Great article! Yes, an experienced elder care attorney can get of great help with assuring all the steps are correct when trying to get a LO qualified for Medicaid long term nursing home coverage. Your State Bar Licensing "agency" can be helpful in finding licensed attorneys in your state who specialize in "elder care law" and "Medicaid." Also, your local Area Agency on Aging may have suggestions. And also worth talking with the "business office" director or person responsible for Medicaid long term nursing home processing at a Medicare/Medicaid qualified skilled nursing facility (one w/high marks, US News and other sources including CMS rate them) can be a possible source for a competent elder care attorney as these facilities often have to deal with them for residents who may be under "State Guardianship" or who have worked with families to get their LO place in said facility.

Where we live (east coast urban area), when I priced out a one-stop fee across several elder care attorneys, to help get my mom qualified for Medicaid long term nursing home coverage; the price points ranged from $6K to $12K. And this was for a "simple" process in that my mom had virtually no assets (no home to sell) just some funds in a IRA, a bank account, and income from Social Security and my dad's pension. For my mom, it was a "clean spend down" approach, but still having the attorney work with us on all the paperwork, to interface/advise with the bank to get the POA accepted in order to close the IRA and spend down those funds too; to become the representative payee on the pension so I could pay down/spend down those funds monthly, to review all the paperwork for the nursing home placement so I did NOT by accident sign something making me personally responsible; was all well worth the money. And it was paid to the attorney from my mom's funds as part of the spend down.

The attorney also advised us to "pre-pay" all funeral expenses as part of my mom's spend down, I would have never through of that if he had not advised it. And I was shocked how expensive funerals are. Just a simple burial, no services NOT even a grave site service was $15K and that did NOT include the cost of the plot ($10K) which my cousin who owned it gifted it to my mom...... The cost for a service and grave site service w/the plot would have been $40K. The attorney advised to go the cheap, simple, no service route as our State Medicaid folks would "not like" -- may not approve -- an expensive pre-paid funeral paid within the 5-year look back window. In other words, someone with few resources and doing a Medicaid spend down should NOT do the "bells and whistles" funeral spent from their own funds. I would have never known that.

All to say, yes get with a licensed elder care lawyer as NOT knowing is not a defense and the penalty may be your LO is disqualified or has a long delay before Medicaid picks up their nursing home expenses. Where we live that is $15K a month/$180K a year, yikes.

The $9k figure seems like alot unless you have over $1 mil in assets to work with going forward which is alot of paperwork.
We have hired an Elder Atty firm about an hour from us but they had good reviews.

The elder attorney I hired to help me get Medicaid for my husband is charging $9,000. Does this sound reasonable for folks needing help? My husband, 93, has dementia

Apparently in a community of just over 200,000 population, there is not a big enough client base to have elder law attorneys. SNFs, Medicaid, and other elder services are of little help. Banks did not know what I was asking for when I said I needed to set up a QIT. No one knew of a trust for the poor, only the rich. I would not recommend Medicaid except for the fact that elders have no choice. It will be interesting to see how the Baby Boomer population is treated in the upcoming years. Many are on the brink of SNF placement.

My mom was lucky in that no house,car,life ins, just her savings acct. she had 18.000 and we paid nursing home while on Medicare to 14,000. She got approved for Medicaid within a month and half. The billing dept person at nursing home was so efficient and pushed it through for her quickly. It could have been a nightmare if not for her. Mom also had all records going back 10 yrs right in her apt. I didn't have to travel or call to get all paperwork that was needed. Needless to say, with my stress and worry about my mom it sure was so much easier. Mom passed last month from dimentia and failure to thru e as she just gave up.

1 local attorney (friend's referral) said it was so specialized an area of law that he would have to learn a new specialty. He could not recommend anyone. The second local attorney I found in the phone book. He has limited experience so would handle some things but not others. I located an attorney online and 40 miles away - the only fully qualified attorney within 100 miles. This attorney works mostly with VA cases. Next I tried legal services for the poor. They said did not work cases like ours. They bumped it up to a very qualified Medicaid attorney in the state's capital - a 100 miles away. He asked me to fax all my information. He asked for a name/number of a contact person. He initiated a 3-way call. He asked "WHY hasn't the application been approved by now"? He told the contact person there is no reason to not approve if everything is the way I stated. The attorney gave her a few hints for how to deal with Medicaid. He said the 3 of us should not even need this conversation. The facility should be paid and I should not have it unresolved after this long. He said during the 3-way call that he was available for hire by either me or the facility, but neither should have to do this. I received a call from a case worker about a month later. She made a passing reference to an attorney. I don't know if that meant word got to her that an attorney may be involved. Approval notices all came at once (in the 9th month following initial application). I paid a month's deposit to the snf, paid for other services and about 10 months out started getting refunded for the deposit and other covered costs. I don't know if this cash will be used against us this next certification. I used most of it for delayed urchases/services.

In Connecticut, we are very lucky to have Medicaid For You, they are the very best when you want to apply for Medicaid for yourself or elderly parent (s)! With an attorney, the cost are not controlled and/or much higher than the flat fee they charge and you then have to compile and retrieve a great deal of financial records and info. With MEDICAID FOR YOU, it is so very much less stressful, time consuming on your part, they pretty much took care of everything. They met with Mom and my sisters once, in a rehab facility, scanned all documents we did have, took all the info to obtain records from banks etc; and we were done with that phase. They then proceeded to facilitate doing all the documentation and fullfill the balance of the application process in a very quick and timely fashion. Kept us updated regularly on the progress, helped with the spend down process advice, answered any and all questions usually the same day. Within 3 months, Mom was pre approved and once the spend down sum was within $1500.00 the then obtained the final approval. Seamlessly, efficiently and even during the most stressful time of Mom having been hospitalized from the retirement home and then to a rehab facility from which long term SNF care was necessary and her Medicaid approval was critical in helping us achieve our goal of having Mom admitted to a Nursing Home of Our choosing. Without them we would never have gotten thru it all, in such a smooth, timely, efficient and effective manner.

Very good article. Especially the part about not all attorneys are qualified to help you! Looking for one is more of a problem than people think. Just like looking for a good doctor. Even if you do your research you might get into trouble. All say that they are topped in their field. No one is in the middle or lower on the bell shaped curve. How can that be?