Medicaid Planning

Key Takeaways:

• Medicaid planning is a type of long-term care planning that helps ensure that a person will be able to access Medicaid to help with long-term care.
• An elder law or estate planning attorney can help you set up a Medicare and/or long-term care plan. This includes the drafting of important documents that are essential in the event that you become incapacitated or require long-term care.
• Whenever possible, long-term care planning should be undertaken in advance before the need for long-term care arises. It is never too early to start planning for long-term care. However, it is also never too late to start planning for long-term care, and an elder law or estate planning attorney will work with you to meet your needs.

Medicaid planning is a type of long-term care planning that can be pursued with the help of an estate planning attorney.

There are several goals of long-term care planning.

One goal of long-term care planning is to put proper legal documents in place. These documents will help you or your family members if there ever comes a time where you need long-term care. Long-term care planning documents will facilitate decisions related to care, finances, and assets

Most people—including many people who come into my office—do not understand what goes into a long-term care plan. One of my jobs as an estate planning attorney is to sit down with clients and lay out the basics of long-term care planning, as well as the reasons why it’s important to pay attention to this sort of planning.

Failing to undertake proper long-term care planning (or undertaking incorrect long-term care planning without the supervision of an attorney) can expose a person to enormous amounts of risk. This can include risk to your assets, as well as risk that you won’t be able to access the level and quality of care that you need.

Common Questions And Concerns About Long-Term Care Planning

When I sit down with clients, I explain that there are two major categories of long-term care planning.

This starts with a question. Specifically: are we planning for the future, or is this an in-crisis, emergency situation?

For those who are planning for the future, there is a specific set of questions and concerns that I get most frequently. These include questions such as:

• How do I protect my assets?
• If I need long-term care outside of the home, what are my options in care?
• How much do these long-term care options cost?
• How are we going to pay for these long-term care options?
• What type of estate planning can we do now to preserve and protect our assets and ensure our access to long-term care?

For those who are facing an emergency, active crisis scenario—i.e., a massive injury or a sudden onset of disease has immediately necessitated long-term care—there is a different set of questions and concerns.

Usually, people facing this sort of crisis planning will have estimates from medical authorities about what level of care their loved one will need. They are primarily concerned with what can be done in the immediate, and especially with how they are going to pay for everything.

It is essential to remember that it’s never too early to do long-term care planning. Life is fluid. We are at different points in life at any given time, so the discussions an individual or couple has about long-term care looks different at any given time.

However, I am always having this conversation with my clients, no matter where they are in life. I consider it my duty to at least ensure that my clients have a baseline of long-term care.

As clients age, we might have more detailed conversations in addition to the baseline planning for long-term care. We might consider financial tools that are made to be used by people later in life, rather than earlier. For example, there’s a certain type of trust that can be implemented for asset protection that can only be utilized on a certain timeline. In general, when it comes to this sort of planning, and especially when it comes to planning for Medicaid, there are always timelines involved

It is also essential for me to communicate to my clients and their families that I can help them and be of service to them whether the issue is planning for the future or dealing with an immediate crisis.

When families run into an emergency situation where their loved one goes into the hospital or into a rehab facility after the hospital, there are very important decisions that have to be made.

A conversation with an elder law or estate planning attorney about these matters can make a tremendous difference in the level of care their family member might be able to access, as well as the amount of assets that the individual and their family can protect. It can also provide peace of mind to the family, who will know that there is a professional advocating on their behalf.

So, in addition to it never being too early to do this sort of planning, it is also never too late. If you are ever facing an emergency that necessitates long-term care for a loved one, you should absolutely consult with an elder law or estate planning attorney.

Wagner Law is here to help and to take care of individuals and families who find themselves facing such issues.

