It can be stressful when a beloved relative requires skilled nursing. One primary concern can be how the family will afford ongoing care in the nursing home or care facility. Under the right circumstances, Medicare can financially cover a part of the nursing home stay for a limited amount of time. After that, Medicaid can help fund skilled nursing; however, there are very specific rules regarding:

• assets the patient in the nursing home can own without affecting Medicaid eligibility
• assets the patient’s spouse can own without affecting eligibility
• the income of the patient that the spouse may be entitled to
• techniques available to achieve eligibility for a patient who is ineligible asset-wise or income-wise.

The following questions (and their corresponding answers) can help you start navigating the complexities of Medicaid planning:

What is Medicaid Planning and Why Does it Matter?

Medicaid planning involves helping a potential Medicaid applicant in advance of and in preparation for their application. The preparation involves collecting necessary documents, potentially restructuring financial assets, and preparing the details required for the application.

This preparation is crucial. Because Medicaid eligibility is complicated, the way the planning is done can make or break whether an individual’s application is accepted or not.

What documents do I need to apply for Medicaid?

There are a variety of documents needed to apply for Medicaid, including one proof of age document, one proof of citizenship documents, an identity document, and a marital status document. Other applicable documents for submission may include financial resources, social security cards, insurance cards, income information. If the individual’s spouse is living outside of the nursing home, there will be other documentation required.

Do I need a lawyer to apply for Medicaid?

It isn’t legally required. However, it can be very beneficial to get the help of an elder law attorney. This is because Medicaid officials subject these applications to enhanced scrutiny. Sometimes the officials require up to five years of financial records and documentation. Any unexplained expenses may be considered a disqualifying transfer of assets. Many planning steps, including trusts and family care agreements, are viewed as suspicious without the proper amount of evidence. It can be beneficial to have a lawyer to help you prepare the countless documentation and to help you answer the questions that come from Medicaid officials.

How does James Johnson help with Medicaid planning?

Our firm can help the patient and their family come up with a plan to become eligible for Medicaid and prepare and file the application required to obtain Medicaid coverage for the patient’s ongoing skilled nursing.