Call Today for Your FREE Initial
One-Hour Consultation



Medicaid and Long Term Care Planning Attorney

A Medicaid and Long Term Care Planning Attorney can help individuals and couples qualify for Medicaid or the VA Aid and Attendance Pension Benefit often with the goal of preserving assets. Nearly one in two women and one in four men find themselves in a long-term care facility at some point in their lives, which can mean not only great loss of personal autonomy but also tremendous financial burden. Depending on location and level of care, long term care cost can exceed $100,000 a year.




Long-term care is In Home Care, Adult Family Home Assisted Living, or Skilled Nursing (the highest level of care). If you pre-plan you can be sure to keep all of your options open but if you spend down your entire estate you will be pigeon holed into one or two facilities. Preserving some of your estate will provide you with the choice of where you reside, whether that is in your own home with in home care, or a residence facility of your choice. Preserving part of your estate will improve the quality of your life as you grow older. Remember, Medicaid does not pay for everything; you will need your own finances if you want things like a second pair of glasses or a private room.

A common thing we hear is, “My husband has been in the nursing home for two years, I have liquidated everything and now I am broke, how can you help me?” We often see a family that has spent down all of their assets on a high quality of care until they are broke. The facility they are in then has the potential to kick them out and into a place of much lower quality where they are left with no choices.

Before you start to liquidate and spend down your assets we can help. Once you are broke your only choice is Medicaid. Many facilities do not accept Medicaid and many that do accept it require a private pay wait period. Funds can be depleted very quickly; an elder law attorney will work with you to strategize asset preservation and planning to get government benefits before you become impoverished.

Depending on your family’s priorities, how your assets are held and how much we need to strategize to preserve, we can help you to qualify for government benefits while preserving the estate for the well spouse or the person on benefits. Some of those strategies include:

  • Complex Trust Drafting
  • Gifting: We ask Medicaid to impose a penalty against us for gifting, and then use that period to our advantage to purchase exempt resources such as homes or vehicles.
  • Annuity: A Medicaid compliant annuity to create a source of income for the well spouse and preserve the estate. Medicaid annuities are very complex with many statutory rules.
  • Transferring Assets out of the ill spouse’s name.
There are four ways to pay for long-term care:

Private Pay
Long-Term Care Insurance
Veteran’s Aid & Attendance Pension Benefits

We specialize in the two government programs that are available to help pay for long term care, Medicaid and the Aid and Attendance Pension Benefit. For both there is an asset or resource requirement, an income requirement, and a medical need requirement. You have to meet all three, and that is where we come in.

For someone that is over resourced or over income, know what your options are before you start to liquidate assets. Know that you have choices, you can strategize, but the planning is very complex. There are complex rules even with gifting that you need to know about. The laws are changing all the time, in fact the laws can change every quarter.

“Holland is a great listener and lawyer. When we came to her with our needs, she thoughtfully listened, was helpful with all our questions, and then explained our options. Her sense of humor helped us through some long waits with the system. In the end, we ended up with a surprisingly favorable settlement and a good friend in the courts.”



The cost of long-term care has risen significantly in the past decade, and will continue to rise. The average cost of an assisted living facility in Washington State is $5,000.00/month, and a nursing home runs about $10,000.00/month.

One way to pay for this cost is Medicaid. Medicaid is a social health program for low income individuals. Since the cost of care continues to rise, many people find themselves depleting resources to pay for care. The problem is they will soon become impoverished With the right planning, our office can assist seniors in obtaining this benefit while preserving their assets.

There are two types of planning opportunities when qualifying for Medicaid: Pre-Planning and Crisis Planning.


Medicaid has a five year look back period, so it is important that you take the steps necessary to preserve your assets, even if you are perfectly healthy, as soon as possible. If you are thinking about preparing for the possibility of needing long-term care in the future, you should contact an attorney to advise you and guide you through the process. Not consulting an attorney exposes you to misinformation that could lead you to do something that could disqualify you from Medicaid altogether.

Our office can assist you in reviewing your assets and income and creating a long-term care plan that utilizes legal and ethical strategies to preserve your assets and get you qualified for Medicaid.

Crisis Planning

If you find yourself or your aging parent in need of long-term care immediately, than your case would be considered a ‘crisis case’. This means there are certain strategies that cannot be used because the benefit will be needed sooner than the five year look back period. It is important to consult an attorney immediately, because there are still many strategies that can be implemented to qualify you for Medicaid without going broke. Even if you don’t have the five years to pre-plan, we can still help preserve some of your assets and qualify you for Medicaid.

Our office can evaluate your situation and make the correct recommendations to get you qualified sooner rather than later, and guide you step by step through the whole process.


