A Cautionary Tale for Medicaid

Over the last 32 years, I have encountered any number of people who had heard that “you don’t need a lawyer to …,” so, they did. This is particularly true in the Medicaid Benefits area. You do not need a lawyer to file an application for this special form of government relief. But, doing something because you “can” is not the same as doing what you “should.”

In the Medicaid benefits environment, applications filed without legal help often result from the advice of a caring involved person who just wants to help the family. Often, this person is a nursing home bookkeeper or administrator who, having seen many applications in the past, knows the form is designed to be “user friendly” and is more than happy to help.

But, beware, there are two things everyone has to remember when accessing these state/federal benefits. First, the Medicaid Application is a statement made under oath. What this means is that you can go to jail for lying and you can be sued for fraud if you don’t tell the whole truth. The door looks easy to open, but just touching the doorknob makes you extra responsible for telling the complete truth.

The second thing to bear in mind is that the set of forms represent volumes of law that look more like a maze when viewed from above than like the doorway you see at the Application stage. A few hours on the internet, or a casual experience base with the forms, does not provide a bird’s eye view. It takes Elder Law Attorneys years of law school to begin their training as competent professionals in this area. This means that it is possible to “tell the truth” and still be effectively lying because you do not know what the law says the form is actually asking you. The result can be months of private pay care followed by a denial you did not see coming. In the case of Medicaid Benefits, having competent legal advice is important.

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