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  • Writer's pictureJenny Rozelle, Host of Legal Tea

Cautionary Tales - Last-Minute Planning & Medicaid Qualification - Episode 103


Hey there, Legal Tea Listeners –This is your host, Jenny Rozelle! I hope you caught that I did not do an episode last week since new episodes always come out on Tuesdays, and last Tuesday was 4th of July. It was a blessing in disguise because I got busy at work and I fell a little behind on the podcast. So, the holiday gave me a chance to get caught up on this – so here I am back and refreshed and ready to rock and roll on today’s new episode, which is a cautionary tale, where we talk about real-life cases with real-life clients with real facts – they’re things me or my office have worked on. For today’s episode, we’re going to be talking about a little about a sad situation, a sad case that my office is working on – but I’m not sharing it to bring down the mood, but to shine a light on the situation and hopefully have you all learn a thing or two – one of the biggest takeaways is something I shout from the rooftop all the time. We need to get estate planning done, even if it’s the most basic documents like Health Care and Financial POA, as soon as possible – NOT when and during an emergency happening. That happened here … well what I mean by that is there were NO documents in place at the time the emergency happened, which to get documents in place at THAT time, just added to the stress and added to everyone’s plates. Not ideal. Okay, so let’s get into it … starting at the very beginning.

So, this story is about a guy named Mike. Well, that’s not his real name, but for sake of this story, we’ve named him Mike. Alrighty, so Mike suffered a massive stroke, and even before the stroke, he was battling early stages of Parkinsons Disease. Mike’s brother, Tom, called my office, explaining what was going on, and basically said, “Mike doesn’t have any documents, first of all, and second of all, we don’t know what we should be considering and thinking of … so help!” Mike, at the time of this event, was in the middle of a divorce from his long-time spouse – and Mike and his wife, did not have any children. So, Tom, the brother, basically had this land on his plate – and at that time, he was willing to pick the baton up and carry it forward. My office ended up scheduling a meeting with Tom – and fast forward a bit of time, it was Tom and Tom and Mike’s mom, Sherry, at the meeting. Sherry, of course, was an emotional mess because this was her son – this is not the normal course of life, right? Mike, who was in his early 60s, needed help from his brother, Tom, and mother, who was in her early 80s.

So, the meeting happens – and somewhat long story short, two things are products of the meeting. First, we need to get a Health Care and Financial Power of Attorney in place because no one, at this point, has authority to make decisions on Mike’s health care nor his legal or financial matters. Thankfully, post-stroke, he was “well enough” to have the mental capacity to sign those documents. The second thing we were going to be navigating and doing for Mike was getting him eligible for Medicaid – which was going to be a doozy of a process. So, we got our plan together on getting the documents signed as well as commencing on the Medicaid path, and at that time, Mike’s brother, Tom, was going to take the lead because his Mom was struggling with everything. We understood – Tom was our point of contact.

We get to work, get the documents prepared, get them signed, etc. start working our way doing Medicaid and we get a call from Mike and Tom’s mom, Sherry, that Tom cannot and does not want to be the Power of Attorney anymore. It was a little out of the blue because everything was fine and dandy working with Tom – but you know, stuff happens like this when stress is HIGH and it sure was high. So, Tom bowed out and Sherry, the mom in her 80s, basically said, “I guess I get to do this.” She was willing to jump in for Mike, her son, but I had serious concerns about the level of stress and energy it’d take to get to the finish line. I shared those concerns with her because the last thing I wanted to do was have this woman step into this role and carry the stress/energy to a point of injuring or killing herself. I see that stuff happen – where the one in charge carries the stress that they start having health issues. Seriously.

So, she agreed to keep on keepin’ on – she agreed to be the one in charge and do everything needed to get Mike squared away. And I tell you what – she’s done just that. Sure, does she have some moments of total-freak-out and moments with tears? She sure does. But we’re there for her – we’re there to listen to her, to pick her up, and support her to keep going. The relationship and friendship that Sherry has with a few of my team members at this point would warm anyone’s heart. Heck, even the Grinch would probably smile!

So, shifting over to the Medicaid side of the case – this is really where many of the total-freak-out moments and tears have occurred. It wasn’t really too much about getting the basic documents, like Power of Attorney, in place – it was more through the Medicaid process. Mike didn’t really set up his peeps for success, and I’m not trying to poo-poo on him because honestly, A LOT of people are massively unprepared or underprepared for if something happens – and what I mean by that, is that their stuff is not organized in any way, shape, or form. That’s what happened here with Mike and what Sherry was navigating through. For Medicaid, there’s a lot of documents and information that needs to be pulled – and not only did Sherry get thrust into this position, but now she’s have to gather this stuff from a not-very-organized place.

