beware: Letting a Nursing Home Complete Your Medicaid Application

It all sounds too good to be true.  The nursing home offers to prepare and submit your Medicaid Application (called MassHealth in Massachusetts) to get your loved one qualified, free of charge.   Good deal, right? Well, you may want to think twice before accepting this offer.

Moving a loved one into a nursing home

Moving a loved one into a nursing home is often a difficult process. In addition to the emotional toll it can take, you are inundated with a mountain of paperwork. If your loved one has little to no funds to private pay for their care at the nursing home, then there is also the enormous pressure to get them eligible for state-funded Medicaid benefits as soon as possible. Although obtaining Medicaid benefits may seem like an easy way to deal with the cost of nursing home care, there can be several pitfalls when going this route.

Should you let a nursing home complete your Medicaid Application

A recent client had previously accepted the nursing home’s help with completing their Medicaid application. Although well-intentioned, it is important to remember that the nursing home employees are not attorneys and not experienced in dealing with more complex situations. In this instance, there was a financial nuance with the client’s scenario that caused the applicant to be ineligible if it was not corrected. Since an elder law attorney was not consulted, the application was denied, and the client was determined to be ineligible for Medicaid benefits. In the meantime, the client had accumulated a $100,000 private-pay bill owed to the nursing home.

More alarming, nursing homes will not be able to advise you how to protect the family home from nursing home costs. Private family funds may be unnecessarily spent down at the nursing home or family members may be erroneously convinced that they are responsible for paying for these costs out of their own pocket.   An experienced elder law attorney would be able to advise the family in protecting assets either for the community spouse (healthy spouse living at home), a disabled child, or for the institutionalized individual at the nursing home.  An elder law attorney can also advise you when it might be appropriate, in certain limited situations, for a nursing home to complete the application.

The rules to qualify for Medicaid and other government programs can be quite confusing and complicated. Failing to understand your options regarding planning for and submitting a Medicaid application could cost your family dearly and may have irreversible consequences.  An experienced elder law attorney will help ensure it is your best interests that are being protected.

Generations Law Group helps families navigate the complex areas of estate planning, elder law, and probate to inform and protect loved ones of every generation.


For more articles related to Medicaid/MassHealth Planning and Applications, see:

Medicaid Applications in Massachusetts: When DIY is a DON’T


Medicaid Program Options for Your Loved One