Applying for Medicaid: The Paralegal’s Perspective

Life Care Planning Law Firms help families with every aspect of an aging loved one’s care, including the process of finding ways to pay for long-term care. When families need to access Medicaid benefits, attorneys oversee the process, but they are supported by other staff members, including paralegals.

What does a paralegal do to help families who are trying to qualify an elderly loved one for Medicaid benefits? We posed this question to Ann Vetrano, a paralegal with Anderson Elder Law, a Life Care Planning Law Firm in Media, Pennsylvania. Before joining Anderson Elder Law as a full-time employee, she spent 33 years working for the State of Pennsylvania’s Medicaid office, including six years processing Medicaid applications for nursing homes. “We joke that I came from the dark side to the light,” Ann laughs, noting that her experience is a great asset to the firm’s clients during the Medicaid application process. “I used to teach new caseworkers how to evaluate nursing home Medicaid applications, so I am quite familiar with how things work.”

Ann works closely with both attorneys at Anderson Elder Law--Linda Anderson and Chari Alson--during the Medicaid application journey. How does her role in the process differ from that of an attorney during the life of a Medicaid application? “The attorney chooses the qualification strategy,” Ann said. “She is responsible for selecting the approach we will use to qualify a client. My role is in the implementation of that strategy.”

Those implementation-related tasks could include anything. Moving assets, transferring deeds and titles, helping a client liquidate assets during the spend-down process, filling out the Medicaid application, getting signatures, assembling documentation, double-checking the application to make sure it’s accurate, and then mailing the entire package to the Medicaid office are just a few of the tasks Ann might complete during the application process. She also keeps clients abreast of developments as the application is being evaluated by the state Medicaid office.

As one might expect, this involves a tremendous amount of interaction with the client. “After the attorneys have figured out which approach will work best to qualify the older adult for Medicaid, I am constantly in touch with the clients,” Ann explained. “There are a lot of phone calls and emails during the process, and I usually have more contact with the client and his or her family than the attorneys do.”

Ann is also closely involved in troubleshooting problems that can come up during the Medicaid qualification process. One of the biggest problems involves gifting. “Many people don't realize that they can't give away their money and then come in and try to apply for Medicaid,” she explained. “Thanks to Medicaid’s five-year lookback period, those kinds of transfer can lead to steep penalties and costly delays. When people make those transfers, we have to reverse them somehow or find another way to qualify a person when they've given away their money. Hopefully, the kids didn't spend it, and they can give it back.”

As a paralegal, Ann plays a vital role in managing the details of the Medicaid application process. “Little things matter a lot,” she added. “Much of my job is to make sure that everything is done properly so that each claim has the greatest chance of approval.”