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Medicaid

Monday, December 10, 2018

What Veteran's Benefits Are Available in California?


In addition to Federal Veteran’s Benefits, California offers a number of state-sponsored benefits for veterans in California. It may not always be easy to find these benefits, or understand exactly what to do when you find them, so talking with a California public benefits lawyer may be helpful, especially if you find that you have been denied for some reason.

Here is a quick guide to veteran’s benefits available to California resident veterans who have been honorably-discharged.
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Thursday, July 21, 2016

Mom Frozen Out of Public Benefits After Son’s Death


Can in-home supportive services caregivers collect unemployment benefits after their child dies?

In an ideal world, no parent would have a terminally ill child or have to bury a child. It’s just not the natural order of life. Yet, life isn’t ideal--or even fair.

In California, a parent of a terminally ill child may not only apply for assistance through the federal Social Security Disability Insurance (SSDI) Benefits program, but may also seek state-based assistance by applying to be an In-Home Supportive Services (IHSS) Caregiver for their child. The latter designation allows the parent to stay home to care for their terminally ill child while earning minimum wage.


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Saturday, October 31, 2015

Avoiding Prepaid Funeral Scams When Medicaid Planning

I recently received correspondence from a company claiming to help with Medicaid eligibility by offering prepaid funeral services. Is this legit?

When it comes to Medicaid planning, the overall goal is to reduce personal assets either by transferring these assets to a trust, gifting to family, or making exempt purchases. Exempt purchases and transactions are those that do not trigger a penalty even during the 5-year look-back period, and include any of the following:

  • Full or partial payment on any legitimate debt (e.g. mortgage, auto loan, etc.)
  • Purchases of an exempt asset (e.g. an exempt home)
  • Preplanned funeral
  • Preplanned burial
  • Annuities
  • Caregiver costs
  • Maintenance of a non-countable asset (e.g. home improvements to an exempt home)

Of these “spend down” options, one of the most notorious areas for scams involves the concept of a prepaid funeral and/or burial service. While there are many trustworthy and reliable outfits available to help planners prearrange these events, planners are cautioned against working with any companies that seem questionable or aggressive. It is vital to work with a prepaid funeral service provider with a strong reputation in the community. If possible, it is best to obtain a personal referral.

Sound Alternatives

Too often, prepaid funeral plans require monthly payments that, in the end, amount to more than the actual cost of the average funeral. In addition, these plans may include costly and wasteful “service” or “account maintenance” fees that create an unnecessary burden on the decedent’s estate when it comes time to prepare for the memorial services.

As an alternative, planners may be able to direct funds into an interest-bearing account for purposes of pre-paying funeral costs and expenses. By designating a beneficiary as payable-on-death, family members can rest assured the process is handled with ease, and preplanners can rest easy, knowing the process is being taken care of in a cost-effective manner.


Tuesday, August 11, 2015

Center for Medicare and Medicaid Services Likely to do Away With Mandatory Arbitration Agreements

What are my options if I disagree with a decision rendered by a long-term care facility accepting Medicaid?

In many states, the staggering monthly costs of long-term care are approaching $10,000 per patient – prompting the exponential growth of the practice area known as ‘Medicaid planning.’ During the Medicaid planning process, clients are counseled as to the best ways to protect their modest nest eggs from these nursing care costs while staying within the legal guidelines set forth by the Center for Medicare and Medicaid Services (CMS). 

As the number of Medicaid-eligible seniors continues to grow, so too do the number of conflicts that arise between nursing homes and patients – primarily regarding the payment of the outstanding bill, covered expenses, and similar sources of contention. 

Up until recently, patients receiving Medicaid benefits for long-term care were required to sign binding arbitration agreements in the event of conflict. These agreements essentially eliminated a patient’s right to pursue a cause of action in a traditional court of law, which also significantly limited their rights to redress and compensation in the event of fraud, negligence, or breach of contract. 

For years, patient advocates have warned against the use of these binding agreements, pointing out that many do not fully understand what they are signing at the time – and are particularly surprised to eventually find out that they unknowingly waived their right to file a formal lawsuit over issues involving Medicaid coverage. Of course, the opposite argument is that mandatory binding arbitration cuts down on litigation costs for nursing homes, which results in savings for taxpayers overall. 

As of June 2015, CMS announced a new proposed rule that would eliminate mandatory binding arbitration agreements, instead inserting voluntary clauses allowing patients the opportunity to pursue either legal option – which is already the law in California. However, as many legal experts assert, patients still feel compelled to submit to binding arbitration at the time of admissions, believing they have no other option.

However, as part of the proposed rule, nursing homes accepting Medicaid must make absolutely certain that the agreements are drafted in a way that patients can understand the language and fully understand what they are signing. 

For assistance with elder law planning in the Bay Area, including San Jose and Santa Clara Counties, be sure to contact the attorneys at Berge & Berge right away: 408-985-9918.


Thursday, July 23, 2015

Understanding Medicaid Eligibility Rights for Same-Sex Spouses

Now that same-sex marriage is a fundamental right in all 50 states, how will Medicaid eligibility change to ensure same-sex spouses are afforded the same allowances and exclusions? 


Qualifying for Medicaid is often a vital milestone for those in need of long-term care, and generally requires a drastic spend-down of assets in order to meet financial eligibility regulations. Generally speaking, married couples tend to fare better overall when it comes to reducing assets, as the spouse able to remain in the community (known as the “community spouse”) is allowed to continue living in the marital home and receive a modest monthly income. For unmarried same-sex couples, this left them in a predicament in terms of calculating separate assets if they were living in a state that did not recognize same-sex marriage as valid. Now, as all same-sex couples are able to marry – and same-sex marriages are recognized as valid in all jurisdictions – applying and qualifying for Medicaid may take same-sex couples on a new path toward eligibility. 

Benefits of Medicaid eligibility for spouses

Medicaid’s financial thresholds were created with the dual-interest of not only ensuring the beneficiary has exhausted his or her own personal assets before receiving assistance, but also avoiding unnecessary impoverishment of the community spouse. For instance, 2015 guidelines allow the community spouse to maintain $119,000 in assets – a protection not previously afforded to same-sex couples in an unrecognized union. Likewise, state Medicaid authorities cannot initiate a Medicaid lien on a beneficiary’s home if his or her spouse still lives there – another new benefit for spouses. 

Another major benefit now enjoyed by same-sex spouses is that one may transfer assets to the other without triggering a penalty during the look-back period. Before, a transfer between same-sex spouses residing in a jurisdiction that did not recognize same-sex marriage was treated as a general asset allocation similar to a parent-child transfer. Now, same-sex couples can enjoy the same rights to keep their assets in hand as applicants in a traditional marriage. 

If you are considering applying for long-term care benefits, or you would like to speak to a reputable estate planning attorney for additional information, please contact the Law Offices of Berge & Berge, serving the areas of San Jose and Santa Clara County, California, today: (408)985-9918. 

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