8 Tips for Having 'The Talk' with Elderly Parents

Talking about estate planning is a difficult, emotional topic but it’s essential for every family.

Unless you’re certain your parents have an up-to-date will and a wider plan for what should happen in the event of their passing, you shouldn’t assume everything will be taken care of.

According to a 2017 survey, less than half of Americans have a will. If your mother or father dies intestate – meaning without a will – such a situation could lead to added emotional strain and stress. And it could have financial implications for all their children and/or other family members.

The following eight tips can help you discuss the hard topics thoroughly and respectfully and prepare you for the road ahead.

1. Plan What You Can

Continue reading
  164 Hits
  0 Comments
164 Hits
0 Comments

Medicaid Case Study: Know Medicaid Application Processes—It Could Save You Money

PW, age 75, was previously approved for Community Medicaid as an individual. PW lived with his ex-wife that he only divorced because their previous counsel advised them that it would increase their chances of being approved for Community Medicaid. Even though the couple was divorced, they considered themselves to be a married couple. The couple presented themselves to the community as husband wife and Texas recognizes common-law marriage, therefore we were able to submit a long-term care Medicaid application for PW as one half of a married couple.

During the application process, HHSC sent out an H1020—Request for Information or Action. The clients received the notice later in the allotted response period. As such, the spouse did not have ample time to gather the requested supporting documents. To prevent a denial, the Michels Law Firm requested a delay of certification before the deadline, per MEPD H B-6510. The HHSC caseworker made an error and denied the case for Failure to Furnish.

As the client’s rights were violated during the application process, The Michels Law firm appealed the denial.

During the appeal, the HHSC Hearing Officer determined that the agency made an error and sent the case back to the caseworker to be processed properly. Even though the hearing officer sent the case back to the caseworker, there were months of no action on the case.

The Michels Law Firm filed a HEART Complaint with the Office of the Ombudsman against the State of Texas for non-action. Once there was interference from the Office of the Ombudsman, The Michels Firm was able to secure an approval for Long-Term-Care Medicaid for the client. The nursing facility was able to retroactively bill Medicaid for nine months of nursing home coverage. The facility collected over $35,000.00 in nursing home fees from the state.

Continue reading
  132 Hits
  0 Comments
132 Hits
0 Comments

Medicaid Case Study: Can You Identify an Uncompensated Transfer?

EO, a widow at 92, is in a long-term care facility. She owned a home jointly with her family. She received a notice from the Texas Department of Transportation that the State had to acquire her property for road expansion and would purchase her property.

The policy found in MEPD Handbook F-3121 states that if you sell your homestead, you have 90-days to reinvest the proceeds into a new replacement home, which she did. HHSC delayed her case because she:

  1. Never resided in her new home-- which is not required with a replacement home, and

  2. Wanted to consider the purchase of the new residence as a transfer because her daughter previously owned the property. It was a fully compensated exchange and not a gift-- thus not a transfer of assets

The Michels Law Firm argued the regulations found in the Medicaid Handbook, “If a home was excluded for intent to return and the individual purchases a replacement home, the replacement home retains that exclusion even if the individual has not physically occupied the new home.” HHSC requested a policy clearance with the legal department. Once HHSC Legal determined that The Michels Firm interpretation of the policy was correct, the HHSC caseworker was able to certify the long-long term care benefits. Without a proper challenge, the denial would have been sustained.

  136 Hits
  0 Comments
136 Hits
0 Comments

Medicaid Case Study: Are IRAs Countable or Non-Countable? If the Policy is Misapplied, Denial is Likely.

RC, age 67, and married, developed severe Parkinson's disease that required a hospital stay. He eventually needed long-term care. His wife wanted to avoid spousal impoverishment. He would not qualify for Medicaid because he was over income, and they were also over the resource limit. A QIT resolved the income problem, but what about resources?

During the application process, the caseworker rendered a denial of the application for being over the resource limit.

How did this happen? The HHSC caseworker made an error in the calculation of resources by incorrectly counting the IRA as being non-countable when it was countable at the time of the SPRA Snapshot. Even though there is no policy in the MEPD Handbook that expressly states that the IRA is not countable when a client is over the age of 70 ½ and is taking his Required Minimum Distribution (RMDs), The Michels Firm is aware of the legal determination based on federal policy that excludes an IRA from countable resources. This error artificially reduced the amount of resources the community spouse could have for living expenses.

After the SPRA month (the first month that the institutional spouse admitted into a long-term care facility), the Community Spouse converted her husband’s IRA into an Employment-Related Annuity-- which made the annuity non-countable. Interestingly, HHSC made yet another policy interpretation error and counted the now non-countable annuity as a Countable Resource. MEPDH F-7000 clearly states that an employment related annuity is non-countable leaving nothing to interpretation.

The Michels Law Firm had to appeal this case twice—once for the SPRA month and a second time for the ongoing months. Because we prevailed, the facility was able to retroactively bill the state for nine months of coverage. The nursing home collected $33,821.00 in nursing home fees.

Continue reading
  147 Hits
  0 Comments
147 Hits
0 Comments