Careful Medicaid Planning May Be Essential To Affording Long-Term Care
The average cost of skilled nursing care in Florida is over $100,000 annually, and assisted living care is nearly $40,000 a year. Unless significant private funds or a comprehensive long-term care insurance policy are available, these costs are more than most seniors can afford without quickly depleting their resources. Medicaid is often the only source of funds available to pay for the care expenses of many seniors. Like most government programs, however, Medicaid has strict eligibility requirements: no more than $2,000 in countable assets for an individual and similarly strict limits on monthly income.
At Feldman & Feldman, Counsellors at Law, P.A., we believe that no one should be pauperized just to meet their basic living expenses and health care needs. Our experienced elder law attorneys can help your family navigate the maze of Medicaid regulations and qualify your or a loved one for benefits while protecting assets, both to supplement care needs and to provide a legacy for future generations.
Table Of Contents
How Medicaid Planning Works: An Overview
Preparing For Your Medicaid Planning Consultation
What Will Be Addressed During Your Consultation
What Will Not Be Addressed During Your Consultation
Answers To Common Questions About Medicaid Planning
How much does Medicaid planning cost?
Can all of my assets be protected?
What are Medicaid planning companies, and are they legitimate?
What is the difference between Medicare and Medicaid?
Don’t Act On Medicaid Myths – Talk To An Attorney Instead
Learn About Your Options By Speaking To An Experienced Medicaid Planning Lawyer
How Medicaid Planning Works: An Overview
There are two types of Medicaid planning: long-term care planning and crisis planning. Long-term care planning is appropriate when there is no immediate need for Medicaid benefits. A plan may then be implemented that both protects assets and qualifies the senior for benefits in the future when needed. Crisis planning is required when benefits must be obtained immediately, such as when a senior faces imminent placement in an assisted living facility (ALF) or skilled nursing facility. The seniors are faced with paying for such care out-of-pocket unless they are qualified for Medicaid.
There are four steps to Medicaid planning:
1. An initial consultation to assess the client’s needs, inform the client about available public benefit programs, discuss the planning process in greater detail, and answer the client’s questions about available benefits or planning.
2. Preparing a written asset protection plan which provides the client with their options to qualify for Medicaid while protecting as much of their remaining assets as possible. An experienced elder law attorney will fully inform the client about each option so that an informed decision may be made about which qualification strategy to pursue.
3. Implementing the planning option(s) selected by the client. This may require the elder law attorney to prepare trusts, powers of attorney, deeds and other legal instruments; or it may require overseeing the proper implementation of gift transfers, loan arrangements or other strategies. Every client’s situation is unique, and there is no “one size fits all” solution.
4. Overseeing submission of a Medicaid application at the appropriate time. An experienced elder law attorney will coordinate their efforts with the client’s treating physician, the care facility, and other professionals (such as geriatric care managers, accountants and financial planners) to see that the application process runs smoothly and benefits may be approved as quickly as possible.
While each client’s plan is unique, Medicaid planning often involves the creation of one or more trusts, including qualified income trusts or QITs.
Preparing For Your Medicaid Planning Consultation
You may feel more at ease about Medicaid planning after a consultation with Feldman & Feldman, Counsellors at Law, P.A.. We will do our best to assist you and your family through this often difficult process. What follows is a summary of what you can expect during your consultation with one of our elder law attorneys.
What Will Be Addressed During Your Consultation
- We will review the medical and financial requirements to qualify for Medicaid.
- We will review the HCBS/ALF Waiver waitlist process (if applicable).
- We will review the Medicaid application and fair hearing process.
- If the Medicaid applicant is not capable of retaining our firm directly, we will determine whether anyone else has the legal authority to retain us on their behalf.
- We may provide a cursory review of any documentation provided, if it is deemed helpful to the attorney during the consultation.
- We will outline the steps involved in Medicaid planning (e.g., providing a written plan, implementing the plan and submitting the application).
- We will provide our Medicaid planning questionnaire so that we may obtain the relevant information to produce a Medicaid plan.
- We will quote an initial retainer fee for step one of our planning efforts and provide an estimate of the total required fee based upon the Medicaid applicant’s circumstances (e.g., long-term care planning, crisis planning).
What Will Not Be Addressed During Your Consultation
- We will not provide specific planning recommendations that may qualify the applicant for Medicaid (this will be provided in our written Medicaid plan).
- We will not provide an in-depth review or analysis of any documentation provided prior to or during the consultation. This review and analysis will be performed after we have been retained to provide Medicaid planning services.
