Did you know that the average cost of a nursing home in Michigan is more than $8,000 per month? Because of this tremendous expense, two out of three families facing a nursing home situation run out of money within the first year of a prolonged nursing home stay? The more disturbing part of these statistics is that many families do not realize that with proper Medicaid Planning a large percentage of a senior’s hard-earned assets can be protected.


At Casterline Law, we can show you ways to obtain assistance from Medicaid, without losing all of your assets and in some instances keeping most of the income. We can also show you a number of ways to prepare in advance for the possibility of incapacity and the need for long-term care.

Non-Crisis Medicaid Planning

Non-crisis Medicaid planning is for people who are healthy now but want to make sure that if they do become incapacitated, they will have an asset protection plan in place to protect their life savings. Having a well-designed plan in place, designed by an attorney that is highly qualified in the complexities of elder law, not only ensures you will be well cared for if you become incapacitated, but that this can be accomplished without going broke.

A Medicaid Crisis

A Medicaid crisis occurs when a person has already been admitted to a nursing home, and have been told they own too many assets to qualify for Medicaid. Many of our clients have this news from nursing home intake staff, social workers, Medicaid workers, and other well-meaning professionals. Unfortunately, these families are not told that a highly qualified elder law attorney can implement a Medicaid Plan that will allow these families to protect their entire life savings!

At Casterline Law we can help your family through the complexities of the Medicaid process and help you protect your hard earned assets. If you or a loved one is facing a Medicaid crisis, please contact us immediately.


Medicaid Qualification:
With long term care costs skyrocketing, questions about Medicaid are everywhere. Additionally, Medicaid rules are under attack and have had significant changes over the last three years. I help separate fact from fiction as to what the Medicaid rules really are. I show you how a family can provide for the long term care of a loved one while assuring the financial security of those still living at home or, how a single person can maintain his or her financial dignity and independence when long term care needs are pressing. Nursing home and other long term care costs can quickly deplete a lifetime of hard work. I help navigate the confusing and daunting question of how to pay for long term care of a loved one, whether it is through savings, insurance or Medicaid qualification.

Whether you live around the corner, in the next town, or a thousand miles away, dealing with an aging loved one can create anxiety, guilt and frustration. Having an experienced and knowledgeable support team can help alleviate your anxiety, guilt and frustration with those concerns. Planning for and coordinating the care of a loved one is complicated and emotionally exhausting. Whether you are dealing with issues of independent living or a Medicaid crisis, having an experienced and supportive Elder Law attorney as a member of that team is crucial.

Casterline Law Offices utilizes a comprehensive set of legal and care-based services that serve as a road map for you as the caregiver and your loved ones as they face the issues and challenges of growing older. I am here to guide you through this maze, step by step. I allow you to spend time with your loved one, not be consumed with questions about what to do now. “You do life. I do the planning.”


Dispelling Common Myths

In our aging population, a growing number of people are concerned about the high costs of medical and long-term care. These costs can be one of the greatest expenses a person faces in life. Sometimes people need to consider Medicaid as a source of payment for these services. However, Medicaid coverage qualifications can be confusing.

Many people receive misinformation about Medication, qualification, coverage and the application process. This disinformation comes from lawyers who do not specialize in Elder Law, from nursing home social workers and from neighbors who are trying to be helpful. Hopefully, this brochure will help dispel some of the common myths that people often have regarding this complex area of the law.

Casterline Law Offices, PLLC provides clients with personalized attention focused on each individual’s unique needs. Services include elder law planning and advocacy, wills, trusts, estate planning, special needs trust, trust administration, probate, guardianship, conservatorship, and discharge planning assistance.

RULE: You should not transfer assets without careful review and planning.

Myth # 1: Medicare will cover my nursing home bill.

Truth: Many people are surprised to learn that Traditional Medicare and Medicare Advantage plans only cover a small portion of the nursing home care costs. Traditional Medicare pays up to 20 days of full coverage if you go into a nursing home after at least 3 nights in a hospital and you need skilled care or rehabilitation (not basic or intermediate care). Then, if you still need skilled care, you can get up to 80 days of partial coverage from Medicare. After that, unless you have long-term care insurance, you must either pay out of your own funds or get Medicaid. The rules for Medicare Advantage plans may be different, and you will need to review your specific plan benefits.

Myth # 2: I have to give away everything to get Medicaid.

Truth: You are permitted to own some property and still be eligible for Medicaid. The trick comes in knowing what is “countable” and what is “non-countable” under the Medicaid rules. For example, your house is not a countable asset during your lifetime. However, your house funded into your Revocable Living Trust is countable. (This is not a typo, it is just confusing). Other non-countable assets include certain prepaid burial or funeral contracts. There are many other types of “non-countable property”. The bottom line is you do not need to be completely without assets to be Medicaid eligible.

