Medicaid Planning

When it comes to Medicaid’s assistance with Long Term Care Planning for seniors, there are different programs for different needs. The rules are constantly changing, and the rules for federal programs can vary from state to state. North Carolina’s Medicaid program changes so frequently that there is no printed handbook for navigating the system; there is only an online avalanche of 200,000+ rules that are subject to change from day to day.

The complexity of the system is why it is so important to talk to an experienced Certified Medicaid Planner© (CMP) who has access to the best documents available in planning for long-term needs. A good CMP will be able to address the following, often-asked questions:

  • How do people shelter a lifetime worth of assets when Medicaid and other offices seem to want people to be broke?
  • Do people simply give everything away? If not everything, how much?
  • Isn’t it true that planning can only be done five years before nursing home care is ever needed? And if you don’t have five years, you’re out of luck?
  • (For the children) Is there anything I can do if Mom or Dad has to go into a nursing home in the next few weeks?

No one really knows what life will bring. There are highs and lows, and lots of in-betweens. Even day to day, let alone years in advance, there is no real way to know what will happen to us and our loved ones. All we can do is hope for the best AND plan for the worst.

A Few Simple Truths

After nineteen years working as a Life and Estate Planning attorney the following has consistently been proven true:

  • Families that plan ahead are better off than those who do not;
  • Families that plan for multiple contingencies, even unlikely ones, are rarely caught unprepared for the big disasters; and
  • The further ahead families plan, the more families can save.

Working with estate planning professionals can provide you with sound, reasoned, experienced advice. If you take the time to plan ahead the right way, there is a much better chance that things will work out well for you and your family. Nowhere is this more true than with Medicaid and Long Term Care Planning. The key is taking certain simple but effective steps while avoiding simple but disastrous “folk remedies” that are out there.

For example, a loved one is deep into dementia, and the doctors estimate that in about one year she will need skilled nursing home care. Financially speaking, however, she could qualify for Medicaid today. And, by arranging her assets the right way with enough lead time, she won’t even need to spend down a single penny by the time she applies for Medicaid.

Our staff is happy to help you learn the basics of Care Assistance Planning before you begin rearranging assets. One thing we can tell you about Medicaid qualification specifically is that it is never simple and it is never a matter of taking the same three steps that everyone else does. Each situation is unique, and getting one little thing wrong can cause the entire plan to implode.

Paying for Care

Click on the video below to learn more about the four ways of paying for nursing home care…

Did you know that the cost of nursing home care in North Carolina ranges between $5,000 to $10,000 a month? That’s a lot of zeroes. After the sticker shock wears off, it’s time to think about how to plan for long term care – since statistics show the majority of us will need it at some point in our lives. The question is: How to pay for it?


If you have the money to cover the costs of a nursing home, that is certainly one way that you could pay.  The big problem is that the average cost for nursing home care today is $6,500 per month in North Carolina. It’s more in the metropolitan areas and less in the outlying regions. Having that kind of income to cover those monthly expenses may not be an option for most people.

Liquidate Assets

Paying for care may include a combination of readily-available income and the liquidation of assets in order to pay the difference. Selling off stock and real estate to generate the cash are examples of these options.

Long Term Care Insurance

This may be a very valuable tool if you get it at the right time and at the right price when you are young enough, before there is actually a need for it. Unfortunately, a lot of people who come to me with questions about long term care insurance have not purchased it, and now something has come up and they are not in a good financial position, making long term care insurance not an affordable option.

Care Assistance Planning

That’s where we look at everything and try to get the person qualified for Medicaid to handle the costs of nursing home care. It’s very complex:  It involves income, possible rearranging and spending of some assets, followed by Medicaid coming in and picking up the difference.