Services: Employee Assistance Programs

Incorporating Medicaid Planning services into Employee Assistance Programs (EAPs) can not only be invaluable for employees, but also for their elderly loved ones who are facing healthcare and financial challenges. That’s because EAPs with Medicaid Planning services can help individuals and families access the long-term care they need without depleting their savings.

Our Medicaid Planning services can guide employees and their elderly loved ones along every step of their journey to long-term care. That starts with understanding Medicaid’s financial and medical eligibility criteria, which can change depending on the applicant’s state of residence, their marital status and the Medicaid program. The process includes searching through all of the available long-term care services and supports, and finding the options that make the most sense for the employee and their family. After eligibility is established and care options are chosen, we will assist with the Medicaid application process to make sure all of the forms are completed and submitted according to state rule. This includes gathering all of the required financial documents, which is usually the most painstaking part of the process.

If an employee or their elderly loved doesn’t meet their financial eligibility criteria, our Medicaid Planning services can help them become eligible. Our team of professionals will make sure families are using all of Medicaid’s exceptions and allowances that might be relevant to their situation, like the Community Spouse Resource Allowance or Child Caregiver Exemption. We can also help employees and their families use planning strategies like “spending down” or purchasing a Medicaid Compliant Annuity. If they remain ineligible, our services can provide them with information about other healthcare resources that may be available, and help them formulate a plan to cover the gap until they become Medicaid eligible.

Our Medicaid Planning services don’t end when the application has been submitted. If the applicant happens to be denied, our team will work to reverse the decision. Some denials can be overturned though informal communication with the state, while others require an official appeal and a fair hearing, and our services will clients navigate both paths. After the applicant has been accepted, we can help them and their families understand their rights and responsibilities in their particular Medicaid program and state.

Adding Medicaid Planning services to an EAP can benefit both the employee and the employer. Employees feel supported and empowered by the services because it helps them create long-term care plans for themselves and their family members who need it most. This can alleviate a significant stress that would have likely impacted their performance at work, and that’s good news for any employer. Contact us to talk about a partnership or refer a client.


The Process for Employees

Each employee starts with a personalized, and confidential, 60-minute consultation with a Certified Medicaid Planner (CMP). These CMPs have been trained and tested in all aspects of Medicaid across all 50 states, and they put their training to use on a daily basis helping clients qualify for Medicaid and receive the care they need. During this introductory phone or video meeting, the employee will have time to ask questions about the Medicaid programs, eligibility requirements and application processes in their state. They can also share the healthcare and financial goals they have for themselves and/or their loved ones.

This conversation is designed to create peace of mind for the employee. We know how frustrating planning for long-term care can be for people who don’t have experience with the process. We’d like to ease those frustrations by providing answers and guidance, starting with this meeting. We will also provide clearly written follow-up material so the information covered in this initial conversation will be available for future reference.



Who We Can Help

Our Medicaid Planning services can assist any employee who has questions about Medicaid long-term care and how it relates to them or their family. This can include employees and families who don’t know the first thing about Medicaid, to those who are in the process of applying, to those who already have family members enrolled in Medicaid. We can help single individuals, married couples, adult children with aging parents and anyone else who might need Medicaid long-term care now or in the future.

As mentioned above, we can also help people qualify for Medicaid who do not initially meet their eligibility requirements. This includes families with complex financial situations, such as business owners or landlords.



How Employees Can Prepare for a Consultation

1) Be able to describe the level of care need and living situation for themselves and/or their family member who needs care.

2) Be ready to discuss healthcare and financial goals for themselves and/or their family.

3) Gather documents that detail all assets and income of the individual who needs Medicaid long-term care, including:

  • Official bank records for any checking or savings accounts
  • Statements detailing values of retirement accounts such as a 401k, IRA, 403b, Keogh, TSA, etc.
  • Life insurance policies
  • Deeds for all homes and land
  • Titles for all vehicles
  • Social Security statement or benefits letters
  • Tax returns
  • Pay stubs
  • Pension statements



Services Offered

  • Benefits Consultation – introductory consultation that provides an overview of the available Medicaid benefits for an individual or family given their eligibility criteria and state
  • Medicaid Planning – long-term healthcare and financial strategy for individuals and families who are interested in Medicaid
  • Trust Assessments – assessment of all trusts held in the applicant’s name and their potential impact on eligibility
  • Moving with Medicaid – assistance for Medicaid beneficiaries who are moving out of state
  • Medicaid Continuity Consultation – addresses potential issues when there is a change in a Medicaid beneficiary’s financial situation
  • Medicaid Redetermination – help with the annual process of renewing Medicaid coverage, also known as Medicaid Renewal