Medicaid Planning
Medicaid is the only realistic path for most families. The rules don't make sense. We make them work.
Medicaid planning is the legal and financial strategy used to qualify for long-term care Medicaid benefits while preserving as much of a family's assets as the rules allow. It involves the five-year lookback, spousal protections, trust structures, and a state application process that punishes small mistakes.
Recognize yourself in any of these?
Mom's running out of money and the nursing home wants $14,000 a month.
This is the call we get most often. There is almost always more room to plan than families realize, even after a parent has entered care — but the clock starts the moment you ask.
We were told to spend down. We don't think that's right.
It usually isn't. A blanket 'spend down to $2,000' instruction ignores spousal protections, exempt assets, and legitimate planning tools that can preserve a meaningful inheritance.
We tried the application ourselves and were denied.
Medicaid denials are common and almost always appealable. The application is a 100-page document with adversarial reviewers. We've handled hundreds.
The work, named honestly.
- —Pre-need Medicaid planning, ideally five-plus years before care is needed
- —Crisis Medicaid planning when care is imminent
- —Medicaid Asset Protection Trusts (MAPT)
- —Spousal Refusal and Community Spouse Resource Allowance strategy
- —Caregiver agreements and qualified transfers
- —Application preparation, submission, and appeal
An approach, not a transaction.
Medicaid work is time-sensitive. Every month of delay is roughly a month of private-pay nursing home costs. We respond to crisis intakes within one business day.
About the Guidance ProgramFrequently asked questions about medicaid planning.
What is the five-year lookback?+
When you apply for long-term care Medicaid, the state reviews five years of financial history. Any gifts or transfers made during that period can trigger a penalty period during which Medicaid won't pay for care. The lookback is the single most important rule in Medicaid planning and the reason early planning matters so much.
Will Medicaid take my house?+
Not while you're alive, in most cases. The primary residence is generally an exempt asset for Medicaid eligibility purposes. After death, the state may seek to recover what it paid for care through estate recovery, but careful planning — particularly with trusts and life estates — can protect the home for the next generation.
Can my spouse keep our savings if I go on Medicaid?+
Yes, within limits and often more than families realize. The Community Spouse Resource Allowance protects a significant portion of joint assets, and Spousal Refusal in New York and certain other tools can preserve substantially more. The numbers change each year — call us for current limits.
Is it too late to plan if Dad is already in a nursing home?+
Almost never. Crisis Medicaid planning has its own toolkit — gifting with promissory notes, spousal refusal, personal services contracts — that can preserve assets even after care has begun. The earlier you call, the more we can do.
Let's figure out the next step together.
A 15-minute call is free. There's no obligation, and there's no sales pitch.
Schedule the call