Long-Term Care Costs Are Becoming a Concern
You or your spouse may be worried about how nursing-home care could affect savings, property or the financial security of the spouse who remains at home.
ELDER LAW & LONG-TERM CARE PLANNING
Medicaid Planning Attorneys for Missouri Families
Planning for Medicaid involves more than completing an application. When nursing-home care or other long-term care may be needed, decisions involving income, property, savings, transfers and existing estate-planning documents can affect the options available.
LifeGen Law Group helps individuals, spouses and families understand Medicaid planning before long-term care is needed and when a health or care crisis has already begun.
The goal is to understand your situation, identify the legal and financial issues that matter and determine what steps may be appropriate before important decisions are made.
MORE THAN AN APPLICATION
What Does Medicaid Planning Actually Address?
Missouri’s Medicaid program is called MO HealthNet. For people who meet the applicable requirements, MO HealthNet may help pay for nursing-home care and certain other long-term-care services.
Eligibility is not determined by one factor alone. Depending on the program and the person’s circumstances, issues may include income, countable resources, property ownership, marital status, previous transfers and the level of care needed.
Income and Financial Resources
Some financial resources are counted for eligibility purposes while others may be treated differently.
The question is not only how much money you have, but what you own, how it is owned and how those resources may be treated under the rules that apply to you.
Your Home and Other Property
Owning a home does not automatically prevent someone from qualifying for Medicaid.
Treatment of a home or other property can depend on the circumstances, including whether a spouse remains in the home and what happens to the property later.
A Spouse Who Remains at Home
When one spouse needs qualifying long-term care and the other remains in the community, special rules may allow some income or resources to be retained for the spouse who remains at home.
Missouri uses a process known as Division of Assets in applicable cases.
Gifts and Property Transfers
Giving away money or transferring property does not automatically resolve an eligibility concern.
Certain transfers made before applying for long-term-care Medicaid can affect when benefits become available.
When long-term-care planning also involves preserving property for a spouse or family, Wealth Protection may become part of the larger planning discussion.
For more detail about transfers, read Missouri Medicaid Look-Back Period: How Gifts and Property Transfers Can Affect Eligibility →
TIMING CHANGES THE OPTIONS
Planning Ahead or Facing a Long-Term Care Crisis?
Medicaid planning can begin years before care is needed, or it can begin after someone is already preparing to enter a nursing facility. Those situations require different conversations.
Proactive Medicaid Planning
Proactive planning gives you time to look at future long-term-care concerns before an immediate crisis develops.
The discussion may involve your finances, property, marital circumstances, existing estate plan, previous transfers and future care goals.
Having more time does not guarantee that every asset can be protected or that Medicaid eligibility will eventually be available.
If you are looking further ahead, Proactive Long-Term Care Planning can help connect Medicaid concerns with the broader elder law and estate-planning picture.
Crisis Medicaid Planning
Sometimes there is little time to prepare.
A parent may be unable to return home after rehabilitation. A spouse may experience a sudden decline in health. A hospital discharge may require nursing-home placement sooner than expected.
That does not necessarily mean there is nothing left to discuss.
LifeGen’s Crisis Planning & Power of Attorney Assistance service addresses situations in which immediate legal authority, care planning or related decisions may also need attention.
BEFORE YOU MOVE OR GIVE AWAY ASSETS
Missouri Medicaid Rules Can Affect the Choices You Make
Some decisions made before a Medicaid application can have consequences later.
Something that seems helpful from an estate-planning or family standpoint may be treated differently under Medicaid rules.
The Medicaid Look-Back Period
Missouri applies a 60-month look-back period to certain transfers for long-term-care Medicaid.
Certain property transfers made during the five years before eligibility is evaluated may be reviewed.
A transfer for less than fair value can result in a period during which long-term-care Medicaid coverage is unavailable.
Not Every Resource Is Treated the Same
Missouri Medicaid rules distinguish between resources that are counted for eligibility and property that may be excluded under applicable rules.
Homes, vehicles, household property, cash, securities and other resources are not necessarily treated the same way.
Married Couples Have Additional Rules
When one spouse needs institutional or qualifying long-term care and the other remains in the community, spousal-impoverishment protections may allow certain income or resources to be set aside for the spouse who remains at home.
