Medicaid Planning Strategies

Medicaid planning strategies vary from state to state. At Millman Law Group, we specialize in solutions from Florida residents and those planning to move to Florida, especially those in the Palm Beach County area.

What is the Process for Medicaid Planning?

At Millman Law Group, we start every Medicaid plan with a free consultation. This is the best way to quickly get a handle on a client’s situation while simultaneously ensuring that we are able to fully serve a client’s needs before we commit to working together. We go through a series of questions that tell us exactly where you stand from a Medicaid eligibility perspective; understanding health status and financial situation are crucial. Before the end of the consultation, we make a determination on whether you’d save enough money from Medicaid planning to work together. If you will not save more money than we charge, we will not take you as a client. The goal is to ensure your resources are not drained, and we include our own costs in that calculation.

Once we have decided to work together, we begin the process in earnest. We help move assets, analyze specific care facility costs, and make sure you have a robust plan that will secure Medicaid assistance. The planning process can take several weeks. Implementing the plan can take several months, depending on the solutions you have selected. We are upfront with estimated times to implement each part of the plan during the planning process, giving you plenty of time to prepare. Finally, we prepare Medicaid documentation and applications and help follow through on applying that coverage once you get it. This includes assistance with retroactive coverage.

Common Medicaid Planning Strategies in Florida

We employ a variety of strategies to ensure Medicaid eligibility. Some are routine, and others are more obscure. Here are some of the most common solutions we help our clients with.

Medicaid Alternatives

We look into Medicaid alternatives to both replace and supplement Medicaid’s role in a long-term care plan. Some of the programs we examine are:

• Medicaid Waivers/Home and Community Based Services
• Standard Medicaid/Aged Blind and Disabled
• Nursing Home Medicaid (Institutional)

Each of these Medicaid alternatives has different requirements of their own to qualify, and we help with both the qualification process and making sure it is perfectly fitted into a larger plan.

Asset Planning

Asset planning for Medicaid involves changing assets from countable assets to exempt assets. These strategies are used to both protect assets from being seized and ensure assets are available for your heirs according to your wishes.

• Irrevocable Trusts
• Spousal Annuities
• Spousal Asset and Income Transfers
• Personal Services Contracts
• Purchase of Exempt Property
• Spending Down Excess Assets (home improvements, non-insurance covered medical devices, paying off debt, etc.)
• Lump Sum Personal Caregiver Agreements
• Owning Exempt Properties or Assets
• Purchase of Rental Properties

Exempt Assets

The following assets (although not an exhaustive list) are some of the exempt assets from Medicaid qualifications:

1. Homestead:
   1. so long as the well spouse continues to reside there.
   2. if there is an “intent-to-return” by the applicant (subject to equity limits)
   3. if a dependent SSI-disabled child lives there.
2. Certain Retirement Accounts in regular payout mode.
3. Rental or Income properties.
4. $2,500 designated for burial expenses
5. Irrevocable funeral contracts.
6. One burial plot per family member.
7. One Vehicle
8. Life insurance – with zero cash value – or if – with cash value – the total face value of all life insurance policies is less than $2,500.
9. Life estate interest in real property.
10. Certain annuities.
11. One wedding ring.
12. Assets of the Community Spouse (if applicant files under spousal refusal guidelines)

For more information on any of these services and to learn how we mix and match them depending on the situation, schedule a free consultation with us.

Income Planning

We help both individuals and couples plan for Medicaid acceptance when their income exceeds Medicaid limits. We use a combination of trusts, income transfers, and other solutions to ensure your income is brought below the Medicaid threshold and any healthy spouse is still well cared for.

Qualified Income Trusts

We use a variety of trusts to transfer income from one spouse to another when income exceeds the Medicaid limits. Qualified income trusts, or Miller Trusts, is one of them. Income exceeding Medicaid limits is placed in the trust to create Medicaid eligibility for the recipient.

Spousal Asset Transfers

Spousal asset transfers allow us to move assets from one spouse to another. Asset and income limits are much higher for the spouse that does not require Medicaid, and so this is often the simplest solution and first step in Medicaid planning. As aging couples often enter care facilities around the same time, however, we also include backup solutions for when this is no longer an option.

Spousal Refusal

Spousal refusal is an aspect of Medicaid regulations that allows the non-applicant spouse to refuse to pay for the costs of the spouse who is applying for Medicaid. Spousal refusal law sees the assets of the spouse at home as unavailable to the spouse applying for Medicaid, meaning that those assets are not counted in the Medicaid application. This process can be tricky to navigate, and Florida is one of the only states that practices this method. We highly recommend you get professional help for this strategy.

Understanding the MMMNA

The Minimum Monthly Maintenance Needs Allowance, or MMMNA, is the amount a healthy spouse may legally have in income each month. It is part of the Medicaid spousal impoverishment provisions, and is updated annually. There is both a minimum and maximum amount that is protected for spouses of Medicaid recipients, and we aim to maximize this potential. It is also crucial in income planning for Medicaid.

Many people believe the only way to qualify for Medicaid when your assets exceed their limits: gift your assets directly to other parties or into an irrevocable trust and wait five years so they aren’t included in the lookback section of their assessment. Here at Millman Law Group, however, only a minority of our clients employ a direct gifting strategy in their Medicaid planning. There are many alternatives to Trust Planning/ Gifting available depending on your specific situation.

This is only a limited menu of the tools we use in Medicaid planning. Every case is different and requires a unique combination of strategies to maximize savings and meet your family’s goals. Please contact us for a free consultation, to learn which of these tools may be most helpful for your specific situation, and to start the Medicaid planning process.