Qualifying for Medicaid and acing the application process is important, but during the Unwinding of the PHE it’s a new level. This blog will discuss some Spend-down Tips and Terms to keep top of mind to optimize your application processes Medicaid Anticipated Date Gather all information to understand when Medicaid will be needed and then […]
June 9, 2023
Qualifying for Medicaid and acing the application process is important, but during the Unwinding of the PHE it’s a new level.
This blog will discuss some Spend-down Tips and Terms to keep top of mind to optimize your application processes
Medicaid Anticipated Date
Gather all information to understand when Medicaid will be needed and then calculate when the resident will be left with no funds to pay privately. Once you’ve figured that out you can calculate an anticipated date needed and plan accordingly. It is best to begin preparations 90 days prior to the resident exhausting their resources to limit challenges down the road.
Proper Spend Down
You will want to identify how much the resident needs to spend-down in order to qualify for Medicaid. You need to ensure that the resident follows policy guidelines to avoid a penalty as they decrease their assets/resources. Here’s some wording you can use with your residents to keep to the policy guidelines. You can say things like, “per Medicaid policy the State allows for you to purchase an Irrevocable Prepaid Burial Agreement as a means of spending down funds.” Other situations might require different wording like, “per Medicaid policy the State does not allow for funds or assets to be given away or sold for less than fair market value. Medicaid policy states that giving away funds/assets/selling for less than fair market value may result in a penalty.”
It is a good practice to make sure that a resident and/or their POA understands the rules of Medicaid and the consequences for unallowable transactions/transfers. It is important that you always “cite policy” and clearly communicate that you are not providing legal advice.
When you have identified that a resident is over the asset limit to qualify for Medicaid, they are referred to as “spend-down” residents. Keep the lines of communication open with these residents and their families during the spend-down period. Don’t wait until the final hour to start collecting financial verifications and reviewing documents for red-flags.
Liquidating Resources
If a resident is over-resourced in the form of assets that need to be liquidated such as a home, it is a good practice to involve your Administrator/upper management to
discuss consulting legal. They may advise to put a voluntary lien on the property to ensure private payments can be made to limit the risk of unpaid dates of service.
If a resident is slightly over-resourced and you are in a State that allows for spend-down within the month of application to occur– set aside some time for you, social services, or the activities director to sit with the resident and do some online shopping for items they need to accomplish a small, quick spend-down.
Tracking resources, money, and resident’s status can be complicated. We’re here to help.
Reach out to discover why over 649 facilities are using Aidace software to get more Medicaid approvals in less time. Get all the details at www.aidace.com
June 9, 2023
Qualifying for Medicaid and acing the application process is important, but during the Unwinding of the PHE it’s a new level. This blog will discuss some Spend-down Tips and Terms to keep top of mind to optimize your application processes Medicaid Anticipated Date Gather all information to understand when Medicaid will be needed and then […]
June 9, 2023
Missed months of eligibility is the bane of every BOM’s existence. Tracking asset limits and clinical levels can get detailed and confusing. All too often updates are received too late and a resident’s application and spend down doesn’t happen in time. Obviously aidace can help you keep track of all these details for advance preparation […]
April 25, 2023
When it comes to Medicaid, well it’s a maze of confusion. The complicated verbiage almost needs its own dictionary. We’ve compiled a list of commonly used terms and their definitions for easy reference when talking to residents and families. LTC Medicaid guidelines require an applicant to meet Financial Eligibility guidelines as well as Medically Needy […]
