Due to the complexity of the Medicaid application and eligibility process, it can be quite a challenge to get started on your Medicaid planning. Since these programs differ greatly between states, the body of rules, regulations and requirements that govern them change often. For this reason, numerous medicaid planning services exist to help individuals with various complications and financial circumstances that arise during the application process.

To help you better navigate this convoluted domain, we’re sharing some basic knowledge about Medicaid planning to explain why and when an individual might need these services.  

What Are Medicaid Planning Services?

Medicaid planning refers to any assistance provided to a potential Medicaid applicant in preparation for their Medicaid application. This can be as simple as assistance with the collection and preparation of documents, or as complicated as a complete restructuring of one’s financial assets. While everyone’s situation and assets are entirely different, some primary reasons why an individual would consider using Medicaid planning services include:

  • They want to ensure that their loved ones receive the care they require, which they could not otherwise afford
  • The complicated nature of the Medicaid eligibility process. Sometimes, even simple errors can result in a denial of benefits, which can be devastating to the health and happiness of the applicant, their caregivers, and family members
  • Working with a Medicaid planner can accelerate the application process and save applicants unnecessary stress and travail during a time-consuming process
  • They want to ensure that a healthy spouse will have the financial resources to continue living at home
  • Helping to preserve a family’s limited assets from Medicaid’s estate recovery program to ensure the next generation can live in a home and/or afford an education

When Does An Individual Need Medicaid Planning Assistance?

In many states, the most pertinent Medicaid eligibility factor is the value of one’s countable assets, with the limit being approximately $2,000 for a single applicant. If an individual has less than $2,000 in countable assets, Medicaid planning assistance may not be needed at all. Further, if an applicant has countable assets between $2,000 and $15,000 (or $30,000 if married), they can probably avoid using a Medicaid planning advisor, and instead look into self-planning.

Various family situations can also impact the need for a Medicaid advisor to help with your assets. These can include situations like:

  • Only One Spouse Requires Care – For couples in which just one spouse is applying for regular Medicaid, the spousal impoverishment rules do not apply. In these instances, speaking with a Medicaid planner can help to protect assets for the non-applicant spouse.
    • Both Spouses Require Care – The long term care costs for two individuals can be extremely expensive. Given the critical nature of acceptance into Medicaid, a Medicaid planner can help in these situations where there’s a lack of a healthy spouse to engage in planning.
  • Long-Term Planning – A Medicaid advisor can also be helpful for healthy families wishing to preserve some of their assets for their children and grandchildren. If a family member is not confident in their loved ones’ ability to manage the complexity of an application, it’s best to use a professional.

The Cost of Medicaid Planning Services

Those looking to get started with Medicaid planning assistance can expect to see fees ranging from $3,000-$15,000, depending on the state and other factors. This is typically related to the amount of income and assets an individual has, as well as other complicating factors like marital status, home ownership, life insurance, veteran benefits, etc. Another aspect to take into consideration is what type of service provider you’re using for your Medicaid advisor, beit an elder law attorney, eldercare financial planner, insurance agent, or other providers, as this can affect the cost.

The Medicaid Planning Process

Most Medicaid planning assistance providers will begin with a free consultation to go over your assets, health status, family situation, and other facets that will go into your application and eligibility determination. They will establish the likelihood of success, and examine all of your information to determine whether to accept you as a client, as well as generate a cost estimate.

As an elder law attorney in Florida, Walser & Herman Law Firm has been assisting Florida seniors with life and estate planning for more than 30 years, with a team of lawyers who can help you plan for your future health and life needs. Contact us today to learn more about our practices, or to schedule a consultation for your Medicaid planning needs.