Why Should You Consider Hiring a Certified Medicaid Planner to help with Medicaid or ALTCS Planning?

Here’s an alarming fact is you may have to spend more when you’re at the least financially productive stage of your life. That’s the harsh truth facing everyone over 65.

According to the Department of Health and Human Services,  on average, senior citizens spend around $140,000 on long-term care expenses. In Arizona, the average cost of a nursing home is over $8,000 per month or  $96,000 per year, and the average cost for assisted living is around $6000 in 2022!

For most in the U.S., without government-funded insurance programs such as Medicaid,  future long-term care cost would wipe out all their life savings. Medicaid long-term care, ALTCS in Arizona is by far the best state-sponsored program for the elderly and disabled to fund their long-term care. That said, qualifying for Medicaid long-term care or ALTCS is anything but simple and easy.

The program has severe limitations and asset requirements, and the rules frequently change. Its complexity threatens to keep out many people who’ve paid taxes deserve such assistance in the future.

Because of the limitations,  asset requirements, frequent changes, and often complicated Medicaid / ALTCS application process, you should consider the assistance of a Certified Medicaid Planner(CMP) to structure your financial resources to improve your odds of qualifying for the program.

In this guide, you’ll learn about what a Certified Medicaid Planner™ (CMP™) is, how can a CMP™ help, why do you need one, and more.

What is a Certified Medicaid Planner?

A Certified Medicaid Planner(CMP) is a professional and an expert in the rules and regulations of the Medicaid / ALTCS long-term care program. The CMP™, through course work, comprehensive study of the regulations under Medicaid, along with the actual practice, has demonstrated mastery over the subject to earn certification from the CMP™ Governing Board.

Medicaid rules differ from state to state, from slightly to significantly, and the rules change frequently. The Certified Medicaid Planner™ is required to complete twenty hours of continuing education every three years.

The CMP™ must carry out its duties and responsibilities in a way that matches the highest ethical and professional standards laid down by the CMP™ Governing Board.

What Does a Certified Medicaid Planner Do?

The primary role of a Certified Medicaid Planner is to use the acquired subject knowledge and experience to ensure seniors have the best possible chance of qualifying for the government assistance program for both Medicaid or ALTCS Planning and crisis long-term care needs.

Through their efforts, a CMP™ can help clients save a significant among of money on long-term healthcare costs. The Medicaid Planner’s functions include but are not limited to the following:

  • Explain to the client the benefits of the Medicaid program, its eligibility, the Medicaid / ALTCS application process, etc.
  • Ascertain whether the client is eligible and advise whether they should pursue the plan of applying for Medicaid.
  • Collect required documents from the client or for the client from various sources. Along with the Medicaid application, the client may need to provide bank statements, paycheck stubs or other income reports, proof of residence, birth certificate, etc.
  • Help to convert countable assets to non-countable exempted assets.
  • If possible, assist clients to potentially protect the family home and other properties from Medicaid recovery for the future inheritance of the loved ones.
  • Advise the client on avoiding or minimizing penalties for past and future inadvertent mistakes in managing assets.
  • Explain and advise clients on Medicaid divorces and marriages, Lady Bird Deed (not allowed in Arizona) gifting, Medicaid Compliant Annuity strategies, and other strategies to protect assets.
Steve Dabbs with her Wife

Steve Dabbs

Steve Dabbs and Cecilia Dabbs are both Certified Medicaid Planners or CMP. 

In Arizona, 70% of ALTCS Applicants waste their Time and Money when they are denied for ALTCS after applying for it. Steve Dabbs can help you to qualify for ALTCS through his Professional Value-Added Services.

Steve Dabbs is a Certified Medicaid Planner, Certified Long Term Care Insurance Specialist, Registered Financial Consultant, Certified Estate Planner and Investment Advisor Representative. With over 35 years’ experience he is a uniquely qualified Long Term Care Financial Planner.

Contact us for Free Consultation!

Why Should I Hire a Certified Medicaid Planner?

You work for decades to build up a nest egg and pay your fair share of taxes along the way. Then when you need assistance, you find you are ineligible for Medicaid / ALTCS because of this nest egg, even though you paid into the system with your tax dollars.

It isn’t fair, any which way you look at it, that you should be penalized for planning for the future.

Sadly because of the high cost of long-term care in most households, this nest egg isn’t sufficient to meet future medical and health care needs.

Medicaid / ALTCS or similar programs allow individuals and families to use means-based government assistance for their long-term care. These public benefits programs have strict eligibility guidelines. Through Medicaid planning, you can protect your assets and yet gain eligibility for the program.

You should not take Medicaid planning / ALTCS Planning lightly. Planning can avoid costly delays! The eligibility provisions are complex, the application process takes time, the review period could be lengthy, and a minor oversight could lead to denial of benefits and further delays.

