For any WHOLE Life Policy, you will need to provide a document from the company stating your POLICY NUMBER, FACE VALUE and CASH VALUE of your policy.  TERM Life Policies do NOT have a CASH VALUE, but will still need to be provided to the County Assistance Office to be reviewed. If you are married, you will need to provide the CASH VALUE of the policy on the date of admission to the Nursing Home. **Remember, the Medicaid Office will need to see information on ALL accounts owned by the client, the spouse (if applicable), or if a policy is OWNED by the client or spouse but insures someone else, such as a child or grandchild.

For Social Security – you will need to provide the current year’s Social Security Award Letter showing the GROSS amount of income received from Social Security, prior to the Medicare Deduction.  The County Assistance Office will not accept any 1099 forms or a bank statement showing your deposited, NET amount.   For Pensions, please obtain either a pension stub from the current year or a letter from the Pension Company stating your GROSS monthly payment before any deductions.  Again, a 1099 form will not be accepted by the County Assistance Office.

Please submit a current statement regarding what your monthly or quarterly PREMIUM is for your Medicare Supplement plan for you and your spouse (if applicable).  The County and Nursing Home will need this information to calculate the Patient Pay Liability to the facility in order to deduct any premiums.

We will need a copy of the title for all Vehicles (cars, trucks, motorcycles, ATV, trailers, boats, RVs).  We will obtain a Kelly Blue Book Value for all vehicles to obtain the value to submit to the County Assistance Office.

This is an option to “spend down assets”, however please wait for direction from your Attorney prior to setting up any arrangements.

Patient Pay Liability is the patient’s income (Social Security, Pension, Royalties etc.) that is paid to the nursing home monthly.  This amount will vary depending on the spouse’s monthly income (if applicable). This will be discussed with you at the spend down meeting.  Lastly, the patient is permitted a Personal Needs Allowance every month in the amount of $60.00.  The $60 (Personal Needs Allowance) is deducted and kept from their total monthly income. Please see the example below. Example:  Social Security GROSS amount $2,500.00      Pension GROSS amount            $1,000.00                   Total Income:                                $3,500.00                   Medicare A deduction            -   $   202.90                   Highmark BC/BS deduction   -   $   132.00                   Personal Needs Allowance     -   $     60.00 Total Patient Pay Liability owed monthly = $3,105.10

Generally, 30 days.  However, the State is notoriously understaffed, and they sometimes simply take longer.  They will also occasionally simply deny the application based on “lack of information” just to buy themselves more time.  Then we must appeal that denial and work with the caseworker to gain eligibility.

You have the affirmative duty to notify the state of any major changes in your situation.  For example, if you inherit money, sell a house, or otherwise change your financial position, you need to notify the state.  As these changes can also impact your eligibility, you should call us first to discuss.  Also, you will be required to re-certify your eligibility by filling out a form each year.  We can help with these forms for a reasonable fee.

For single cases, generally no.  Any gift of assets may impact your continued eligibility.  In a married case, the healthy spouse can make gifts from his or her protected share.  Generally, it is not allowed to transfer the house. There are exceptions to these rules, so please call before making gifts.

If you are single or a widow(er), you are only allowed to retain $60 per month of income.  The balance will be paid to the nursing home.  For married applicants, the healthy spouse is likely allowed to keep some of the institutionalized spouse’s income.  We can help calculate this for you.

When a Medicaid recipient passes away, anything in their probate estate is subject to the state’s post-death Estate Recovery Claim.  Accordingly, you should work with our legal team to help avoid probate and estate recovery, where possible.  Once your loved one passes away, we can help with the forms sent to you by the state.

Call us… We’re here for you.

The Medicaid Recipient is required to make an estimated payment of their income to the nursing facility each month. Recipients of Medicaid long-term care benefits are typically required to contribute a portion of their monthly income towards the cost of their care. This is generally referred to as the "patient pay portion." Essentially, each individual pays what they can from their income, minus a $60 monthly personal needs allowance they are permitted to retain. It is important to remember that even after Medicaid benefits are approved, the recipient must consistently pay their patient pay portion. Paying the patient pay portion to the nursing facility while the application is pending can reassure the nursing home's business office and demonstrates that you have engaged an experienced law firm that understands the process. If the patient pay portion is not paid to the facility, you may be placed on their watch list as they become increasingly concerned about the accumulating unpaid balance during the Medicaid application process. During your spend-down meeting, our team will calculate your patient pay portion and advise you to send checks with a memo line clearly indicating it is for the patient pay portion. Since everyone's situation is unique, we will provide you with clear instructions regarding the exact amount you must pay the nursing home. Please do not be alarmed if you continue to receive invoices from the nursing home for the full cost of care during the Medicaid application process. This is a common occurrence, as nursing homes typically do not adjust their billing until they receive the official Medicaid Notice approving benefits.

Yes. Here's the list you can use for reference. If you'd prefer to download and print it out, please click the link below. LONG-TERM CARE DOCUMENTATION CHECKLIST ● Federal Income Tax Returns for the last 5 years (not state) ● Social Security card (and spouse’s if living) ● Birth certificate ● Driver’s license or other government issued photo identification ● Marriage license ● If spouse is deceased, death certificate ● Military discharge paperwork ● Medicare card/other health insurance card (documentation showing any monthly health care premiums) ● All monthly bank statements for Medicaid Applicant AND spouse for the last 5 years. This includes: ● checking/savings/money market accounts ● IRA/401K accounts ● Investment accounts/stocks ● CD’s/savings bonds ● Checks (over $500 only) for the last 5 years ● Property deed(s); sales agreement/settlement statement if sold within the last 5 years ● Most current property tax receipt(s) ● Oil/gas/mineral rights lease ● Irrevocable funeral documentation; deed(s) for cemetery plots ● Life insurance policies (spouse’s too) ● Title to all vehicles ● If married, rent/mortgage; homeowner’s/renter’s insurance; HOA fees ● Proof of all Income for both Medicaid Recipient and Spouse ● Social Security Retirement Income Statement(s) ● Veteran’s Income ● Social Security Disability Income ● Pensions that pay on a monthly basis ● Oil/gas/mineral income