Understanding Medicaid Planning and Its Costs

Medicaid Planning

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Medicaid planning is a critical process that allows individuals to organize their financial resources in a way that enables them to qualify for Medicaid, a joint federal and state program that provides healthcare coverage to individuals with limited resources. This article provides an in-depth analysis of what Medicaid planning entails, the professionals involved, the costs, and its relevance in the present day healthcare system.

What is Medicaid Planning?

Medicaid planning refers to the process of structuring one’s financial resources to meet the eligibility criteria for Medicaid. It can range from simple assistance with document collection and preparation to complex financial restructuring. This process is particularly important for individuals whose monthly income or resources exceed the financial eligibility limits set by Medicaid.

The complexity of Medicaid planning arises due to multiple factors. These include an individual’s income level, the value of their countable assets, and their marital status. In addition, the Medicaid laws and regulations vary by state and change frequently, adding to the complexities.

The Role of Medicaid Planners

Medicaid Planners are professionals who assist clients in navigating the Medicaid eligibility process. They structure clients’ financial resources, manage asset transfers, and convert countable assets into exempt assets to preserve a family’s resources and ensure Medicaid eligibility.

They also work towards protecting a family’s home from Medicaid recovery and managing finances to ensure that a healthy spouse continues living independently during and after the time when their partner is receiving care assistance.

It is estimated that between 60% and 75% of Medicaid applicants engage in some form of Medicaid planning before submitting their application. This highlights the significant role that Medicaid Planners play in the Medicaid application process.

When to Hire a Medicaid Planner

Whether or not to hire a Medicaid Planner depends on the individual or family’s specific situation. For instance, if an individual’s countable assets are well below the limit set by Medicaid, they may not need to hire a Medicaid Planner. However, if an applicant’s countable assets exceed the limit, it might be prudent to retain the services of a Medicaid Planner.

The decision to hire a Medicaid Planner should be based on a thorough analysis of one’s financial situation, the complexity of their case, and their understanding of Medicaid’s rules and regulations.

The Cost of Medicaid Planning

The cost of Medicaid planning varies significantly based on the complexity of the case, the type of Medicaid Planner hired, and the specific services required. While some planners offer free services, others may charge fees ranging from $3,000 to $10,000.

It’s important to note that the cost of Medicaid planning is generally less than the cost of one month’s care in a nursing home. Therefore, despite the potentially high upfront cost, Medicaid planning can be a cost-effective investment in the long run.

Types of Medicaid Planners

There are numerous types of professionals who offer Medicaid planning services. These include:

  • Elder Law Attorneys: These professionals have a comprehensive understanding of Medicaid laws and can establish necessary trusts on behalf of their clients.
  • Geriatric Care Managers: They offer a broad range of services, including care planning and coordination. They are also familiar with local programs that provide financial assistance alternatives to Medicaid.
  • Eldercare Financial Planners: These planners have a deep understanding of all financial options available to seniors and are well-versed in planning strategies that address long-term care needs.
  • Public Benefits Counselors / Case Managers: These are state-employed individuals who offer free assistance with the Medicaid application process.
  • Commission-Based Medicaid Planners: These planners help individuals whose assets exceed Medicaid eligibility limits. They provide free services and are compensated through commission earned when the client purchases Medicaid compliant annuities.
  • Insurance Agents: They can help navigate the Medicaid application process, but their primary goal is to sell insurance products.
  • Long-Term Care Ombudsmen: These are federally funded individuals who help resolve complaints of individuals residing in nursing homes and other such facilities. They also provide some counsel on financial matters.


Medicaid planning is a crucial process for individuals seeking to qualify for Medicaid benefits. It involves complex legal and financial maneuvers aimed at ensuring that applicants meet the eligibility criteria set by Medicaid. While the cost of Medicaid planning can be high, the potential benefits often outweigh the upfront costs. By working with a professional Medicaid Planner, individuals can navigate the complexities of the Medicaid application process, protect their assets, and secure the medical care they need.