Paralegal Alexandra Doupis Eases Medicaid Filings
Paralegal Alexandra Doupis has been handling Medicaid applications for Littman Krooks clients for the last nine years. Medicaid is presently the only publicly funded program that will pay for long-term care, including nursing home and, in appropriate cases, home care services.
“By far, most of the clients who come to us for Medicaid planning are in crisis,” she explains. “A family member has become seriously ill, requiring nursing home care and they are panicked about paying for it.” In New York State, the monthly nursing home fee can range from $10,000 to $15,000, so timing is important when it comes to Medicaid planning. “When a client is already in a nursing home, or soon will be, we can’t protect as many of their assets as we could if they’d come to us sooner.”
Alexandra is one of several experienced Littman Krooks paralegals who handle Medicaid applications. She works closely with attorneys at the firm, who advise clients regarding available asset protection strategies.
In order to be eligible for Medicaid, an individual may have no more than $13,800 in “countable assets” (2009 level). In addition, financial activity prior to application will be closely scrutinized. Many clients question whether they are allowed to transfer assets out of their names in order to qualify for Medicaid. While Medicaid allows transfer of some assets such as transfers between spouses, and transfers to a child with disabilities, Medicaid will penalize applicants for most other “gifts” made during the 60 months prior to application.
The process is detailed and complex, which is why individuals often choose to retain an elder law firm. Alexandra’s first step is to collect the many necessary documents relating to age, citizenship, identity, marital status and, of course, finances, including living expenses for a well spouse who continues to reside in the community.
“Sometimes the well spouse is unfamiliar with the details of a couple’s finances, and I end up playing detective,” notes Alexandra. ‘In many cases, clients need quite a bit of guidance through the process, so I’m in touch with them on a regular basis and help them gather all necessary information.” She then assists the attorneys in analyzing the many months of financial statements to confirm that the applicant will be Medicaid-eligible at the appropriate time.
Alexandra is very much the client’s advocate, not only filing the necessary paperwork, but also meeting with the assigned case worker at the local Department of Social Services. Afterwards, she assists the attorneys in maintaining ongoing communication with the Department of Social Services and others involved in the case, such as social workers and nursing home admissions staff.
“Because of our longtime relationships and great familiarity with the Medicaid system, we are able, in many cases, to streamline the process,” says Alexandra. Depending on the amount of assets to be protected and the planning strategies involved– including transfers, collection of documents, and analysis of assets– the process can easily take months. While Medicaid is supposed to render a determination within 45 days from the date of submission of the application, it often takes longer, depending on the circumstances. This is one reason for families to start the planning process early. Doing so can save families a great deal of time and prevent a loved one’s life savings from being spent on nursing home care.
“Our clients are often going through a very emotional time,” says Alexandra, “and one of my roles is to be as supportive as possible. I enjoy working with the families and believe that our work makes life easier for many seniors facing a very difficult situation.”
Alexandra Doupis is a senior paralegal in the White Plains office of Littman Krooks. She has a B.S. in paralegal studies from Mercy College and has been with the firm since 2001.