• In one of my first posts I wrote about the experience of a middle class family being financially drained by $11,000 monthly nursing home bills, and finally being forced to confront a Medicaid application.

    The family was my own, and the nursing home bills were for my mom, who had already been through a series of group homes, assisted living, and finally nursing facilities by the time she turned 65 a year ago. 

    In our twenties when she became too ill to live on her own, my sister and I were not equipped to care for her directly, nor to manage the alternatives.

    We were already working with a professional care manager, who referred us to an elder law attorney, who in turn referred us to an accountant and financial manager. 

    We tried to figure out whether we really needed to pay exorbitant fees for all these services, and what we could do ourselves. But we kept being told that we were incapable of navigating this stuff ourselves, that the only intelligent option was to keep writing  the checks.

    We quickly felt like we were caught in an elaborate racket, but we were overwhelmed and desperate.

    By the time we established a supplementary needs trust to pay for care costs not covered by Medicaid or Medicare, there was hardly anything left to fund it.

    When it came time for the Medicaid redetermination last year, my elder law attorney strongly recommended that she should prepare the documents, at least for the first year so we could see how it was done. The same went for the annual trust accounting required by the State of Maryland. The bill: $2,000.

    This year, when it came time for the annual redetermination, I emailed the attorney. I reminded her of her suggestion last year and asked if she could provide any templates or guidance to prepare the application ourselves.  

    The response:  she would not answer questions piecemeal, and would not help us with either application unless she received another $2k payment to prepare both.

    Plus it turned out she had never submitted the trust accounting from the previous year due to a miscommunication about a $300 balance on our account. 

    After writing her a scathing email, it was time to take matters into my own hands.

    I started searching for the right people to talk to in Maryland’s bureaucracy. I started making calls, appealing to real live people to help walk us through the process.

    The case officer at the Long Term Care office turned out to be lovely. She responded to my calls and prepared a clear list of what she needed, which I worked with my accountant to prepare.

    The contact person for the trust accounting was a little harder to track down, but once I did, I realized I already had her contacts from emails forwarded from the attorney during the initial process. 

    Even with the attorney fielding the communications and preparing the submission, I’d been the one excavating records to compile all the documentation.  As I looked back through the email traffic, I realized I’d been paying a very expensive middleman. 

    We finally compiled all the documentation, and just received notice that the Medicaid Redetermination was approved.

    I’m certainly not making a blanket statement undermining elder law attorneys – they provide incredibly important services, usually at times when families are desperately in need. But it sure is empowering to figure out how to navigate the process directly.

    Have experiences with elder law attorneys you want to share? Please comment here:

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    This entry was posted on Monday, September 3rd, 2012 at 2:27 pm and is filed under Communication & Planning. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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