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Applying for Medicaid Too Late or Too Early

Medicaid Long Term Care Lawyer in Cary, NC

The timing when an individual, or their “authorized representative”, apply for Medicaid is extremely important. Applying too early or too late can result in significant unintended consequences.

Applying Too Late

Applying for Medicaid too late – assuming the individual is otherwise eligible – can result in the lost opportunity to have the government program pay for skilled nursing care for the individual, which can amount to tens of thousands of dollars depending on the length of the delay. That’s money out of your pocket – or your loved one’s pocket. Although it is possible in North Carolina to apply for retroactive benefits for up to 3 months prior to the date of application, that retroactive coverage is capped at 3 months, so the best practice is for the individual to apply as soon as they are eligible.

Applying Too Early

Applying for Medicaid too late can be even more costly. This is mainly because of the 5-year look back period (gifts made for the purpose of becoming eligible for Medicaid within 5 years prior to the application date are penalized based on the value of the gifts made – unless they are exempt transfers). Unless triggering a penalty period is part of your overall Medicaid planning strategy – which should never be undertaken on your own, there are just too many traps and opportunities for mistake – you must be extremely thorough with reviewing your past gifts and finances to eliminate surprises.

Apply When You Are Qualified

The general rule is to never apply for Medicaid until you’re absolutely sure that you or your loved one are qualified for benefits, or if you are absolutely sure that you want to start a planned penalty period immediately.  

Contact an experienced Medicaid Planning Attorney to discuss your options and determine when you or your loved one should apply.

Paul Yokabitus