There are two major government programs which provide medical benefits for senior citizens, some children, and certain persons with disabilities. One of these, Medicare, provides various hospital and outpatient physician and other health services. This can be compared to the health insurance that some employers provide.
The other is called Medicaid. Medicaid provides services for long term care in many cases. In order to qualify, a person must generally be over the age of 65, or must be disabled or meet certain other criteria. In addition, since this is a needs based program, a person must generally qualify in terms of income, in terms of assets, and in terms of care needs.
A skilled elder law attorney can often help a person qualify for Medicaid if that person does not have enough income to pay for their necessary care, but has too much income to qualify for Medicaid without an income cap trust.
A skilled elder law attorney can also advise a person on different spend down strategies, to save assets and quality of life for a spouse, and to allow the person to qualify for Medicaid at some point in the future if the person has too many assets to currently qualify.
Estate recovery, or the recapture of funds by the state when the state has advanced the cost of care through Medicaid, can be another area where advice of an elder law attorney can be of significant value. Advice both on positioning oneself for expected future estate recovery, and advice once the state has asserted a claim can be helpful.
In a related area, it can be very wise to consult an elder law attorney before making transfers or gifts, or before selling or otherwise disposing of or encumbering assets, as some such transfers or actions will create periods of Medicaid ineligibility.
If such transfers have been made improperly, and a period of Medicaid ineligibility has resulted, an elder law attorney may be able to assist in obtaining a hardship waiver, or seeking other solutions.