Long term care planning is an extremely complex process that can be overwhelming. You want a team backing you up and helping with all of the strategies and planning. Our team will ensure that the correct planning is put in place so that you are qualified as soon as possible for the benefit programs. Typically time is of the essence and if you have an attorney you can expedite the process. Every month that there is a delay in qualifying for Medicaid or Aid and Attendance is potentially a lot of money out of your pocket. Medicaid rules can change every three months and the VA has made the Aid and Attendance process so complex that many applications are denied, and often denied without cause.

  • Plan for your parent’s future.
  • Get qualified for Medicaid.
  • Learn how to pay for long term care without going broke.
  • Find a facility that is safe and comfortable.
  • Find a facility that you want to be in, not one that you are forced into because of lack of choice.
  • Your loved one needs to be moved into a facility and you are afraid they are going to lose everything.

If you have an attorney who is familiar and skilled in Medicaid and VA Benefits you can avoid unnecessary delays and potentially save many thousands of dollars.


In a culture that often brushes seniors aside, we have a team of attorneys, paralegals and administrative assistants to help. Our team is devoted entirely to the complexities of long-term care planning and keeping up with the frequent changes in rules.

Our office takes a holistic and hands on approach to planning. We help seniors and their families with all of their needs. We are not just doing a will or an estate plan, we are looking at all of the issues seniors face. What sets us apart is that we take a team approach. Everyone in our office is passionate about helping seniors and we have a unique perspective and appreciation for the difficulties of the process of getting old and dying.


A mother and daughter came to our office. Mother was a senior with need for assistance with activities of daily living. Daughter was providing extensive in home care for the mother so that she could reside in her home as long as possible. When they came to our office the daughter said to us, “I can’t afford it anymore, I can’t take care of my mom.” ” I need to go get a job.”

The mother was the surviving spouse of a veteran. We were able to get this family the resources they deserved. We put together a ‘personal care contract’ and applied for the Veterans benefit. The ‘personal care contract’ was for the daughter to officially provide in home care for the mother. We applied for the VA benefit for the mother and we were able to get cash for her as a surviving spouse of a veteran. She now receives the benefit every month tax free, and is able to use it to pay her daughter for providing care. This was a huge success for the family and accomplished all of their goals. It was their shared goal to keep the mother in the home for as long as possible. Now the daughter is able to afford to continue providing in home care and the mother is able to stay at home.

Another recent client qualified for the Aid and Attendance Benefit of approx. $2200 per month. Because they did not have an accredited attorney, they had been denied four times over the past four years. As a result they had missed out on four years of benefits (approx. $105,600). They were getting information from a non-VA accredited attorney who was not trained or updated on the VA rules. As a result they were inappropriately denied.

We were able to get them approved in less than three weeks.

They had submitted applications that they thought would be approved, but were denied because they did not have the necessary knowledge and were not getting correct information from an accredited attorney. If they had sought an attorney early they would not have missed out on these benefits for the past four years. Unfortunately, they lost out on over $100.000 but they were so happy that we were able to help.


621 W Mallon, Suite 306
Spokane, WA 99201-2163

8350 W. Grandridge Blvd. Suite 200
Kennewick, WA 99336-1678

MON - FRI 8:30am to 5:00pm*
Sat + Sun Closed

*Ask about our evening appointment availability


Business Phone: (509) 325-5222
FAX: (877) 331-5798
Email: info@evergreenelderlaw.com




Up and Personal with Telelaw

By Holland McBurns, Managing Partner, Evergreen Elder Law Remember not so long ago when “up and personal” meant a hug or handshake? When getting together didn’t require a mask? When sitting in my office care meant we could sit at a table together and not worry about...

Expanding Medicaid During a Pandemic

By Holland McBurns, Managing Partner, Evergreen Elder Law I wouldn't have thought that Oklahoma would be the first state to vote on expanding Medicaid since the COVID-19 pandemic began. I congratulate the Oklahomans! There are currently 38 states that had previously...

Yes, Yes, Yes! Everyone Needs Health Care Directive

By Holland McBurns, Managing Partner, Evergreen Elder Law Who knew that 2020 was going to be a year where our health was going to be at the forefront of a global pandemic. People waiting in long lines to be tested for a virus. Having your temperature taken to have a...

Looking Back to Look Forward

By Holland McBurns, Managing Partner, Evergreen Elder Law I’ve been thinking quite a bit lately about how life has changed these past few months and wondering where do we go next. I never thought in my lifetime a viral pandemic would bring the US to a roaring halt,...


© 2020 Evergreen Elder Law, PLLC