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Avoiding Medicaid penalties and pitfalls

Many people who try to figure out Medicaid eligibility and how to maximize its benefits are soon overwhelmed by the program's dense, bureaucratic language, and its many detailed rules, regulations and procedures. Unsurprisingly, many then look for help in navigating a complex system.

We recently read a letter from a 77-year-old woman to a newspaper advice column about obtaining Medicaid benefits for her husband, who is in a nursing home. The woman said an agency she turned to for help advised her not to report to Medicaid a cash gift her husband had given to her son two years ago. The paper's columnist - an elder law attorney far from us here in Colorado - spotted a big problem with that advice.

The columnist wrote that the advice from the non-lawyer at the agency was deeply flawed. "Hiding assets and falsifying information on a Medicaid application is a crime," the Florida elder law attorney said in his reply. He said it would be best for her to cut her ties to the agency and find instead an attorney experienced in this area of law.

In that way, she (and others who are struggling to understand the system) can get targeted help for their specific needs.

For most people, it makes sense to get help with Medicaid planning before they absolutely need the program's benefits. In that way they can plan ahead and avoid things such as the look-back penalty.

What is the look-back penalty?

The look-back penalty involves the transfer of gifts or assets within the 60 months (five years) of the date the person applied for Medicaid benefits. The penalty isn't calculated in dollars, but in months - months in which you will not be eligible for Medicaid and must use your own funds to pay for things such as a nursing home.

Careful planning with an experienced elder law attorney can help you avoid these types of expensive penalties and pitfalls.

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