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The Best Medicaid Lawyers in NY

Friday, April 3, 2020

According to the U.S. Census, in 2015, there were over 48 million people over the age of 65 years in the United States. This number is expected to grow to roughly 98 million by the year 2060. As people age, health issues become a concern and many older individuals will require a change in their lifestyle as a result that can be facilitated and funded at least in part by Medicaid.

Though many individuals will be able to apply for Medicaid on their own, without assistance, complex financial situations and other issues lead some to seek out elder law attorneys who specialize in working with Medicaid and other problems that older individuals regularly encounter later in life. Though the services of an elder law attorney may be expensive, it is often worth the cost because individuals save money and avoid some of the pitfalls that can happen when people go through the Medicaid application or planning process alone.

What do Medicaid lawyers do?

Medicaid is a complex federal program that serves the needs of uninsured individuals. These people include pregnant women, disabled individuals, certain children, and senior citizens who are in need of nursing home care. To receive Medicaid benefits, individuals must meet certain eligibility requirements. Though Medicaid is a federally funded program with policies that are put in place by the federal government, each state sets their own eligibility requirements.

Even straightforward situations can become muddled because Medicaid is a program that is funded by the federal government with federal rules and policies, but that’s implemented on the state-level. In addition to the state and federal government, Medicaid involves multiple healthcare entities that add even more confusion and complexity to the mix.

An elder law attorney knows and understands the complexity of Medicaid and they specialize in relieving family members or the beneficiary themselves from having to spend hours and hours working with a system that is often confusing and time consuming. Most elder law attorneys provide asset planning to help beneficiaries qualify for Medicaid, but they may also help with Medicaid applications and other issues including non-Medicaid-related legal problems related to elder care.

 

Elder law attorneys are legal professionals who specialize in navigating the complex laws of state Medicaid programs. They may perform a variety of functions to assist individuals in getting the coverage they need. If a person who is eligible for Medicaid gets denied coverage, an elder law attorney can help by making an appeal to review the denial.

Elder law attorneys can also file for an appeal if a person’s Medicaid application gets stalled in the system and is not reviewed within a timely fashion. Many elder law attorneys specialize primarily in helping individuals and families with asset planning to become eligible for Medicaid in the future. And Medicaid recipients who experience problems with the services rendered by a health organization that’s authorized to provide Medicaid services may need the assistance of a lawyer to deal with denial of services or disputes over payments. Having a lawyer who knows Medicaid policies very well can help people who are experiencing problems with the system get the Medicaid coverage they need when they need it.

 

Elder law attorneys often work with the guardians of children or those who provide care to the elderly or disabled. They act as advocates to work within the bureaucracy of the Medicaid system and to help individuals avoid denials, mistakes, and delays that naturally occur within a program that functions on both the state and federal levels. Ordinary people often need the assistance of a lawyer to overcome issues with this complex system.

 

Elder law attorneys also provide legal services that go beyond the scope of just Medicaid applications. Though there are elder law attorneys who specialize in working primarily with Medicaid-related issues, many elder law attorneys also have expertise that extends into the general domain of elder rights and care. Most elder lawyers focus on a specific subset of problems that are faced by seniors, but as a rule, their specialty is in navigating the general issues that older individuals face as they set up a retirement plan, prepare to enter long-term care, and plan and settle their estate.

Many people choose to work with an elder law attorney at a firm that can handle all of the legal needs they might encounter in regard to elder care, but in some instances where the Medicaid situation is complex, it might be better to choose an elder law attorney who works almost exclusively with this insurance program. While a broader knowledge-base makes it possible for an attorney to provide more general assistance to seniors, elder law attorneys who are highly specialized to work with Medicaid issues in-depth every day are more likely to have very detailed expertise that can be valuable when that sort of precision is necessary.

Do you need a lawyer to get Medicaid?

 

Not everyone needs a lawyer to apply for Medicaid coverage or to manage it. But whether or not you should prepare your own Medicaid application yourself or hire an attorney will depend on the following factors:

 

●       Applicant’s age

●       Complexity of the applicant’s financial situation

●       How much free time does the applicant have available to work with the Medicaid application and benefits issues themselves?

