The Role of a Medicaid Planning Attorney

Why is Medicaid Important?

The need for long-term care is common but the cost is staggering.  Seventy percent (70%) of people over age 65 will need long term care during their lifetimes. Figures on average nursing home stays vary widely. A 2019 report from HHS from 2015 to 2019 found an average stay of 485 days. The average annual cost of a nursing home room in the Cleveland Metropolitan area is $98,556. 

Medicare pays the cost of a skilled nursing facility for up to 20 days, with a co-pay of $152 per day for the next 80 days.  However, once Medicare coverage terminates at 100 days, the individual must pay out of their own pocket.  How can the average person afford to pay for nursing home or other long-term care? The answer is Medicaid.

How do I qualify for Medicaid to pay for my assisting living or nursing home?

You must meet these four eligibility requirements:

• Residency- You must be a resident of the state in which you are applying.
• Care Needs- You must meet the level of care requirements.
• Income- An applicant cannot have more than $2,829 in income a month as of January 2024. If the applicant’s income is greater than the income limit, he can utilize a Qualified Income Trust (QIT) to qualify.
• Resources- As of January 2024, a single individual cannot have more than $2,000 in countable resources. There are many exempt resources including the home he lives in, intends to return to or has a spouse living in, automobile he uses for transportation, life insurance policies with aggregate cash value less than $1,500. Different resource rules apply to married couples.

What happens if I have too much income or resources to qualify for Medicaid?

This is where the Medicaid Planning Attorney comes in. A Medicaid Planning Attorney will review all your assets and income with you and guide you through strategies to save assets for you, your spouse and/or beneficiaries, depending on your goals. It is crucial to engage an experienced Medicaid Planning attorney as just “giving away” assets can result in loss of eligibility for benefits. A Medicaid Planning Attorney can also handle the Medicaid application process for you, from start to finish. Medicaid Planning can be done prior to the five-year look-back period or at the time care is needed. However different strategies will be available depending on the timing of the planning.

What is the most important document to have in place for future Medicaid Planning?

A Financial Power of Attorney with long term care planning authority is the most important document to have in place for future Medicaid planning. Without a financial power of attorney in place with Medicaid planning authority, should you become incompetent, your loved ones would not be able to engage in Medicaid planning. Many powers of attorney do not have long term care planning authority. Hence, it is crucial that you have yours reviewed by a Medicaid Planning Attorney while you are still competent to do so, in the event it must be replaced.

The law is constantly changing.

The laws that govern Medicaid are constantly changing and so too are the appropriate planning strategies. For that reason, it is essential to have the guidance of an experienced Medicaid planning attorney before embarking on any plan.