Why to use Bellomo & Associates for Medicaid Instead of Doing it Yourself

When it comes to filing an application for Medicaid, the process can be quite daunting.  Hiring a professional at Bellomo & Associates can relieve the pressure on everyone. 

To qualify for Medicaid, you must be determined both medically and financially qualified.  To be medically qualified, you must be assessed by the County Area Agency on Aging and the family or Nursing Home physician.  Becoming financially qualified is the tricky part.  For Community Based Services your monthly income cannot exceed the yearly income limit established by Pennsylvania. For skilled Nursing Home Care your income needs to be below the Cost of Care for that facility.  In addition, you must provide statements for the previous five years for all accounts, verify all transactions over $500, and document all closed accounts. 

How can we help preserve excess assets if you sell the home or car, or even if you transferred or gifted assets?   This is done by a process that follows the rules for Medicaid qualification.  We will review the financials and determine what can be done to get Medicaid approval. 

A single person can have one house, one car, and up to $2,400*,  or possibly as much as $8,000* depending upon their income,  in all accounts.  If you have resources within those limits but have transferred assets for less than Fair Market Value or given a gift over $500, you will not qualify.  You are penalized and must pay privately during this period.  We can help determine the penalty period and establish how the payments to the skilled nursing care will be paid. 

A married couple can have one house, one car, and assets are divided in half with the maximum protected at $130,380* for the Community Spouse, this is the Resource Allowance.  As of 2021 the Community Spouse’s retirement accounts are exempt from the Resource Allowance calculation.  If you file for Medicaid and have assets over the established Resource Allowance, you will be denied Medicaid, and will need to spend the excess over that amount, then refile.  Most likely the excess will be paid to the Nursing Home or private care.  This is another time way Bellomo & Associates can help protect assets and assist in obtaining financial eligibility for Medicaid.

Bellomo & Associates can potentially assist in qualify a single person that has excess assets, has previously made gifts and perhaps even leave a legacy for their beneficiaries. We can also protect the excess assets for the Community Spouse so that the Community Spouse can maintain the same lifestyle and the family legacy.  Requesting help from the team at Bellomo & Associates will ease the process and help preserve what you worked so hard to earn.  

If you are interested in learning more about Medicaid crisis planning, please call our office at 717-845-5390, or click the link here to RSVP to our upcoming workshop to learn more about it.



The Bumpy Ride of Care for Your Parents

Holding elder persons hand“Thanks to Father Time and copious amounts of prescription drugs, people are living longer. But with longer lives comes the potential for increased healthcare needs.”

It can happen out of the blue. One second your folks are in pretty good shape. The next second, your dad is in the hospital with pneumonia and your mom is showing signs of early onset dementia.

How the devil did this happen? This is the basic question asked by Chicago Now in its recent article, “Getting Old Sucks: Why To Start Estate Planning With Your Parents.” As the article puts it: “you are officially on the rollercoaster ride to elder hell.”

Fortunately, there are things you can do on this bumpy ride to make it easier on you and your parents. While it’s uncomfortable at first discussing the topic of death with your parents, it’s necessary and important.

Talk to them about estate planning and make sure that they have wills, durable healthcare and medical powers of attorney (POA) and health care directives. If your parents don’t have these documents, you should make an appointment with a qualified estate-planning attorney and get this completed today as soon as possible.

For example, what if your father has a debilitating stroke, doesn’t regain consciousness and needs 24/7 medical support indefinitely? Without a health care directive, the hospital will keep him alive, even in a vegetative state, until he passes naturally.

You’ll be unable to have him removed from life support, unless you can show the physician and hospital administrators his legally valid health care directive and his medical POA that details his wishes. Without these estate planning documents, you and your mother will have limited control on how he should be treated.

From a financial standpoint, it is important to remember that the hospitals will continue to bill you even when your father is on life support and technically brain dead. After 100 days of Medicare coverage, your mom will be fully responsible for these care and treatment expenses, if there’s no supplemental insurance.

Start the dialog with your parents and let them determine how they want to live and die. This will save you and your loved ones considerable stress, frustration and heartache in the future.

Once this is under control, work on your own estate planning. You should contact a knowledgeable and experienced estate-planning attorney with your questions.

Reference: Chicago Now (March 7, 2017) “Getting Old Sucks: Why To Start Estate Planning With Your Parents”


The Fine Print about Reverse Mortgages

Realtor with keysA reverse mortgage is a mortgage you can take out when you’re 62 years or older. This plan lets you stay in your home as you age. The Federal Trade Commission says that it’s turning your equity into cash without having to sell your home. However, the FTC warns that reverse mortgages can be tricky, so you need to do your homework.

wfmz.com’s article, “Life Lessons: Reverse mortgages: When are they dangerous,” reports that Elder Law attorneys have had adult children come to their offices wondering how they were named in a foreclosure lawsuit, when it was the mother’s reverse mortgage.

When parents pass away, their homes are commonly inherited by their children. In the case of parents with a reverse mortgage, however, the children could also be named in a foreclosure. This can come as quite a shock to adult children. Seniors also may not understand that they have to keep paying for the upkeep of the home.  If you’re married and there’s just the one name on the mortgage, it could also spell trouble for your spouse.

