Absolutely. You do not have to hire someone to apply for Medicaid, and for some families, handling the process themselves may be perfectly reasonable. We also understand that the money being spent often belongs to Mom, Dad, or another loved one, and families want to know that paying for professional help is actually worthwhile.

Our value isn't simply filling out an application. It's knowing what to look for before the application is ever filed. We evaluate the financial picture, identify potential eligibility problems and planning opportunities, help determine what Medicaid rules actually apply to your situation, develop a strategy, gather and organize the necessary documentation, respond to agency requests, monitor the case, and advocate for you when something doesn't look right.

That can be particularly important when there are significant assets, a spouse at home, property, prior transfers or gifts, trusts, unusual financial transactions, an urgent nursing home admission, or other complications. Decisions made before or during the application process can affect eligibility, how much a family is required to spend, and what options remain available later.

We also know when a situation requires expertise outside our role. When legal advice or documents are needed, we help identify that need and coordinate with an attorney or other appropriate professional rather than allowing an important issue to fall through the cracks.

You can certainly navigate Medicaid without us. Our job is to help you navigate it with a plan, avoid costly mistakes, preserve the options available to your family, and take much of the burden off your shoulders.

Sometimes the most valuable thing we do isn't completing the paperwork. It's knowing what not to do before the paperwork begins.

Just reach out. You don't need to have everything figured out first.

Call, text, email, or send us a message through our website. We offer a free, no-obligation 15-minute initial consultation by phone, in person, or by video. Tell us a little about what is happening, where your loved one is currently living or receiving care, and what concerns brought you to us.

And don't worry if you've already started the process. We can jump in at almost any stage. Maybe you've already submitted a Medicaid application, received a request you don't understand, made a financial decision you're now questioning, encountered a problem with eligibility, or simply feel like the process isn't going the way you expected. A decision or process already in motion doesn't necessarily mean it's too late for us to help.

We'll look at where things stand now, identify any concerns, and help determine the best path forward. If your situation requires a more detailed review, we'll explain what information we need, what services we recommend, and what those services will cost before you make any commitment.

And please don't gather five years of bank statements before you call us. We'll tell you what we actually need and help you through it one step at a time.

Quite a few things—but we'll try to keep this short.

We are Medicaid-focused, experienced, hands-on, and fiercely committed to the families we serve. We understand the rules, but we also understand how those rules actually play out in nursing facilities, hospitals, state agencies, and around a family's kitchen table.

We don't believe our job is simply to complete an application and wait for an answer. We look at the whole situation, anticipate problems, develop a plan, coordinate with the people involved, follow up when something isn't moving, ask questions when something doesn't make sense, and advocate when something isn't right.

We're also honest and straightforward. We'll tell you what we think, explain why, and give you realistic expectations—even when the answer isn't the one you were hoping for. And when we believe there is a solution worth pursuing, we're persistent, passionate, and tough when we need to be.

Perhaps most importantly, we've experienced this system personally as daughters and caregivers. We know that behind the applications, bank statements, deadlines, and Medicaid notices is a family trying to make good decisions for someone they love.

We'll be compassionate with your family and tenacious in advocating for it.

That's the difference.

We try to make it easy to reach us. You can call, text, email, or send a message through the contact form on our website. Both phone numbers listed on our website can send and receive text messages, so if texting is easier for you, that's perfectly fine.

You can also message us through our Facebook page. You're welcome to send us a message whenever it's convenient, and we aim to respond as quickly as possible—usually within one business day.

We know questions and concerns don't always arise during normal business hours. You don't need to wait until you have everything organized before reaching out. Send us a message, tell us what's happening, and we'll take it from there.

We believe families should have a reasonable idea of what professional help will cost before they ever pick up the phone. You shouldn't have to schedule a consultation or sit through a sales pitch just to find out whether our services fit your family's budget.

Our base flat fee for a standard Medicaid case starts at $2,750. More complex cases may cost more depending on the amount of planning, research, documentation, coordination, or advocacy involved. After your initial consultation, we'll evaluate your situation, explain the services we recommend, and provide a clear, written fee quote before you decide to move forward.

For matters that are better suited to hourly assistance, our standard professional rate is $195 per hour, with a two-hour minimum ($390). We'll let you know when hourly assistance makes more sense than a flat-fee engagement.