●       Is the individual applying for benefits for long-term care or community home benefits?

●       Ability of the individual to organize complex material

 

Though most eligible recipients can apply for Medicaid on their own without the assistance of a Medicaid lawyer, a complex financial situation or even just a busy schedule that makes it impossible for the applicant, guardian, or caregiver to fill out the application may warrant assistance from a lawyer.

 

Hiring an elder law attorney  can help you avoid a major catastrophe. Recent state and federal rule changes have made Medicaid law more convoluted than ever, and seeing a lawyer can be profitable in terms of future savings. Many seniors benefit from at least doing a consultation with an elder law expert in their state to determine if there are specific concerns or opportunities that they might be missing. A consultation can help seniors get a feel for the challenges they may face and determine whether or not they feel competent to do the work themselves.

 

As a general rule, individuals who are experiencing declining health and anticipate that they will need to move to a nursing home soon should contact an elder law attorney to determine what can be done to protect their assets for family members (spouse and children) or other beneficiaries. Individuals with more assets will have a more complicated Medicaid application. A lawyer may be necessary to determine how to achieve eligibility for Medicaid and do asset planning to protect the beneficiary’s assets.

How a Medicaid lawyer can help you get Medicaid?

Elder law attorneys who specialize as Medicaid lawyers work directly with beneficiaries, as well as the guardians of children and elder caregivers to ensure that the application process goes smoothly and eligibility requirements are met.

Attorneys who work regularly with Medicaid can provide valuable assistance by filling out the paperwork and application, and by providing supporting documents to help the individual receive benefits. But the most common task that elder law attorneys are hired to do is asset planning to ensure that seniors are able to receive Medicaid coverage while protecting the beneficiary’s assets.

 

In most states, it isn’t necessary for individuals to receive assistance from a lawyer to fill out the application forms or the paperwork. Medicaid planners may be more affordable than hiring an elder law attorney, but in some situations, the extra level of knowledge that lawyers may have about the process involved in applying for Medicaid can help avoid delays or a denial of benefits.

How much does a Medicaid lawyer cost?

The cost of a Medicaid lawyer depends on several factors:

 

●       Whether the lawyer charges by the hour or a flat-fee rate. Today, many lawyers are charging a flat-fee that reflects both the expertise and the amount of work time required to complete the necessary work.

●       What type of work you need to have done (application, planning, or addressing a specific issue with the individual’s Medicaid coverage).

●       The state or region where you’re applying for coverage.

 

The actual cost of a Medicaid lawyer has to be considered up against the potential cost of not hiring a lawyer. Today, the average cost of hiring a Medicaid lawyer to apply for Medicaid is between $3500 and $10,000 according to a variety of sources, but each state differs and lawyers set rates that reflect their level of experience and the amount of time they expect a given application to take. Applications can be very time consuming, and though much of the work can be completed by a paralegal, individuals who seek out professional help from a lawyer should expect to not only pay for the expertise, but also reap the rewards of doing the process correctly.

Why do I need an elder law attorney?

 

An elder law attorney may be needed in a variety of situations pertaining to end-of-life care. Elder law attorneys are often called upon to help individuals obtain Medicaid coverage, but they also work with a variety of other issues that are commonly encountered during old age.

 

All elder law attorneys are knowledgeable about Medicaid and they are often hired to help people apply for coverage. Though some nursing homes will offer to help people with their Medicaid application, nursing homes rarely hire staff who have the specialized knowledge of Medicaid rules and regulations that lawyers have. And, more importantly, there is a conflict of interest that occurs when a specific nursing home assists prospective residents with their Medicaid application. When the individual or a caregiver hires an elder law attorney to work through the application process, there is no conflict of interest and the attorney can use their expertise to consider other, broader issues faced by their client. The financial results are often superior to what a Medicaid specialist can do as a result and clients also know that this person can help them navigate other elder law issues including:

 

●       Durable powers of attorney

●       Financial powers of attorney

●       Medical powers of attorney

●       Proxies

●       Guardianships

●       Healthcare surrogates

●       Revocable Trusts

●       Irrevocable Trusts

●       Long-term care planning

●       Miller Trusts

 

