Is it worth it to pay a lawyer to help file for Medicaid?

Unless the situation is very straight-forward, it is worth it.

My mother had no assets, was renting, didn't own a car or much of anything else. Her only income was SS. She first needed in-home care and then eventually a nursing home. One daughter was able to complete the application, no sweat.

When it comes to a situation where there are assets to spend down and/or preserve, where there is a community spouse, where the monthly income is over the limit, where there is a disabled adult child, if assets are owned jointly with other people, if there is a reverse mortgage, if there has been significant gifting in the last 5 years, is there is anything at all not perfectly routine, then, yes, paying a lawyer is worthwhile.

Yes a trust is an awesome solution. It creates financial options for her that will save her money in the long run. It will also allow you to have money available to improve her quality of life. You should definitely hire the attorney. As an only child having a professional trustee will offer you a lot of resources.

What I would recommend you doing is going to your local human services and make an appointment with your case worker who has been assigned to your case. If you don't have one, I'm sure they'll probably assign you one. You can also ask at the window if someone can help you fill out your medicaid form. Just explain that it's hard to understand the forms and they'll arrange for you to sit down with someone who can help you with the form.

You can also speak with someone who already has Medicaid and see how they or someone they know can help you.

How do you find one that is qualified in this area? Local bar association?

I'll just add one thing to the excellent previous answers. The situation with my late husband and I was similar to your mother's, and he was approved for Medicaid to pay for his nursing home, despite the fact that my income was higher than his. However, the contract the nursing home made me sign before admitting him said I was personally liable for all his expenses. If you can afford a lawyer, you will spare yourself the anxiety I lived with for two months before he was approved.

During a hospital stay, a social worker completed the paperwork and my dad was approved for Medicaid. However, To jeannegibbs point, he is married, had a couple of assets which cause him to have a significant monthly spend down which almost makes having Medicaid useless. My mom also had to write a spousal refusal letter so she cannot get Medicaid and now she needs it. If you can manage a lawyer, I'd say it's worth it. There may also be non-profit legal help in your area, a quick google search can help you find that answer. Good luck.

A very experienced elder law attorney will be a certified elder law attorney and have CELA after their name.

Absolutely! Best $3500 I had ever spent! The complexities of the process, coupled with the conflicting information--that is, if you can get any information to begin with--is not something to tackle unless you do not work full-time, are not faint of heart, and if you have a legal degree. Run to your nearest attorney, but one who specializes in Medicaid.

First question: Is mom married? That has a bearing...

Also: "Half the money" is a vague term...Depends upon how much is half.
There is a top limit, although it is generous as I see it.

By all means get a qualified and WELL RECOMMENDED elder care atty, especially if mom has substantial financial means..

It is also a good idea to pay a fact-finding visit to your county social services department..You can speak to them without applying for Medicaid at the time of the visit...

Tip: Go to your social services office about a half hour before they open on a Wed morning. Be close to first in line...(Don't ask why I say this.)

Grace + Peace,

Bob

In the experience of the folks who attend the Alzheimer's Association sponsored support group that I facilitate in Arizona, the cost of an elder attorney is well worth it.

Most nursing homes have a Medicaid Specialist who helps you fill out and apply for the Medicaid. My husband is in a Veteran's Home and the girl who helped was wonderful and put me completely at ease even though it is a complicated and stressful process. We applied in December and it was not approved until May 1st. It was retroactive to December. The Medicaid Specialist put me in touch with a Lawyer who also was a specialist in the area of Medicaid. Her first session was free. She told me what I was able to safely spend and what I was not. I was shown how to set up Bank accounts and how to borrow against my husband's whole life insurance. He still has some of that insurance which I must pay interest on in order to retain it. Your insurance agent, your Medicaid Specialist and Lawyer are all a team who will help you. It is such a relief to know that my husband will be taken care of at the home for as long as he needs it. The process needs to be reviewed yearly so mine is coming up in December. I have no idea what that entails, but the Medicaid Specialist said it will be a review of the year to make sure I have no new income or nothing has changed in my financial situation.

