Sponsor spotlight: Alan and Betty’s Medicaid story

“You don’t have to go broke to qualify for Medicaid, especially if you’re married,” Attorney Peggy Sanders.

When Alan came to see us, he was distraught. A hardware store clerk in his early 70s, he and his wife had limited financial means. They had been married over 50 years, owned their own home, and in their younger days had been able to travel Europe. Now his wife, Betty, was in a skilled nursing facility with a serious medical condition. The cost of care was overwhelming to them. At over $10,000 a month, their savings would be drained quickly. A helpful social worker at the care facility helped them apply for assistance through Medicaid. That application had been rejected by DSHS because the wife had too much money.

Alan asked Attorney Peggy Sanders review his case. Peggy determined that the social worker, though her heart was in the right place, didn’t know what she was doing.

First, a review:

MediCARE is a Federal government program that covers health insurance for adults over the age of 65. It covers doctor visits, hospital stays, prescriptions and rehabilitation services. It does not cover long term care.

MediCAID is also a public assistance program, administered by both the Federal Government and the individual states. In Washington, it’s administered by DSHS. Based largely on financial need, it can provide for long term care assistance.

Peggy was able to restructure Alan and Betty’s estate, re-apply to DSHS for Medicaid assistance, and save them approximately $50,000 in care costs.

Most people have the idea that you need to be broke to qualify for Medicaid. While it’s true that that the maximum a person can have is $2,000, that only tells part of the story. For one thing, the government does not want the spouse to go broke. It really doesn’t. However, the rules to keep that from happening are complex, often counter-intuitive, and sometimes contradictory.

One of the reasons the practice of Elder Law came into being was to address this very issue. Too many families were going broke unnecessarily. We’ve seen that in our own practice. We almost can’t count the times Daughter has come to us, panicked because Mom’s bank account has been drained and now Daughter’s is rapidly disappearing.

It’s also true that applying for Medicaid is EXTREMELY complicated. And if it’s not done right, benefits can be denied, and there can be painful financial penalties. This is another reason for Elder Law Attorneys. In our case, our attorneys have read the laws, they know how to deal with DSHS (which can be job by itself), and they know how to structure estates to take best advantage. Every time we’ve seen someone other than an Elder Law Attorney try applying, it’s been a disaster. On the other hand, our long-term care plans, which can be highly technical, have been described as “brilliant.”

One of our most important jobs is to take the fear and uncertainty out of long-term care planning. Our goal is to help make your silver years as independent, secure and to assure your peace of mind.

(Note:  Alan and Betty are a fictional couple, but are based on real cases.)

— By Ralph Sanders, Sanders Law Group


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