25 Sep, 2017

Bearing the Medicaid Burden

She walked through our office door at 1:30 on a Friday afternoon. We checked the calendar, confused—no appointment. I wasn’t prepared, but she needed help; I could see it in her face. So I brought her back to my office to see what I could see.

“Since January, everything that can go wrong has,” she said. We had done estate planning for her mother a year and a half ago, and now mom was in a nursing home. Daughter had problems of her own, too. She wasn’t the first loved one I’ve seen overburdened with all the financial and medical problems of a parent in addition to her own.

She dropped a large stack of papers, folders, and a binder on my desk. I started sifting through them, looking for any bits of information I could clarify for her.

The largest stack was a copy of a Medicaid application submitted for her mom. It was the third application in as many months. The first she had tried herself. Denied. A hospital worker prepared the second. Denied. This one was prepared by the financial person at the nursing home.

At least I was able to tell her this application wasn’t denied—yet. The key was a single piece of paper, front and back, titled “Notice of Proof.” It said she had one week to get more proof of her mother’s finances, or the application would be denied. Just like the others had been.

She looked exasperated when I explained this. “I’ve already given them all that, many times.” But whatever she gave them wasn’t enough. Unfortunately, the Notice didn’t do much to tell her what she really needed to get.

On top of all that, when she called to clarify things the workers wouldn’t talk to her. They said they didn’t have an authorization to speak to her. I looked at the application and saw the problem: the authorization form had been submitted without a required signature. A quick call and a fax fixed that, at least.

But that wasn’t the only mistake the nursing home had made on the application. I circled a few others for her. Of course, the home was pressuring her to pay all the while—they even suggested using a credit card.

At the end of it all she thanked me for looking things over and helping her understand. That was the first time she didn’t sound frustrated or angry or just overwhelmed. It wasn’t over; not by a long shot. But at least I had been able to help.

Sometimes just being the person who helps is the best part of my job. Too many people bearing the burden of a sick loved one are forced into an endless legal maze without a guide. They try to do what the nursing home workers tell them. They try to do what the government workers tell them. Somehow, it’s never enough and it never seems to end and they have no idea why.

That’s why lawyers exist. Because when you hire us, you have someone in the system who is completely on your side. Someone who can bear some of the burden for you.

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