NAVIGATING YOUR PATH TO MEDICAID ELIGIBILITY

three steps to long-term security

STEP 1: MAKE A PLAN

Comer Elder Law helps you gather the information and documents needed to assess your unique circumstances. Then an attorney reviews your documents and creates an Assessment for you and your family to review. The attorney will present the best way(s) for you to protect as many assets as possible from the costs of long-term care. You will decide which course of action to pursue in consultation with your attorney.

STEP 2: APPLY FOR MEDICAID

Comer Elder Law puts together the application and presents it to Medicaid, along with an attorney position statement that addresses the challenges specific to your case. We handle the conference(s) with the caseworker and the request(s) for documents and information that follow.

STEP 3: KEEP YOUR COVERAGE


Comer Elder Law helps make sure that your Medicaid eligibility will not be jeopardized by an accidental inheritance or other windfall. We help your spouse and loved ones change their estate plans to make sure that your eligibility will not be affected by any money they want to leave for you. We can help you plan how to handle the settlement of a lawsuit so that you can keep your Medicaid eligibility, even if you’ve already received the money.

results that make a difference

You do not have to spend all of your money to become eligible for Medicaid to pay for your nursing home care.

Our client “Janet” was recently admitted to a nursing home because she needed skilled nursing care 24/7. Her private room was costing nearly $9,000/month.  Her daughter hired us to help her preserve as many of her assets as possible and to help the family get all of the documentation together to apply for Medicaid for long-term care.  We created a plan that helped Janet preserve most of her assets for her use during her lifetime, including a way for her to pay for her private room – which Medicaid does not cover.  Janet was then able to apply for long-term care Medicaid immediately.  The family also hired us to review and organize 5 years’ worth of Janet’s documents and to represent Janet during the application process with Medicaid.  Janet got to keep her money to use for her care during her lifetime, and she became eligible to use her Medicaid benefits. Plus, she and her family got the help they needed to go through the application process.

If you move in with your kids, make sure you spend your money the right way to preserve your eligibility for nursing home Medicaid in case you need it.

Our client “Don” fell ill and moved in with his daughter and son-in-law.  Don sold his own home, and he wanted to know if it was possible for him to give the money to his kids outright as a gift for moving him into their home. Don anticipated that he would need skilled nursing care in the next 5 years, and Don did not have the income to cover the $8,200/month that the semi-private nursing home room would cost.  We created a plan that helped Don properly spend his money to make improvements to his kids’ home for his benefit so that he can stay out of the nursing home for as long as possible, in a way that followed Medicaid’s regulations.  We also helped the family develop a caregiver plan to allow Don’s son-in-law to provide in-home care and be paid a reasonable amount to do so in a way that followed Medicaid’s regulations for doing so.

Don’t let an accidental inheritance make your loved one ineligible for nursing home Medicaid. 

Our client “Beth” had been in a nursing home and on long-term Medicaid for years. Unfortunately, Beth and her husband did not know that they needed to make changes to their estate plan because of her Medicaid eligibility, so that when he died, he accidentally left Beth money outright, and that money put her over the asset limit for her nursing home Medicaid. Beth lost her benefits and started spending down the inheritance to try to get eligible again.  After her sister called us, we helped her preserve the rest of her inheritance for her use during her lifetime and helped her get back on Medicaid.  Medicaid will have a claim to any of that unused inheritance at Beth’s death.  If her husband had known that he needed a different kind of estate plan that would still include Beth, but would have set up a private trust for her.  Then she would not have lost her benefits, or had to spend any of the inheritance, and Medicaid would not have a claim on any unused money at her death.

Frequently Asked Questions

What is included in a Consultation and Strategy Session?

Do I get legal advice?

Yes, you get legal advice. You will have a one-hour consultation with your attorney after she has reviewed your documents. During your consultation call, you and your attorney will discuss the issues you are facing and your options. You will receive a written report that details what you talked about and the recommendations of your attorney, so you don’t have to worry about missing something.

How do I sign up

for a Consultation and Strategy Session?

Click on the button below to give us your phone number and preferred time of day, and we will reach out to you to book your appointment and for payment of the $750 fee. You will receive a welcome email with your personalized link to upload relevant documents (like powers of attorney, or veterans’ discharge papers) to a secure folder for the attorney to review prior to your session.

Does Medicare pay for long-term nursing home care in Alabama?

No, Medicare only covers a limited stay in a skilled nursing facility for rehabilitation purposes, typically up to 100 days. Long-term care in a nursing home or assisted living facility will require other payment methods, such as private pay, long-term care insurance, or Medicaid.

How do I qualify for Medicaid for long-term care in Alabama?

Eligibility for Medicaid in Alabama requires meeting both financial and medical criteria. The financial criteria include asset and income limits, which can change annually. The medical criteria typically involve the need for a nursing home level of care.

Can I qualify for Medicaid if I have too many assets?

While there are asset limits to qualify for Medicaid, there are planning strategies, permissible under Alabama law, to protect and preserve assets while still achieving Medicaid eligibility. It's advisable to consult with an elder law attorney to navigate these strategies.

What is the look-back period in Alabama for Medicaid?

Alabama, like many states, has a 60-month (5-year) look-back period. This means any assets transferred for less than fair market value within five years prior to applying for Medicaid could result in a penalty period during which Medicaid won't cover care costs.

Can I give away assets to qualify for Medicaid?

While you can gift assets, it's crucial to remember the

5-year look-back period. Transfers made within this timeframe can incur penalties and delay Medicaid eligibility. However, certain transfers are exempt from penalties, so consulting an elder law attorney is crucial.

If my spouse needs care, will I be left with nothing?

No. Alabama has spousal impoverishment provisions in place to protect the community spouse (the spouse not needing care). There are specific asset and income protections for the community spouse to ensure they aren't left destitute.

How does Comer Elder Law charge?

We charge a flat fee for each stage of the work, to be paid up front. The fee is held in the attorney trust account and is earned as certain milestones in the representation are achieved. These milestones, as well as the scope of the representation, are spelled out in the written engagement letter.

Are attorneys’ fees an acceptable “spend down” item for Medicaid purposes?

So far, yes. You use your money to pay for your legal services, and Comer Elder Law will provide you with an invoice for your records. If you are calling for your parent or spouse, and you are your loved one’s agent under her/his power of attorney, then you can pay your loved one’s invoice with her/his money.

Will Medicaid take my home?

In Alabama, the primary residence is typically an exempt asset for Medicaid eligibility. However, upon the death of the Medicaid recipient, the state may seek recovery from the estate, which can include the home. There are strategies to protect the home from estate recovery, and it's advisable to discuss these with an attorney.

Are there any exempt assets when considering Medicaid eligibility?

Yes. Some assets aren't counted towards Medicaid's asset limit, such as the primary residence (subject to certain equity limits), one vehicle, personal belongings, and funeral and burial arrangements, among others.

Can I protect my assets with a trust?

Certain types of trusts can be utilized in Medicaid planning. However, not all trusts protect assets from Medicaid's perspective. It's essential to consult with an elder law attorney familiar with Alabama's regulations to ensure the proper trust structure.

What happens if I’m denied Medicaid eligibility?

If denied, you have the right to appeal the decision. The denial notice will provide reasons for the denial and instructions on how to appeal. It's advisable to work with an attorney during the appeal process to address the specific issues raised in the denial.

Note: Medicaid rules and policies can be complex and change over time. It's always best to consult with an experienced elder law attorney or Medicaid planner familiar with Alabama's specific rules to get accurate and tailored advice.

No representation is made that the quality of legal services to be performed is greater than the quality of legal services performed by other lawyers.