The rules state that if you’re out of the house for a year, the reverse mortgage company is allowed to foreclose. In addition, a reverse mortgage may not provide enough cash to assist you, especially if you need around-the-clock at-home care costing as much as $12,000 a month. Despite these dangers, a reverse mortgage still may be right for you.

A reverse mortgage would be a good option, if a person insists on staying in the home and they have a family caregiver.

There are also Medicaid programs that may help pay for nursing home care as well as waiver programs through Medicaid that may help pay for assisted living and home care with the ability to keep your home and can leave it to your children or spouse.

If you have more assets, talk to an Elder Law attorney to develop a plan that protects those assets. For example, in some states you can pay a relative to be your caregiver.

Reference: wfmz.com (January 24, 2017) “Life Lessons: Reverse mortgages: When are they dangerous”


Elder Law Attorneys Help Seniors and Their Families

Bigstock-Extended-Family-Relaxing-On-So-13907567The (Fort Worth TX) Star-Telegram recently published an article, “Elder care attorneys can help with long-term care, Medicaid.” The article explained that this segment of the legal profession focuses on the needs of older and disabled adults. Elder law attorneys focus on issues of guardianship, estate planning, probate, veteran’s benefits and Medicaid.

One thing that most seniors don’t plan for is long-term care. Many people are trying to pay for long-term nursing care. A focus of elder law is how an elderly person can pay for it. With this in mind, the majority of long-term care is paid for by Medicaid, so understanding how that program integrates with estate planning is important. For example, you wouldn’t want a bequest in someone’s estate planning to adversely impact your Medicaid planning. A family member may be ineligible for Medicaid if they inherit something.

Completing the Medicaid application can also be a challenge. Elder law attorneys see many of their clients’ applications initially denied. An experienced attorney may be successful on appeal. It might be a mistake at Health and Human Services (HHS). The best way to do this is to ask for the assistance of an elder law attorney. People who apply on their own may be denied and won’t question it—or even realize that they can question it.

Some people worry that their parent will go broke before they need costly end-of-life care and they’re afraid that Medicaid patients received substandard care. However, they should receive the exact same care as a private pay or short-term disability in the nursing home. Even so, you should look at several facilities, speak with residents and staff, and observe the conditions before making a choice.

There is also a lot of bad information floating around about Medicaid eligibility. Some folks believe they won’t qualify. However, some assets, like a house and vehicles, are exempt when qualifying for Medicaid. This allows the community spouse — the one remaining at home — to continue to support themselves.

Also, there are a few elder law attorneys who receive an extra certification called a Certified Elder Law Attorney, or CELA. It’s a national certification program that requires five years of practice in elder law and a written exam.

Reference: The (Fort Worth TX) Star-Telegram (October 14, 2016) “Elder care attorneys can help with long-term care, Medicaid”


Medicare’s Observation Status Can Have You Seeing Extra Dollar Signs

If you’re in the hospital under “observation status,” which is a Medicare designation applied to patients deemed insufficiently ill for formal admission, but still too sick to be allowed to go home, you need to take note. Observation status can mean thousands of dollars in higher costs, particularly if you require post-hospital nursing care.

As Money’s article “The Medicare Quirk That Can Cost You Thousands” explains, Medicare covers care in skilled nursing facilities. Unfortunately, that’s only for patients who are first admitted to a hospital for three consecutive days.

Hospitals have applied this status to avoid costly penalties from Medicare for improper admissions. The number of Medicare patients classified as under observation has skyrocketed and has created pushback from Medicare enrollees and advocacy groups.

A new law, “the Notice Act,” requires hospitals to notify patients if they stay in the hospital more than 24 hours without being formally admitted. Patients will begin to get this notice beginning in January 2017. Moreover, hospitals will be required to inform patients verbally and in writing if they are on observation status for more than 24 hours.

DoctorThe written notification is called the Medicare Outpatient Observation Notice (“MOON”), and also explains the cost implications of receiving hospital services as an outpatient.

The costs of observation status can impact any enrollee on traditional fee-for-service Medicare. The program typically covers up to a maximum of 100 days of care in a skilled nursing facility following a hospital admission. It will pay 100% for the first 20 days; patients are responsible for a daily $161 co-pay for the next 80 days. However, patients who leave the hospital for a nursing facility after an observation will pay the full cost out of pocket. And skilled nursing care costs are substantial and continue to rise.

Observation status also has an impact on the coverage of drug usage in the hospital. Medicare Part B would cover drug usage for the specific problem related to the hospitalization, subject to the Part B 20% co-pay. For routine drugs taken at home, the practices vary. Some hospitals let patients bring their own drugs from home, others don’t, and charge much more than you’d pay at your pharmacy.

A broader solution to the observation status has had a lot of support, and bipartisan legislation was introduced in the U.S. House and Senate that would require time spent in observation to be counted towards meeting the three-day prior inpatient stay necessary to qualify for Medicare coverage. The bill counts the time in hospital, no matter what. If you are in the hospital for three midnights, you’ve met the requirement.

Reference: Money (September 29, 2016) “The Medicare Quirk That Can Cost You Thousands”

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