Medicaid Planning



  • Asset Transfer Strategies
  • Planning with a Life Estate
  • Medicaid Trusts
  • Medicaid Compliant Annuities
  • Trust/Estate Planning Coordination
  • Medicaid Assistance Applications
  • Interview Process Representation
  • Appeals & Representation in Fair Hearings
In Hawaii, the average statewide cost of a nursing home exceeds $8,500 a month. This average is one of the very highest in the nation. Nowadays, it seems that the greatest risk to the middle class is not probate or estate taxes, but the cost of nursing home care. The passage of the American Taxpayer Relief Act of 2012 on January 1, 2013 permanently established an estate tax exemption of $5.25 million per person in 2013. This means that as long as a single person does not have more than $5.25 million in assets at the time of his or her death, they will not owe a tax. Also, probate can be avoided using estate planning strategies such as a revocable living trust or co-ownership. Therefore, the real threat to the middle-class is not so much taxes and probate, but risk that a person will run out of money before they pass away trying to cover the high cost of nursing home care. This threat is particularly more concerning for married couples where one spouse is still able to live on his or her own at home because they still need financial support.

If a family does not have long-term care insurance or sufficient assets to self-insure (i.e. pay out of pocket using their own money), they may consider attempting to apply for Medicaid, which is the applicable government assistance program that can pay for nursing home care costs. The Deficit Reduction Act and the Hawaii Administrative Rules impose certain requirements regarding 1) the amount of available resources (assets) someone may keep and still be eligible for benefits; 2) retention of monthly income; 3) the impact of prior estate planning documents such as assets held in trust; and 4) the treatment of the transfer of assets under various circumstances and timing (e.g, five year lookback and penalty waiting rules). In addition, there are special rules regarding Medicaid assistance recovery liens (i.e., government liens that are placed against a home residence to cover costs once a Medicaid recipient passes away), transfers to care-giver children, life estates, mortgages and annuities.

Macanas Law Group, LLLC delivers quality, customized legal representation for those seeking to protect family assets from the high cost of long-term care. There are many planning opportunities that can help protect hard-earned assets from losses associated with the cost of nursing homes. For those clients who have lower to moderate net-worth, Macanas Law Group, LLLC offers solutions to take advantage of the most effective and ethical asset protection strategies currently used in the field.