Frequently Asked Questions

There are different types of professionals that can provide assistance to families needing to qualify for Medicaid benefits to pay for long-term care. Two of the most common are Elder Law Attorneys and Certified Medicaid Planners.

Elder Law Attorneys are lawyers that specialize in legal issues affecting the elderly.  An Elder Law Attorney focuses on all aspects of planning, including long-term care planning, Medicaid planning, asset protection planning, estate planning, and planning for incapacity.  Elder Law Attorneys can help clients qualify and apply for Medicaid and cope with any issue that arises during the process. Elder Law Attorneys are very knowledgeable about the Medicaid eligibility laws. They are also empowered to establish any necessary legal documents (such as wills, trusts, powers of attorney, and deeds) on behalf of their clients.

Certified Medicaid Planners on the other hand are singularly focused on Medicaid related issues. This includes Medicaid eligibility rules, strategic planning to qualify for Medicaid if over the income or asset limits, and appealing a Medicaid denial. Certified Medicaid Planners are extremely capable and accurate when it comes to Medicaid planning, qualifying, and applying and benefits. They have demonstrated their knowledge and skill during the certification process and they put it to use on a daily basis working with clients.

Not all Elder Law Attorneys are Certified Medicaid Planners and not all Certified Medicaid Planners are Elder Law Attorneys.  What makes our firm different is that Attorney G. Thomas Rodfong is both an Elder Law Attorney and Certified Medicaid Planner.  This makes Rodfong Elder Law a complete solution for long-term care and Medicaid planning.

No, it’s never too late to protect your assets even if your loved one is already in a nursing home.  Someone may have told you that it’s too late to do anything because there is a five-year lookback period.  They “assume” that there is nothing that you can do.  Often the people giving bad Medicaid advice include well-meaning lawyers, accountants, financial advisors, and even nursing home staff.  But the truth is it’s never too late to take planning steps to protect your assets.  It’s only too late if you have no assets or money left, so the sooner you get started the more you can protect.

Yes.  Your primary residence is considered an “exempt” asset as long as you reside there and the entire value is excluded in determining your spouse’s eligibility for Medicaid.  However, certain planning strategies are still recommended in order to protect the home from a Medicaid estate recovery lien after the death of your spouse.

The application process is very complex and time consuming, and securing an approval from Medicaid can sometimes take months, though benefits will be available retroactively to the first day of the month in which the application was filed.  Timing is crucial in accessing Medicaid benefits.  For example, an application submitted on March 31^st will be eligible for one more month of benefits than an application filed on April 1^st.  Additionally, should Medicaid deny your application or ask for additional information, timely and appropriate responses to Medicaid are also crucial.

Yes.  The Medicaid rules for gifts are much stricter than the IRS rules.  A gift of assets within 5 years of applying for Medicaid benefits will result in a Medicaid penalty.  The penalty is a period of time that you will be ineligible for Medicaid benefits.  The length of the penalty varies depending on the amount of the gift.  Penalty periods can last for months, or even years.  If you have made a gift that is not allowable under the Medicaid rules, a Medicaid planning professional can help you minimize or avoid penalty periods.  Likewise, you should never attempt to give assets away without first obtaining professional advice from a qualified Medicaid planning expert, such as an elder law attorney.   

No.  Assets in a revocable living trust are considered “countable” assets under the Medicaid rules.  Therefore, they are available to a nursing home and thus not protected.

No.  Medicaid treats any financial account with your name on it as 100% yours unless you can prove that the joint owner actually contributed money to the joint account.

Many people apply for Medicaid without professional help.  But beware, this is a complicated field that most people deal with only once in their lives.  Tens of thousands of dollars are at stake.  The Medicaid rules are nearly impossible for the layperson to understand.  The Medicaid agency will not tell you how to protect your assets.  Our firm offers specialized knowledge, skill, and experience to help you follow all the proper application rules and procedures, and handle all of the necessary legal correspondence with the Medicaid office.  More importantly, we offer a range of options and strategies for protecting your assets.  We will see your case through to its conclusion and work hard to produce a positive outcome for you and your family.

This is a big mistake.  The timing of the Medicaid application is critical.  It may be hard to believe, but allowing a nursing home social worker to help you fill out a “simple” Medicaid application can cause you to lose thousands of dollars, and create a Medicaid penalty because you applied too early.  The Medicaid rules are extremely complicated and are constantly changing.  Only a qualified elder law attorney can determine when you should apply for Medicaid.  There is too much at risk and you simply can’t afford to make mistakes.

We have seen countless examples of incomplete or improper advice leading to significant lost planning opportunities for our clients, no matter how well-intentioned the advice giver may be.  Rectifying the situation may cost more in legal fees than would have been the case with a proper plan.  It is also important to remember that the nursing home and the resident’s family often have conflicting interests since their “private-pay” rates are much higher than the Medicaid reimbursement rates.  In other words, every month that a resident pays privately rather than receives Medicaid coverage is additional money going to the nursing home and less money preserved for the family.

No, this is a common misconception.  Medicare does not pay for “long-term” nursing home care.  Part of the reason for the confusion is that Medicare does pay for “short-term” rehabilitation if a senior has been admitted to a hospital for at least three consecutive days and then is admitted to a Skilled Nursing Facility for rehabilitation.  In that event, Medicare will cover part of the cost for the rehabilitation up to a maximum of 100 days.

Yes.  We will meet with you in person or via telephone to discuss your personal situation and how we might be able to help you.  At that meeting, we will fully explain our unique planning process and our fees.  If you choose not to hire us, then you will owe us nothing.

The cost of Medicaid planning varies depending on many factors, including the amount of assets at risk and the complexity of the case.  Fees are typically less than the cost of one month in a nursing home.  The hidden cost of not engaging in Medicaid planning can be much higher by comparison.  In most situations, engaging in Medicaid planning will save significantly more money for families than it will cost.  You have nothing to lose.  Since the initial consultation is free, you will only choose to invest in Medicaid planning if doing so would save your family more than it would cost.