Elder law attorneys often refer to themselves as Medicaid specialists, but their knowledge and experience working with the rules and regulations regarding Medicaid far surpass the knowledge and experience of so-called “Medicaid specialists” working in nursing homes. Though a Medicaid specialist who is not a lawyer will likely charge a lot less than an elder law attorney, the Medicaid coverage results that take shape through the work of these two types of professionals may be quite different. In the end, an elder law attorney can save you a lot of money, particularly if the beneficiary is married, owns real estate, and has a significant amount of money in savings. 

 

In summary, elder law attorneys have a deep understanding of not just Medicaid law but also secondary issues and considerations that seniors often face that are not related to Medicaid. For the best results, hire a member of the National Academy of Elder Law Attorneys in the state where the beneficiary plans to seek coverage.

What is the average cost of an elder law attorney?

The cost of an elder law attorney varies considerably from state to state. And it also varies in terms of the complexity of the case and the services that will be rendered. Some elder law attorneys do consultations over the phone while others require in-person meetings. Some attorneys charge for the initial consultation while others provide this service for free.

 

As a general rule, elder law attorneys are likely to answer general questions about the law without charging a fee, but clients who are seeking specific information about a specific situation should be prepared to pay for this service. While general questions about the law are easy to answer, once clients start asking for information about a specific situation, elder law attorneys must provide accurate legal advice and if their advice is incorrect, they can be liable for it. By asking for payment for an initial consultation about a specific elder law situation, elder law attorneys are able to formally create a contract with the client and do the necessary footwork to find the correct answers to the client’s questions.

 

Elder law attorneys who have a great deal of experience in their field will charge more by the hour than those with less experience. And attorneys will charge a fee that’s based on supply and demand in the city where they’re located. So, while an elder law attorney in Kansas may only charge $125 per hour, an attorney with the same level of education and experience in Massachusetts may charge $600 per hour.

 

These days, many elder law attorneys charge a flat-fee for services related to Medicaid planning and hourly fees don’t apply to that service. Even if other legal documents are required or a trust must be set up as part of the Medicaid planning process, many attorneys will just include these services as part of the flat-fee. For legal services that extend beyond Medicaid planning, however, clients should be prepared to pay an additional fee for those services.

 

What assets are excluded from Medicaid?

Medicaid eligibility is determined by the applicant’s income and assets which must be under a certain amount. Additionally, the applicant must have a functional need for long-term care in order to qualify for the program. If the applicant has an income or assets above the financial limits for Medicaid eligibility in their state, they may still be able to become eligible for Medicaid by “spending down” their income and assets to a level that makes them financially eligible. There are many rules governing how Medicaid spend down can legally be applied to an elder’s financial resources and if the rules are violated, applicants may be denied Medicaid coverage. Many elder law attorneys specialize in providing asset planning services.

 

In terms of assets, applicants must have resources under a certain amount to qualify for Medicaid, but certain assets are exempt. In other words, certain types of assets are not counted toward the Medicaid asset limit. As such, assets can be categorized into Countable Assets and Non-Countable Assets.

 

Countable assets that can be counted toward the Medicaid asset limit include liquid assets, or those resources that can easily be converted into cash. They include:

 

●       Cash

●       Bank accounts (checking, savings, and money market accounts)

●       Mutual funds

●       Stocks

●       Certificates of Deposit (CD’s)

●       Bonds

●       Property

●       Vacation houses

●       401(k)’s

●       IRA’s (under certain circumstances, depending on state law)

 

Non-countable assets are those that are not counted toward the Medicaid asset limit. These are the assets that are excluded from Medicaid. The following are non-countable assets:

 

●       Primary home (if the individual applying for Medicaid or their spouse lives in the house or, in some states, intends to live in the house)

●       Home equity value limits between $595,000 and $893,000 (with the exception of the state of California, the home equity value is calculated by taking the market value of the home minus debt against it, however there is no equity value limit in most states if the applicant’s spouse lives in the home)

●       Pre-paid burial or funeral expenses

●       Automobile

●       Life insurance policies with a cash value of $1500 or less

●       Term life insurance

●       Household furnishings

●       Appliances

●       Clothing

●       Engagement and wedding rings

●       Personal items

How much money can you have in the bank to qualify for Medicaid?

