Questions to Ask Elder Care Lawyer About Medicaid
Questions for a first meeting with an elder law attorney about Medicaid coverage for long-term care. They cover eligibility, transfers already made, the family home, the spouse who remains at home, estate recovery, timing, and fees. Rules differ by state, so the answers should be specific to where the person needing care lives.
The questions
Open any question for the note
How much of your practice is Medicaid long-term care work, and roughly how many applications did you handle last year?
Why ask it
Volume matters here because the rules are state-specific and change. An attorney who does this occasionally alongside general estate work may know the statute but not the local caseworkers, the current processing times, or which documents that office asks for twice.
Are you licensed in the state where my parent lives, and where would an application be filed?
Why ask it
Eligibility follows the state where care is received, not where the family lives. If a move across state lines is being considered, say so now, because it can restart parts of the process.
Based on what I have told you, does my parent appear eligible today, and if not, what is standing in the way?
Why ask it
A useful answer names the specific obstacle: countable assets over the limit, income above a threshold, a recent transfer, missing documentation. Anyone who answers with reassurance rather than an obstacle has not yet looked at the numbers.
Which of my parent's assets count toward the limit in this state, and which do not?
Why ask it
The distinction between countable and exempt property is where most family assumptions turn out to be wrong, particularly about a car, a burial fund, or a retirement account. Ask for this in writing, since you will be working from it for months.
How does the look-back period apply to money we have already moved?
Why ask it
This turns an abstract rule into your own timeline. You want the date the clock starts from and which past transactions fall inside it, including gifts to grandchildren and help with a relative's rent.
We gave money to family a while ago. What is the likely consequence, and can anything be done about it?
Why ask it
Disclose this early, because the alternative is a caseworker finding it later. Listen for whether a penalty period is likely, how long it would run, and whether returning the money is an option in this state.
What happens to the house while my parent is receiving care, and what happens to it afterwards?
Why ask it
The two halves have different answers, and families often hear only the first. Ask specifically about who else lives there, since rules can differ when a spouse, a disabled child, or a caregiving child is in the home.
If one spouse needs care and the other stays at home, how much income and how many assets can the spouse at home keep?
Why ask it
This is the question that decides whether the healthy spouse can pay the bills. Ask for the figures that apply in this state this year, and ask what happens to those protections if the spouse at home dies first.
Would a trust or any other arrangement help in our situation, and what does it cost to set up and to undo?
Why ask it
The cost of reversing a plan is the part rarely volunteered. Be cautious of a recommendation made before anyone has reviewed the account statements, and ask what happens if care is needed sooner than the plan assumes.
In my parent's situation, what would Medicare pay for and what would Medicaid pay for?
Why ask it
Families frequently arrive believing Medicare covers a long nursing home stay. Getting the split stated plainly, with the limits on the Medicare side, prevents a painful surprise a few weeks into a rehabilitation stay.
Is there anything we should do or stop doing this month, before anything else?
Why ask it
A good answer is short and specific: stop making gifts, keep every bank statement, do not sell the car yet, get a power of attorney signed while your parent can sign it. If nothing is urgent, that is worth hearing plainly too.
What documents will you need from us, and how far back do they have to go?
Why ask it
The volume tends to surprise people, and gathering statements from a closed account or a former bank can take weeks. Ask for the list in writing and start with whatever is hardest to obtain.
Who deals with the state agency during the application, you or us?
Why ask it
This is a common gap between what a family assumes it has bought and what the fee covers. Get it clear who answers requests for more information and who is responsible for meeting deadlines.
How long does an application usually take in this county, and what causes delays?
Why ask it
Local experience shows here. The delays named are usually mundane, such as a missing statement or a life insurance policy nobody remembered, which means most of them are avoidable if you know in advance.
How does the nursing home get paid between the application and a decision?
Why ask it
Coverage can be retroactive, but the facility still wants money in the meantime and may ask a family member to sign for it. Ask what to sign and what not to sign, since personal liability sometimes hides in admission paperwork.
If the application is denied, what does an appeal involve, and is it included in what I am paying you?
Why ask it
Denials are often about paperwork rather than eligibility, so the practical question is how quickly a fixable denial can be corrected. Find out whether appeal work is billed separately before you need it.
Once approved, what has to be reported, how often, and what happens if we miss something?
Why ask it
Eligibility is reviewed, not granted once. Ask what triggers a review, such as a change in income, an inheritance, or a sale, and who in the family will be responsible for noticing.
How does estate recovery work in this state, and what can be done about it in advance?
Why ask it
This determines what is left for heirs, and it is the part most families learn about too late. Ask what the state can claim, what it cannot, and what the practical options are rather than only the theoretical ones.
What are your fees, what should the total cost be, and what is not included?
Why ask it
Ask whether the work is flat fee or hourly, what triggers extra charges, and whether court filings, appeals, and deed work are separate. A written engagement letter listing exclusions is more useful than a single number.
If we did nothing beyond paying the bills as they come, what would happen?
Why ask it
This gives you a baseline to judge the advice against. An attorney willing to say that a family's situation needs little planning is more trustworthy than one who finds a costly structure necessary in every case.
Preparing for a Medicaid planning consultation
Practical guidance for the conversation itself
What to gather beforehand
- Bank, retirement, and investment statements, ideally covering the full look-back window the attorney names.
- The deed to any property, plus mortgage and tax records.
- Life insurance policies, annuities, and any prepaid burial arrangements.
- Income records: Social Security, pensions, rental income, and any support from family.
- A written list of gifts and transfers, with dates and amounts, including informal help to relatives.
- Existing legal documents: power of attorney, healthcare directive, will, any trust.
- A short written summary of the current care situation and what the facility or home care agency charges.
During the meeting
Bring the person who holds the power of attorney
The attorney can only take instructions from the person needing care or from someone with legal authority to act for them. If no power of attorney exists and your parent can still sign, that is usually the first task, ahead of any planning.
Say everything, including the parts that look bad
Undisclosed gifts, a joint account with a child's name on it, an unreported sale, or cash held outside a bank all change the advice. Advice built on an incomplete picture is worse than no advice, and the state will see the accounts.
Ask for the state figures in writing
Asset limits, income thresholds, and spousal allowances are numbers that change and vary by state. Leave with them written down, along with the date they apply from.
Take notes and ask for a summary
A one-page written plan with steps and owners is worth asking for directly. If the answer is that the firm does not provide one, write your own and send it to them for correction.
Answers that warrant a second opinion
- A promise that all assets can be protected, made before anyone has read the statements.
- A specific financial product recommended at a first meeting, particularly by someone who earns a commission on it.
- Advice to move assets quietly, to leave a transfer off the application, or to say a gift was a loan.
- No written fee agreement, or a fee described only as depending on how things go.
- Reluctance to say which state rules apply, or answers given in general terms when you asked about your parent's state.
After the consultation
- Write down what you were told the same day, including the numbers, and share it with the siblings who are not in the room.
- Do the urgent items first, particularly signing a power of attorney while your parent has capacity to sign.
- Keep every statement and receipt from this point on, in one place, sorted by account.
- If a facility hands you admission paperwork, ask the attorney to look at it before anyone signs as a responsible party.
- If you consulted more than one firm, compare what each said about the look-back period and the house, since disagreement there usually reveals who knows the local practice.