The document discusses the importance of elder law attorneys in assisting individuals with long-term care planning and Medicaid eligibility in Dane County. It outlines various factors affecting an individual's needs, such as age, disability, and asset ownership, while emphasizing the legal services provided by elder law attorneys. Additionally, it details Medicaid asset and income tests, and identifies specific client groups that should consider seeking legal assistance.

1. Medicaid, Long Term Planning
and the role of an Elder Law
Attorney in Dane County
Eric J. Deml- Medicaid Specialist
Haskins Short & Brindley LLC

2. What are the individual’s needs?
• Does the individual need long term care in assisted living or skilled nursing facility?
• Does the individual have the means to privately pay for assisted living or a skilled
nursing facility?
• Has the individual decided who will make decisions on their behalf if they become
incapacitated?
• Does the individual own a home? Do they own property other than a home?
• Does the individual has a disabled child or special needs child?
• Does the individual have a will?
• Is the individual married with a spouse living in the community?

3. Every individuals needs are an unfinished jigsaw
puzzle
As people age, the need for services increases. Often, adult children are tasked with
helping their parent(s) navigate services offered. Coordinating health care, long term care
planning, guardianships, retirement accounts, Social Security, Medicare/ Medicaid planning
and other important matters is a task most people do not have time for. They need
assistance to help them navigate the systems available to ensure a favorable outcome.
Elder law attorneys are most equipped to handle the sensitive emotional and physical
needs or older or disabled adults, and are therefore able to handle a variety of challenging
situations. A skilled elder law attorney will help an individual take all the “pieces” of their
situation and put the jigsaw puzzle together. The sole focus of an Elder Law attorney is the
needs of older adults. They assist in the important financial and estate planning matters as
well as the day to day issues affecting the actual care of the seniors.

4. What an Elder Law Attorney does for a
client?
 Create financial and health care powers of attorney
 Explore financial planning, housing opportunities, income and estate planning
 Draft living and last wills and testaments
 Help with the selection and appointment of a legal guardian.
 Real property deeds
 Help locate long term care facilities and manage assisted living and skilled nursing
home costs
 Establishing Supplemental Needs Trusts
 Applying for Medicaid

5. Medicaid- The Payer of Choice
 In Wisconsin, Medicaid is often the payer of choice to pay for services.
 To Qualify, you must be
 65 years or older
 64 younger, have a disability determination by the federal government (receiving SSDI or
SSI payments)
 Blind
 Have a “non formalized” disabling condition certified by your primary care physician
requiring immediate care in a hospital

6. Medicaid- Single vs Married Couple
Medicaid determines your eligibility for coverage based on two factors and whether
you apply as a single person or as a married couple.
 Asset test
* Single applicant- $2,000.00 asset limit
* Married couple- sliding asset limit scale. Minimum of $52,000.00 maximum of
$122,900.00
 Income test. Once an individual is asset eligible, Medicaid uses a formula to
determine how much of your gross income from all sources is to be used to pay for
your care. Your “cost of care” will NEVER be more than your income.

7. Asset rules for Medicaid
Medicaid has strict set asset limits, but many providers are unaware of allowances
and asset exemptions for Medicaid purposes. Medicaid asset rules are constantly
changing. Do the people you support:
 Own their home? Homes can be exempted for Medicaid purposes
 Have money set aside for burial purposes?
 Own a special needs trust?
 Have a disabled child?
 Have an IRA?
While there are strict asset limits to qualify for Medicaid, HOW you arrive at the
asset limit is what an Elder Law Attorney can assist with. Where are you today vs.
where you need to be to qualify for Medicaid?

8. Which clients need to seek the advice of an
Elder Law Attorney?
 Married couples. Medicaid policy allows for married couples to retain certain assets
and income above regular Medicaid financial limits. Medicaid law is set to prevent
a spouse from being financially impoverished to pay for the care for their
institutionalized spouse.
 Those who have not established living wills, trusts or financial and health care
powers of attorney. If your wishes are not formalized in a document, a court will
determine your wishes. *U’Ren Example*
 Those who have a disabled child regardless of age
 Those who have liquid assets in excess of $240,000.00
 Those who have divested more than $500.00 in any single transaction in the last 5
years.