Call: 415-854-8653 | Fax: 415-484-7048

What are the Differences between a Certified Medicaid Planner and an Elder Law Attorney?

Article Summary
Both Certified Medicaid Planners (CMP) and Elder Law Attorneys can assist clients in qualifying and applying for Medicaid Long Term Care. There are pros and cons to both and, of course, exceptions abound. However, generalizations can (and will) be made. CMP are generally faster, less expensive and operationally more efficient. Medicaid is complicated, and their knowledge allows them to guide clients on institutional Medicaid alternatives and alternative pathways to eligibility. Attorneys may be better suited for longer term, estate planning and higher net worth individuals as these cases often involve more complicated legal structures and receiving benefits quickly is not a priority.

What Are the Differences Between a Certified Medicaid Planner and an Elder Law Attorney?
When clients need help qualifying and applying for Medicaid Long Term Care, most health care professionals direct them to a Certified Medicaid Planner or an Elder Law Attorney. Both can assist your client, but which one would be more helpful?

The answer, as with most things related to Medicaid, depends on the client and their needs. Most Certified Medicaid Planners and Elder Law Attorneys can handle whatever issues arise during the entire process, but each one has different areas of expertise that may prove especially useful in certain situations. There is little doubt, however, that your client should hire one of these Medicaid professionals rather than trying to complete the process on their own.

Certified Medicaid Planners
Certified Medicaid Planners are experts in all things related to Medicaid Long Term Care applications, qualifications, regulations and benefits. They start to develop that expertise during their certification process, which requires them to reach specific education and/or experience levels, show their proficiency by passing an examination and commit to maintaining the highest professional standards. Their expertise is then honed on a daily basis as they work with Medicaid Long Term Care applicants. That combination of education and experience makes Planners both efficient and precise when it comes to the nuts and bolts of the Medicaid planning and application process – collecting and verifying documentation; calculating allowances and spend downs; filling out and submitting the application in an optimal manner; and correcting any mistakes that may come with a denial and resubmitting in a timely manner. The priority for most of your clients will be help with those kinds of administrative tasks, and Planners are best suited to deliver that help.

Planners are also especially useful when your client needs to spend down their assets on Medicaid-approved goods and services in order to qualify for Medicaid. Planners have gone through that process so many times they know exactly what goods and services are Medicaid-approved, and they can avoid the denials and delays that come with spending down on non-approved items.

Elder Law Attorneys
Elder Law Attorneys can certainly assist with those administrative, nuts-and-bolts tasks and spending down assets, but they are typically more focused on the legal aspects of Medicaid and long-term estate planning. If your client has complex financial holdings, or has any kind of legal complications, seeking out an Elder Law Attorney may be their best option. For example, your client may need a divorce to qualify for Medicaid, or they may need to set up a trust to protect their estate. However, it’s important to note that many Planners partner with lawyers in order to handle these types of legal issues and provide a seamless, one-stop-shopping experience for their clients.

Geographic Considerations
While Elder Law Attorneys have in-depth knowledge of the Medicaid laws in the state where they are allowed to practice, Planners are familiar with the national Medicaid rules and regulations, as well as those in other states. This is valuable in a place like New England, where living near state borders is common. A Planner working with New England residents can advise them on which state’s Medicaid program might help them save money, receive better care or avoid wait lists. A Planner’s multi-state experience is also valuable when adult children live far from the aging parent they are trying to help apply for Medicaid. For example, if the helping adult child resides in New York but their parents live in Florida, they would benefit from knowing the details of both states Medicaid programs, and a Planner is more likely to have that information than an attorney.

Billing Considerations
An Elder Law Attorney can research Medicaid rules in multiple states, and they can help with the administrative tasks of completing the application, but a Planner is more likely to do it faster and with fewer errors. The time factor is important because attorneys usually charge per hour, so the longer the process takes the more it will cost your client. And errors that lead to a denial and the need for an application to be resubmitted will also mean more time with the attorney and higher bills for your client. Planners, on the other hand, usually charge a flat-rate for the entire engagement. You may find some Planners who charge per hour, or an inexpensive attorney, but for the most part Planners are more affordable than Elder Law Attorneys, another point to consider when advising your client.

Time to Benefits
Importantly for families in crisis mode, the specialized processes CMP have created can often help their clients obtain benefits more quickly. If a client needs Medicaid benefits as soon as possible because of an unexpected health situation or financial issue, Planners are best suited to expedite the Medicaid application process. They have completed and submitted so many applications that they can do it at high speed without compromising quality.

A Grain of Salt
There are exceptions to all of the above considerations. One can find attorneys so specialized in Medicaid that they are essentially the same as Certified Medicaid Planners. These generalizations are simply to help those unfamiliar with the differences to become aware of the relative strengths of the two service providers.

The table below shows a list of possible client priorities and who would best be suited to help with those priorities – a Certified Medicaid Planner, or an Elder Law Attorney. Of course, in the real-world clients often have multiple competing priorities so a no-cost initial consultation with either a CMP or an attorney is strongly recommended.

Client Priorities Certified Medicaid Planner Elder Law Attorney
Needs help filling out and submitting the application X
Needs benefits quickly due to unexpected health or financial issue X
Needs help gathering correct documentation X
Needs to maximize savings and benefits X
Needs long-term estate planning X
Needs to establish trusts X
Needs to spend down without violating Medicaid rules X
Multiple states are potentially involved X
Needs to appoint a guardianship X
Needs a Medicaid divorce X
Cost is a primary concern X
Cost is not a primary concern X