Don’t Know the Answers to Medicaid Application Questions

Last updated: June 08, 2020
Medicaid Long Term Care | Questions and AnswersDon’t Know the Answers to Medicaid Application Questions
medicaidplanner Staff asked 4 months ago

My mom has Alzheimer’s and my dad has passed away. Medicaid is asking questions to which we just don’t know the answers. My mom can’t remember the details. How can we still apply for Medicaid?

1 Answers
medicaidplanner Staff answered 4 months ago

If you were granted durable power of attorney (POA) by your mom prior to her mental incapacity, you will be able to apply for Medicaid on her behalf. If you were not, you will need to go to court to become her legal guardian or conservator (the terminology changes based on the state), which will allow you to act on her behalf.
 
Durable POA gives you the legal right to make financial decisions, such as applying for public benefits, for your mom when she is unable to do so herself. (There are two types of POA: financial and medical. For the purposes of this discussion, medical POA, to make healthcare decisions on one’s behalf, is not relevant). While POA’s are always designated prior to one’s inability to make decisions for himself / herself, they generally do not become effective until one become incapacitated (i.e., cognitive impairments from the progression of Alzheimer’s disease).
 
Guardianship / conservatorship, on the other hand, must be granted by a judge and can only be done after one becomes incapacitated. To be clear, if there is a POA, this option is not relevant. As with POA, legal guardians (conservators) are able to make decisions on behalf of an individual who is incapacitated. This includes financial decisions, and hence, the ability to apply for Medicaid on one’s behalf. (In some states, the term guardianship might be used when power is granted to make personal and health decisions for an individual, while conservator might be used when financial decisions can be made).
 
It is important to note that as part of the application process for long-term care Medicaid, there is a look back period in all 50 states. Essentially, the state Medicaid agency “looks back” at all financial transactions immediately preceding the date of one’s Medicaid application to ensure no cash or countable assets were given away or sold under fair market value in order to meet Medicaid’s asset limit. (To see asset limits by state, click here). If it has been determined that the look back period has been violated, one will be penalized with Medicaid ineligibility for a specified period of time. (The timeframe for the “look back” is 5-years in all states but California, which has a shorter period of 2.5 years).
 
Because of the look back period, Medicaid will require financial records dating back 60 months (30 months in CA) as part of the application process. Since your mom is unable to request these records, you will need to do so on her behalf, which with a POA or guardianship / conservatorship, you will be able to do so. In this situation, it can also be helpful to request a credit report for your mom. This will show not only current open financial accounts, but also those that have been closed, which can be extremely helpful since your mom may have forgotten about a closed account(s).
 
You also will likely have to locate and submit other types of documentation as part of the application process, which you will legally be able to do so. For instance, proof of income, such as a Social Security award letter, is crucial, and if deposits have been made into your mom’s bank account that do not match your mom’s record(s) of income, these deposits will also be questioned. Other documentation that may be requested include copies of unpaid medical bills, tax returns, mortgage statements, etc.
 
Applying for long-term care Medicaid can be a complicated process without the added stress of having to act as power of attorney or guardian (conservator) on someone else’s behalf. If you find yourself in such a predicament, it is highly recommended that you hire an experienced Medicaid planner to assist with this process. Furthermore, restructuring of finances may be required in order to meet Medicaid’s eligibility criteria if one is over the income and / or asset limits, and unfortunately, can cause Medicaid delay or denial if done incorrectly. To see eligibility requirements by state, click here.

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