Medicaid is a government program that provides free or low-cost subsidized health insurance coverage to certain people, including eligible low-income adults as well as elderly adults, disabled individuals, pregnant women, and children.

LTC is a term that is used to describe an array of services that are available to people with prolonged illnesses, disabilities or cognitive disorders. LTC services include health, medical, personal care, and social services.

• Assistance with activities of daily living (ADL’s) such as eating, bathing, dressing, toileting, transferring, continence.
• Around-the-clock skilled nursing care for those with prolonged physical illness, disability, or cognitive disorders, such as Alzheimer’s.
• Custodial care in an Assisted Living Facility.
• Homemaker care, Adult Day care, Hospice care, Respite care.
• Personal care for basic instrumental activities of daily living (IADL’s), such as cooking, cleaning, laundry, or bill paying.

We act as your authorized representative and will facilitate the application and communicate directly on your behalf with the county worker.  We will work with you to ensure all documents are provided in a timely manner.  We will use our expertise to guide the process making it less frustrating and confusing for you.

Federal law requires states to cover certain groups of individuals, such as low-income families, qualified pregnant women and children, individuals receiving Supplemental Security Income (SSI), or seniors aged 65 or older. Those who meet Medicaid guidelines are eligible to apply.

A primary home is considered an exempt asset only if a single applicant intends to return home. However, if an applicant’s home is no longer their primary residence because they live in a care facility, that home would not be exempt. For married couples, the house is exempt up to a specific limit and only if the healthy spouse remains living in the community.

Medicaid will not take your home. The states can participate in estate recovery whereby upon the death of an applicant and spouse, Medicaid has the option of placing a lien on the house or estate of the deceased to recoup costs for care.

Once approved, Medicaid eligibility goes back to the first day of the month of the application. Also, you can request retroactive benefits up to three months before the application date. To receive approval for retroactive months, the applicant will need to have met the eligibility requirements for those months.

The applicant’s signature is preferred. However, if the applicant is unable to sign physically but is aware, he/she can mark with an X, and anyone can witness the signature. The applicant’s Power of Attorney and Designated Authorized Representative can also apply and sign the Medicaid application on behalf of the applicant.

Under the Medicaid spousal impoverishment provisions, up to half of a couple’s liquid assets, subject to certain limits, can be protected for the “healthy” spouse living in the community. Income belonging to the spouse in the institution can also be set aside for the community spouse’s use. A couple does not necessarily need to spend all their assets to qualify for Medicaid. Many spouses wait too long and apply for Medicaid benefits much later than they could have.

Attorneys will quote anywhere from $10,000-$20,000.  Our fee is significantly less and price is contingent on your need and your file’s complexity. Also, most attorneys while they understand in practicality the nuisances with Medicaid, they have never worked for long term care Medicaid or have worked in a facility securing these benefits.  We have experience in both settings which gives us a competitive advantage at a reduced rate.

Yes! Medicaid regulations state that the applicant can spend down assets on certain expenses.   We will provide proof of payment for our services with the application.   It is considered a legitimate expense. 

We cannot guarantee Medicaid approvals; However, we can guarantee our work! Upon our financial interview and review of the five-year look-back, we can communicate any difficulties we foresee with the process.  While there may be some roadblocks with eligibility, we will strive for an approval.

1. Keep applicant’s bank statements.
2. Keep financial information organized.
3. Consolidate banking into one account.
4. Ask for help.
5. Provide as much information as possible.
6. Spend $ on the applicant’s bills and care.

1. Don’t give $ or property away in order to meet the resource limit.
2. Don’t shred important documents.
3. Don’t withhold any information.
4. Don’t pay family’s or friends’ bills with applicant’s money.
5. Don’t be afraid to ask questions.