Myth # 3: I cannot give anything away and get Medicaid.

Truth: Medicaid rules penalize some types of gifting. The penalty is Medicaid disqualification. Not all gifts create penalties. It depends on what is given away, to whom, and when. Because the Medicaid rules are complicated, you have to be careful not to create penalties. If you wish to gift assets, it is best to first consult with an elder law attorney who knows the law.

Myth # 4: I have to wait five years after gifting before Medicaid.

Truth: The Medicaid “look-back” is not always five years, but sometimes there is no disqualification penalty. The “look-back” rule applies to some asset transfers (gifts). This means that the Medicaid agency will review all gifts of property, including sales “for less than market value”. Because Medicaid policy recently changed, for some gifts the “look-back” may be only three years.

Myth # 5: I can keep all marital and inherited property when my spouse gets Medicaid.

Truth: When a married person applies for Medicaid, most assets in either or both spouse’s name are considered countable by the Medicaid Agency. However, some assets may not be “countable”, and you may keep some as part of the asset allowances. You should also be able to use special planning rules to allow you to protect more of your assets.

Myth # 6: If I private pay for a nursing home, I must spend-down all of my assets before I apply for Medicaid.

Truth: You are not required to spend-down all of your assets for nursing home care before applying for Medicaid. However, nursing homes may make you believe that you do. Nursing homes prefer private pay because they are paid less money from Medicaid. An experienced elder law attorney can help you develop a plan for Medicaid eligibility and asset preservation. Protected assets can then be available to help assure best placement, quality of life and quality of care.

Myth #7: A Power of Attorney gives my Agent power to take property out of my name if I ever need Medicaid.

Truth: Most Durable Power of Attorney (DPOA) documents do not include critical legal authority and planning provisions. For example, many DPOA’s contain a “gifting” provision that is usually limited to the IRS annual gift exclusion ($12,000 per year for 2008). However, such a limitation generally will not work for government benefits asset protection planning. A property drafted elder law Durable Power of Attorney can be the single best planning tool to protect you and your loved ones. For elder law planning purposes, the DPOA should contain special provisions regarding gifting, asset transfers, and Medicaid benefits planning. Without an effective DPOA for legal and financial matters, legal authority can be obtained only through the Probate Court. Probate Court procedures can be expensive, time-consuming, frustrating, and may not allow the type of asset protect that most people want. You should also require your Agent to consult an experienced elder law attorney for guidance with government benefits planning, asset transfers, and care advocacy. If you have a DPOA, you should have it reviewed to make sure it will work if and when needed. If you do not have a DPOA, seek the advice of a qualified elder law attorney who can help you create one to protect you and your loved ones.

Myth # 8: I can only give away $10,000 per year under the Medicaid rules.

Truth: This is an IRS rule, not a Medicaid rule. Under federal estate and gift tax law, the annual gift exclusion for 2008 is $12,000. Generally, people whose estates are large enough to be taxed under federal estate tax laws will not be concerned with Medicaid, because there is no estate tax for individuals with less than $2,000,000 of assets. Michigan Medicaid law disqualifies a person from Medicaid in most circumstances if they give money away. Under federal law, gifts made within the 5-year look-back period are added together. There are ways to successfully include gifting as part of an overall Medicaid eligibility/asset preservation plan. Because the Medicaid and government benefits rules are complicated, you should seek the advice of a competent elder law attorney for guidance.

Myth # 9: My income may have to be used to pay my spouse’s nursing home bill.

Truth: This not generally true in Michigan or in the majority of states. In fact, you may be able to keep a portion of your spouse’s income to help pay your monthly living expenses. In 2008, Michigan law allows the community spouse to retain a minimum of $1,712 per month of the couple’s joint income. However, the monthly income allowance can be increased to a maximum of $2,547 or higher with Court approval. An experienced elder care attorney will help you determine how much income you can keep and how much has to be used to pay for care.

Myth # 10: If I hide assets, I will be Medicaid eligible.

Truth: Intentional misrepresentation on a Medicaid application is a crime and can be costly. The IRS shares any information concerning income or assets you have with the Medicaid Agency (Department of Human Services). You or whoever applied may also have to pay Medicaid back to avoid prosecution. However, with proper planning, assets can be protected.

Myth # 11: The same Medicaid rules that applied to my neighbor when he went into a nursing home will also apply to me.

Truth: Medicaid policy just changed dramatically on July 1, 2007, and has been subjected to constant rule changes over the last three years that make it more difficult to qualify for Medicaid. You should not rely on what worked for your neighbor or friend. Also, there may be facts about your neighbor’s situation you do not know. It is best to have your situation analyzed by a competent elder law attorney.