The topic of the day is how you can save money and live well without breaking the bank. By understanding how to navigate the legal system, you can save thousands of dollars in health care bills. These agreements are used in Florida when someone is in a nursing home and has been denied coverage from a Managed Medical Assistance plan (MMA). This is a form of Medicaid – the government insurance program that supports the low income and disabled – which can significantly lower out of pocket medical expenses if handled properly.
A Medicaid Single Case Agreement is a legal agreement with a nursing home that spells out how the resident’s medical bills will be paid. It is important to find out about a Medicaid Single Case Agreement soon after your loved one is admitted to a nursing home, especially if you have the financial means to qualify for Supplemental Security Income (SSI). It is important to know that these agreements usually require you to pay a monthly amount to the nursing home and the government will cover the rest. It is important to do the math and prepare your budget to determine if it is worth applying for this program. If you meet the financial requirements, it could help you save thousands of dollars on out-of-pocket costs.
Real world scenarios where Medicaid Single Case Agreements save people: Linda’s mother was diagnosed with Alzheimer’s disease last year. To afford the costs, Linda cashed in her father’s life insurance policy to help pay for the first year of her mom’s stay in a nursing home. After one year, Linda applied for the Medicaid Single Case Agreement so that her mom’s medical bills would be paid by a government plan. Linda’s mom did not qualify for the plan, however, because of the income limitations. Creditors are still billing them for her mom’s medical costs. Linda notes that if she had applied sooner, perhaps then her mom would have qualified. She is now considering filing a claim to appeal the decision.
Mark’s grandmother was placed into a nursing home after having a major surgery. His grandmother’s financial resources, including the sale of her home, quickly depleted, leaving her with less than the $2,000 allowable under Florida law. Mark’s family had originally planned to pay for her nursing home stay out of pocket, but learned about the importance of asking for a Medicaid Single Case Agreement. To Mark’s surprise, his grandmother qualified for the program and the government agreed to cover her medical costs. Several months later, Mark’s family learned of her passing. The Medicaid Single Case Agreement saved them thousands of dollars on medical bills.
Medicaid Single Case Agreements are not for everyone, but if you find yourself in a situation where you have to pay out of pocket for an elderly relative’s stay at an assisted living or nursing facility, ask your lawyer if your loved one qualifies for a Medicaid Single Case Agreement under Florida law. This financial counsel is priceless.