Experienced & Knowledgeable Medicaid Planning Attorney in New York

Many people confuse Medicare and Medicaid. These programs are very different, as Medicare is run completely by the federal government and Medicaid is administered by each individual state. The most important difference is that Medicaid has financial requirements and limitations, and you need an experienced attorney to help you determine whether you qualify and how to obtain those benefits.

Contact my office via e-mail or call me today at  to discuss your Medicaid elibility and how to plan for those benefits in the future. The Law Offices of Andrea Lowenthal, PLLC, has extensive experience in Medicaid planning issues and can help you plan appropriately.

Medicaid Benefits – Financial Restrictions and Limitations

The Medicare and Medicaid programs are very complex. In general terms, although Medicare will cover certain hospitalization for a limited period of time, it does not cover care in a chronic care facility (nursing home) when that care is “custodial” or “personal”.

Custodial or personal care generally refers to assistance with “activities of daily living” (“ADLs”), which include:

• Bathing
• Eating
• Dressing
• Toileting
• Transferring

High Costs of Nursing Home Care

The cost of a nursing home stay varies by region across New York State, with New York City having the highest average rate. The annual cost of a nursing home can as high as $100,000 or more depending on the region, a sum that would very quickly exhaust the assets of many people.

Planning for the financial strain of chronic care does not have to mean that you or a loved one will necessarily enter a nursing home; you might still plan and be able to secure care in your own home. However, without advance planning, your options for enduring the financial strain become more limited.

I am very experienced in the complicated nature of Medicaid planning, including the “look back period” through which the government can examine asset and debt transfers as far back as 5 years in determining whether you or a loved one may qualify for Medicaid benefits. The law and the means of qualification are complex, so consultation with an attorney is essential.

Medicaid Assets and Income Concerns

Determining Medicaid eligibility depends upon the type of assets, or resources, that the applicant has, and whether the applicant has less than the maximum for Medicaid eligibility. In New York State, for Medicaid “community” or home care, there is an income maximum as well; however for Medicaid “chronic care” (nursing home) there is no maximum income permissible, and instead all of the applicant’s income (except the “monthly allowance”) must be used to pay for care of the applicant. If the applicant is married, the spouse has a duty of support, and the spouse’s income must also be considered (but there is some minimum income protection for the at-home spouse).

The Medicaid rules are complicated, and you want to be very sure that you understand what benefits are available to you, whether you are seeking care at home or in a nursing facility. You also want to be sure that you are obtaining the maximum Medicare benefits available you for the medical and rehabilitative care that you may receive.

At the Law Offices of Andrea Lowenthal, PLLC, you will receive compassionate, thoughtful support, and will be educated about the choices available to you and how you can plan, whether your needs are immediate, or you have a planning horizon of several years. Call for a consultation.

The Medicaid Application

Preparing and defending an application for Medicaid benefits is document-intensive, and must be done correctly or valuable time and benefits may be lost. For most families the application process is very burdensome. For example, the applicant must provide 5 years of bank, investment and related financial statements, which must be reviewed carefully, as well as numerous personal documents for the applicant. Often this burden falls upon the adult children of the applicant who already feel overwhelmed with their caretaking responsibilities. With appropriate legal support and guidance, the application process can be far less intimidating.

Becoming eligible for Medicaid is not just a matter of filling out the application, but of understanding how all the information you provide will be used to determine your eligibility. If you fail to provide certain information, or if you are not prepared ahead of time to explain certain of the information you are providing, your application might be rejected and you will have lost even more time and suffer significant expense in bearing the costs of your care privately. You can begin to plan ahead, even if its only a few months ahead, but if you need care now, then don’t lose time just because you are not familiar with the application process. Guidance is available.

At the Law Offices of Andrea Lowenthal, PLLC, you will receive compassionate, thoughtful support, and will be educated about the choices available to you and how you can plan, whether your needs are immediate, or you have a planning horizon of several years. Call for a consultation.

Caregiving or Personal Care Contracts

Caregiving or Personal Care Contracts can be important both for financial Medicaid planning and for personal planning. Whether you are a person who needs someone to help care for you, or you have found yourself with the responsibility to care for an aging parent or other relative, creating a formal Caregiving or Personal Care Contract may be appropriate for both parties. While spouses owe a duty of care and support to one another, many caregivers are in the immediate or extended family and do not have that legal duty to provide care. Often, these caretakers have children of their own to care for, and this dual burden gives rise to the term “Sandwich Generation”.

For the recipient of care, having a contract, even with a family member, may help alleviate the ongoing sense that the care given is not defined or compensated. For the caregiver, having both compensation and defined responsibilities, provides both financial and personal recognition and minimizes misunderstandings and stress, especially because the caregiver is often foregoing other employment or personal activities. The responsibilities, compensation, and other terms must be carefully established in accordance with Medicaid guidelines so that future Medicaid benefits are not inadvertently lost.

A Caregiving or Personal Care Contract must be prepared by an experienced and knowledgeable attorney so that the payments made under the contract are not later rejected by Medicaid resulting in a “penalty period” for “uncompensated transfers of assets”.

At the Law Offices of Andrea Lowenthal, PLLC, you will receive compassionate, thoughtful support, and will be educated about the choices available to you and how you can plan ahead, whether you are looking ahead 5, 10 or 20 years or whether your planning horizon is “yesterday” because you are facing immediate decisions.

Contact My Office for Compassionate Care

I will help you plan ahead for the funds and resources necessary for your long term care or for elderly family members. If you have to take action right now, I can help you with last minute planning arrangements, and the Medicaid application and fair hearing process.

Contact my office today to discuss your planning needs with a compassionate and caring lawyer.