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

i did the paperwork for my aunt. When i had the stumbling questions, i contacted Legal Aid [i got their contact number from Area on Agency for my region]. If someone is needing to file for Medicaid, they aren't going to have resources for an attorney - and even your funds will go fast, as generous as you are. Try Legal Aid or your State's Senior Services Counsel [usually located in the County Seat]. God Bless - you can do this.

We just had our first meeting with an attorney for this reason and I can tell you the help she is giving us is well worth the price.

which other agencies can help me with setting up my mom to a nursing home...or assistance in her living at her place? I know an attorney can be very helpful,but it takes time to see which attorney is the most helpful.Im the only sibling my mom has and dealing with this issue myself can be very time consuming.

absolutely worth every penny, if she will eventually run out of money and you can't afford to hire help. It might make the difference of staying in her home or going to a nursing home. There are other agencies, besides lawyers that do this medicaid thing and they are legit as well, and probably dont charge as much, just get a personal recommendation.

I would agree that a lawyer that specializes in elder law would be worth the money. Medicaid is very cumbersome, and can be tricky. If she is not married, any assets she has (even in a trust) can be recovered, even after she dies, so be sure you get someone who really knows what they are doing and has done it before. It would not be out of line to ask for recommendations and call people this lawyer has helped, (or their family members) to see what happens later. If she does not own a home, or have significant $$, you can probably do ok with the help of your local DHS office. Before you pay the lawyer, I would make an appointment to meet with a social worker from the DHS and just talk about what her options are. When my gma had to go to the nursing home, her only asset was her home. The gov't ok"d her Medicaid to pay for the nursing home care, but put a lean on her house. So when she passed away, there was $23,000 that had to be repaid to get clear title to the house. My sister wanted the house, and took out a loan to pay the $ and it all worked out fine. But the gov't will look for assets and they have a "recovery" program. Also, you can't transfer assets within 5-7 yrs of needing Medicaid or that is seen as fraud.

This is a great question, and there are several good comments posted by members of our AgingCare.com community.

One of the members mentioned that her father had "a significant monthly spend down" to qualify for Mediciad, even though her mother is still living.

This is one example of the many complexities of applying for Medicaid coverage for nursing home care. Unless both spouses need nursing home care, you shouldn't need to spend down their assets; Medicaid regulations require only that the assets be held in a way that complies with the laws and regulations in your state that protect Medicaid applicants and their spouses. Often, it takes an attorney in your state who is trained in the field to recognize all of the facts and know which regulations can help people who are going through tough times of transition.

A Committee On The Unauthorized Practice Of Law Appointed By The Supreme Court Of New Jersey issued an Opinion on May 16, 2016 to answer questions involving people in similar situations.

The New Jersey committee took a look at: "non-lawyer advisors [who] advised a family member that she could receive monies as a caregiver when the family member did not qualify for that status; advised a family member to spend down an IRA when it would have been more reasonable to purchase an annuity with those monies; advised a family member to draw down her assets when it would have been more sensible to transfer monies to a disabled child; advised a family member to transfer real estate when it would have been prudent to address the significant tax implications of that plan; and the like."

In all of those situations, you need legal advice to protect yourself and your family.

"[A]dvisors [had] also counseled people on wills and powers of attorney; on the need for guardianships and the authority to transfer assets; on the standards for Medicaid coverage; on nursing home laws; on transfers of property; on the impact of marriage and divorce; on estate administration and the elective share; and similar legal matters." The New Jersey Committee said that these non-lawyer advisors "may not provide legal advice on strategies to become eligible for Medicaid benefits, including advice on spending down resources, tax implications, guardianships, sale or transfer of assets, creation of trusts or service contracts, and the like."

Guidelines may be available in your state for decisions on whether to go with a non-lawyer application preparer, or hire an elder law attorney who understands the laws and regulations that can help you.

In 2011, another review board in Ohio came to the conclusion "that Medicaid planning requiring specialized legal training, skill, and experience constitutes the practice of law. However, especially in situations where the applicant’s income and resource levels are near the Medicaid limits, there may be some Medicaid planning scenarios involving only document review and a financial calculation." So, "whether nonattorney involvement in Medicaid planning constitutes the unauthorized practice of law must be determined on a case-by-case basis."

The Attorney General in Tennessee said people should consider "whether the legal assessments or advice at issue would require the professional judgment of a lawyer."

The Florida Bar’s Standing Committee on the Unlicensed Practice of Law heard evidence in 2015 about the types of harm caused by non-lawyer Medicaid planners, including: Denial of Medicaid eligibility, Exploitation, Catastrophic or severe tax liability, and Purchase of inappropriate financial products threatening or destroying the client’s life savings.

These results illustrate how you may not end up saving money by relying on a Medicaid application preparation service.

Read more at:
https://www.judiciary.state.nj.us/notices/2016/n160518c.pdf

http://www.floridasupremecourt.org/decisions/2015/sc14-211.pdf

xinabess: I am going to give you a big "YES" here; do go see an elder estate lawyer. But my question to you is why have you removed your info on your profile? I can't find out who you're caring for because you don't say on your profile. Also it wouldn't let me send you a private message on the message board. What is going on?

@caring42 I find the recertification to be easy, I just fill in any new information since SS changes year to year, the account balances and proof of monthly payments to the trust. I'm surprised that you have issues but maybe each state is different.

I did all the paperwork and trust for my situation. It's not that difficult depending on how many assets your parent has and your personal threshold for the time/stress involved. Once you get a disability determination from social security, you can find the pooled trust you want to use. I found the one I used to be helpful and Medicaid will let you know what you're missing for them. IMHO, $3500 sounds like a lot if the situation isn't complicated. If the money they are going to protect is the spend down, that's easy to do on your own but if they are going to protect other things, then maybe? You could always contact the pooled trust beforehand and they could advise you. I also think the office of the aging here helps with the forms for free. Good luck!

In my area, elder lawyers start at 7 grand to help with Medicaid and maybe throw in the first annual review.
Yes, Get a lawyer. The hard part is not getting Medicaid, it's keeping it.
www.naela.org
for real lawyers in your city
Pick out 3 that offer a free 1 hr consult
Make your questions very specific.
Trust your gut.
Try to get a lawyer that will communicate by email afterwards and is included in the up front fee - this is critical. You will have more questions later than in the beginning.
Medicaid can be a life saver but getting a good caseworker is luck of the draw - you will need a lawyer and also you will need a backup plan in case you ever become Medicaid ineligible. That's where the lawyer can help with maintaining assets in the beginning to liquidate later if necessary.
If you are lucky, a social worker may be of help.
Document everything.
Spend money only on the beneficiary, immediately.

To set up the trust and protect what assets you can, yes, the attorney is worth it. To apply for Medicaid, no, you can do this yourself. When my mother was alive, Medicaid didn't pay for assisted living in my area, but I was able to work with my county human services person to find a special program she qualified for. I just kept calling and asking questions till we found what we needed for her!

We found that when we contacted the aging commission. We were told ALL assests medicaid would attach and take whatever money they spent after her passing.
My mother in law could not have more than 3000 in the bank and couldn't make more than 2200 a month. Any and all assest must be transfered 5 years prior to application.
They wanted copies of ALL life insurance policies, mortgage information and a copy of the title to her car.
It is very sad that anyone has to go thru this yo get thier family help.

At the bottom of this page click on "Elder Law Attorneys" and put in your zip code/

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

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.

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.

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.

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??

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.

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

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.

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.

Correction: 38 is supposed to read 18.

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.

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.

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.

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!

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.

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♥

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...