What Can a Medicaid Planning Advisor Do For Me?

Dec 17, 2021 | Uncategorized

As more Americans reach retirement age, they will be faced with higher costs of healthcare and long-term care. And, sadly, a significant number of seniors will require long-term nursing care at some point in their lives.

Today, the average monthly cost for nursing home care in the United States is about $8,200 and this can quickly deplete any savings the senior has accumulated within no time. Faced with higher costs of nursing home care, many seniors now rely on Medicare for long-term care assistance.

Medicare, however, only offers very limited long-term care, and most seniors have no choice but to try to purchase long-term care insurance (which is very expensive on its own, especially the older a person gets) or try to qualify for Medicaid coverage. A Medicaid planning advisor is well-versed in what is needed to qualify for Medicaid coverage and can answer any questions you have.


Medicaid Application

Becoming eligible for Medicaid assistance is neither easy nor straightforward. There are no universal established rules to determine who is eligible and who is not as many factors vary from case to case. Each applicant is individually assessed to determine his or her needs and financial status.

Even though Medicaid has very stringent rules for qualification, it does provide good long-term services coverage; unfortunately, many seniors do not qualify primarily because they have more assets than the Medicaid asset and income cap allow. A Medicaid planning advisor can help you in understanding the qualifying processes.

Medicaid looks at many factors for eligibility and many seniors have no idea if they are eligible or not for assistance. Some seniors may have slightly more assets than the Medicaid cap, so how should they proceed? This is where seniors can benefit greatly from Medicaid planning services. Today, there are estate lawyers who can assist seniors with Medicaid planning services and first determine if they are eligible; second, provide legal assistance; and, third, assist with the Medicaid application.

What Exactly are Medicaid Planning Services?

For Americans turning 65 today, there is a greater than 70 percent probability that they will need some type of long-term care or support within 10-15 years. Of those needing long-term care, women generally need longer care than men. Overall, at least 20 percent of seniors will need long-term care for more than 5 years. And, for each year of long-term care, the costs range anywhere from $90-$140K, which means that most of any savings will be quickly depleted.

Therefore, many seniors will need assistance to pay for long-term care out of pocket or apply for Medicaid long-term care assistance. In order to apply to Medicaid, you need to know several things, including the eligibility requirements, what are countable assets, the income cap rule, an explanation of the 5-year look-back period, and many other details. The application process is complex with little room for error.

If Medicaid believes that you have transferred your assets to your family or friends just to become eligible, you can even be charged with fraud. Due to the fact that the application process is quite complex, it is important to seek assistance from an estate lawyer or a Medicaid planning advisor.

What Does a Medicaid Planner Do?

The most basic services that a Medicaid planning advisor or lawyer will provide include the following:

  1. Educate you on Medicaid planning services, what it involves, why it is necessary, and how you can benefit.
  2. Educate you on your legal rights.
  3. Explain the different types of Medicaid benefits that are available to seniors.
  4. Determine your eligibility for Medicaid, which requires meeting the income and asset cap limits.
  5. Assist you with the Medicaid application.
  6. Help collect all the necessary documentation that is required, including your income, tax slips, paycheck stubs, birth certificate, proof of U.S. citizenship, and all your other income and investments.
  7. Go over the completed application to ensure that everything is correct before submission. Medicaid considers any omissions or missed documentation a potential indicator of fraud.
  8. If you are not deemed to be eligible for Medicaid because of your assets or high income, the lawyer will suggest ways to restructure your assets so that you have a better chance of qualifying in the future.
  9. Provide you with suggestions so that you can protect your home, car, and other assets legally and yet ensure Medicaid eligibility.
  10. Discuss other options for qualifying for Medicaid long-term care assistance, which includes divorce, spend down method, and spousal refusal.

Medicaid Penalties

A reputable Medicaid planner will educate you on the Medicaid penalties. Some seniors will apply for Medicaid long-term care on their own and, unfortunately, may restructure their finances and assets to make it look like they have limited income before they learned about the “5-year look back” period.

Others may spend the extra money they have to build a swimming pool, buy an RV for travel, or build a bigger home; however, these are not acceptable expenses, according to the Medicaid rules. But seniors should be aware that Medicaid does perform a 5-year look back and does not permit individuals with significant assets to simply transfer their money, spend it on anything, or give it away to other family members, just to qualify for Medicaid.

If Medicaid discovers that restructuring of finances has taken place, the senior is usually barred from Medicaid services for a specified amount of time and may even face a monetary penalty. During Medicaid planning, attempts to defraud the system should never occur, and, therefore, it is important to work with a Medicaid planner who knows the rules and regulations on restructuring finances.

How Long Does Medicaid Planning Take?

The process of planning for Medicaid can take a few weeks to several months because there is an exhaustive list of documents required. The Medicaid planning advisor will discuss the pros and cons of ways to restructure the assets and recommend the best legal strategy for you.


Medicaid planning services are an endeavor to protect the senior’s assets, while also trying to enable the senior to become eligible for long-term nursing care. The key is to start the process early because Medicaid does have a 5-year look-back period.

Because the application process is complex, it is vital to seek assistance from an experienced estate lawyer with experience in dealing with Medicaid applications. An experienced Medicaid planner can not only simplify the application process and prevent unnecessary penalties but help the senior save a significant amount of money on long-term nursing care.

The cost of Medicaid planning services is usually no more than a month’s fee for long-term nursing care but, in some cases, it may be more depending on the size of the estate. Call Elder Law today at 1-561-588-7512 to learn more. The first consultation is FREE.

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