No! I process MA applications for a living. just make sure to list everything, wait for the determination & appeal anything you don't agree with. depending on the type of Medicaid she is requesting (I live in NC) there are different income limits for i.e., private living Medicaid, long term care, or special assistance. don't waste $ on a lawyer. just know the state/counties eligibility requirements.

And therein lies the problem. Are you applying for Community Medicare? NH Medicare? How much does mom have in assets and what is appropriate use of that money for spendown?

If the lawyer is a certified ElderCare atty, I'd say it's worthwhile.

Hire an attorney...they can protect some of the remaining assets and handle the paperwork... we could not have survived this past year without ours... Make sure they specialize in Elder Care...

Most Definitely!! I just went through this with my mom and it was even complicated for the elder lawyer and she was glad I had everything in order. Worth every penny.
Dad has passed 5 yrs. ago. Good Luck and God Bless♥

Yes you need an Estate Plan and a plan to control the assets. Your mothers money will be used. She can keep up to $120,000.

Yes, it is absolutely worth it. I did my mother's Medicaid application and the 5 year look-back Medicaid required for short-term rehab, which the NH insisted was the same as LTC application and it was a nightmare! Getting 5 years of bank statements and pulling together evidence of SS and meager pension seemed straightforward. But it wasn't that easy. Getting the correct documents from the banks required submitting requests (not just from me, but from the NH, plus evidence of my POA.) Then I was under time-constraints and one particular bank took forever and didn't provide everything. My ,mom really had no assets, just a Checking Account and SS and a small pension from my dad. Once the documents were submitted, Medicaid started questioning every little thing on the statements nonsense deposits like a $14.95 refund on the statement. My mom stayed with my brother for 7 months and they wanted the title to his house, a letter from 2 neighbors attesting to the fact that mom did not live there permanently. Then Medicaid would come back and say they didn't have documents which were sent though I had copies of the forwarding. I did speak with a lawyer and we set up a NYSARC Community Trust for my mother (she was only supposed to be in the NH for a short period). The NYSARC Trust is an approved way to deposit the Medicaid Spend-down (what Medicaid considers excess income - they only allow you to retain $800/month in NY if you stay in community) the rest goes to Medicaid. Mom could not pay rent, utilities, food etc on $800/mo. We established the trust and submitted the documents with the Medicaid application. The Employee from the NH Medicaid office submitted the documents to Medicaid and she was late, so we missed out on a couple of months coverage, and she didn't send the NYSARC documents. I sent the NYSARC documents to Medicaid and they denied receiving. They started dunning me for thousand of dollars. Getting the paperwork together was not the worst part - it was the delay tactics and the jumping through hoops that was a nightmare. I have friends that went through an elder lawyer and it was a cake-walk and done in 1/4 the time it took me, with far fewer grey hairs. Evidently, Medicaid does not give the lawyers the same run around. Also, the elder lawyers can give you very valuable information. When my mom was being released from rehab, they helped with options as alternatives to permanent NH residency. If I had it to do again, I would go to a lawyer that knows his/her stuff right from the start. They can also Help you set up Irrevocable Prepaid Funeral Arrangements that can come from your parent's income that Medicaid cannot attach! It is worth it!

I handled it myself, though I must say I had NO HELP AT ALL FROM ANYONE, and it was frustrating and strenuous. I did have the nurse who did my mother's PRI look it over and help me with a few of the questions. I got the 5 years of bank statements with no problem. (Medicaid did, later, question a few things, but it worked out all right). The 'elder care lawyer' wanted $750 to do all this. If the situation is complicated, there is still a spouse in the home, children, if there are rental properties and ....you know, stuff, it's worth it to get a lawyer involved. If mom is renting, has little property, you can do it yourself.

Xina - if you are thinking that by using an elder law atty. that everything from here on will be done by the atty., so you will never have to deal with anything medicaid related with mom; the trust with 1/2 mom's assets gets done; mom dies @ the NH and and all assets passes to you and taken care of with a bow…...well imho as one who has dealt with a now-deceased parent NH Medicaid application & estate recovery that is not going to happen.

