What Do Medicaid Planners Do?Medicaid eligibility is very complex; the rules change frequently, differ by state, the application is time consuming and the review process lengthy. The consequences of being denied by Medicaid are severe and can negatively impact the comfort, happiness and health of an individual and their entire family.
Medicaid Planners help clients structure their financial resources and prepare documentation to ensure the best possibility of being accepted into the Medicaid program. They create the necessary transfers and trusts which convert their countable assets into exempt assets to ensure eligibility and preserve a family's resources.
Do I Really Need to Hire a Medicaid Planner?
The short answer is one does not need a Medicaid Planner; however in many situations it is prudent, cost-effective and strongly advised. The decision should be based on a family’s specific situation and should not be made ignorant of the quality of care paid for by Medicaid.
If an applicant is just over Medicaid's asset limit, one simple option they have that does not require a Medicaid Planner is to purchase a funeral trust. A funeral trust is essentially pre-paying for the funeral and all the associated expenses, but does not require the family to plan those details. The family simply allocates money towards that purpose and therefore Medicaid no longer considers that money a "countable asset". Learn more about establishing a funeral trust.
Here, we examine the question of whether to work with a Medicaid planner in four different common situations.
When One Spouse Requires Care
The cost of caring for one spouse can very quickly exceed a couple’s total resources including the value of their home. To protect the healthy spouse financially and allow him or her to remain living at home, a separation of resources is necessary and unfortunately complicated. Given the critical nature of acceptance into Medicaid, the use of a Planner is advised.
When Both Spouses Require Care
The long term care costs for two individuals can bankrupt most American families very quickly. Without one spouse able to care for the other, the financial and caregiving burdens created by a Medicaid denial and placed on the adult children are substantial. They can overwhelming when the adult children have children over their own. Given the critical nature of acceptance into Medicaid and the lack of healthy spouse to engage in planning, the use of a Medicaid Planner is recommended.
A Healthy Couple doing Long Term Planning Without An Immediate Need
For healthy families wishing to preserve some of their assets for their children and grand-children, working with a Planner is helpful but not critical. Without an immediate need for care, families are more able to do the planning themselves without professional guidance. It is worth noting that a mistake in planning can impact eligibility for as long as 5 years. If one is not confident in their family's ability to manage some complex legal and financial techniques, using a Planner is advised.
A Single Person With No Assets Or Income Regardless of Their Health
In this scenario, because of the severe financial hardship experienced by the individual, they should be able to gain acceptance into Medicaid without assistance provided there are no procedural errors. One might consider getting assistance from a social services agency with the Medicaid document preparation.
How Much Does Medicaid Planning Cost?
Engaging a professional to help with the Medicaid enrollment process can be free or cost as much as $5,000. This is a high cost for a family that is struggling to pay for care. However, as Medicaid Planners will point out, this is less than the cost of one month of nursing home care. Persons retaining a Medicaid Planner should ask if the Planner will guarantee acceptance into the Medicaid program.
How Does the Process Work?
Most Medicaid Planners start the process with a free consultation in which they will discuss the health status and financial resources of the individual who is applying or will someday apply for Medicaid. They establish the likelihood of success as well as the positive impact they can have on preserving a client’s assets. They use this information to determine whether or not to accept the prospective client.
Once engaged with a client, several weeks are typically required for the collection of information and formal analysis of the family’s assets. A plan is built, discussed, modified as needed and then put into action. In some cases, this includes an immediate application for Medicaid and in others the application may be delayed for a period of time.
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The American Council on Aging provides a free service to help individuals find their best local option for Medicaid planning assistance. |
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