Hello, my name is Christopher Lavin, I’m an attorney with the Lavin Law Group. We are an elder law firm here in Lebanon, Ohio. This is Christy Doss and she is a Medicaid case specialist.
Her job is to do the same thing for clients that a caseworker for the county does for the state of Ohio. It’s a very detailed job because what a lot of people don’t realize is that when you apply for Medicaid, you’re basically put through an audit. Everybody knows the, what is it, five years, Christy? Yes, there’s a five year look back, so everything has to be verified from five years from the date of application.
And everybody looks at the five years as kind of like a punishment period, but it’s not. I don’t care who you are and what you do, every time we apply, everybody has to go through the five years, don’t they? Yes. And there’s no free lunch.
And they want to look at just about everything, don’t they? Oh yes, it’s important to keep all your paperwork. When bank accounts open and close, new accounts are open, we have to have a very good paper trailing. It’s an audit.
And if we don’t have the paper trail, or we’re surprised by something, it can be a disaster. We just had a case, we never mentioned names, but I mean, the cases take a while, how many months on average are we? I have one currently that’s been pending since January. And that’s a little unusual, thank goodness, but summer breaks and turnover hurts with that.
But we have another case that I’m thinking of that I think has been going on for three months, and it seems pretty easy at the beginning because they looked what we call resource eligible and what resource eligible means. Before I can initiate the Medicaid application, we have to make sure the client is under the eligibility guidelines, meaning they have to be resource eligible for Medicaid. And that’s confusing because it depends, if there’s a spouse, it can be a little higher.
What’s the highest number on that right now? Is it- 32,000. 32,000 to 150. Yeah, to 150 is our maximum.
So with the spouse, we can have up to 150,000, which is not what you hear on the internet. They tell you 2,000 no matter what, but for an individual, everybody’s what? It’s 2,000. Yeah, so everybody’s down to 2,000 no matter what for an individual.
So when those numbers are in place, Kristi fires off the application because this is pretty time-sensitive. Yes. But we just had somebody not know about, was it insurance policy? Yes.
Life insurance policies are my biggest hang-ups. Cash values, the state of Ohio looks at cash values as money in the bank and often pulls us over our resource guideline. And I think the unexpected cash value was 14,000, it put them, what, 2,000 or 3,000 over? Yeah, 2,000 or 3,000 over our resource guideline.
And if you’re a penny over or 3,000 over- There’s no eligibility for Medicaid. So we lose those three months and that’s why the nursing homes get nervous because they now need to get paid for January, February, and March. So it’s an audit.
That’s why I have Kristi help me with the audit. She does the same thing, as I said, that the caseworkers for the state are doing, just looking at it from your perspective. But that’s why you want to be very prepared before you sit down across the state of Ohio.
I totally agree, Mr. Lavin.