By Tony Rovere
For those of us who have been through it as caregivers, applying for Medicaid is one of the most arduous tasks that you will ever face. It is a time-consuming, life-altering situation which can literally cause you to put your life on hold while you go through the process.
Having just dealt with this situation due to my mother's heart attack, the best way for me to explain the Medicaid application is for me to tell you my personal story of dealing with the government and the accompanying red tape that comes with applying for Medicaid.
It was a little over a year ago that mom had her heart attack. She pulled through but lost most of her motor skills as well as some cognitive function, so my family had to get her into a quality nursing home. Even more stressful than choosing the right nursing home was figuring out how to pay for it.
For lack of a better word, mom was broke and there was no way that my brother and I could possible pay for a nursing home. That meant that we had to apply for Medicaid. I have to say it was probably the single most difficult things I have ever had to do in my life.
To get mom approved for Medicaid, the government requires a five-year look back period into her personal finances. It is tough enough to accumulate this information under normal circumstances. I had the additional problem of not having a power of attorney to obtain the information. Plus the fact that mom could not be cooperative to help us given her condition made it even more difficult.
As a note to caregivers, it is imperative to sit down with your parents before this type of situation happens to you and make sure that you get a power of attorney ready before they get sick, as well as a health care proxy. I was extremely fortunate that Mom's condition started to clear up to the point where the social worker in the nursing home was willing to notarize a power of attorney so I could accumulate the information I am going to go over. If this didn't happen I would have needed to go for legal guardianship of my mother through the courts, costing me thousands of dollars.
The process for applying for Medicaid
Once I was legally able to begin obtaining the information, I received a list of the required information plus the Medicaid application from the social worker.
Here was the initial list of information that was required:
(Note: because Medicaid is a joint Federal/State program it is possible that the list below may be slightly different than the requirements in your area. Nonetheless, the information will approximate the necessary information required to get on Medicaid)
- Social Security Card or Social Security award letter showing the amount of monthly benefits.
- Marriage information. This can take the form of a divorce decree, separation papers or the death certificate of the ex-spouse.
- For those born outside the USA, proof of legal residency.
- Birth certificate.
- Deed, mortgage and property tax statement if your parent owns his or her residence.
- A copy of the rental agreement if the residence is rented. In either case of renting or owning, a legal address must be established for a period of 5 years.
- All loans owed.
- Child support and/or alimony statements, whether your parent is obligated to pay or is the beneficiary.
- All unpaid medical bills (note: Medicaid will not approve a person unless he or she already has unpaid medical bills…one of the many things that I learned during this process.)
- Health insurance premiums, paperwork and identity cards.
- Military discharge paperwork if applicable.
- Any type of savings and retirement information, including bank statements going back 5 years (Note: I do not know if this applies for all banks but when I requested this information from my mom's bank, they waived the standard $6 a month fee for bank statements due to the fact that it was a Medicaid request, saving me $360)
- All life insurance policies and statements including any cash value accumulated within the policies.
- Any cars owned.
- Pay stubs for the last 6 weeks.
- Any pensions being received.
- Copies of tax returns of the applicant for the last 5 years.
And that's only the first part!
Because after all of that information is accumulated, you then have to submit the information and wait for Medicaid to ask for clarification on any or all of the information submitted.
In my mother's case, most of the clarifying information took the form of any cash deposits she made at the bank that were not part of her regular income, Social Security or alimony.
After I received the initial set of bank statements I sat down with the social worker and looked at every deposit into her account over those five years. Anything that did not fall into mom's regular check, Social Security check or alimony was going to be questioned.
I know that it may seem ridiculous to have to clarify a $38 deposit that was made four years ago, but this is the way it is. There were dozens of them and I had to request from the bank copies of all the deposit slips. These deposit slips are enough for Medicaid to approve these deposits as ‘valid'.
Now, I understand that if the government is going to pay out $14,000 a month for a nursing home (that is what mom's costs) they have the right to question the information and make sure that no fraud is being committed.
What infuriated me was that the U.S. government only gives caregivers a few days to gather this information or you have to start the application process over! Even more infuriating was that fact that most of the information had already been submitted the first time. It's just that the person handling the file couldn't read it right.
So you are going to have to be ready for these types of disruptions in your life. Fortunately, I was able to get all of the required information re-submitted but had to take two "vacation" days from work in order to do it.
The only good thing is that once you gather this second round of information it is normally smooth sailing and you are just waiting for the approval. My approval came for my mother in around 5 months.
Tips on applying for Medicaid
If I was to offer any tips, advice or suggestions to caregivers who may have to face this someday, here is what I would suggest:
- Prepare now. It is imperative to sit down with your parents before a situation like mine happens. Get a power of attorney to manage your parents' finances in an emergency plus a health care proxy in place so you are able to make medical decisions on their behalf if they are not able to.
- Speak to your parents and try and gather as much information as you can now, or at least understand what their filing system is so that you can access all of this information when the time comes. I have things set up much better to handle my father if anything happens. Everything is in one briefcase, all organized. I just need to take the briefcase and start the process again.
- Have you spoken to your loved one about a specific nursing home they would want to go to? I know that can be tough but if you have the chance to take the tour beforehand. Using the Medicare Nursing Home Comparison tool can be a great benefit to you.
Now that I have experienced the extensive process of qualifying for Medicaid on my mother's behalf, I can say without a doubt that I was not ready to initially meet the challenges that awaited me. I hope that sharing my personal story will help other caregivers prepare now so that they will be ready in the future.
Tony Rovere became involved with seniors and caregiving after his mother's heart attack forced him to navigate the government bureaucracy that comes with caregiving. His website, StuffSeniorsNeed.com, Stuff Seniors Need, is a resource for seniors and caregivers who can benefit from his personal experience as a caregiver.