BAD ADVICE CAN MAKE YOU SICK

“But why would I keep my mother’s health insurance if she’s on Medicaid?” asks the woman who’s come to consult with me today. “Won’t Medicaid pay for her health care? My neighbor told me that when her mother began receiving Medicaid benefits, she discontinued her mother’s health insurance.”

Ah, the neighbor. Or the friend, cousin, guy-you-met-on-the-street. They’re all the same, no matter what the person’s relationship. They are all people who have an opinion on an issue in which they firmly believe, yet are almost invariably incorrect.

Like many fields, practicing law is a job that many people believe they can do for themselves. They seek advice from the people around them, then adopt those beliefs for themselves. They then become defensive about the positions they’ve adopted and the longer they hold those beliefs and the more they change their position in reliance on those beliefs, the more entrenched those beliefs become.

For instance, Medicaid is a health insurance program. It is a health insurance program for needy individuals. Once a person qualifies for Medicaid, Medicaid will pay for the person’s long-term care needs (such as a nursing home or assisted living residence) and for their general health needs (prescription drugs, hospital coverage, doctors’ bills); however, not all health care providers accept Medicaid. For instance, some doctors do not accept Medicaid.

When a person resides in a nursing home and is the recipient of Medicaid benefits, the person’s family often believes that they should discontinue any private health insurance benefits the person receives, such as Medigap policies of insurance. After all, since Medicaid is paying for the person’s care in the nursing home, what is the benefit of maintaining private health insurance?

The truth of the matter is, people who reside in nursing homes quite frequently go to the hospital for a variety of exacerbated health concerns and may need to either visit a doctor or have the doctor visit her in the nursing home. When these health issues arise, Medicaid may not pay for the care that is provided, depending on whether or not the health-care provider accepts Medicaid.

The Medicaid office will often encourage a family to maintain any health insurance that the person has. In fact, Medicaid will allow the family to deduct the amount of the health insurance premium from the Medicaid recipient’s income. When a person qualifies for Medicaid, all of her monthly income is paid to the nursing home, except for a $35 monthly personal needs allowance that the recipient can retain.

When the family agrees to continue the recipient’s private health insurance, Medicaid will allow the family to deduct the amount of the health insurance premium from the recipient’s income, in addition to the $35 personal needs allowance. In other words, maintaining the private health insurance costs nothings. So, to me, the real question is, why wouldn’t you maintain the private health insurance, even if there were only the slightest possibility of the insurance benefiting the person?

Often, the answer to this question is that the neighbor (or friend or cousin) told them that they shouldn’t maintain the health insurance. And, we all know that neighbors, friends, and cousins know best.

There are a number of examples that I could provide of neighborly advice hindering a person’s course of action. I guess there are worse circumstances than someone getting legal advice from their friend or neighbor; for instance, getting health advice would certainly be worse.

I have found that in life, you get what you pay for. The neighbor’s or friend’s advice is worth as much as you paid for it. (That’s nothing, folks.) In fact, that neighborly advice could cost you dearly because it could cause you to take a course of action that is adverse to your best interests.