We work hard to keep our services reasonable, practical, and cost-effective. Whenever practical, we meet by phone or video, but when an in-person meeting is necessary, we'll come to you when possible—at home, bedside, or in a long-term care setting. We do not charge additional travel time, mileage, or routine travel expenses.

In certain circumstances, flexible payment arrangements may be available, particularly when an urgent need exists but the family is temporarily unable to access the applicant's funds or is still obtaining the legal authority necessary to manage them.

No hidden fees. No mystery pricing. No obligation to hire us just because you called. You'll know what we recommend, what it includes, and what it costs before you make that decision.

Working with us is collaborative, honest, and straightforward. We’ll explain what we’re doing and why, give you realistic expectations, and tell you when we see a problem—even when it may not be what you hoped to hear.

We are passionate, persistent, and tough when we need to be. We ask questions, follow up, challenge things that don’t make sense, and don’t give up simply because the process becomes difficult. We believe good advocacy sometimes means pushing a little harder, asking one more question, or refusing to accept an answer until we understand the reason behind it.

At the same time, we never forget who we’re working for. We’ll be compassionate with your family and tenacious in advocating for it. You’ll know where your case stands, what we need from you, and what comes next.

Please don't transfer the house based on your neighbor's advice. Your neighbor means well, but transferring property can have serious and sometimes unintended Medicaid consequences.

Medicaid has specific rules about homes, property transfers, spouses, certain family members, and estate recovery. A home may be treated very differently depending on who owns it, who lives there, whether there is a spouse remaining in the community, and what planning has already been done. In some circumstances, transferring a home may be permitted or even appropriate; in others, the same transfer could create a Medicaid penalty or eliminate options that would otherwise have been available.

And no—the nursing home does not automatically “take your house” simply because you need long-term care.

Before you sell, give away, transfer, or change ownership of real estate, talk with someone who understands how that decision will affect Medicaid eligibility and your long-term plan. It is much easier to plan before a transfer than to try to fix one afterward.

Not until you understand what you're signing—and in what capacity you're signing it.

Admission paperwork can be overwhelming, especially when your family is dealing with an illness, hospitalization, rehabilitation stay, or sudden move to long-term care. Many of the forms may be routine and necessary, but others can address payment responsibility, insurance and Medicare coverage, access to financial information, resident funds, arbitration, discharge policies, or other important rights and obligations.

One of the biggest things we want families to understand is the difference between signing for Mom as her authorized representative and signing something that could potentially create an obligation for you personally. If you are acting under a Power of Attorney, guardianship, or other authority, make sure the document accurately reflects the capacity in which you are signing.

You also don't have to understand an entire admission packet by yourself while everyone is waiting for your signature. Ask questions. Ask what a document means. Ask whether it is required for admission. And ask for a copy of everything you sign.

If something doesn't make sense, you're uncomfortable with the language, or the financial arrangements involve Medicaid or long-term-care planning, call us before you sign when possible. We can help you understand how the paperwork fits into the Medicaid and long-term-care picture and identify issues that may need review by an attorney or another professional.

And if you've already signed something and are now wondering, “What did I just agree to?”—call us anyway. A signature already on the page doesn't mean there's nothing that can be done.

Sometimes, yes. Not every problem requires a formal complaint or major intervention. Sometimes there has been a misunderstanding, a communication breakdown, or simply a need to get the right people talking to one another. When appropriate, we may be able to help by communicating with facility staff, asking questions, helping you understand what is happening, or participating in a conversation about your loved one's care or situation.

For more significant concerns, we generally encourage families to address the issue with the appropriate facility leadership, such as the Administrator, Director of Nursing, social services staff, or another appropriate representative. We can help you organize your concerns, determine what questions to ask, and decide what the next step should be.

When a concern involves the rights, care, quality of life, transfer, or discharge of someone living in a nursing home or licensed assisted living facility, we may recommend involving Indiana's Long-Term Care Ombudsman and can help connect you with that resource. Other serious concerns may need to be directed to the appropriate regulatory agency, healthcare professional, or attorney.

You don't have to know who to call before you call us. Tell us what's happening, and if the issue falls outside our role, we'll do our best to help point you in the right direction.

