Ethics of Nursing Home / Medicaid Planning

An essential component of our elder law and estate planning practice at The Center for Elder Law, a division of BRMM, is advising clients on nursing home planning, which includes Medicaid planning. Through sound long-term care planning, we assist elders, their spouses, and families in planning for the high cost of long-term care and navigating the ever-increasingly complex Medicaid laws and rules.

For several decades, the topic of the “ethics” of Medicaid planning has been discussed publicly and vigorously. In recent months, a nationwide newspaper took on the subject and ratcheted up the dialogue. At the root of the debate is the question of whether it is “ethical” for a person to qualify for Medicaid coverage by transferring assets in order to meet Medicaid eligibility requirements.

Ethics of Qualifying for Medicaid

The ability to qualify by converting or transferring assets exists because of the way the law is written and applied: Federal and state laws and regulations set income limits and asset restrictions for meeting eligibility. In some circumstances, individuals may be able to get within the limits by making gifts to family members, purchasing an annuity, creating a trust, or buying certain long-term care insurance.

Some critics assert that it is unethical for a person to use to those options to become “artificially impoverished” and thereby become eligible to receive Medicaid payments for long-term care. Many other commentators are in complete disagreement with that view of Medicaid planning.

Elder law attorneys are uniquely positioned to counsel elders regarding this complex area of the law. If they fail or refuse to counsel elders regarding legally permitted options, elder law attorneys will have failed in their duty to their clients. Thus, a lawyer’s failure to advise a client of all of the client’s long-term care financing options is unethical.

We have a health care system that addresses interests of the market place and not the person. For an elder who is “lucky” enough to develop an acute illness, such as myocardial infarction or a stroke, Medicare will pay the bill. For persons who are unlucky and develop a chronic illness such as Alzheimer’s disease that requires years of costly long-term care, the American health care market place forces them to “spend down” to Medicaid eligibility. No moral disgrace should therefore attach to efforts by the sufferer and his or her family to engage in Medicaid planning to minimize the financial impact chronic illness imposes on them. Until the United States elevates health care to a moral right, instead of a property right, Medicaid planning is morally and ethically justified.

Why Nursing Home and Medicaid Planning Matters

Our elder law and estate planning attorneys at BRMM help elders and their families evaluate resources and needs to ensure that the elder will be taken care of in the best possible way. Part of the evaluation includes considering what might happen if there comes a time that staying in the community is not the best option for the elder. That requires discussing long-term care planning issues, which means nursing home and Medicaid planning.

Medicaid is a complex government program provides long-term care for people without the means to pay for that care themselves. In fact, many individuals do not have the personal financial resources to pay out-of-pocket for the high cost of nursing home care for years on end. As proof of that fact, Medicaid is the primary source of payment for long-term care services throughout the United States.

Medicaid planning involves anticipating future needs and determining how potential Medicaid eligibility will affect long-term care options. Our elder law attorneys evaluate the client’s circumstances within the context of the federal and state Medicaid laws and regulations, including the eligibility requirements and restrictions. In some cases, Medicaid planning may involve giving consideration to transferring or converting assets within the parameters permitted by those laws to facilitate receiving Medicaid assistance. Ultimately, the client decides on what approach is best to accomplish his or her goals.

Sound Medicaid planning can benefit you and your family in a number of different ways, including:

  • Making your resources last longer, by qualifying for partial assistance for home and assisted-living care
  • Protecting the financial health of your spouse
  • Preserving the family home or business
  • Taking care of family members with special needs

Additional information about Medicaid is available in two articles by our elder law and estate planning attorneys: What Is Medicaid and How Can It Help You? and Medicaid Myths: A Grain of Truth, but Mostly Myth

Talk With an Attorney at The Center for Elder Law

Medicaid planning is just one component that will be taken into account when you consult with a BRMM estate planning and elder law attorney about planning your financial future. We have been serving clients in southeastern Michigan since 1970s and now have the ability to meet the needs of our clients with interests or property in both Florida and Michigan.

Call us at (248) 494-4577 or complete our online form to set up a free initial consultation.

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