Is a Nursing Home Account Balance Jeopardizing Your Medicaid Eligibility?

A lot of people make the mistake of thinking Medicaid is a once and done process. They think once the HHSC approves Medicaid the first time that their parent can’t lose benefits. This is far from the truth and also an expensive lesson to learn the hard way.

The HHSC determines nursing home Medicaid eligibility on a month to month basis. This means that each month you have to meet the same requirements. If you don’t meet them one month, your parent can lose benefits for that month. In addition, they will remain ineligible for as many months as the defect occurs.

One of the hidden traps I am seeing more people trip up on is the nursing home resident account balance. Let me give you some free advice on how to avoid this problem with your nursing home Medicaid case in The Woodlands.

Your Asset Limit

Everybody on Medicaid has an asset limit. They must stay under that dollar amount. If they exceed their asset limit when a snapshot occurs, then they can easily lose valuable benefits.

For un-married people, the limit is currently $2,000. It is also $2,000 for married residents after the initial eligibility determination. The asset limit is very different for a married resident when they first apply, but that is beyond the scope of this post so I’ll trust your attorney took care of that for you.

The Forgotten Asset

So, most people remember to keep track of things like bank accounts etc. Sometimes keeping track of cash value life insurance is an issue. But one asset people can easily forget about it is the resident account at the nursing home. It is understandable after all, since for the most part it is out of sight and out of mind.

However, even though you may not keep track of it or remember it, the HHSC does. When it comes to renewing benefits, they count it the same as cash or any other bank account.

Accumulations Are the Enemy

For many families, the nursing home resident account does not accumulate significant funds. But in some cases, it can. The most common example of this problem is when the resident has one or more hospitalizations. Those hospitalizations can trigger increased insurance coverage. The increased insurance coverage reduces the amount of money they owe the nursing home. So when they keep making the same nursing home co-payment while the amount they actually owe is less, that is how the account gets bigger.

If You Find Out Too Late, You’re Screwed

This account is out of sight and out of mind for many people. It is easy to lose track of. And that is when disaster strikes. During the annual Medicaid renewal you have to give the asset information to the HHSC.

When they see that resident account pushing your family member over their asset limit it is already too late to fix unfortunately. They are already going to lose one or more months of Houston nursing home benefits.

How You Can Easily Avoid This Surprise

So how do you avoid this disaster? Easy, be pro-active in keeping track of the account. Insist on regular monthly statements from the nursing home for the account. And when you get those statements, look at them, don’t just file them away.

On top of that, when your parent has any unusual transactions like a hospitalization or changes in insurance benefits stay on top of the nursing home in confirming changes in their co-payment for that month.

As long as  you keep track of this account like a regular bank account you are well on your way to avoiding many of these problems.

Call the Medicaid Attorney, A Big Deposit Just Showed Up

As I said at the beginning, Medicaid eligibility is a month to month process. Your Medicaid lawyer can usually fix problems caused by a transaction within the same month.

The huge problem becomes, for example, if there is a deposit in October and it keeps them over the limit through November 1. Now you have crossed over two months and that is a whole new ball game that you do not want to be playing.

But, if you can spot the deposit problem before the next month (in October above), then your Medicaid lawyer can tell you how to handle it within the rules.