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Foundational Questions About Medicaid Planning


Here’s what many people ask first.

How do I apply for Medicaid Assistance?
The process to apply for Medicaid assistance is a complicated one. There are numerous requirements and forms that need to be completed as part of the formal application process as well as face to face interviews with the Department of Social Services.

Should I only worry about Medicaid Assistance when it is needed?
No. The time to plan for Medicaid assistance is well before it is needed, generally several years. Without proper planning, an individual may be ineligible for assistance or face delays when it is needed most.

Do I need an attorney to file my Medicaid Application?

No, it is not necessary to retain an attorney to file. In fact, many attorneys are not familiar with the Social Services Law. Additionally, those that do process Medicaid applications often charge high retainer fees and will bill additionally for follow-up interviews, telephone time, etc.

If I have a home and signivicant assets, can I apply?
Yes, however with the new laws in place you will need additional planning.

I called the Department of Social Services and they said I make too much monthly income to be eligible for Medicaid.  Can I still apply?

Anybody can apply. Most of an applicant’s “excess income” can be protected by initiating a Charitable Pooled Income Trust.

If I am approved for Medicaid will I have to change my physician?

Medicare coverage will remain the primary payer of your health care costs and if you have supplemental health insurance you will keep that too. Your physicians will not change.

How much help at home can I get from Medicaid?

This depends on a formal assessment that is completed on every applicant. Over the years I’ve found the Medicaid Program has for the most part provided the care that our clients needed.

Will I lose my home if my spouse or I need Medicaid?
Of course not! As long as either one of you remains in your home, there can be no lien placed upon it. If you are a single elder, you are entitled to remain in your home while receiving services and there may be ways to protect your homestead, or at least a significant portion, even if you require care in a skilled nursing facility.

However, we recommend the protection of your home and work in conjunction with attorneys. Even if you enter a nursing home without pre-planning, you may preserve a portion.

Can I obtain all the information and help I need from the Department of Social Services or the Human Resources Administration?

Quite frankly, NO. Although they are mandated to provide you with information and assistance, they are so inundated with the overwhelming number of applicants, these departments are unable to provide significant assistance. Potential applicants often misinterpret the information which is provided. Plus, they cannot help with Medicaid planning for the protection of assets. We can provide this information, as well as the expertise and assistance you will need to apply.

If my spouse or I need a nursing home now, is it too late to plan?

Absolutely not. If a spouse needs a nursing home, you can still protect assets even if the need for care is immediate. And if there is no spouse, a significant portion of your assets may be preserved at the last minute if our advice is followed.

Do I have to do any planning if it is my spouse who needs Medicaid?

Absolutely. If a spouse needs a nursing home, you can still protect assets even if the need for care is immediate. And if there is no spouse, a significant portion of your assets may be preserved at the last minute if our advice is followed.

What are the rules for gifting assets?

The rules governing the gifting of assets are those most commonly misunderstood. They are different for Community Medicaid and Nursing Home Medicaid. The amount and the timing of the gifting is paramount when it comes to planning for a Nursing Home Medicaid application. Additionally, people tend to confuse the Federal, State and Local tax laws with Medicaid statutes. This can create significant penalty periods and unnecessary expense.

How long does the initial consultation take, and how should I prepare for it?

Our initial meeting will probably last about one hour, although we will meet with you until you are satisfied that all of your questions have been answered. You should bring information about your current income and financial holdings. We will give you specific, detailed guidelines regarding what documentation will be needed to process the application as the process progresses. The more info you bring to the consult, the more accurate the recommendations.

How long will it take to process my application?

The length of time it takes to process the application is in great part determined by how quickly you provide us with the documents needed, and what type of application you are applying for. Depending upon your county of residence, once the application is submitted, a Community application can take 1 to 2 months to be approved, and a Nursing Home application can take 3 to 6 months.

I bought long-term care insurance, so I don’t have to plan, right?

Many people are under this assumption, but this is not necessarily true. Metro Elder Care will review your policy to determine if it meets your needs.

How much do you charge for your services?
There is a fee for the initial consultation. The fee for processing your Medicaid application is determined during the consultation. This is based upon the complexity of your financial situation, and the type of Medicaid program you are applying for. Community and Nursing Home programs have varying requirements for documentation.

How can I schedule an appointment?

Metro Elder Care is located at 626 RXR Plaza, West Tower, 6th Floor, Uniondale, NY 11556.  Call to schedule an appointment at 516-797-0601 or email us at to set up a consult.