Planning Documents

There are a number of documents involved in this sort of estate planning and long-term care planning. These documents are sometimes referred to as the Court Planning Documents. They include:

• A Healthcare Power Of Attorney. This document allows another individual to make medical and healthcare-related decisions on your behalf if you are unable to make them yourself.
• General And/Or Financial Power Of Attorney. This document extends the powers of a healthcare power of attorney, such that an individual can make financial decisions as well as day-to-day decisions for you should you not be able to.
• Specific Trusts. There are certain trusts that can be included in this group of documents where we address specific elder law or issues that can arise when there’s a disability with respect to a trust-maker or a beneficiary.
• Living Will Or Healthcare Advanced Directive. This document can be drafted to express your wishes with regard to your care should you be on artificial life support and should a professional determine that you’re only being kept alive by that artificial life support. You can use the document to make a declaration that you do or do not wish to be kept alive in that condition.
• HIPAA Release Document: This is a form that can be prepared to grant specific individuals access to your healthcare information.

How Much Does Long Term Care And Nursing Home Care Cost?

The cost of long-term care and nursing home care depends on the individual’s circumstances and needs.

There are a few state-wide average numbers that are often used to price care in the State of Michigan. According to these numbers, the cost of skilled nursing care is $250 a day.

I should mention, however, that the actual cost in an individual case can—and often will—be much higher than that.

For those paying nursing home costs privately in Michigan, the average monthly cost of care is around $9,000. It is not uncommon, though, for that number to be much higher, sometimes reaching as high as $12,000 or $14,000 a month on average.

Care facilities tend to be far more expensive than the average person knows or anticipates. As a result, I often see clients experiencing sticker shock when they’re told how much it is going to cost to privately pay for a care facility in Michigan.

Qualifying For Medicaid In Michigan

The process of qualifying for Medicaid in Michigan has several components.

Firstly, there is a medical component to qualifying. In order to qualify for Medicaid, a patient must meet a certain level of care requirement or need.

Secondly (and perhaps more importantly), there’s a financial aspect to qualifying for Medicaid. Medicaid is a need-based government program, and you can only qualify if you have a certain amount of income/assets or less. When processing your application, Medicaid officials will take a look at your countable assets to make sure that you do not exceed the financial threshold.

Those who plan on getting qualified for Medicaid to deal with their long-term care often exceed the asset cap. This is an area where I have seen individuals make very costly mistakes, almost all of which are rooted in trying to do Medicaid planning on their own, without the help of an expert (such as an elder law attorney).

Medicaid planning is an area where an elder law attorney can absolutely provide unique value and peace of mind for the individual and their family. They can help lay out something called a Medicaid spend-down strategy. This will help the individual meet Medicaid’s very specific financial requirements by strategically spending down or giving away assets.

There are many complex situations and questions that arise when it comes to qualifying for Medicaid.

One scenario that I see often has to do with married couples. If there is a married couple and only one of the two needs to go into a nursing home, does that mean that the other spouse also has to spend down or give away all of their assets?

In situations like the one mentioned above, both spouses are usually subject to what is called a “community spouse resource allowance.” Part of what I do as an attorney who helps with Medicaid planning is to ensure that we provide for the spouse who will not be entering a nursing home, retaining as many of the couple’s shared assets as we can.

Of course, it bears repeating that there are many requirements when it comes to Medicaid and long-term care, and we want to make sure that we’re doing this type of planning in a lawful manner and not exposing the individual or family to an assessed penalty from Medicaid.

My law firm offers a full suite of Medicaid services. Not only will we strategize with you to create a Medicaid spend-down plan, but we will also handle your Medicaid application as well, including any retroactive applications that need to be completed.

If an individual is in a nursing home currently and they have not applied for Medicaid, oftentimes it’s still beneficial to contact my office and see if there’s anything that can be done. Depending on what kind of estate plan the individual has in place, there might be opportunities to protect more assets before we apply for Medicaid.

It is also helpful to consult us before applying to Medicaid because it is necessary to understand what happens once you are accepted into the Medicaid program. Specifically, individuals and their families need to be aware of the State Recovery programs, and other programs that affect Medicaid beneficiaries in Michigan.

General Information:

• Medicaid Planning: Balancing Benefits And Inheritance Possibilities
• What Mistakes Do You See People Make When Trying To Do This Type Of Planning On Their Own?
• Understanding The Differences Between Medicaid And Medicare

For more information on Medicaid Planning in Michigan, a complimentary consultation is your next best step. Get the information and legal answers you are seeking by calling (248) 800-2548 today.