Medicaid Planning Attorney in Houston

Helping Clients With Medicaid Crisis Planning

Change is life’s only constant. Sometimes these changes strike without warning. If you or a loved one has experienced a sudden illness or serious accident, you understand how abruptly everything can change. Are you or a loved one suddenly in need of nursing home care? Finding and affording quality care on short notice can be a stressful and draining experience. Medicaid planning can help to take some of the worry away about how you will be able to afford long-term care and protect your hard-earned assets.

Only a well-qualified attorney can help you navigate the ever-changing Medicaid rules and eligibility requirements. When you come to us for help, we can assist you with completing and filing a Medicaid application and explain other aspects of long-term care planning.

If you are interested in Medicaid planning or have questions about your legal options, contact Kisch Law Firm, PLLC, today to schedule a consultation. Our experienced attorney will gladly review your case and help you determine the best options for care, as well as how to qualify for Medicaid assistance.

What is the Cost of Long-Term Care?

Long-term care is expensive, and these costs only continue to increase as baby boomers age. Although the range varies depending on where you live, according to the Genworth Cost of Care Study for 2020, the national median annual cost of a private nursing home room is $105,850, with a 3.57% annual increase since 2019.

With improved medical care, the average life span of adults is also increasing; this translates into more years of care at increasingly higher rates. Without some sort of financial assistance, these costs could be financially devastating. Your entire life savings could be quickly depleted within a few years of needing long-term care. That being the case, you must begin thinking about advanced planning before an emergency occurs.

The most effective solution is to consult an attorney about Medicaid planning. Medicaid is a joint federal and state program that assists individuals with low incomes and limited resources. While Medicare provides minimal long-term care coverage, Medicaid offers much more extensive coverage. However, due to its restrictions, qualifying for Medicaid can be extremely challenging. However, paying for a nursing home without it could be nearly impossible.

How is Medicaid Eligibility Determined?

Although Medicaid requirements vary from state to state, they all share one common element: complexity. Each state specifies a maximum allowable income for individuals and couples to qualify for Medicaid.

To qualify for Texas Medicaid, the applicant must be a state resident and a U.S. citizen or have a lawful immigration status. More importantly, a physician must attest that the individual’s stay in a nursing home is medically necessary and that it requires that particular level of care.

Additionally, the applicant’s total assets cannot exceed a specified amount known as the Individual Resource Allowance, which is consistently very low, often as low as $2,000. Although certain possessions, like your home and automobile, are “exempted” for purposes of determining Medicaid eligibility, this figure is still alarming. To further complicate the situation, Texas also enforces a five-year look-back period, during which the state checks for any asset transfers. If you have transferred assets within the past five years, you could be penalized, making it more challenging to receive the financial help you need.

What is the Maximum Community Spouse Resource Allowance?

If only one spouse is applying for Nursing Home Medicaid or Home and Community Based Services (HCBS) Waivers, the asset rules become more complex. The applicant spouse is generally allowed to keep up to $2,000 in countable assets, while the non-applicant (or community) spouse can retain a Community Spouse Resource Allowance (CSRA) — up to $157,920 in 2025, depending on the state.

If a couple’s combined countable assets are at or below $157,920, they may not need to spend down at all. The full amount could be protected for the community spouse, allowing the applicant to meet the $2,000 limit. However, if the couple’s assets exceed the combined total of the applicant’s $2,000 limit and the community spouse’s CSRA, a spend down is required. For example, if the couple has $160,000 in assets, the community spouse may keep $157,920, but the applicant would be left with $2,080 — requiring a spend down of $80 to qualify.

Importantly, giving away assets to meet these limits can trigger a Medicaid transfer penalty, potentially delaying eligibility for months or even years, depending on the value of the assets transferred.

How Can a Medicaid Planning Attorney Help Me Prepare for the Future?

If you are trying to qualify for Medicaid benefits, you need an experienced Medicaid planning attorney who can assist you with navigating the program’s complex rules. A Medicaid planning attorney is familiar with the legal nuances involved in obtaining benefits, especially with the upcoming changes.

The first action your attorney will take is to assess your income and assets thoroughly. Suppose your primary concern is qualifying for Medicaid nursing home benefits. In that case, an attorney can help you structure your assets through comprehensive estate planning or gift-giving strategies. For example, suppose your monthly income exceeds the allowable limit. In that case, a Medicaid planning attorney may be able to help you set up a Qualified Income Trust (QIT), also known as a Miller Trust. Your excess income is placed in the QIT and no longer considered part of your countable assets.

Your attorney can also assist you in completing the complex application process and ensure that you have the proper documentation. In many instances, applications are denied or delayed because they are filled out incorrectly or are missing information.

Fortunately, though, our experienced professionals can guide you through the Medicaid maze. Our legal team can advise you throughout the application process, ensuring that you retain the maximum income and total assets allowed by law.

What are Some of the Ways That I Can Protect My Assets and Still Qualify for Medicaid Benefits?

Although the Medicaid program has strict guidelines for determining eligibility, there are ways to protect assets and still qualify for benefits. Aside from creating a Qualified Income Trust, there are other legal strategies that your attorney can recommend.

Irrevocable Trusts

A Medicaid Protection Trust (MAPT) is one type of irrevocable trust that can be used to protect assets from estate recovery. Assets placed in an irrevocable trust are no longer considered to be under your control and, in most instances, are not considered countable assets.

Gifting

Another option in Medicaid planning is “gifting,” where an individual transfers assets to another person for less than fair market value. However, due to the complexity of Medicaid’s five-year look-back period and potential penalties that may apply, it is advisable to consult with an attorney to determine if this is a viable legal strategy.

Lady Bird Deeds

A Lady Bird deed, also known as an enhanced life estate deed, is a Medicaid planning tool that allows a recipient to retain ownership of their property during their lifetime and pass it directly to their heirs upon death. A Lady Bird deed allows the property to bypass probate and avoid Medicaid estate recovery.

It is worth noting that although there are several ways that a lawyer can act to protect assets, there may be critical time limits that can restrict your options. Your best option is to obtain sound legal advice from a qualified Medicaid planning attorney.

Why Should I Choose Your Houston Medicaid Lawyer to Help Me Plan?

One of the primary concerns for older adults is the worry of having to go to a nursing facility and losing their hard-earned assets. If you are concerned that you may need to be admitted to a nursing home, you must seek appropriate counsel before you apply for and seek to qualify for Medicaid. Due to the high cost, even a short stay in a nursing home could result in financial devastation for you and your family members.

Our law firm is passionately committed to helping Houston families maintain their assets and preserve their Medicaid eligibility. Our highly experienced Houston Medicaid lawyer possesses the knowledge and training necessary to achieve results and assist clients with accessing essential government benefits.

We will work tirelessly to give you and your family peace of mind during a difficult and uncertain time. When dealing with Medicaid, legal advice is something you cannot afford to go without. Contact Kisch Law Firm, PLLC, today at 844-417-6343 to schedule a free consultation and begin working on your case.