Medicaid is NOT a single one time paperwork & eligibility event.

All the states have some sort of renewal paperwork with required documentation to accompany the renewal - so if you are hands-off in the initial application you are going to have to on your own dime pay the initial atty or get a new atty. to do the renewal and get the whatever paperwork required for renewal done and within the very tight timeframe the states set for renewals. Keep in mind that once mom goes onto NH Medicaid, she is required to do a co-pay (also called her SOC - share of cost) of ALL her monthly income to the NH less a smallish personal needs allowance (which varies by state from $ 35 - 105). Any future costs needed for management of mom's or her assets (like her home, car, taxes, legal, funeral, etc costs) will need to be paid by you or others from day 1 of Medicaid till whatever time frame is needed to get out of probate or any other after death legal.

Please realize that once mom dies there will be MERP (estate recovery) to deal with as MERP is required to send an NOI (notice of intent) with a questionnaire in an attempt for a recovery of any & all assets to recoup $ Medicaid paid for care. Usually for a trust to be Medicaid compliant my understanding is that a trust either needs to be done irrevocable 5 years prior OR is a special needs trust which has the state as it's beneficiary. So for SNT $ left in the trust at mom's death goes to the state. No $ to heirs. SNT are wonderful as it enables them to get things that Medicaid either doesn't pay for or pays for low cost items. But if your planning on having those funds, not going to happen. I was a trustee on a still living independently cousin's SNT for several years and it has been spent on getting him a car retrofitted for him to drive, caregivers for outings & travel; a very specialized pneumatic wheelchair, etc & all things not ever going to be paid by Medicaid or Medicare. There is an annual reporting on items paid by the SNT. There will be no SNT funds left eventually so it will dissolve but till then has done what an SNT is about - providing for care & equipment & services to enable them to live life better.

Now you do need an atty as there is legal that does need to be done - DPOA, MPOA, a will or codicil, a guardian in case of incapacity document (if your state does these). But the Medicaid application, imho you need to be involved with and reviewing the documents submitted and active in gathering these together as if something is needed later on OR the application is denied, it's you who will be on the hook financially to pay the NH for all those months mom was/is there which Medicaid denies to pay.

Also laws can change. Items that pass outside of probate (like Life Estates) were viewed as beyond MERP so used for Medicaid asset avoidance. But now many states (NYS) are going after life estates under MERP.

Also another item on things can change…..till very recently, term life insurance was not viewed as a spend-down asset. Only whole life insurance was as it had a obvious cash value. Now states are starting to require LIFE INSURANCE POLICY CONVERSIONS aka Life Care Funding, aka Medicaid Life Settlement. So far 8 states (mine - Louisiana - is one and regs apparently are being written like now so probably in effect in 2017) have done the legislation on this. TX & FL have done it, so all the other states are sure to follow. Basically it means that all insurance policies (whole, term, GUL, universal) over a minimal value (like under 3K - 5K) will need to convert to an irrevocable account with the funding used to pay for their care and any $ left after death to the state as the beneficiary except for either a death benefit of 5K or 5% of policy - whichever is less. The insurance co probably love the states move to conversions.

Medicaid means "at need" both medically & financially.Financially for NH Medicaid they just have to be impoverished & stay that way. States are doing whatever to make sure that happens.

SNF assistance in the application process helps to a degree. They are not allowed to say anything in the county and state in which we reside. We still need advice but our community has NO eldercare attorneys.

Given no elder attorneys in our community, we could not get help. Post-application, the best we could do was see an estate/probate attorney. He is willing to try to find some straight answers from the state, but admits this isn't his area of expertise.
Since many resources will be lost anyway, I'd just as soon pay some to an attorney as the state. Those same dollars forfeited to the state don't build a stronger legal community. At least a smart attorney will learn something and can apply it to future cases, such as yours.

