Is It Too Late to Plan for Medicaid/TennCare? Saving Assets from “Spend Down” in a Crisis

Amelia Crotwell, CELAMy Gran is turning 107 today, and I’ll get to visit with her over the weekend.  I can’t wait to see her and sit in the courtyard, hold her hand, and talk about flowers, birds, and relatives.  We decided against the Big Birthday Party this year as we’ve been having big birthday parties for her every year since she turned 100.  She just said “No” this year.  When Gran says no, that’s the end of the story.Gran has always been a hearty person with few health concerns, but a few years ago she fell and broke her leg – a devastating injury for someone then aged 102.  She could no longer walk or transfer and needed long-term care around the clock.Aha, it was finally time to do that Medicaid planning that I’d been preaching about for years!  I had never been able to persuade her to pursue pre-crisis planning.  That’s the way of things – you can be an expert for everyone except your own family.But that’s the good news about Medicaid/TennCare planning:  it’s never too late to plan.  Yes, there is that five-year lookback period that we must adhere to, and yes, planning a long time before a crisis happens is optimal.  But for many families, it just isn’t possible to convince our loved one to relinquish some control or to admit vulnerabilities or needs.  While the lookback period does cause challenges for crisis Medicaid planners, a knowledgeable and experienced elder law attorney knows many creative asset protection strategies to save Mom, Dad, or Gran’s home, farm, savings, or retirement accounts.  With crisis Medicaid planning, a family can expect to salvage at least half of the assets, but in many cases, most or all of the assets considered to be “at risk” for “spend down” can be saved.  Of course, it all depends on the unique facts and circumstances of each family.If you or someone you care about is facing “spend down” and the crisis is upon you, don’t get discouraged because you didn’t plan earlier.  Don’t spend it all on medical bills because you think you have no other options.  Call someone experienced who can show you the options available now.  You’ll be glad you did. 

Amelia Crotwell, JD

Amelia Crotwell, founder and managing partner at Elder Law of East Tennessee, has guided families through long-term care and special needs challenges for nearly two decades. Specializing in Life Care Planning and special needs trusts, Amelia also collaborates across all areas of elder law, including wills, trusts, Medicare, Medicaid, probate, and veterans benefits planning. Certified as an Elder Law Attorney since 2011, she is president-elect of the Life Care Planning Law Firms Association and co-chair of their strategic planning committee. Amelia is deeply involved in the Special Needs Alliance and a prominent member of the National Academy of Elder Law Attorneys. She played a key role in founding the Tennessee chapter of NAELA, serving as its first president. A member of the Tennessee Bar Association and past chair of its Elder Law Section Executive Council, Amelia also dedicates time to pro bono work and community education. She earned her J.D., summa cum laude, from the University of Tennessee College of Law and teaches Elder Law there as an adjunct professor since 2018.

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