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The Value of the Attorney in Medicaid Planning and Medicaid Applications

Should you involve an attorney for even “simple” Medicaid planning or a “simple” Medicaid application?  This depends on your situation, but it has been our experience that in most cases, the prudent answer would be “yes.”

The Medicaid program began as the government health care program for individuals who were of minimal means and needed health care coverage.  Beginning in the late 1980s, Congress expanded the program to include “safe harbors” to shelter assets and otherwise allow individuals of more moderate means to obtain long term care coverage not covered by their Medicare and other insurance.  Consequently, many people have come to rely on Medicaid for assistance in paying for care at home or in nursing homes.

Medicaid applicants seeking long term care assistance are limited to $2,000 in countable assets. It’s possible to transfer assets over this amount in order to become eligible, but individuals need to be careful in doing so because they may need the funds in the future and if they move to a nursing home or require home or community based alternatives to long term care, the transfer could make them ineligible for benefits for five years.  Methods to protect assets other than transferring them may also be available through the use of the statutory defined “safe harbors” where the applicant can shelter assets in excess of the countable resource standard.  These transactions do not result in a transfer penalty.

Professional advice is crucial in situations where the applicant intends to transfer assets or avail oneself of a “safe harbor.”  While a well-intentioned friend or family member, non-attorney professional, or even staff of the applicant’s care provider may know a lot about the program, they may not know the particular rule that applies in your case or may not know the newest changes in the law.  You do not want to miss out on significant planning opportunities because of an issue you and your advisors were unaware.

Even if the applicant has very little assets, it is still usually a good idea to consult with an elder law attorney.  The attorney can advise you on how to protect those remaining assets and accelerate Medicaid eligibility.  The attorney can also review the entire situation before you apply for benefits and identify any financial transactions that you think are fine, but could result in a denied Medicaid application.  At the very least, the price of the consultation should purchase some peace of mind.  You are also likely to learn other important legal issues to be aware regarding your loved one’s care.

When it comes to filing the Medicaid application, hiring an elder law attorney to do this for you can be valuable.  This has several advantages, including expert advice on how best to qualify for benefits as early as possible, experience in dealing with the more difficult eligibility questions that often arise, and a high level of service through a long, grueling process.  It also frees up your time to concentrate on other aspects of your loved one’s care.  Our firm strives to take the “pain” out of the application process.

Contact us today to schedule an appointment to review your eligibility for valuable Medicaid benefits.