LTC Bullet: The Medicaid Seduction

Wednesday, April 14, 2004


LTC Comment: How do Medicaid planners seduce affluent families into settling for welfare-financed nursing home care? Read a typical spiel after the ***news.***

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*** TOPICS ANNOUNCED FOR THE 17TH PRIVATE LONG TERM CARE INSURANCE CONFERENCE. Titled this year "Financing Long Term Care: Policy, Politics, and Practice," the longest-running LTCi conference is scheduled for June 23-25, 2004 at the Marriott Wardman Park Hotel in Washington, DC. Following are major topics to be covered:

o An Insiders Look at Care Coordination in Long Term Care Insurance
o The Do's and Don'ts of Long Term Care Marketing
o The Politics of Health Care and Long Term Care
o Growing Pains: Industry at the Crossroads
o New Insights from a Decade of Buyer / Non-Buyer Research
o Buying Behavior in Today's Economy
o Assisted Living: Latest Developments
o Pricing Issues in Long Term Care Insurance
o NAIC Update
o National Partnership - Second Generation Goes National
o Claims Management: New Learning and New Strategies
o Employer Interest and Progress in Delivering Long Term Care Insurance

For more information, go to or call Diane Fulton at 703-968-8863. Stay tuned to this space for more details as the conference date approaches. In the meantime, visit our Virtual Visit to last year's 16th iteration of this meeting (in San Antonio) at . If you lack the user name and password to view our Virtual Visits, just keep reading for instructions on how to Zone In. ***

*** LATEST DONOR-ONLY ZONE CONTENT: Here's the latest Zone content followed by instructions on how to subscribe so you can receive these critical epistles daily by email.

LTC E-Alert #4-020--Michigan, Medicaid Estate Recoveries and LTCi (Medicaid can't survive as "inheritance insurance" for baby boomers; finally, Michigan sees the light.)

LTC E-Alert #4-021--The Suffering Saints of LTC (Who carries the weight in long-term care shows in the statistics on workplace injuries.)

LTC Reader #4-013--Something's Gotta Give . . . One Million With Unmet LTC Needs, but 23 Million Already Provide Free Care (The vise of care and cost is closing on LTC.)

LTC E-Alert #4-022--Candidate Kerry Nixes LTCi Tax Deductibility (Go figure?!)

Don't miss our "virtual visits" to major LTC industry conferences in The Zone. You'll find our comparison of the conferences, session summaries, interviews and pictures at .

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LTC Comment: Medicaid is a means-tested public assistance program. It is welfare. The program is supposed to be a publicly financed long-term care safety net for disadvantaged elderly people. But it has become much more than that. Medicaid eligibility rules are generous and elastic. They are easily manipulated so that people with substantial income and assets can qualify for extensive health and long-term care benefits without spending down first.

Sadly, however, Medicaid is so overused by middle and upper-middle class people that the program's ability to purchase quality care for anyone has been severely undermined. Today, Medicaid has a dismal reputation for problems of access, quality, low reimbursement, discrimination, institutional bias, and loss of independence. Tort liability lawsuits plague LTC providers who are dependent on Medicaid's notoriously inadequate reimbursement rates.

Nevertheless, one or two lawyers with a dozen paralegals can easily rake in millions selling Medicaid to well-heeled families with an elder who needs care. Adult children of the elderly, i.e. their heirs, are usually the driving force behind Medicaid planning. It is easy to convince heirs that they should get their parents' money instead of it going to a long-term care provider to purchase care. Medicaid planners routinely charge rates equivalent to a month or two in a private nursing home ($5,000 to $10,000) to shift the cost of long-term care from individuals and their families to taxpayers.

Ever wonder how Medicaid planners sweet talk prospects into becoming customers? Read on for an actual example. For additional information about the Houston, Texas law firm that distributes the five-and-a-half minute compact disc transcribed and excerpted below, go to . The CD is titled "Q: How Can We Afford Nursing Home Care Without Losing Our Life Savings? Medicaid Planning is the Answer." Both of the principals in the firm responsible for this material are Certified Elder Law Attorneys and members of the National Academy of Elder Law Attorneys (NAELA).

We invite readers to consider the ease with which Medicaid planners make money by waving a magic legal wand after long-term care is already needed. Now compare their money-making machine to the huge challenges long-term care insurance agents face. The agents struggle to convince a public in denial to pay premiums for years in advance for insurance benefits the attorneys casually promise to give away at government expense. No wonder Medicaid planning thrives and LTCi sales languish.

What really galls and perplexes, however, is that Medicaid planners routinely claim the moral high ground, as if they were doing good instead of undermining America's flawed and failing long-term care system. Worse yet is that most legislators, policymakers, insurers, providers, and financiers of long-term care acquiesce silently in this travesty. If they don't see the light and stop this abuse of Medicaid soon, it will be too late to prevent a long-term care catastrophe for baby boomers.


Excerpts from "Q: How Can We Afford Nursing Home Care Without Losing Our Life Savings? Medicaid Planning is the Answer," distributed by Wright Abshire Associates of Houston, Texas.

"Thank you for contacting the law firm of Wright Abshire to assist you and your loved one in achieving nursing home eligibility while legally protecting your assets. . . .

"Hundreds of families have sought the services of the attorneys of Wright Abshire over the years, and MILLIONS OF DOLLARS HAVE BEEN PRESERVED FOR PEOPLE JUST LIKE YOU. [Emphasis added.] The attorneys and staff are committed to guiding you through the complicated Medicaid maze. You must be aware, however, that when you're dealing with Medicaid, time is your enemy. Much of what can be done in the area of Medicaid is time-sensitive. This means you may need to act now. . . .

"If you want the assistance of this firm, they will give you the legal advice you need to preserve assets. Usually they're able to help clients whether the family member is a few years out, has just arrived at the nursing home, or even one who has been in the nursing home for several years, depleting their assets. EVEN IF A CLIENT'S ASSETS ARE SUBSTANTIAL, THE FIRM WILL IN ALMOST EVERY CASE BE ABLE TO SUCCESSFULLY ACHIEVE A SATISFACTORY PLAN FOR THE CLIENT TO PRESERVE ASSETS. [Emphasis added.]

"Many people believe that if they did not do something three years ago, then there is nothing that can be done. However, the firm will in most cases prove that this is not true. . . . Likewise, IF THE MEDICAID APPLICANT HAS EXCESS INCOME, THE FIRM WILL IN MOST CASES BE ABLE TO ASSIST THE CLIENT IN THE CREATION OF A MILLER TRUST TO SOLVE THIS ELIGIBILITY OBSTACLE. [Emphasis added.]

. . .

"Although there is not enough time to go over every type of case involving Medicaid, it has been the experience of Wright Abshire that they can help almost anyone who desires their assistance. Whether your case involves a situation with one spouse going into the nursing home and one staying at home, or both spouses going into the nursing home at the same time, or even a single person going into the nursing home, the firm wants to help you protect your assets. THEY WANT TO ASSIST YOU TO OBTAIN THE BENEFITS CONGRESS INTENDED FOR YOU TO OBTAIN WITHOUT BECOMING IMPOVERISHED IN THE PROCESS. [Emphasis added.] . . .

"Wesley E. Wright, the firm's founder, is board certified by the Texas Board of Legal Specialization in estate planning and probate law. Mr. Wright and Molly Dear Abshire are members of the national academy of elder law attorneys.

"Nothing contained in this recording should be considered as the rendering of legal advice for specific cases. This recording is intended for general informational purposes only."