In earlier years knowledge, expense, and experience in difficult times potentially pays off. A better education, a better job, housing, financial stability, opportunities for children and grandchildren.

SNF Medicaid education and experience without good legal help accelerates the process by which the cs meets the federal/state goal of impoverishment. The less legal help you employ, the quicker you become a statistic. SNF state Medicaid can more readily present it's statistics of dollars saved. Medicaid statistics don't carry footnotes that reference the government's corresponding achievement of cs poverty.

Approximately 120K maximum assets retained by a 70 year old spouse is much more devastating than 120K retained by an 85 year old cs. The 85 yr. old has almost achieved his/her life expectancy as projected by Social Security. The 70 year old is projected to live 18 more years. The 120K now gets stretched over a projected 38 year remaining life span.

Maybe good legal advice can delay this process so cs can have a few more years of quality life. Anything an attorney can help with is probably worth the money. Especially the younger the snf spouse and cs are when this all starts.

Correction: 38 is supposed to read 18.

If you have records for the look back period and current money coming in, then no. In a nutshell Medicaid wants to pay the least it can for care, which is understandable, since it is funded mostly by taxpayer's money.

Yes, it's worth it totally. Cost $7000 in December, now nursing facility is $334 a month, as opposed to $6500 a month. Is more than paying for itself. All meds are paid also. The lawyer got it done in six weeks, start to finish, instead of me having to find my way through the red tape.

A great deal depends on the assets and also the state. All trusts are not "protected" from Medicaid. If this is a complicated situation, then an elder law attorney is probably a good idea. Having recommendations is also good. As Bob mentioned, you can make an appointment with Medicaid to ask questions so that is an option.

Most of the people posting seem to think it's a good idea. I simply paid out of pocket but much more is known now so if I'd had it to do over maybe I'd do it differently.

Good luck,
Carol

My Mom's case was similar...no assets other than a few small investments...income was SS and a pension...very low savings. I thought I'd be able to handle the process myself but people who had been through it strongly recommended an attorney or financial specialist. I chose the financial specialist and it worked out fine. I thought the fee was high but it came from Mom's savings and helped bring down her assets.
Keep in mind that Medicaid regs vary from state to state. I had a lot of questions for the person I chose especially "What happens if we go through all this and it doesn't get approved?" Their reply was: "We always get approval."
They were right. I gave them whatever documentation they asked for, answered whatever questions they had and let them handle it.
Keep in mind that after approval is obtained, the case will be reviewed annually so you will need to continue to account for any income your Mom may receive.

Im already having a property atty change the assets my mom has to my name,but because of the terrible(Ive spoken about my mom's situation in other topics before)horrific experience my mom has had with perpetrators who cleaned her out of all the money she had for her old age,I'm having a difficult time finding a real elder attorney in Texas who would help me.Any suggestions as to who I can go to in hopes of finding a competent elder atty in Texas??

I couldn't afford an attorney, so I had to fill out the paperwork and gather all of the documentation myself. I have two siblings, but somehow it became my job to handle it all. I work full time and have no legal experience and although it is a time-consuming process, it wasn't that difficult to get through it all. The nursing home that my Mom moved into was helpful in answering any questions that came up as I was filling out the forms. However, if you can afford an attorney, why not have them deal with everything. It would cut down on the time (and stress) involved.

I do not know your state, but if your Mom is ready for Medicaid, there are no assets to preserve. My mom is in Iowa and we set up a trust for my Mom in 2014. She has already run out of money, we dissolved the trust and are now ready to apply for Medicaid. I would NOT do it again. Be careful of Elder Care attorneys, the one we used was a scammer, didn't do anything worthwhile and won't even help us with the Medicaid application unless we give him another $3500. I wish I could tell you how to find a good honest attorney, but I cannot.

If you live in CT, MA or RI, you might want to check out medicaid4you website. They know exactly what's needed for Title XIX, and they'll do everything from start to finish for a flat fee of $3000 no matter how long it takes. They'll apply when the time is right.

anyone know where I can get assistance in finding an elder atty in Texas??