Medicaid & Long-Term Care Planning

The cost of long-term care can create significant financial concerns for individuals and families. Whether you are planning years in advance or a loved one is already receiving nursing-home care, understanding your options can make an important difference.

At Carlin Law, we help individuals and families navigate Wisconsin's Medicaid long-term care rules, evaluate available planning strategies, and coordinate Medicaid planning with estate planning and asset protection goals.

It is not too late to plan. Even when someone is already in a nursing home, there may be planning opportunities available depending on the individual's assets, income, marital status, prior transfers, and other circumstances.

Planning Before Long-Term Care Is Needed

The best time to consider long-term care planning is generally before a crisis occurs.

Advance planning provides more time to evaluate your assets, estate plan, family circumstances, and long-term goals. Depending on the circumstances, planning may involve trusts, changes in ownership or beneficiary arrangements, exempt assets, or other strategies permitted under Medicaid rules.

Wisconsin Medicaid has stringent rules, and giving property or money to children can create serious Medicaid eligibility problems. Planning should be done deliberately and with an understanding of the potential consequences.

What If Someone Is Already in a Nursing Home?

A common misconception is that nothing can be done once someone enters a nursing home.

That is not necessarily the case.

We also assist families with crisis Medicaid planning when a spouse, parent, or other family member is already receiving long-term care or expects to need it soon.

The available options depend heavily on the circumstances. A married couple may have different planning opportunities than an unmarried individual. The type and ownership of assets, income, previous gifts or transfers, estate plan, and timing of a Medicaid application can all affect the analysis.

Our goal is to identify the options that remain available and develop a lawful strategy appropriate for the client's circumstances.

Medicaid Planning for Married Couples

When one spouse requires nursing-home care and the other remains at home, Medicaid rules include special protections commonly referred to as spousal impoverishment rules.

Medicaid planning for married couples therefore requires more than simply determining whether the spouse receiving care is over an asset limit. We evaluate the couple's assets and income, how property is owned, and the planning options available to protect the financial needs of the spouse remaining in the community.

Because Medicaid rules and applicable figures change, we analyze eligibility based on the rules in effect at the time planning is undertaken.

The Five-Year Look-Back

The Medicaid five-year look-back is often misunderstood.

It does not mean that you cannot do any planning during the five years before applying for Medicaid. 

Not every transfer is treated the same way, and Medicaid rules contain exceptions. This is one reason it is important to obtain advice before transferring property as part of a long-term-care plan.

Medicaid Planning and Your Estate Plan

Medicaid planning should not be considered in isolation.

A strategy designed solely to address Medicaid eligibility can have unintended consequences for your estate plan, control of your property, beneficiaries, taxes, or the financial security of a spouse.

We look at the larger picture and, when appropriate, coordinate Medicaid planning with wills, trusts, powers of attorney, beneficiary designations, and other estate-planning documents.

Wisconsin also maintains an Estate Recovery Program through which the state may seek recovery of certain Medicaid long-term-care costs from assets after a recipient's death. Estate recovery should therefore be considered as part of the overall planning analysis.

Medicaid Applications

We can also assist with the Medicaid application process.

Long-term-care Medicaid applications can involve substantial financial documentation and questions regarding assets, income, property ownership, and prior transfers. When planning is necessary, it is important that the application and the planning strategy work together.

We can help clients and families understand what information is required and address eligibility issues that arise during the process.

Preparing for Your Consultation

Before your consultation, it is helpful to gather information regarding:

• Your real estate
• Bank and investment accounts
• Retirement accounts
• Life insurance
• Vehicles and other significant assets
• Monthly income and its sources
• Existing wills, trusts, and powers of attorney
• Significant gifts or transfers made during the previous five years
• Long-term-care or nursing-home information, if care has already begun
• Basic information about your spouse and family

Do not delay scheduling a consultation simply because you have not gathered everything. We can identify additional information that may be needed after discussing your circumstances.

Start Planning

Whether you are planning well in advance or dealing with an unexpected nursing-home admission, the appropriate strategy depends on your particular circumstances.

Contact Carlin Law to discuss Medicaid and long-term care planning in Wisconsin.