Sometimes—but not always. Medicaid's treatment of real estate depends on several things, including who owns the property, who lives there, whether there is a spouse at home, how the property is being used, and whether it qualifies for an exemption under Medicaid rules.

In some situations, non-exempt real estate may need to be offered for sale or rent. In others, the property may be exempt or there may be planning options that should be explored before a decision is made.

This is one of those situations where good planning and collaboration can make a significant difference. HMS can help evaluate how Medicaid rules apply to the property and the family's overall situation. When the available options involve deeds, trusts, estate planning, or other legal matters, we can work alongside a qualified estate-planning or elder-law attorney to make sure the legal and Medicaid pieces are considered together.

Don't sell, rent, give away, or change ownership of property simply because someone told you that's what Medicaid requires. Before making a decision that may be difficult to undo, find out which rules actually apply and what options are available to your family.

And if you've already made a transfer or taken another action that you're now questioning, don't panic and don't try to fix it on your own. Many transactions can potentially be reversed, corrected, or otherwise addressed, depending on the circumstances. But unwinding a transaction can create additional Medicaid, legal, title, or tax consequences if it isn't handled properly. That's the time to get professional guidance before making the next move.

Maybe today. But that doesn't necessarily mean they can't qualify for Medicaid.

First, it helps to understand that Medicaid looks at income and resources separately, and the rules aren't always what families expect.

Income: For someone entering a long-term care facility, Medicaid has special income rules that differ from many other Medicaid programs. Depending on the circumstances, income that initially appears to be “too high” may not prevent eligibility. When there is a spouse remaining at home, additional spousal protections may also apply.

Resources: Not everything a person owns necessarily counts toward Medicaid's resource limit. Some assets are countable, while others may be exempt or treated differently under Medicaid rules. We can help you understand which is which and how those rules apply to your family's situation.

One of the most common misconceptions we hear is that someone simply has “too much money” to ever qualify for Medicaid. In reality, being over Medicaid's financial limits today may simply mean that planning needs to happen before an application is filed.

And planning doesn't necessarily mean spending everything on the nursing home until the money is gone.

Depending on the circumstances, there may be legitimate ways to spend, reposition, or protect resources within Medicaid rules while preparing for eligibility. The right strategy depends on the whole picture—whether the person is married or single, what they own, their income, real estate, retirement accounts, life insurance, vehicles, previous gifts or transfers, debts, future needs, and many other factors.

That's why we believe in planning before simply spending. Our goal isn't just to get someone's bank account below a certain number. It's to develop a thoughtful plan for Medicaid eligibility while making the best lawful use of the resources Mom or Dad spent a lifetime building.

So before you assume your family has “too much money for Medicaid,” let's actually look at the numbers. You may have more options than you think.

No—not exactly. And please don't start spending money just for the sake of spending it.

Medicaid does have resource limits, and someone who has countable resources above those limits may need to reduce them before becoming eligible. But a Medicaid spend-down is not the same thing as simply handing everything over to the nursing home or spending money as fast as possible.

There may be many appropriate ways to use Mom or Dad's resources for their benefit while working toward Medicaid eligibility. Depending on the circumstances, that could include paying debts, addressing medical or dental needs, replacing necessary personal items, making appropriate home or vehicle expenditures, arranging certain prepaid expenses, or using other Medicaid-compliant planning strategies.

And if there is a spouse remaining at home, stop before you start spending. Medicaid has special protections for married couples, and the amount that may be preserved for the spouse at home can be very different from what families expect.

The order and timing of these decisions can matter, too. Something that seems perfectly reasonable may have an unintended Medicaid consequence, while an expense you never considered may be completely appropriate.

That's why we don't particularly like the phrase “spend it all down.” We often think of it as converting resources—evaluating what is countable, what may be exempt, and whether countable resources can appropriately be used or converted into something that Medicaid treats differently.

This is actually one of our favorite parts of Medicaid planning. Every family's situation is different, and sometimes there are surprisingly creative—and completely legitimate—ways to use resources for Mom or Dad's benefit while working toward eligibility. Some of those solutions can even be fun. Maybe Mom has needed new hearing aids for three years. Maybe Dad's 20-year-old car has seen better days. Sometimes good Medicaid planning means finally taking care of things that have been put off for far too long.

