Although the context is slightly different, in my best Liam Neeson voice I want to call attention to elder law attorneys’ “very particular set of skills.”
When someone you love gets sick, their care becomes a responsibility to manage. This care may require out-of-pocket costs and health insurance coverage. For serious, long-term illnesses, Medicaid is necessary to cover the exorbitant care costs that can run more than $200,000 annually for some nursing home stays.
Medicaid applications are not just some forms to fill out and submit. Long-term healthcare planning requires serious financial realignments. Assets must be transferred and this results in a person’s previous estate plan being upended. While anyone can complete a Medicaid application and compile the documents, doing it correctly while keeping a trained eye on the multitude of legal and financial consequences is a job for an elder law attorney.
One of the first casualties related to a person’s illness is their estate plan. Carefully drafted Wills and Revocable Trusts relying on assets being titled in a specific way are rendered obsolete following a crisis. Medicaid has asset limits ($30,182 in 2023 for an individual), which necessitate transfers by applicants to become eligible. Funds from a joint account or Revocable Trust account may be placed in the healthy spouse’s solo account.
An aging parent’s investment account that had three children listed as beneficiaries may be transferred to the adult child caregiver who is also an agent under a Power of Attorney. These drastic changes have to be addressed properly so that originally named beneficiaries are properly recognized in the new arrangement.
Elder law attorneys have the ability to execute the Medicaid plan while resetting an altered estate plan.
Elder law attorneys use Irrevocable Medicaid Trusts to protect assets for Medicaid, as well as avoid Probate to simplify the estate process. While the first priority is to secure and pay for long-term care services through Medicaid eligibility, ensuring the protection of assets for a family is a close second. This two-prong approach is vitally important in a situation where a seriously ill loved one may not survive to receive extensive Medicaid coverage.
An Irrevocable Medicaid Trust allows assets to flow more easily to the Trust beneficiaries and sets instructions that take into account all relevant family dynamics. Looking at each client’s situation three-dimensionally is a hallmark of elder law practice.
When a local Department of Social Services reviews a Medicaid application, there are numerous regulations and guidelines that must be adhered to. Often, DSS will request further documentation to clarify an issue in an application. If questions remain unanswered or a Medicaid decision is unsatisfactory, agency reconsiderations and fair hearings are useful tools to generate solutions.
Fair hearings are legal administrative proceedings with evidence and witnesses. Not having legal representation is a huge disadvantage.
Elder law attorneys bring working knowledge of Medicaid law together with the practical application process experience to forge positive results. They can handle all facets of the Medicaid process from beginning to end and provide nuanced estate planning guidance at the same time.
Alan D. Feller, Esq., is managing partner of The Feller Group, located at 625 Route 6, Mahopac. He can be reached at alandfeller@thefellergroup.com.