Private-pay nursing home care costs between $9,500 and $12,000 per month in Montgomery, Bucks, and Philadelphia Counties. Some nursing facilities provide more intensive care, such as those with ventilators, and can cost over $22,000 per month. Without proper planning these expenses can quickly erase a lifetime of savings.
At the State Level, the Medicaid program is administered through the Department Of Human Services (DHS) local County Assistance Offices (CAO). Caseworkers at the local County Assistance Offices review Resource Assessments and Medical Assistance applications. They manage the applicants’ files and make determinations of eligibility. The Caseworker’s job is to find all available resources to pay for your care before making you eligible. They work for the taxpayers NOT you. We can help both married and single nursing home residents, and the spouse at home.
Medicaid Application Process
Caregiving, work, and family responsibilities add up. Many times these responsibilities all fall to one child who is stretched thin. We can take the Medicaid application process off of your worry list.
We know you want the Medicaid application process to be over as quickly as possible. There are many forms, and lots of documentation to provide to the Pennsylvania Department of Human Services (DHS). Our team works diligently to compress the time-period when the application is pending and have the application approved.
Normally a payment of income should be made to the nursing home each month while the application is pending. We identify any applicable allowances, such as an allowance of income for the spouse at home, and precisely compute the payment that should be made to the nursing home while the application is pending. The nursing facility will normally wait until the Medicaid application is approved for the full payment of their bill. We will communicate with the nursing home’s business office so they are aware that we are applying for benefits. If you do not pay what is owed on an ongoing basis you will receive an unwelcome surprise bill at the end. We will help you avoid that problem.
Our office will complete the Medicaid application and related forms, often working with the nursing home resident’s spouse, children, or agent under power of attorney. We communicate with the caseworker assigned to our application at the County Assistance Office and handle the eligibility interview. We keep you informed during the entire process. We help you obtain the verification and documents requested by the Pennsylvania Department of Human Services’ County Assistance Office.
Medicaid Appeals (Requests for a Fair Hearing)
Unfortunately applications can be denied for any number of reasons:
- Excess resources
- Failure to provide financial verification
- Transfer of resources for less than fair consideration
- Late filing
With nursing home costs that can exceed $10,000 per month, the stakes are high. We have handled many appeals before the PA Department of Human Services Bureau of Hearings and Appeals over the past 40 years. We can evaluate your case and provide recommendations on how to proceed.