As always, our goal is to advocate for the elderly and disabled. Our advocacy goal includes filing lawsuits on behalf of our clients when appropriate. Over the past six months, we have had the opportunity to file three separate federal lawsuits against the State of New Jersey in order to allow our clients to obtain necessary Medicaid eligibility to assist in covering their expensive nursing home costs. I am pleased to report that we have been successful in each of the three cases in requiring the State of New Jersey to approve Medicaid benefits for our clients.
Each of the three cases involved the purchase of an immediate annuity pursuant to applicable Medicaid law in order to achieve Medicaid eligibility. In each case, the State of New Jersey denied Medicaid benefits on the ground that the purchase of an annuity was an uncompensated transfer of assets within Medicaid’s five year look back.
In Flamini v. Velez, decided on July 19, 2013, Mr. Flamini purchased an immediate annuity in the amount of $200,000 from his IRA proceeds in order. These IRA proceeds otherwise would have had to have been used to pay for Mrs. Flamini’s nursing home care. The IRA funds represented Mr. Flamini’s life savings that was to support him and his wife in retirement. A federal court has ordered the State of New Jersey approve Medicaid benefits for Mr. Flamini.
In Roccia v. Velez, decided in June 6, 2013, Mrs. Velez, a single individual, purchased an immediate annuity for $40,000 in order to achieve Medicaid eligibility for nursing home care. Mrs. Velez has no children. Her nephews are her primary caregivers. In order to have some additional funds set aside (approximately $20,000) to cover Mrs. Roccia’s ancillary nursing home costs not covered by Medicaid, our office recommended the purchase of an immediate annuity. Pursuant to a federal court order, Mrs. Roccia’s Medicaid application ahs been approved.
In Carlini v. Velez, decided on June 4, 2013, Mrs. Carlini purchased an immediate annuity in the amount of approximately $300,000 from spousal assets that otherwise would have been used to pay her husband’s nursing home bills. Mrs. Carlini needed the additional funds in order to allow her to pay her monthly assisted living bill of about $5,000.00 per month. Therefore, the annuity purchase allowed Mrs. Carlini to remain in an assisted living setting. Otherwise, both husband and wife would have been spending over $15,000 per month for care which would not have allowed Mrs. Carlini to remain in an assisted living setting for the remainder of her life.
In each case, although each lawsuit involved the issue of Medicaid eligibility, that is not our ultimate goal. Medicaid, if used correctly, is a tool to achieve maximum financial and physical independence. In the cases of Flamini and Carlini, the goal was to protect a community spouse from the devastating cost of a spouse’s nursing home care. In the case of Roccia, the goal was to allow family members the ability to pay for care expenses not covered by Medicaid.
I want to thank Jane Fearn Zimmer, Esquire of our office whose tireless efforts on behalf of our clients resulted in the cases being brought to successful conclusions. Jane, congratulations on a job well done!
Annual Open Enrollment Period – October 15 to December 7, 2013
If you already have a Medicare Part D (prescription drug plan), this is your time to look back over the year and make a decision. Should you stay with your existing coverage or make a change? Here is your opportunity to decide. If you make no decision, you will remain in the same plan as you elected this year.
If you change your plan, your new prescription drug plan becomes effective on January 1, 2014.