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  • John Todd

$100k+ and two attorneys later . . .


I love sharing some of the success stories I get to see in the families I work with.

This one reminds me why I keep doing this work.

This is what happens when you get stuck in the Medicaid Maze:

Karen and Kent (names changed) were still quite young. Kent was only 58 when he was diagnosed with dementia. Karen took care of him at home for about for about 6 years. Finally, his decline was so bad, she was no longer able to provide care, and transferred him to a Certified Family Home.

Karen later wrote, "I started paying privately for his care . . . sold his truck for $1,100. He had been going to (an adult) daycare while I worked . . . (In April, 2020) I found a place (nearby) to take him . . . @$6500/m.

"I had already cashed out my IRA ($11,000) to help pay for Kent's care. . . Eventually, I used up all his IRA ($40,000). . . I am now using some of my emergency fund money to pay for his care . . ."

The the home was sold - part was used to build another home, and part was spent on Kent's care.

During this time Karen had reached out for help with the Medicaid Maze to two different attorneys. One was local, the other about 30 minutes away. Neither one was able to resolve the issue with Medicaid and get it approved.

By the time Karen called me, it had been ALMOST 18 MONTHS of private-pay, and she had no idea how to qualify for Medicaid.

I received permission to talk with Medicaid, and discovered 3 main problems that had cost this couple about $110K and almost 18 months of frustration:

Problem #1 - Errors by the Medicaid workers.

Problem #2 - The OPTIONS on how to BECOME MEDICAID ELIGIBLE were never explained to Karen.

Problem #3 - Difficulty finding the financial "PROOF" required by Medicaid with specific statements, dates, etc.

I received the call and permission to speak with Medicaid on September 30, 2021. By October 19, Medicaid had all the financial proof to approve Medicaid back to September 1, 2021 and continuing forward.

WIN #1 - Kent is approved for Long-Term Care Medicaid, so he can continue receiving the care he needs.

WIN #2 - Karen received a REFUND of about $10k for the months that Medicaid was approved. She also has the peace-of-mind that she is NOT going to have to spend her emergency fund to pay for Kent's future care.

WIN #3 - The Medicaid workers has reviewed the whole plan and approved Long-Term Care Medicaid.

The sad part of this story is that, with the right help, Kent could have qualified for Medicaid in JUNE 2020 instead of waiting until September 2021. That was a waste of 16 months of frustration and $100k+ in UNNECESSARY private-pay costs.

ALL because of lack of information and communication - on the part of Medicaid PLUS 2 attorneys from different offices that didn't know what they were doing, and no readily available source to clear things up.

Thankfully, she finally found that I could help. It's just too bad that she hadn't found me sooner.

I just had to share!

Hope you have a great day!


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