We start by evaluating the resources and making a plan. Then, when appropriate, we may have what we affectionately call “Conversion Day”—the point when the plan is put into action before the Medicaid application is filed.

Before you start writing checks, moving money, giving things away, paying the nursing home months in advance, or making major purchases, let us look at the whole picture. The goal isn't to make Mom or Dad poor. The goal is to achieve eligibility while using and preserving their resources as wisely as Medicaid rules allow.

She can give her money away—but Medicaid may have something to say about it later.

Medicaid generally reviews certain transfers made during the five years before someone applies for long-term care Medicaid. If money, property, or other assets were given away or transferred for less than fair market value, the transfer may result in a penalty period during which Medicaid will not pay for nursing home care—even if Mom has otherwise become financially eligible.

That's why simply giving the kids the money is usually not a Medicaid plan.

But here's the equally important part: not every transfer is treated the same way. There are exceptions, special rules, and circumstances in which transfers may be permitted. Who received the asset, why it was transferred, what was received in return, when it happened, and the person's circumstances can all matter.

And please don't assume that every check Mom wrote to a child during the last five years means disaster. Families often come to us worried about birthday gifts, Christmas money, help Mom gave a grandchild, payments to a family caregiver, shared household expenses, or transactions they can no longer remember. We look at what actually happened before deciding whether there is a problem.

If there is a problematic transfer, that still doesn't necessarily mean the answer is, “Come back in five years.” Depending on the circumstances, there may be ways to document, correct, return, or otherwise address a transfer as part of an appropriate Medicaid plan. When correcting a transfer involves legal, tax, property, or other issues outside our role, we'll help coordinate with the appropriate professional.

The five-year lookback is not a five-year waiting period. It is a review of certain transactions that occurred during that period—and understanding the difference can completely change how a family approaches Medicaid planning.

So before Mom starts writing checks to everybody because someone said she needs to “get the money out of her name,” call us first. And if she already did? Call us anyway. We'd much rather evaluate what happened than have your family assume Medicaid is no longer an option.

No. Medicaid does not expect the spouse remaining at home to become impoverished just because their husband or wife needs long-term care.

Medicaid has special spousal protections for married couples when one spouse needs nursing-home care or certain home- and community-based long-term care services. These rules recognize something very important: there are still two people who need to live.

Depending on your circumstances, the spouse remaining at home may be allowed to keep certain resources, including exempt assets, as well as a portion of the couple's countable resources. There are also rules that may allow some of the Medicaid spouse's income to be allocated to the spouse at home when appropriate.

But this is another area where we strongly recommend planning before spending or moving anything.

Families are sometimes told to separate accounts, spend assets down immediately, remove someone's name from property, change beneficiaries, transfer money, or start paying the nursing home before anyone has evaluated the couple's complete financial picture. Those decisions can affect what options remain available later.

We look at both spouses, not just the person entering the nursing home. What does the spouse at home need to remain financially secure? What resources are countable? What is exempt? How are assets titled? What income does each spouse receive? Is there a home, vehicle, retirement account, life insurance, debt, or other property that needs to be considered? Are there planning opportunities available before Medicaid eligibility is established?

Sometimes the best Medicaid plan isn't simply about getting one spouse approved. It's about getting one spouse the care they need while making sure the other spouse can continue to live safely and financially securely at home.

And please don't assume you have to divorce your spouse, give everything away, or spend your life's savings before asking for help. Let us look at the whole picture first.

You spent a lifetime building a life together. Long-term care planning should consider both of you.

Not if we've planned for that possibility, too.

Getting one spouse eligible for Medicaid while protecting the spouse remaining at home is only part of good long-term care planning. We also need to ask a harder question: What happens if the spouse at home dies first?

After Medicaid eligibility is established, the spouse at home may own the house, savings, investments, vehicles, or other resources that were appropriately preserved for them. If that spouse later dies and those assets pass directly back to the spouse receiving Medicaid, the inheritance can significantly change the Medicaid recipient's financial situation and may jeopardize continued eligibility.

That's why we believe Medicaid planning and estate planning should work together rather than happen in separate rooms.