The way those rules apply depends on the couple’s individual circumstances.
Eligibility Is Only Part of the Picture
Planning should not stop with the question of initial eligibility.
MO HealthNet also has cost-recovery rules that can become relevant later, including rules involving estates and, in certain circumstances, real property.
Medicaid planning should consider the full financial picture rather than one asset or one eligibility rule in isolation.
If nursing-home costs are an immediate concern, read How to Protect Assets From Nursing Home Costs in Missouri Before It’s Too Late. Medicaid planning also fits within the larger Missouri Elder Law framework.
A PLAN BUILT AROUND YOUR SITUATION
How LifeGen Approaches Medicaid Planning
There is no single Medicaid strategy that works for every family.
The right direction depends on the person’s circumstances, the timing of the care need and the legal and financial decisions that have already been made.
Start With the Whole Situation
Income, property ownership, marital circumstances, estate-planning documents, prior transfers and the expected timing of care can all affect which questions need to be addressed.
Understand the Reason Behind the Recommendation
LifeGen’s approach is to explain the planning process clearly so clients understand what needs attention and why a particular step may be recommended.
Help Carry the Plan Through
LifeGen does not simply prepare a plan and leave clients with a list of instructions.
The firm works with clients through the process so the legal plan can be properly implemented and important follow-up steps are not overlooked.
Match the Planning to the Timing
Someone preparing years in advance is in a different position from a family making decisions after a nursing-home admission. The planning needs to reflect the circumstances that exist now.
Medicaid concerns may overlap with trusts, powers of attorney, long-term care planning and wealth protection.
LifeGen Law Group serves families from its Springfield office and works with clients from Branson and communities throughout Southwest Missouri.
QUESTIONS BEFORE YOU MAKE A DECISION
Missouri Medicaid Planning FAQs
What is Medicaid planning?
Medicaid planning is the process of preparing for possible Medicaid-funded long-term care while considering the eligibility rules that apply to the individual.
It can involve questions about income, property, financial resources, prior transfers, marital circumstances, estate-planning documents and the anticipated timing of long-term care.
For a broader educational overview, read Medicaid Planning in Missouri: What Families Need to Know Before a Crisis Hits.
Do I have to spend everything before Medicaid will help with nursing-home care?
Not necessarily.
Medicaid eligibility is more complicated than simply spending every asset down to nothing. Different resources may receive different treatment, and married couples may have additional protections.
The answer depends on the applicant’s circumstances and the Medicaid rules in effect at the time.
Can I give my house or money to my children before applying for Medicaid?
A transfer should not be made without first understanding its possible Medicaid consequences.
Certain transfers for less than fair value during the applicable look-back period can affect eligibility for long-term-care Medicaid.
What if my spouse needs a nursing home but I still live at home?
Medicaid’s spousal-impoverishment rules may allow certain resources or income to be protected for a spouse who remains in the community.
How those protections apply depends on the couple’s circumstances and current program rules.
Is it too late to plan if my parent is already in a nursing home?
Not necessarily.
There may still be planning issues to address after nursing-home placement, but the situation is more time-sensitive and the available options can differ from those available with advance planning.
When care is already needed, Crisis Planning & Power of Attorney Assistance may also become relevant.
Is Medicaid planning the same as long-term care planning?
They are related, but they are not identical.
Long-term care planning looks more broadly at how future care may be provided, coordinated and paid for.
Medicaid planning focuses on the legal and financial considerations involved in seeking Medicaid-funded long-term care while complying with the program’s rules.
Crisis planning addresses situations in which care or legal assistance is already needed or may be needed very soon.
START WITH A CONVERSATION
Get Answers Before Making Major Financial Decisions
If long-term care is becoming a concern, you do not need to understand Medicaid before asking for help.
You may simply know that a parent needs more care, your spouse may need a nursing home, or you are worried about how long-term-care costs could affect your family.
That is enough reason to begin asking questions.
LifeGen Law Group helps Missouri families understand how Medicaid planning may fit into the larger elder law and long-term-care picture and what steps may be appropriate for their circumstances.
The information on this page is general educational information and is not legal advice. Medicaid eligibility and planning options depend on individual circumstances and current law.