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jayswife

Active member
Joined
Feb 11, 2016
Messages
71
Reason
CALS
Diagnosis
04/2014
Country
US
State
ct
City
stratford
We're having a serious problem. Jay is on a Medicare Advantage plan. An attorney was recommended to us through the als association in our state. Supposedly this attorney can get Jay on Medicaid even though we are over the limit. And the cost to do that is close to $10,000.00. Jay has a friend that is insisting that we do this. He contacted his friend to try to make this happen with the attorney. This friend also invited the attorney to our house one day while i was at work and the attorney drew up POA paperwork naming myself and this friend. I was livid. The friend is intrusive and convincing Jay that he needs to get on Medicaid. He's got Jay convinced that this is going to solve any upcoming problems. Jay said that he will be able to stay in the home with care if he gets on medicaid. I don't know - I don't understand all of this medicaid business. But i do think that attorney fee is outrageous. All that money upfront to not even know if he's going to do that much money worth of work. Jay's friend wrote me a next text last night - Some of the things he said - "I know you're busy but you haven't returned my messages regarding Jay and his treatment." - The attorney has NOTHING to do with his treatment. Then he said A friend "is coming by tomorrow and I asked that he call me and put me on speaker phone so we can work this out." I told Jay I'm not doing that. "Hopefully you'll be there tomorrow because all of his friends and providers that are helping him are concerned about the lack of communication." I'm sorry but WTF? Concerned that we're not coughing up a check? And what providers is he referring to? The attorney? I don't get it. Of course I messaged him back but my problem is Jay is not upset with the way this guy talks to me. A few weeks ago he had the nerve to quietly ask our aid if I'm leaving Jay alone. And rewind to last year when they were pushing this attorney and I wouldn't speak to them because I thought it was too much money, I got a message from the attorney's assistant saying that if I don't contact them then adult protective services can take Jay out of the home. Excuse me?? I take very good care of my husband.
I'm at a loss as to what to do. I told Jay that much money is insane and he asked me if he was my son, would i put up a fight about it? So clearly he feels that I don't have his best interest. We are at odds. Not speaking. And another one of his jerk friends will be at my house when I go home.
 
You are being harassed by both the friend and the attorney. Ethical attorneys and their staff do not behave this way. First, call your local ALSA representative and speak with them about this attorney.

I'm concerned about the Advantage Plan. Some do not pay the co-pay (20%) for durable medical equipment. That is why I chose the Medicare Gap plan over an Advantage plan. Every State is different, by the way. Did you check the Advantage plan before signing up. Maybe the "friend" is concerned you have the wrong insurance plan OR maybe his intrusion has something to do with this attorney.

I suspect the attorney's services would be to advise you on how you can protect your assets and home, should your husband have to go into skilled care. Again, State laws vary so I don't know how much work needs to be done by this attorney. I suspect it will involve some kind of trust but that shouldn't cost over a couple of thousand dollars. Be very careful about letting your husband sign anything.
 
JW,
There are attorneys who make a living doing this, and yes, the fee structure is up front.

Not knowing anything about your finances or CT, I can only say that States are more vigorously pursuing Medicaid fraud these days, no one has eligibility until it's granted, eligibility can be withdrawn (with penalties), and the sequence of events you describe smacks of intimidation (as well as a future attempt to game you into more financial advantage for the attorney).

I would not work further with this attorney or the friend for one second. Jay will have to deal with your well-founded concerns now or later -- far better to deal now than risk all you have. I'm sorry you have the burden, but it's part of being a wife and CALS. Has Jay completed financial/health care powers of attorney/a Will? If not, the time is now.

There are responsible elder care attorneys who can advise you as to your options, that work by the hour, that you can find through your local bar association, better friends, and attorney directory portals. There is an elderly law professional association where you can search in your area.
 
I'm having a hard time understanding what benefit he will have with medicaid. Do they pay for homecare services, medical and non medical?
 
I am not a lawyer but Medicaid has rules and breaking them is fraud. I also think the friend is up to something. I would make sure that any accounts you have are still solvent and that your name is the only one on them. I believe they are trying to do some financial changes that could hurt you.

His friend should never be the POA. With that power he can
change accounts and many other financial stuff. I don't blame you...I would be livid.

Call the ALS Association and see if they can advise and if not I would get a trust worthy attorney of my own. This all sounds to fishy and you do not want to be unprepared. You do have rights as his wife. This friend is causing trouble between the two of you and true friends don't do that.
 
In some states, Medicaid does pay for some home help provided by non-skilled personnel, that is to say nursing assistants/home health aides. That is the program that requires like 6 weeks of training -- these aides help with showering, transfers, feeding, toileting and the like. You would have to use an agency/provider certified by the State. Quality varies.

As for skilled care/assistance (nurses, PTs, OTs, SLPs, social workers), Medicare does pay for them to perform services at your home under some circumstances (including but not limited to hospice care). The usual standard applied to non-hospice/palliative home care is ability to improve. There are pilots to take a different tack, but the overall policy remains the same for now. That said, some plans/agencies treat ALS somewhat differently. It can helpful to have/talk with a case manager to get the most out of your plan.
 
I'm in shock reading that any so called friend would draw up a POA naming himself as much authority as a living spouse! Add to it the way he is treating you?! This reeks of elder abuse!
 
I'm just echoing that this all sounds fishy- it sounds like the "friend" is putting some ideas into Jays head about your intentions with the intent to gain control over his financial matters. A trust should run you 2-3k to set up. 10k sounds ridiculous and the pursuit of you sounds like something the local bar might want to hear about- I would put in a complaint.
 
State bar I mean-
 
I really feel you need to get some independent advice for yourself as this sounds outright fishy as everyone is saying!
 
What a distressing situation and I can only imagine how insulting it must be to have someone outside your relationship interfere with such private matters.

That said, I agree with the other comments recommending independent advice. There are legal ways to structure your finances so that you can benefit from Medicaid and avoid total financial ruin due to medical expenses and an eldercare attorney recommended by the ALS Association would be a good place to start.
 
Please be aware that Medicaid is a quagmire. There are rules that must be followed concerning asset transfers between spouses. 10,000 dollars would buy a lot of private duty care. Call your local home health and see if they know of anyone who will do private duty nursing for you. They do not have to be a "nurse".
 
NYC, you may have missed that the attorney in question was in fact reportedly recommended by her local ALSA. Which is why I added the link to the National Academy of Elderly Law Attorneys' own database.

A general comment -- it's natural to seek out referrals from the ALSA but I personally have gotten some myself that I wouldn't wish on anyone, and JW is going through another example.

ALSA chapters generally consist of a handful of staff who are not really con-savvy, there's no national criteria for vetting and ALS is one of those diseases that attracts some of the bad apples in our world. So, often, subject matter-specific resources and referrals through your own network, in your city or county are better bets.
 
Thank you lgelb for pointing that out, I completely missed it on the original post.
 
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