When we identify this concern, HMS can collaborate with an experienced elder-law or estate-planning attorney who can evaluate the family's estate plan and recommend the appropriate legal tools. Depending on the circumstances, that may include a properly drafted testamentary trust or another estate-planning strategy designed to provide for the surviving spouse without unnecessarily disrupting the Medicaid plan.

The attorney provides the legal advice and prepares the necessary legal documents. We bring the Medicaid piece to the table so that everyone understands how the estate plan and Medicaid rules interact.

And timing matters. Ideally, these conversations happen while both spouses are living and have the ability and legal authority to make the necessary decisions. Waiting until a crisis—or until after a spouse has died—can dramatically reduce the options available.

We understand the importance of this planning personally, because our own family experienced this exact situation. Life didn't happen in the order everyone expected, and having a plan already in place made an enormous difference.

No one likes planning around the possibility that the healthier spouse could die first. But illness doesn't always follow the order we expect.

A good Medicaid plan gets you through today. A thoughtful long-term plan also asks what could happen tomorrow.

Not necessarily. A denial is something we investigate—not something we automatically accept as the final answer.

Medicaid applications can be denied for many reasons. Sometimes the applicant truly doesn't meet an eligibility requirement. But denials can also result from missing or incomplete documentation, information that wasn't received or processed, an unanswered request for verification, a misunderstanding about an asset or transfer, an incorrect eligibility determination, or simply a problem that could have been addressed if everyone had known about it sooner.

The first thing we want to see is the actual notice. Not what someone at the nursing home remembers being told, not what someone heard on the phone, and not just the word “DENIED” on an online portal. The written notice should tell us what action Medicaid took, why it took that action, and what rights and deadlines apply.

Then we work backward.

What happened? What rule was applied? What information did Medicaid have? What information might be missing? And most importantly—was the decision correct?

Sometimes the solution is relatively simple. Other times, we may need to provide additional documentation, communicate with the agency, request reconsideration or another available administrative remedy, or file an appeal and prepare for a fair hearing.

And when we believe Medicaid got it wrong, we're not afraid to say so. We will ask questions, follow the paper trail, cite the applicable policy when appropriate, and advocate for the decision to be reviewed.

There are deadlines associated with Medicaid notices and appeals, so don't put a denial in a drawer and plan to deal with it later. Contact us as soon as possible and send us the entire notice.

A denial tells us Medicaid made a decision. It doesn't necessarily tell us Medicaid made the right decision.

You may not need to—and we'll tell you that if we think that's the case.

Many nursing facilities have experienced business-office staff who routinely assist residents and families with Medicaid applications. If Mom's finances are straightforward, she's already financially eligible, there are no significant transfers or planning issues, and you're comfortable managing the process with the facility's assistance, that may be perfectly appropriate.

The difference is who we're working for and what we're looking at.

A nursing facility understandably has an important goal: getting payment established for the care it is providing. HMS is hired by you and your family. Our job is to look beyond getting an application submitted and consider the entire Medicaid picture—including eligibility, resources, income, prior transfers, spousal protections, planning opportunities, documentation, deadlines, and what decisions made today could mean later.

Sometimes those interests align perfectly. Sometimes there are additional options or considerations that deserve a closer look.

We also don't expect nursing-home staff to serve as your estate planner, financial advisor, attorney, or personal Medicaid advocate. Those aren't their jobs. When a case involves issues outside our role, we coordinate with the appropriate professionals so the different pieces of the family's plan work together.

And we genuinely value good nursing-home business offices. We would much rather collaborate with the facility than work against it. When everyone communicates and understands the plan, Medicaid cases generally go much more smoothly.

So if the facility has offered to complete Mom's application for free, you don't automatically need to say no. But before you assume that submitting the application is the only thing that needs to be done, it may be worth having us look at the situation.

The nursing home can help Mom apply for Medicaid. HMS helps your family develop and navigate the Medicaid plan. Those aren't always the same thing.

Being Mom's daughter doesn't automatically give you legal authority to act for her—even when everyone agrees you're the person trying to help.

This can come as a frustrating surprise. Banks, insurance companies, healthcare providers, Medicaid, nursing facilities, and other organizations may require documentation showing that you have authority to act on Mom's behalf.

