My mother was denied medicare because she has unexplained bank withdrawals from years before her hospitalization.

Started by

She has severe mental illness her entire life and does not know what happened to the money.She has a fair hearing soon and I,her daughter and only relative,will represent her.I am not a POA.What can I expect?


Are you sure it's Medicare and not Medicaid? I thought everyone was entitled to Medicare at 65 regardless of any situation?
I don't know what you can expect as I've never been to such a hearing. But you must do your homework. You may not have POA, but you can search through your Mom's bank statements to find evidence of these withdrawals and follow the money. You should also present evidence of your Mom's history of mental illness - was she formally diagnosed by a doctor? Can you request that the medical report be sent to the court? Consider contacting a social worker that is experienced in Medicaid to find out what goes on at a fair hearing so that you can prepare yourself and your Mom. Good luck.
The look-back period is five years, so don't bother trying to track expenditures older than that.
If you do mean medicaid there is a a "look back" period. This means if five years ago your Mom had $$$ according to her income tax returns, bank accounts, property, any inheritance, pension, income, IRA's, CD's etc they want to know where it went. If a large amount of money is gone and unexplained during the look back period. They want an explanation. I do not believe it is your place to have to explain unless she gave you money or if anyone signed checks or withdrew or transferred anything by way of P.O.A.. So for example she sold a car for 4,000 there needs to be a paper trail of what it was spent on or what account it went into and if it's no longer there ....where did it go...if she spent it was it on herself and you need a log of this. List of bills, monthly rent or mortgage, taxes, medication, health insurance, phone, electric etc.
Someone needs to be P.O.A. or guardian to obtain these records so is it possible that's what the hearing is about?
Oh P.S. if she held a joint account that could be an issue as well
Queenbling,you are right I meant medicaid.And I live in NY and the look back period is 7 years.She had no checking account,just savings,where she would withdraw for rent,utilities,and other expenses.Her account was a joint account only for about a yr with a friend and then just about 15 months ago when she asked for me to go on her account.The money missing in question is not during anytime when I was on the account and just one "questionable"withdrawal when her friend was on her account.The withdrawals are 6 and 7 years ago just within the look time.

Vecc - Been though this. What the hearing will want is something on paper that can give them (the state) the ability to approve her qualification. They want to work with you and approve her. And the more the pages the better for her file. And you want to try to detail her behavior and what she did as a part of the documents you take to the hearing. Double space whatever you write - the thicker, fatter the file the better.

They can spend their $$ on whatever they want except to gift it away. If they want to spend 28K on a face lift or 11K on a trip on the QE2 or play the ponies or go to the casino's, they can as all that is within their purview to do. Your job is to find out what stuff mom could have spent the $$ on that is likely and a story you can with a straight face stick to during the hearing. If she had a home, then I'd look into she did the withdrawal to pay for something at the home, like 12K for a new roof and the roofing guys were a scam and she got taken for 12K but because of her mental state didn't understand or deal with it. Or it was 4K for a ramp, they were putting in and again she got taken. If you think she was taken on a scam, go on-line to the local newspaper for the year of the missing $$ to see what scams were happening or go by the local police and speak with a detective who was working the area the time of the missing $$ to see what they remember. A letter from a cop that there were gypsies or con-artists in the area and that they were targeting elders will be great to take for the hearing. You probably don't have to prove this happened just provide a logical or probable reason as to where the $$ went. Good luck!

igloo572-Thanks for your post.Unfortunately my mom never owned a home ,nor a car.Her bank account all her life was hers only except for 2 yrs ago she had a friend on it for about a year,took her off, and now me for the past year.
The questionable withdrawals are from 6 and 7 yrs ago.She was denied because of those withdrawals and that's why we have a fair hearing next week.I am her only child,her husband is deceased and no relative in the U.S.Im afraid because I am the only relative that somehow I will be responsible for her problem.I am not her POA.All I have is a statement from her last superintendant from her apartment stating he witnessed her with large sums of cash in envelopes in her apartment and that she would attempt to pay rent two days in a row forgetting she had paid the day before.Anyone else that may have a clue as to what happened with money is either deceased,moved,or too old now to be of help.

Keep the conversation going (or start a new one)

Please enter your Comment

Ask a Question

Reach thousands of elder care experts and family caregivers
Get answers in 10 minutes or less
Receive personalized caregiving advice and support