When do I Need a Medicaid Planning Lawyer?

Jan 11, 2022 | Medicaid Planning Legal Blogs | Elder Law P.A


There are about 54 million seniors in the United States and, of these, a significant number of them will need long-term care either at home or in a nursing home. Data indicate that at the current rate, nearly 70 percent of seniors over the age of 65 will need some type of long-term care. Women will need care for about 3.7 years and men for 2.3 years. Only one-third of seniors will not need any type of long-term care. Another fact is that long-term care is not cheap in the United States. On average, a senior who needs long-term care will need about $8,000 a month, and the costs only go up each year. At this rate, long-term care can quickly deplete much of the savings that a senior has accumulated. Consulting with a Medicaid attorney, or a Medicaid planning lawyer Florida makes good sense.

Paying for Long Term Care

For seniors who need long term care, they have a few choices when it comes to paying for the services:

  • For seniors who can afford it, they can pay out of pocket.
  • Some seniors do have long-term care insurance, but unfortunately, less than 7 percent of seniors carry this type of policy.
  • The third option is to apply for Medicaid long-term care assistance.

What is Medicaid?

Medicaid is a federal program that provides health insurance coverage to low-income families and individuals in the US. The program is jointly funded by individual states and the federal government. In general, Medicaid is only for families/individuals living on a low income. In addition, eligible seniors can apply for it to cover long-term care in nursing homes. In the majority of cases, Medicaid will cover 100 percent of the costs of long-term nursing care, which includes meals, room, and medical supplies, as well as all doctor and hospital visits.

The Problem

Medicaid, like all federal agencies, can also be very bureaucratic, and the application for long-term nursing care is complex. The agency requires an enormous amount of documentation to ensure that you are eligible for funding.

To qualify for long-term care Medicaid, the applicant has to meet many requirements, but the key features include the following:

  • Be a resident of the state where one is applying for Medicaid funding
  • Be 65 years or older
  • Be an American citizen
  • Have countable assets and a monthly income below a specified level

The entire process from application to approval can take months and, in most cases, many applicants are initially rejected and have to reapply. Applying for Medicaid long-term care is not an overnight process but requires considerable paperwork and documentation to back up your financial status. Medicaid has very rigid income and asset requirements for eligibility. More importantly, even after the application is filed, Medicaid will look back at all your finances over the past five years to ensure that you have not given money away to friends or family just to become eligible for the funding. The major mistake that many seniors make is to apply for Medicaid later rather than sooner. Because the application process is onerous and prolonged, they may have a delay in getting the help they need while waiting for an answer from Medicaid. The acceptance or denial of a Medicaid application can take anywhere from 4-9 months and rejections are very common. A Medicaid attorney is highly recommended to help seniors be proactive and apply as early as possible.

Should One Consult a Medicaid attorney?

There is no absolute rule that one has to use the services of a Medicaid attorney when applying for Medicaid long-term care assistance. For example, if you have no assets and a limited income, then you can apply online at the CARES website on your own. Online staff can assist you if you have any questions or problems. However, if you have significant assets and an income above the cap set by Medicaid, then you will not be eligible for Medicaid long-term care funding. In these scenarios, a Medicaid attorney can help restructure your assets so that they agree with the requirements. This can improve your chances of qualifying for Medicaid long-term care. The restructuring process of your assets is also a complex procedure and has to be done carefully and legally. Some options for restructuring your assets can include creating a trust, filing for a divorce, spousal refusal, etc. A Medicaid planning lawyer in Florida should have solid knowledge and experience when it comes to restructuring assets to comply with Medicaid requirements, and they can help you save money. If you were to pay out-of-pocket for long-term care today, it would cost you at least $8,000 a month, and within 12 months a significant portion of your life savings (if you had that much to begin with) would be gone. By working with a Medicaid attorney, he or she can help preserve much of your assets, which you will be able to pass down to your children.

Finally, by working with a Medicaid planning lawyer Florida, you will have a chance to learn all the options available to you should you need long-term care. In some cases, the lawyer may advise you that there is not much that can be done, and you will just have to pay out-of-pocket for long-term care. In other instances, however, a Medicaid attorney may be able to assist you with financial planning. By consulting with a Medicaid planning lawyer Florida, you will realize that you have done your best and remain content with whatever decision you make for your long-term care.

It is important to remember that Medicaid does not only assist the poorest of the poor; the agency makes every effort to ensure that the applicant has preserved some of the assets for his/her spouse and children, especially those with special needs. Not every asset is countable, but you need to work with a knowledgeable attorney to determine how best to preserve some of your assets.

When Should I Plan for Medicaid Assistance?

The fact is, nearly two-thirds of seniors will require long-term care at some point in their lives. But when this will occur is impossible to predict. Early planning can save you tremendous anxiety. An experienced estate lawyer can guide you through the estate planning process. Remember, Medicaid does have a five-year “look-back” period to ensure that you have not transferred your assets just to qualify; therefore, it is vitally important to begin estate planning early.

If you are a senior past the age of 65, always consider the possibility that one day you may need long-term care. The best way to prepare for the future is to consult with an estate planning lawyer who can first determine your eligibility and then suggest ways to diversify your assets so that you can become eligible for Medicaid long-term care assistance. Contact Elder Law, P.A. today at 1-561-588-7512 to start planning for your future.

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