The absence of Medicaid benefits could negatively affect the happiness, comfort, and in many cases, the individual’s health. The Medicaid / ALTCS application process is time-consuming and labor-intensive, which is a significant burden on people already suffering from health complications. Furthermore, Medicaid denial could be devastating for individuals, spouses, and families.

When to Approach a Certified Medicaid Planner (CMP)?

certified medicaid planner

Your situation has an equal role in deciding whether you need a Certified Medicaid Planner™ or not. The following are the four everyday situations that necessitate hiring a Certified Medicaid Planner™.

One Spouse Requires Medicaid Benefits:

Medical treatments and long-term care expenses are equally expensive. The cost of caring and other medical and non-medical expenses of aged and institutionalized spouses can deplete, even wipe out assets completely.

Under Medicaid, the residence is an exempt asset. (Equity in the home can not exceed the current limits)

A Certified Medicaid Planner™ will help to develop strategies that can be used to protect additional assets for the at-home or healthy spouse.

For instance, a Certified Medicaid Planner can assist in converting countable assets to income. Although complicated, it can be a great strategy to protect resources for the benefit of the healthy spouse and allow the institutional spouse to qualify for Medicaid benefits.  

Both Spouses Need Medicaid Care:

An aged couple could lose all their life savings, and there is a high chance of going bankrupt without Medicaid.

The mounting cost of home care, physiotherapy, nursing home care, mobility equipment, etc., can weigh heavily upon the couple. Their mental peace is further disturbed seeing their adult children with kids struggling to pay for long-term care of both parents.

Acceptance into Medicaid isn’t something to be taken lightly, especially when both spouses need public benefits. In addition to improving your chances of gaining Medicaid benefits, a Certified Medicaid Planner™  will also ensure the children don’t lose their inheritance.

Individual with No Income or Assets:

It is easy for someone with no income or assets to be approved for Medicaid. Since they fall under the low-income or those already eligible for Supplemental Security Income (SSI) criteria, the application should easily pass through.

Even individuals under this category must seek the help of a planner for document preparation. Errors while filing would lead to the rejection of the application, further adding to the individual’s hardship.

Even here, hiring a Certified Medicaid Planner™ is strongly advised.

If the individual is above the $2000 limit, the fee you pay to a CMP™ is an allowable expense.

Lastly, a Certified Medicaid Planner™ will help family members reduce their overall stress in the process.

Healthy Couple Planning for the Future:

We have all been there. Most people do not feel the need to plan or procrastinate and put off planning for long-term care, especially when they are healthy.

Then, when the need arises, options that you may have used are no longer available to you without a five year look back penalty.  

A Medicaid expert will enlighten you on the benefits of planning. In addition, a planner, who possesses the essential financial and legal techniques, would consider all your future needs and put forward a strong case for you with Medicaid.   

Do I Need Help to Prepare a Medicaid / ALTCS Application?

Before answering the questions, let’s see the most common options available for you.

Option 1: Medicaid Planning Without Assistance

When some learn that they or a family member need long-term care they will read a handful of articles on Medicaid or ALTCS Planning,  then decide against hiring a Certified Medicaid Planner.

The over confident person learns that anyone can  file the application, they decide to apply without any assistance.

A basic understanding of Medicaid is quite different from properly preparing and filing a Medicaid / ALTCS Application to make the individual a beneficiary. Moreover, a Certified Medicaid Planner™, stays in touch with the Medicaid caseworker to clarify red flags on an application and monitor the progress.

Document preparation by an individual who is not familiar with the complexity of Medicaid, or how the system works, is most likely to be shoddy and the application will often be denied.

In fact over 80% of these applications are denied by ALTCS in Arizona.

Option 2: Hiring a Non-Certified Planner

Many seniors planning for Medicaid eligibility do so when they desperately need assistance or expect the need for the same in the near future. They find these individuals on the internet and they fall victim to the first person or service offering cost-effective Medicaid planning.

Most of these people are neither certified and have limited experience in the field. The consequences of using a non-certified planner can be catastrophic. In addition to financial exploitation, hiring an incompetent, non-certified planner can lead to an increase in tax liabilities, denial of assistance, discontinuance of benefits, or even imposition of penalties.

Seniors harmed by non-certified planners have little recourse given their vulnerable health and financial situation.

Option 3: Working with a Certified Medicaid Planner (CMP)

Both methods – Medicaid planning without assistance and hiring non-certified planners – are fraught with financial pitfalls.

Planning for Medicaid involved a thorough understanding of various legal and tax-related concepts. Only a Certified Medicaid Planner™ (CMP™) with specialized knowledge and training can assess the client’s unique situation and develop a plan to structure the assets in compliance with relevant state laws.

The CMP™ can recognize legal and tax pitfalls and recommend a tax expert or attorney if needed.

Furthermore, a Certified Medicaid Planner is duty-bound to maintain the highest professional and ethical standards.

