I take care of my 88 year old mother. Last month I attended a free lunch seminar offered by a company I'd never heard of, about Medicaid planning. It sounded like they could make arrangements so that all of mom's assets would be protected for me and my brother, and that Medicaid would pay for all of her nursing home expenses should we decide to move her to one. It sounded too good to be true. The company is not a law firm but they said they had lawyers working for them. They charge $5,000 to file all the paperwork for Mom to get qualified. Is this a fair price to pay and should I even get Mom on Medicaid?

There’s an old saying that if you take your problem to a carpenter whose only tool is a hammer, don’t be surprised if the solution requires a nail. As the caregiver for your 88-year-old mother, it’s completely understandable that you’re seeking the best options to protect her assets while also considering her healthcare needs. Unfortunately, some believe there is only one solution to the problem of paying for care. The situation becomes more complex, especially with the maze of options surrounding Medicaid and long-term care.

Understanding Medicaid

First, it’s important to grasp what Medicaid is and how it operates. Medicaid is a joint federal and state program that provides health coverage for individuals with limited income and resources. Each state has its own rules and regulations regarding eligibility and benefits, but generally speaking, it offers coverage for long-term care, including nursing homes.

To qualify for Medicaid, applicants typically must meet specific income and asset limits. These limits can significantly vary depending on the state where your mother resides. As an example, while cash resources are generally limited to a certain threshold (often around $2,000 for an individual), some assets such as a primary residence can be exempt under specific circumstances.

Asset Protection Strategies

Your letter described your mother’s situation as including several assets: approximately $250,000 in cash, an IRA worth about $500,000, and her debt-free home valued at around $300,000. Given these numbers, it’s essential to understand how they fit within Medicaid’s asset eligibility requirements.

One common strategy for asset protection involves “spending down” excess assets on qualified medical expenses, making renovations to the home for accessibility, or prepaying funeral expenses. Keep in mind, however, that all transactions need to be documented correctly, as Medicaid has a five-year look-back period. This means any asset transfers made within five years of applying for Medicaid can be scrutinized and may affect eligibility.

Evaluating the Cost of Medicaid Planning Services

Now, regarding the $5,000 fee for the Medicaid planning service you’ve encountered: while hiring professionals to navigate Medicaid’s complex rules can be beneficial, it is wise to critically evaluate the value they provide for their fees. The cost can vary depending on the services offered, the complexity of your mother’s financial situation, and whether you are in need of ongoing legal advice or just a one-time application service. 

Be cautious when dealing with non-lawyer firms promising comprehensive support. Some may present an overly simplistic view of Medicaid planning or fail to fully address your mother’s unique circumstances. In addition, each state may have its own unique Medicaid programs and eligibility requirements so whoever assists you needs to be familiar with the rules of the state your Mom resides in.  It’s crucial to ensure that any advice you receive is tailored to your mother’s specific situation and that you work with professionals who comply with all legal guidelines.

Caution with Promises and Guarantees

In your inquiry, you mentioned that the seminar representatives claimed they could ensure all of your mother’s assets would be protected and that Medicaid would cover her nursing home expenses. This proclamation should raise a red flag. While there are legal strategies to protect assets, there’s no guarantee; the complexities of individual circumstances and state laws come into play, making it impossible for anyone to promise outcomes.

It’s paramount to be leery of companies that use high-pressure tactics or offer unrealistic guarantees. Medicaid planning can be complicated, and what sounds like a straightforward solution may not pan out in the way you expect.

Steps Moving Forward

Here are some suggested steps to consider as you move forward:

  1. Research Reputable Medicaid Advisors: Look for certified elder law attorneys or organizations specializing in aging and disability resources. They often have a profound understanding of available options and can help navigate the intricacies of Medicaid eligibility. If you need to find one in your area, visit the National Academy of Elder Law Attorneys at naela.org.
  2. Consult with a Financial Advisor: A financial planner with experience in eldercare can provide valuable insights into structuring your mother’s assets to achieve her long-term health care needs while considering estate implications.
  3. Evaluate All Options: Before making any decisions, research various paths your mother can take for care. There may be other services available in your area outside of a nursing home setting.
  4. Involve Your Family: Sharing insights and gathering opinions from family members, including your brother, can provide you with a broader perspective on your mother’s needs and wishes.
  5. Be Patient and Diligent: Navigating Medicaid and long-term care planning takes time and careful consideration. It’s essential to be thorough and not rush into decisions that may have lasting implications.

In conclusion, taking care of your mother is commendable, and planning for her future care is an important step. While seeking assistance can be beneficial, ensure you approach it carefully, being aware of the complexities of America’s healthcare system and the potential pitfalls of specific advisors. Always prioritize the best outcome for your mother’s health and financial well-being.