- We will not provide “piecemeal services” – our Medicaid planning services require that our office handle all aspects of the planning and application process, including the initial analysis of the client’s situation, implementing the Medicaid planning options selected by the client, and submitting the Medicaid application.
- We will not provide medical or health care services. Our clients should consult with their primary care physician or a care manager to determine the extent of their care needs.
- We will not provide assistance with placement or transitioning to an assisted living facility or skilled nursing home. Our clients should consult with a care manager to assist with placement and the transition process to an appropriate community.
You can schedule your consultation by calling our Coral Springs office at 954-228-6074.
Answers To Common Questions About Medicaid Planning
While we would be happy to answer any questions you may have during your initial consultation, we’ve also provided answers to some of the most frequent questions we receive from prospective clients.
How much does Medicaid planning cost?
Our Medicaid planning services are typically provided on a flat-fee basis so that clients need not worry about “extra” hourly billing or “surprise” fees. The fees charged are based upon a set fee schedule and are not based on the extent of the client’s assets. The initial Medicaid planning consultation is also billed on a flat fee basis, the cost of which is then credited toward the cost of our remaining planning services.
Can all of my assets be protected?
No attorney is ethically permitted to promise a guaranteed outcome. An experienced elder law attorney will be straightforward with the client about which assets it is possible to protect and which assets may be required to be spent down on care prior to Medicaid eligibility. The elder law attorney will provide the client with the available options and it is then up to the individual client to select the options they are most comfortable with pursuing. Beware those who promise “guaranteed” or “quick and easy” solutions to protect 100% of assets and qualify for Medicaid.
What are Medicaid planning companies, and are they legitimate?
Recently, nonattorney “Medicaid planning” companies have sprung up offering to qualify their clients for Medicaid quickly, easily and cheaply. These planners are often social workers, financial planners or insurance salespeople who charge fees far less than those charged by the average elder law attorney (sometimes working entirely on the commission generated by the insurance products they sell). However, these planners often lack the experience and knowledge to provide appropriate planning services. These planners are prohibited from engaging in legal work and often partner with less-than-scrupulous attorneys who may never even meet with the “client.” Our office is often required to fix the mistakes of these “planners” who have cost their unwitting clients thousands of dollars. Individuals who wish to engage in Medicaid planning are urged to retain an experienced elder law attorney and avoid “too good to be true” offers from these planning companies.
What is the difference between Medicare and Medicaid?
While they can offer overlapping benefits and are often confused with one another, Medicare and Medicaid are very different programs with differing eligibility requirements (although it is possible to be eligible for both).
Medicare is a government insurance program, eligibility for which is based upon your work history. Benefits are generally paid to those 65 years of age or older or to the disabled. Medicare insurance premiums are deducted from your Social Security payment each month. Benefits include doctor visits, hospital stays, the cost of prescription drugs, rehabilitation care and hospice care. Contrary to popular belief, Medicare will not pay for long-term care in an assisted living or skilled nursing facility. Medicare benefits are paid 100% by the federal government.
Medicaid is a public assistance program which provides benefits to the very poor. These benefits include medical services, the cost of prescription drugs, as well as custodial care in a nursing home or ALF. Additional benefits are also available to Medicaid recipients, which vary from state-to-state. Medicaid eligibility has strict asset and income requirements, which also vary from state-to-state. Medicaid benefits are a shared expense of the federal government and individual states.
Don’t Act On Medicaid Myths – Talk To An Attorney Instead
When it comes to large and complex programs like Medicaid, there is always a lot of misinformation, confusion and myths floating around. Here are some common Myths about Medicaid:
- You can qualify by transferring assets to your kids. In reality, Medicaid may impose a penalty for doing something like this and you’ll end up waiting longer to get coverage.
- You won’t qualify for Medicaid until you are broke. One of the main goals of Medicaid planning is to help you qualify without completely destroying your finances or depriving your heirs of an inheritance.
- You’ll lose your home on Medicaid or won’t qualify because you have a home. In most cases, your home is not counted as an asset for purposes of calculating eligibility. It also won’t be taken away.
Medicaid is complex, and even if you heard about a rule that applied in the case of a friend or neighbor, it may not apply to you. Before making any decisions about your property, contact us for case-specific advice and guidance.
Learn About Your Options By Speaking To An Experienced Coral Springs Medicaid Planning Lawyer
To discuss Medicaid planning in a consultation with one of our attorneys, call our office in Coral Springs at 954-228-6074 or fill out our online contact form. We serve clients throughout Florida.