The Benefits of Hiring a Certified Medicaid Planner 

Certified planners improve your chances of getting governmental benefits. They help clients who otherwise won’t be Medicaid eligible. There are 5 more reasons to work with a Certified Medicaid Planner™ (CMP™).

  1. A CMP Simplifies the Documentation and Application Process

Rules on ‘how to apply’ differ from state to state. In some states, you’ll have to visit the Medicaid office, while others allow online application, emailing, etc.

A Certified Medicaid Planner will help you through the entire Medicaid and ALTCS application process. A CMP™ will do much of the hard work. Help you collect the needed documents and certificates of your birth, residence, income, assets/resources, and other insurance and aid programs.

If needed a CMP™ will also help you file an appeal, if your application is turned down by the local Medicaid office.

In addition, beneficiaries of Medicaid / ALTCS are required to recertify (show that they remain eligible) to continue receiving government assistance. Recertification is done annually. Beneficiaries can rely on a Certified Medicaid Planner™ to help recertify the coverage.

  1. A CMP Helps You Gain a Better Understanding of Medicaid

A CMP’s foremost duty is to explain the program’s provisions, the benefits, eligibility requirements, penalties, etc.

As an expert, a Certified Medicaid Planner™ would listen to your needs, assess your situations, and present a realistic picture of the eligibility status.

It is best not to decide a course of action before discussing with a Certified Medicaid Planner™.  

  1. A CMP™ Can Help Save Significant Amount of Money

A Certified Medicaid Planner’s role in the financial well-being of those in need of care may very well be as important as that of a doctor for their health. Financial stress affects anxiety, headaches/migraines, compromised immune systems, digestive issues, high blood pressure, muscle tension, heart arrhythmia, and depression.

Certified Medicaid Planners™ help you save money in different ways.

Certified Medicaid Planner advises clients on the pitfalls to avoid in the future. Any mistake from the client could lead to disqualification and may also lead to penalties (which is not a monetary penalty but in months without Medicaid or ALTCS benefits).

  1. A CMP Prevents You from Incurring Surprise Penalties

Medicaid / ALTCS eligibility penalties are not uncommon. Guidance and timely steps by a certified planner could ensure you receive as few penalties as possible.

How can a Certified Medicaid Planner help avoid penalties? For example, you live in a state with a look-back period of 5 years. Fifty-five months ago, you made a $100,000 gift to a family member. Now fifty-six months later, you apply for Medicaid, triggering the look-back period penalty.

Here the penalty could have been avoided with planning.

Suppose the monthly charge for nursing home care is $10,000, then your benefits will be suspended for 10 months. So, you’ll need to come up with the total amount of $100,000 because Medicaid won’t cover the expenses.

If you had consulted a CMP™, they would have advised you to defer the application by a month. This is just a simple example of how a certified planner would help you avoid penalties and save money.

  1. A CMP Would Help Save Time in Several Different Ways

The government-sponsored Medicaid program is a complex maze. There are layers of complex rules that would take an individual, months to understand. In the absence of an experienced CMP™ to guide, you’ll be lost in it forever.

A Certified Medicaid Planner™ will analyze your case and shed light on only those options and provisions relevant to your situation. Moreover, locating and gathering appropriate documents could take time. A CMP would know what documents you need and how to get them on time.

If your chance of qualifying for Medicaid is slim to none, your CMP™ would be open and honest about your situation. Instead of wasting time, you can make alternate arrangements by filing for Medicaid benefits.

What Is Medicaid Look-Back Period?

The look-back period was introduced to prevent abuse of the Medicaid program.

The provision prevents applicants from gifting or disposing of assets to stay within Medicaid’s asset limit.

While examining the documents, Medicaid would review asset management and transfer during the look back period (which is five years in most states). Violating the look back provision will invite penalties.

How Can a CMP Help if Medicaid Is Denied?

Your Medicaid rejection could be because of many reasons. Not providing the necessary documents and mistakes in the application are just two of the reasons for the denial of benefits.

A Certified Medicaid Planner™ can help with assets management and proper documentation. The steps that your certified planner takes will improve your chances of acceptance when you exercise your right to appeal to the state authority.

Final Thoughts

The Medicaid program helps millions of poor, low-income families, the elderly, and people with disabilities. But keep this in mind, “Medicaid / ALTCS isn’t just for the impoverished, it’s for the smart too.”  

Whether or not you hire a Certified Medicaid Planner could significantly affect your chances of qualifying for the government-sponsored program. A CMP™ will help you understand the public health insurance program, ensure your eligibility by structuring assets into trusts and converting countable to non-countable assets, and work on the documentation so that there is slight delay in joining the program and receiving care.

Finally, around 70% of applicants do not consult a Certified Medicaid Planner™ before forwarding their application. Interestingly, that is about the same percentage who are denied benefits too.

Contact us for Free Consultation!