Medicaid planning is one of those topics that nobody wants to think about until they absolutely have to. Usually it comes up when a parent needs nursing home care and the family realizes that Medicare doesn’t cover long-term stays. That’s a stressful moment, and the rules around Medicaid eligibility are genuinely complicated — asset limits, income thresholds, a five-year look-back period, estate recovery. It’s a lot.
We put this guide together because the right professional help can save families tens of thousands of dollars, but the wrong help (or no help at all) can be devastating. Not everyone needs an elder law attorney. Some people just need a free conversation with a SHIP counselor to understand their options. The trick is knowing which level of help fits your situation.
David Chen helped his own family through Medicaid planning when his grandmother needed memory care two years ago. The elder law attorney they hired structured things in a way that protected most of the family’s assets while still qualifying for Medicaid — but it cost $7,000 in legal fees and would have been much cheaper if they’d started planning earlier. The five-year look-back is real, and waiting until the last minute limits your options significantly.
Medicaid rules vary by state and change regularly. Always verify eligibility requirements with your state Medicaid office or a free SHIP counselor. Need a second opinion? Email us at [email protected] — our team has been through this with hundreds of families.
Medicaid Planning for Seniors: A Practical Guide
Medicaid provides healthcare coverage to low-income individuals, including many seniors who need long-term care. Navigating Medicaid eligibility and protecting your assets while qualifying requires careful planning — and the right type of professional help.
This guide explains the different types of Medicaid planning professionals and how to find the right one for your situation.
What Is Medicaid Planning?
Medicaid planning involves legally structuring your income and assets to meet Medicaid eligibility requirements — particularly for long-term care services like nursing home care.
Medicaid has strict income and asset limits. However, certain assets are exempt (a primary home, one vehicle, personal property) and there are legal strategies to protect additional assets while still qualifying. Planning ahead can make the difference between depleting your savings entirely and preserving meaningful wealth for your family.
Types of Medicaid Planning Professionals
Certified Medicaid Planners (CMPs)
CMPs are trained professionals who specialize in Medicaid planning without practicing law. They help families navigate the Medicaid application process, understand benefit options, and structure assets within legal guidelines.
Best for: Families who need guidance on the Medicaid application process and benefit options.
Cost: Varies; often less than elder law attorneys for straightforward planning.
Commission-Based Advisors
Some financial advisors offer Medicaid planning guidance as part of their services. They’re compensated through commissions on financial products they sell.
Caution: Be aware of potential conflicts of interest. A commission-based advisor may recommend products that benefit them financially, which may not always be the best option for you.
Elder Law Attorneys
Elder law attorneys provide legal advice on Medicaid eligibility, asset protection strategies, estate planning, and long-term care issues. They can execute legal instruments like trusts, spend-down plans, and Medicaid-compliant annuities.
Best for: Complex situations involving significant assets, married couples, or contested estate issues.
Cost: $3,000 to $150,000+ depending on complexity.
Geriatric Care Managers (GCMs)
Also called Aging Life Care Professionals, GCMs coordinate care for seniors and provide guidance on available benefits. While not financial planners, they often have knowledge of Medicaid programs and can connect families with appropriate resources.
Best for: Families managing care coordination who also need benefit guidance.
Long-Term Care Ombudsmen
State-funded advocates who investigate complaints and concerns in long-term care facilities. They can provide information about residents’ rights and available resources.
Best for: Seniors already in or transitioning to long-term care facilities.
Cost: Free.
Public Benefits Counselors
Social workers and nonprofit staff who help seniors access public benefits programs including Medicaid, Medicare Savings Programs, and Extra Help for prescriptions.
Best for: Seniors with limited resources who need guidance on benefits without the cost of professional legal advice.
Cost: Often free or very low cost through nonprofit agencies.
SHIP Counselors (State Health Insurance Assistance Program)
Federally funded counselors who provide free, unbiased guidance on Medicare, Medicaid, and related benefits. They cannot sell insurance or financial products.
Best for: All seniors — SHIP counselors are an excellent first resource regardless of income level.
Cost: Free.
Find your local SHIP: Call 1-800-MEDICARE or visit shiphelp.org.
Understanding Medicaid Estate Recovery (MERP)
Medicaid Estate Recovery Program (MERP) is a federal requirement that states recover costs paid for certain Medicaid services from the estates of deceased recipients. This primarily applies to:
- Nursing facility services
- Home and community-based services
- Hospital and prescription drug services received after age 55 (in some states)
Estate recovery can significantly impact what you leave to your heirs. Proper Medicaid planning — ideally done years before you need long-term care — can help protect assets through legitimate legal strategies.
Important: Medicaid has a five-year “look-back period.” Transfers of assets made within the five years before applying for Medicaid can be scrutinized and may result in a penalty period of ineligibility.
When to Start Planning
The earlier you begin Medicaid planning, the more options you have. Ideally, start:
- Five or more years before you anticipate needing long-term care — Outside the look-back period, more asset protection strategies are available
- At diagnosis of a serious chronic condition — A Parkinson’s or dementia diagnosis is a signal to begin planning immediately
- When discussing estate planning generally — Medicaid planning integrates naturally with wills, trusts, and power of attorney
Finding Help
| Resource | Cost | Best For |
|---|---|---|
| SHIP Counselor | Free | Everyone; starting point |
| Public Benefits Counselor | Free/low | Limited income seniors |
| Geriatric Care Manager | Varies | Complex care coordination |
| Certified Medicaid Planner | Moderate | Medicaid applications |
| Elder Law Attorney | $3K+ | Complex estates |
Start with your local SHIP counselor (free, no obligation) and escalate to legal counsel if your situation is complex.