Recovering Medicaid payments fair or unfair?😗

So what do you say?

A low-income person collects the benefits of public supported Medicaid. However, when they die the substantial asset of a home is used to recover what the state spent on their behalf, in this example, premiums paid to a Medicaid insurer.   Fair or unfair?  “Advocates say it’s unfair, but why?

Here is an interesting perspective from a WSJ article:

 Pam Cortina, 55, of Sky Val-ley, Calif., said doc­tors have sug­gested she have gall­blad­der surgery. But she is hold­ing off be­cause she is on Med­icaid and wor­ried about the gov­ernment go­ing af­ter her es­tate. “I worked very hard for this home,” said Ms. Cortina. “This takes away my choice of who I can leave it to.”

  If the government can confiscate a portion of any estate simply because a person dies, why is it unfair to recover what the public spent for Medicaid benefits when that recovery does not harm the low-income  beneficiary? If it’s mandatory to recover nursing home costs (which it is), why not other health care costs?

Catherine Jarett ran into a nasty surprise after she sent a form to Medi-Cal on behalf of her clients. An estate attorney, Jarett was hired by the sons of an elderly Vallejo woman who had died. For more than 20 years, the woman had been enrolled in Medi-Cal, as the state’s Medicaid insurance program for the poor is known.

After Jarett filed the form with Medi-Cal — a death notice as required — the state sent a bill for a hefty $76,349. Jarett was stunned. It was for the cost of health, vision and dental insurance, she said.

Anne-Louise Vernon from Campbell, Calif. enrolled in Medi-Cal, but then found out the state could use proceeds from her home to recover costs of her health care. (Photo by Pauline Bartolone/Capital Public Radio)

The bill was part of Medi-Cal’s “estate recovery program.” Under a federal law not widely known to consumers, states can seize assets of Medicaid beneficiaries after they die. “I was never aware of this wrinkle that they could recover for health insurance,” Jarett said.

Jarett’s clients did not want to speak to reporters, but Jarett said they insisted their mother had not been to the doctor in years and had even died at home. But Jarett said the charges included a breakdown by month of the state’s payments to a managed care plan as part of Medi-Cal.

While a 1993 federal law mandates that states recover assets for nursing home care, the law makes it optional that states recover for medical services — doctor visits, hospital stays and the like — for people 55 and over. Advocates say just 10 states do this optional recovery, but it isn’t clear that the other states pursue the assets as aggressively as California.

“It’s an awful system, and it needs to be changed. It absolutely needs to be changed,” said Pat McGinnis, executive director of California Advocates for Nursing Home Reform. 

via Some Face A Big Bill From Medi-Cal — After They Die | Kaiser Health News.