If Mom previously signed a valid Power of Attorney or other appropriate authorization, that's a good starting point—but having a POA doesn't necessarily mean the person named in it has authority to do everything that may be needed for long-term-care and Medicaid planning. The actual language in the document matters.

We also frequently encounter families who were given a generic Power of Attorney or healthcare document downloaded from the internet or supplied during a hospitalization or facility admission and told, essentially, “Just have Mom sign this.”

That can create significant problems.

A basic form may be useful for certain purposes, but it may not contain the specific or expanded authority necessary for some Medicaid and long-term-care planning strategies, particularly when a proposed plan involves gifting, transfers, changes in ownership, estate-planning decisions, or other significant financial transactions.

There is another issue that is even more important: the person signing must have the legal capacity required to execute the document. A new Power of Attorney isn't a solution simply because someone can physically put a pen in Mom's hand. When dementia or another cognitive impairment has progressed significantly, whether a new document can validly be executed is a legal question that may require an attorney's evaluation.

On the other hand, being physically unable to sign does not necessarily mean someone is unable to make their own decisions. A person may be completely alert, understand exactly what they want, and have the necessary capacity to execute a document—but be physically unable to hold a pen or produce a traditional signature. Those are very different situations. There may be legally appropriate ways to execute documents when physical limitations prevent a conventional signature, and we can help coordinate with the appropriate attorney or other professional so the person's wishes and abilities are properly respected.

We become especially cautious when there are other children, a spouse, beneficiaries, or other interested family members who disagree, aren't involved in the decision-making process, or could be affected financially by the proposed plan. Questions involving authority, capacity, gifting, conflicts of interest, or competing family interests are exactly the situations where we want an experienced attorney involved before anyone starts moving money or changing ownership.

If the necessary authority isn't already in place and Mom can no longer legally grant it, guardianship or another legal solution may need to be considered. HMS can help identify the Medicaid issues and the actions the eventual plan may require, while the attorney determines the appropriate legal authority and prepares any necessary legal documents.

That's also why we encourage families to address Powers of Attorney and estate-planning documents before a crisis whenever possible. A thoughtfully prepared POA isn't just about naming someone you trust. It should give that person the authority they may actually need if long-term care becomes necessary someday.

But if the crisis is already here, don't assume you're too late. Bring us what you have. We'll help identify what the Medicaid plan may require and, when necessary, work with an attorney to determine what can legally be done.

Sometimes the first step in a Medicaid plan isn't applying for Medicaid. It's making sure the right person has the right authority to carry out the plan.

Maybe there are legitimate planning opportunities—but protecting Mom’s resources and simply transferring them to someone else are not the same thing.

Our first concern is always the person whose money, property, and care are at issue. Medicaid planning may include perfectly legitimate strategies to preserve, transfer, spend, or convert resources within the rules. But every recommendation has to make sense for Mom or Dad, not simply for the people who may eventually inherit from them.

Sometimes a proposed transaction raises questions. Maybe Mom has significant cognitive impairment and someone suddenly wants the house transferred. Maybe a child, caregiver, neighbor, or new companion wants assets moved into their own name. Maybe other family members are being intentionally excluded from the conversation. Or perhaps we're being asked to rely on a recently signed Power of Attorney when there are questions about capacity, authority, or what Mom actually wanted.

That's when we slow down.

We don't accuse people of wrongdoing simply because a situation is unusual, but experience has taught us to pay attention when something doesn't feel right. We may ask additional questions, review the authority documents, want to understand the history of the proposed transaction, or recommend that an independent attorney become involved before anything is moved or signed.

We are passionate about helping families preserve everything Medicaid rules legitimately allow them to preserve. But asset protection and asset taking are two very different things.

If the proposed plan is lawful, properly authorized, and appropriate for the person we're trying to help, we'll work hard to find the best way forward. If we're not comfortable that those things are true, we won't participate until the concerns are resolved.

Sometimes good advocacy means moving quickly.

Sometimes it means knowing when to stop and ask one more question.

Actually, that's often the best time to talk.

You don't need to wait for a hospitalization, nursing home admission, dementia diagnosis, or financial crisis to start thinking about long-term care. Planning while everyone is doing well usually means more choices, more time, and fewer decisions made under pressure.

