Dan Krause, Wisconsin author and Elder Law Attorney, talks about the legality and ethics of doing Medicaid planning to leverage state resources to help families pay for long term care.
I want to talk to you a little about Wisconsin law and less about the law really, and more about should you do elder planning?
When I say elder planning, I mean planning for Medicaid, planning to use state resources to help you pay for nursing care if that should ever come up.
But first, a little bit about Krause Estate Planning & Elder Law Center: We are in Oregon, Wisconsin and we are also in Madison, Wisconsin. We serve people throughout Wisconsin and since COVID, we've been doing this virtually. And for many of our clients, we only meet if they come to drive up when we sign their documents.
So onto what we want to talk about: Is it okay to do Medicaid planning, to plan to take advantage of state resources to help you pay for your nursing home or assisted living or even home-based care?
The answer is, YES it is perfectly legal and perfectly okay, and ethically, it's a wonderful thing to do if that's what you want to do.
I want to tell you two reasons why there is no problem with doing this type of planning.
One is the analogy to tax planning. So there are many people who structure organizations like corporations or LLCs, or they invest here and there in particular assets, and they do things in a certain way in order to plan for taxes. So tax planning has been a long tradition to doing things to reduce their taxes - and that's perfectly legal and perfectly ethical.
While doing things in order to take advantage of Medicaid are also perfectly legal and perfectly ethical.
The second analogy that I want you to think about is not so much of an analogy as it is a truthism about doing Medicaid planning. The way that our system is set up, is that people are discriminated against depending on what their aging illness is. And I want to explain that.
If you have cancer during your elder law, Medicare is going to pay for your hospitalization and treatment, and your secondary insurance - your Medicare supplement, is going to cover the rest.
You may be a millionaire, you could be a billionaire, it doesn't matter as long as you qualify for Medicare, it's going to pay for your care. You don't have to go broke in paying for your own care.
However, if instead of cancer, you have something like Alzheimer's Disease, which is no less deadly, and it's no less devastating. Some people say it's even more devastating than cancer. If that happens to be your illness, your treatment is going to be a nursing home or assisted living or memory care center. And the payment is going to come out of your pocket instead of the payment from the Medicare that you'd paid in for your whole life.
So that is discrimination, and it's discrimination that we don't think is fair.
In any case, people can plan to take advantage of Medicaid, which does help pay for nursing care. It helps to pay for assisted living care and memory care.
So there is nothing that we do in our Medicaid planning process that is illegal. In fact, we run all of our numbers and methods by the county when it comes time to approve someone for Medicaid.
We open up the books and we tell them exactly how we have structured assets, how we have structured income, how we have switched assets from countable to non-countable, and from countable to annuities. And the county takes a close look at that, and the county says yes, you have done everything within the laws and the rules, and therefore you can qualify for Medicaid.
And in that case, now a person is not discriminated against as badly because of the way that they are aging. Instead of cancer, they may have dementia, or just some other form of illness or disability that causes them to need long-term care instead of acute medical care.
Hopefully, this has been enlightening.
Please, if you have any questions about Medicaid or paying for nursing care without losing all of your assets, call me: (608) 344-5491.
We serve all of Wisconsin.