Eligibility for Medicaid is based on the individual’s Modified Adjusted Gross Income (MAGI). Though there are other algorithms used to determine eligibility, this is the one that’s most often used by the government to determine eligibility.

 

The MAGI is calculated using information about the beneficiary’s gross, or total earned income. This is money that is actively coming into your accounts. The adjusted gross income (AGI) is the gross income after tax deductions have been calculated. And the MAGI is the AGI excluding non-taxable portions of your Social Security income, tax-exempt interest, and excluded foreign income. Often, the MAGI and the AGI are the same amount. Medicaid takes both household income and the size of the household into account and states may differ in terms of their required MAGI levels.

 

In 2019, the income limit was $2,313 per month while the asset limits were set at $2000 per individual. Medicaid does not just consider the amount of money in bank accounts when determining eligibility. Assets are also included in the equation. In other words, applicants can have up to $2000 total in one or more bank accounts, but anything above this amount will be counted as Medicaid qualifying assets.

Law Firms Specializing in Medicaid and Elder Law in New York

Moskowitz Legal Group

With offices in Long Island and Brooklyn as well as in New Jersey, Moskowitz Legal Group specializes in elder care law, estate planning, charitable planning, special needs planning, trust and estate litigation, and estate and trust administration. They can assist with trusts, wills, revocable and irrevocable trusts, health care proxies, financial powers of attorney, insurance planning, retirement asset planning, and more.

 

Law Offices of Roman Aminov

With an office in Queens, the Law Offices of Roman Aminov specializes in estate planning, probate, and elder law. They collaborate closely with other professionals (accountants, financial advisers, etc.) to analyze each client’s unique situation and develop a tailored plan that may include durable power of attorney, last will and testament, a living trust, health care proxy, Medicaid planning, guardianships, or an irrevocable trust.

 

Law Office of Inna Fershteyn

Located in Brooklyn, NY, the Law Office of Inna Fershteyn works with wills and trusts, asset protection, estate planning, guardianships, elder law, Medicaid planning, Medicaid fraud, and fair hearings. This law office serves individuals in Brooklyn, Queens, Bronx, Staten Island, and Manhattan.

 

Law Office of Michael Camporeale

The Law Office of Michael Camporeale specializes in elder law. His offices work regularly with estate planning and asset protection from nursing homes, probate, and estate law with locations in Queens, lower Manhattan, White Plains, Bronx, Staten Island, Brooklyn, and Long Island.

 

Ettinger Law Firm

The Ettinger Law Firm maintains locations in Albany, Bohemia, Brooklyn, Huntington, Fishkill, Lake Success, Manhattan, Middletown, Melville, Nyack, Rockville Centre, Rhinebeck, Saratoga, Smithtown, White Plains, and Staten Island. They are an elder law estate planning firm.

 

Melnick Law Group

Located in Newy York, NY, the Melnick Law Group maintains a group of elder law attorneys who specialize in all areas concerning retirement planning, asset protection, estate recovery, and financial planning.

 

Burner Law Group P.C.

The Burner Law Group has offices in Westhampton Beach, East Setauket, and New York, NY. They specialize in elder law including estate planning, special needs planning, asset protection, business succession planning, probate and estate administration, guardianship, and veteran’s benefits.

 

Connors and Sullivan, Attorneys at Law PLLC

With 5 locations in Brooklyn, Manhattan, Bayside, Middle Village, and Staten Island, Connors and Sullivan specializes in elder law, estate planning, and estate litigation.

 

Goldfarb, Abrandt, & Salzman LLP

Goldfarb, Abrandt, & Salzman have two locations in White Plains and New York, NY. They specialize in estate planning trusts and wills, social security issues, healthcare coverage including Medicaid eligibility, applications, and planning as well as Medicaid Asset Protection Trusts (MAPTs).

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