What to bring to an elder-law attorney

Why it is worth preparing

An elder-law attorney's time is what you are paying for. An hour spent finding out what your parent owns is an hour not spent on what to do about it. If you arrive with the figures on one page and the documents in a folder, the conversation can start where it needs to.

The rules the attorney will apply are legal ones, and they differ by state. Your part is the facts.

Finding an attorney

Look for an attorney licensed in the state where your parent receives care, because that state's Medicaid rules apply. The National Academy of Elder Law Attorneys keeps a public directory you can search by location. If cost is a barrier, call the Eldercare Locator, which connects families to local services for older adults, and ask about legal help near you: 1-800-677-1116.

When you call an office, ask a few things before you book:

• How much of the practice is elder law, and how often do you handle Medicaid long-term care cases?
• Is there a fee for the first meeting, and how long is it?
• After that, do you charge by the hour or a flat fee, and what does it usually cover?
• What would you like me to bring?

The last question matters. If the office sends its own list, use that one first.

The checklist

1. About your parent

• Full legal name, date of birth, and current address.
• Whether they are married, widowed, or divorced. If married, the spouse's details too.
• Whether they or a spouse served in the military. The VA's Aid and Attendance benefit adds a monthly payment to a VA pension for some veterans and survivors.
• The diagnosis and the kind of care they receive now, in a sentence or two.

2. Money coming in

• Social Security, with the monthly amount.
• Pensions and annuity payments.
• Any other regular income, such as rent.

3. Money going out

• The facility's latest invoice and its rate sheet.
• The contract or admission agreement your family signed, or the one you have been asked to sign.
• Health insurance premiums, including any Medicare supplement or drug plan.

4. What they own

• The latest statement for every bank, brokerage, and retirement account.
• The home: the deed, any mortgage statement, and a rough idea of its value.
• Vehicles.
• Life insurance policies, especially any with a cash value.
• A long-term care insurance policy, if there is one.
• Any prepaid funeral or burial arrangement.

5. Legal papers

• A durable power of attorney for finances.
• A health care proxy, living will, or advance directive.
• The will, and any trust.

If one of these does not exist, say so. A missing power of attorney is one of the first things an attorney will want to know about.

6. The last five years

Medicaid reviews gifts and transfers made in the 60 months before an application for long-term care. So write down:

• Every gift of money: the date, the amount, and who received it.
• Any property sold or signed over, and for how much.
• Any large or unusual withdrawals you cannot explain yet.

Do not leave anything off because it seems awkward. The attorney needs the whole list, and this guide explains why.

The one page that saves the most time

Before the meeting, put the essentials on a single sheet:

• Each account and its balance, with a total.
• The facility's full monthly cost.
• Monthly income.
• How many months the savings will cover, and the month they run short.
• What you assumed about yearly rate increases.

That page turns "we are worried about money" into "the money covers the bill until this month", which is a question an attorney can work with. Here is how to work out the number of months.

Questions to ask

1. Given these figures, when should we be acting, and what has to be true by then?
2. Which Medicaid income and asset rules apply to my parent in this state?
3. Do any of the gifts or transfers on my list matter, and what would the effect be?
4. My parent is married. What does that change? Federal rules protect a certain amount of a couple's resources for the spouse living at home.
5. Which of my parent's assets count, and which do not?
6. What is estate recovery, and does it affect the house? Medicaid.gov describes the federal rule.
7. The facility says this about Medicaid. Would you read the contract?
8. What will your work cost, and what does that include?

Before the meeting

• Do not move money. Do not make gifts, pay off a relative, or change the names on accounts or deeds. Any of these can count as a transfer.
• Do not sign as a guarantor on a facility contract without reading what you would be agreeing to. The Alzheimer's Association suggests seeing an elder-law attorney before a move if Medicaid may be needed now or later.
• Do not wait for the money to run low. The earlier the meeting, the more there is for the attorney to work with.