We can help you understand what Medicaid may look like if long-term care is needed someday, identify potential issues in the current financial picture, review how assets are owned, and help you recognize estate-planning or authority documents that may deserve a closer look.

That doesn't mean we're going to tell Mom and Dad to start moving money around because they might need Medicaid someday. Good planning isn't about turning your life upside down unnecessarily. Sometimes the most valuable result of a planning session is simply knowing what you should leave alone, what you may want to address now, and what to do if circumstances change.

When legal or estate-planning work would strengthen the long-term plan, we can collaborate with an experienced attorney so the legal and Medicaid pieces complement one another.

The best time to make difficult decisions is often before they become urgent decisions.

Yes. In fact, that's one of the most common places families start.

You don't need to understand Medicaid. You don't need to know whether Mom needs assisted living, a nursing facility, home-based services, or something else. You don't need five years of bank statements neatly organized in a binder. And you certainly don't need to learn an entirely new system overnight because someone you love suddenly needs care.

Tell us what's happening.

We'll listen, help separate the urgent issues from the things that can wait, explain what we see, and start putting the pieces in order. If something falls outside our role, we'll tell you that and help identify the right professional or resource whenever we can.

There may be paperwork, deadlines, financial decisions, phone calls, and difficult conversations ahead. We'll take them one step at a time.

You don't have to know what to ask before you call us.

Sometimes the first question is simply, “Can you help us figure out what to do next?”

And the answer is yes.

The five-year lookback is probably one of the most misunderstood Medicaid rules we encounter.

Families are often told things like, “You can't apply for Medicaid for five years,” “That transfer was three years ago, so you only have two years left,” or “If you give the money away now, the penalty starts now.” Those statements can seriously oversimplify how the rule actually works.

The five-year lookback is not automatically a five-year waiting period. For long-term-care Medicaid, it is a period Medicaid uses to review certain financial transactions to determine whether assets were transferred for less than fair market value.

Generally, Medicaid looks back through the preceding 60 months for potentially disqualifying transfers. If Medicaid determines that a transfer was made for less than fair market value and is subject to the transfer rules, it may impose a penalty period during which Medicaid will not pay for certain long-term-care services.

Here's the part that surprises many families: the penalty does not necessarily begin when the money or property was given away. Under the current rules, the timing of the penalty is tied to when the individual has reached the point at which they would otherwise be eligible for Medicaid payment of long-term care. That distinction can make an enormous difference.

That's also why we're cautious when someone says, “My banker told me we can do this because of the five-year rule,” “The nursing home said the lookback means this,” or “Someone told us just to wait until the five years are up.” These professionals may be excellent at what they do, but Medicaid transfer rules are highly specialized and frequently oversimplified—even by people who encounter Medicaid regularly.

And not every transfer during those five years automatically creates a penalty. There are exceptions, allowable transfers, and circumstances that require a much closer look.

Before making a gift, transferring property, moving large amounts of money, changing ownership, or trying to “fix” an old transaction based on something you've heard about the five-year rule, let us look at the dates and the actual transaction first.

And if the transfer already happened, don't assume you're stuck. Depending on the circumstances, it may be allowable, may not have the consequence you expect, or there may be appropriate ways to address it.

The five-year lookback is not a five-year waiting period. With Medicaid, the details—and especially the dates—matter.

Not necessarily. A nursing home isn't the only way Medicaid may help with long-term care.

Depending on Mom's age, care needs, financial eligibility, living situation, and other circumstances, she may qualify for home- and community-based services that allow her to receive care outside a nursing facility. In Indiana, those services may include assistance in the home, structured family caregiving, adult day services, assisted living, home-delivered meals, transportation, home modifications, and other supports.

The important question isn't simply, “Does Mom qualify for Medicaid?” It's also, “What type of Medicaid and long-term-care services might fit Mom's needs and where she wants to live?”

Sometimes a nursing facility really is the safest and most appropriate setting. Other times, there may be options that allow someone to remain at home, live with family, or receive services in another community setting.

HMS can help families understand the different possibilities, evaluate the Medicaid side of the equation, and coordinate with waiver case managers, healthcare providers, facilities, and other professionals involved in the transition.

Before assuming that Medicaid means “nursing home,” let's look at the person first—their needs, their choices, and the options that may be available.