She successfully gathered all of the documents – it was kind of like pulling teeth, but we got there. It wasn’t her fault. It was the situation’s fault. Mike’s health had already been declining due to his Parkinson’s diagnosis, but then the stroke hit – and it was like everything froze in time. It felt like Mike’s piles of paperwork got bigger – I think it felt like that because Sherry was searching for needles in a haystack looking for this-and-that for us and the Medicaid process. Finally, once we had everything from Sherry, we were able to get Mike’s Medicaid application filed. And before I go on, I think it’s important to pause and explain “why” Medicaid was even being considered – and maybe why the family chose to go through my office, an elder law firm.

So, if you remember, Mike and his wife were getting a divorce and in the divorce settlement, Mike got the house and little bit of the money. Medicaid actually allows for you to exempt out the house (meaning they don’t count it) in VERY limited situations – one of those situations is if the person is single (yes) and the house is for sale. Because of Mike’s condition, he hit both of those qualifiers because there was no way he was ever going to live alone – he’s got to stay in a facility setting. But what the strategy was … was that we were going to exempt the house for sale to get Mike immediately qualified for Medicaid, then one we’re through the doozy Medicaid process, Sherry was going to sell the house. Once the house sells, he’ll temporarily get kicked off Medicaid, but with out strategy, we’ll be able to save and protect some of the house proceeds. THAT is why you work with an elder law attorney – because a whole lot of people would tell you to just sell the house, spend the money on his care, and call it a day. But what we, as elder law attorneys, often do is implement strategies to protect money AND keep Medicaid footing the facility’s bill. Win, win!

As we stand right now, we have filed for Medicaid and annoyingly so, Medicaid denied his application – which that word, denial, and that sentence sounds intimidating and scary, but Medicaid denies people ALL the time for absolutely incorrect reasons. And THAT is another reason you work with an elder law attorney because we’ll slap them around (nicely). The reason for Mike’s denial is because, I kid you flipping not, they pulled a statement from SHERRY’S bank account and were counting SHERRY’s account balance incorrectly. I seriously am not joking. That’s not how it works at all. That was a flat out mistake and oversight on their part. So, AS SOON as we got the (can I say stupid?) denial, my office got on the phone with Medicaid and after too many arguments, they FINALLY pieced together what we were saying and “made it right on their end.”

So with this story, there are two big takeaways – first, please get your documents done. At the very least, everyone over the age of 18 needs a Health Care and Financial Power of Attorney in place. These documents are SUCH basic documents that take absolutely no time to create. Here, in my state of Indiana, there’s even free estate planning documents clinics that are put on by the local Bar Association for individuals that are low income or low asset – otherwise, if you don’t meet their financial standards, these documents are so affordable to have done by an attorney. Please, trust me, everyone should have these documents in place because life happens. Emergencies happen. Emergencies happen to people of all ages every single day. You can make it so much easier on those closest to you to make decisions on your behalf by having these in place.

Secondly, to takeaway from this episode, I highly encourage folks who need to navigate paying for care, whether it’s home health care, facility care, or long-term care, and how to utilize benefits like Medicaid to “foot the bill” – I highly encourage folks to utilize an elder law attorney to do so. I’ve said this before on here and I’ll say it again: An estate attorney and an elder law attorney are two different fields. Like, every single elder law attorney also does estate work (estate planning)…but not all estate attorneys do elder law work and actually, I’d make the argument that MOST estate attorneys do not do elder law work. So, if Medicaid and long-term care is something you or a loved one has to navigate, I recommend getting an elder law attorney on your team to help. I’m in Indiana and happy to help in my state – but if anyone ever needs a resource for an elder law attorney out of Indiana, let me know! Email me at LegalTeaPodcast@gmail.com and I’ll get you some names/contact information for nearby elder law attorneys.

Alrighty … well, I usually try to give a little bit of a shout-out for the next week, which is a current trends/current events topic, but to be honest, I’m writing this and don’t have a set plan for the following episode, so you know what? For once, you’re just going to have to be surprised at what next week is about – and hey, we all like surprises, right? So, I will talk to you next Tuesday, Legal Tea Listeners – talk soon and be well!


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