In the final video of our Coronavirus Preparedeness Series, Wes Coulson discusses the new Illinois Medicaid “Provisional Eligibility.”
This the last of our series of COVID-19 related videos. I really wish I could tell you because we were past the Coronavirus pandemic. We’re not, it’s just lingering on past the number of videos I could come up associated with that, so who knows when we will be past that.
Right now I want to talk about something that is in place only because the pandemic, and that is that Illinois now, if you you apply for Medicaid long-term care costs, they will grant something called “Provisional Eligibility.” And when they’re doing that, they’re just looking at some really quick basics of information so that the nursing home can get paid because they are way behind, because otherwise in processing applications, they’re not looking at your assets to see whether you have too much in assets, they’re not doing the lookback for transfers, they’re just saying, “ok, right now it looks like you meet the basic requirements, so we’re going to give you provisional eligibility.”
It’s good, in that it means that as long you’ve applied and gotten that, the nursing home is not going to be pressing you for payment because they’ve gotten paid. But, it also can also give people the really false sense of security because when they say that, “Oh great, it only took a month and a half, and I’ve already been approved for Medicaid.” Well, they are still going to go back and complete that process. When, we don’t know exactly.
But, if you are over resource and you’ve said, “Well they’ve let me have this extra money” and you’ve gone out and spent it on other things, you may have to come up with it to pay the nursing home bill. If you’ve made transfers and you’ve said, “Good, they didn’t catch me. I got a way with it,” no, that’s not the case yet and you may have to come up with money to pay for your care during a penalty period that instead of starting in the month in which you entered the nursing home, which would otherwise be the case, it’s now going to start whenever they have finally processed the application.
Even for elder law attorneys, people who process people who process Medicaid applications, including the people who work for the Illinois Department of Healthcare and Family Services, its kind of a brave new world, and we are feeling our way through.
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