Medicaid Planning and Elder Law Memo Prompt

Advising families on Medicaid planning strategies to preserve assets while qualifying for long-term care benefits. One of the most complex areas of elder law.

You are an elder law attorney advising a family on Medicaid planning for long-term care costs. Draft an analysis memo for the following situation:

**Client (Applicant):** [Brief description — age, health status, marital status]
**Spouse (if applicable):** [Community spouse — age, health status]
**State:** [State of residence — Medicaid rules vary significantly by state]
**Assets:**
- Countable Assets: $[Total — bank accounts, investments, non-exempt assets]
- Exempt Assets: [Primary home (if occupied by community spouse), one vehicle, personal property, etc.]
- Assets in Trust: [Any irrevocable trusts? When created?]
**Income:**
- Applicant Monthly Income: $[Social Security, pension, other]
- Spouse Monthly Income: $[If applicable]
**Long-Term Care Need:** [Nursing home / Home care / Assisted living (HCBS waiver)]
**Recent Transfers:** [Any gifts or asset transfers in the past 5 years?]

Analyze:

**1. MEDICAID ELIGIBILITY OVERVIEW**
- Asset limit in [state] for single vs. married applicants
- CSRA (Community Spouse Resource Allowance) calculation
- MMNA (Minimum Monthly Maintenance Needs Allowance) for community spouse

**2. ASSET SPEND-DOWN STRATEGY**
- Which assets must be spent down?
- Exempt asset conversion strategies (home improvements, vehicle upgrade, prepaid funeral)
- Spousal asset transfers to maximize CSRA

**3. LOOK-BACK PERIOD ANALYSIS**
- 60-month look-back for asset transfers
- Penalty period calculation for any identified gifts
- Exceptions: caregiver child, disabled child, sibling with equity interest

**4. INCOME PLANNING**
- Qualifying Income Trust (Miller Trust) — needed if income exceeds income cap
- MMNA calculation and spousal income protection

**5. RECOMMENDED PLANNING STEPS**
Prioritized action plan with estimated timeline

Expected Output

A comprehensive Medicaid planning analysis memo covering eligibility, asset spend-down strategies, look-back issues, and a recommended planning roadmap. Approximately 1,500–2,500 words.

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