Medicaid Planners: Pros & Cons of Public and Private Assistance

Last updated: April 10, 2024


There are many different types of professionals and volunteers that offer assistance to families to help them qualify for Medicaid. Not every type of advisor is appropriate for every situation, and not all persons offering advice necessarily have the family’s best interests in mind. Medicaid planning is difficult. While Medicaid is a federal program, it is administered on a state level, and the regulations and rules (such as eligibility) that govern it can vary greatly by state. Even within a state, Medicaid laws and programs may regularly change. To assist one in finding the assistance that best fits their given situation, read through the pros and cons of each type of advisor below, and look at the comparison table for quick reference. Persons are encouraged to use our free locator tool to find the best option for your needs.

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Types of Medicaid Planners

Elder Law Attorneys

Elder Law Attorneys are very knowledgeable about the Medicaid eligibility laws in the specific states in which they are licensed to practice law. They are also empowered to establish any necessary trusts on behalf of their clients. Trusts may be used to restructure one’s assets and / or income to meet Medicaid’s financial eligibility requirements. This makes Elder Law Attorneys a complete solution for Medicaid planning. As their clients pay them directly, typically on an hourly basis, one can be confident that the attorney is advising them in their best interest. Hiring an Elder Law Attorney is, by far, the most expensive Medicaid planning option. Depending on the state, fees can range from $300 – $600 per hour. The entire cost of working with an Elder Law Attorney might range from $3,000 on the low end to as high as $15,000.


Geriatric Care Managers

Geriatric Care Managers (GCMs), also called Aging Life Care Experts, Senior Health Care Managers, or Life Care Managers, typically provide a broad range of services to their clients, such as care planning, assessments, and care coordination. It is estimated that approximately 25% of GCMs also provide assistance with financial planning. They do, however, tend to have more practical experience and less formal training with financial planning and legal matters. One major benefit is that they are very knowledgeable about local programs that provide assistance as alternatives to Medicaid. Since their primary expertise is care management, and hence, a client-centered approach, they are well aware of the individual’s care needs. As they work with a family for broader purposes, there exists a relationship based on trust, which makes it more comfortable to share financial information. Finally, as one pays a Geriatric Care Manager directly, one can be confident they are advising in their client’s best interest. While not as expensive as Elder Law Attorneys, one is still paying for a Geriatric Care Manager out-of-pocket. GCMs cannot perform legal work on their client’s behalf, as do Elder Law Attorneys. Nor do they have broader financial planning experience, as most GCMs come from a nursing or social work background.


Certified Medicaid Planners

The major positive aspect of working with a Certified Medicaid Planner (CMP) is that they have a very broad understanding of all things Medicaid related. This includes eligibility rules, how to qualify if over the income and / or asset limit(s), and appealing cases of Medicaid denial. Certified Medicaid Planners are experts at building a plan that addresses the nature of long-term care. As with Elder Law Attorneys and Geriatric Care Managers, one pays these professionals directly. Therefore, one can be confident they are receiving consult in their best interest and there is no conflict of interest. CMPs are not as expensive as Elder Law Attorneys. They are generally less knowledgeable about the care requirements of their clients than Geriatric Care Managers. For example, a GCM will have a thorough understanding of the care need progression of someone with Alzheimer’s Disease, and the financial impact, while a Certified Medicaid Planner might not have the same awareness. CMPs come from a variety of backgrounds, including finance, law, social work, and accounting, and are ideal for persons whose financial means are initially too high to qualify for Medicaid.


Public Benefits Counselors / Case Managers

Public Benefits Counselors / Case Managers work for state agencies at Area Agencies on Aging (AAAs), Aging and Disability Resource Centers (ADRCs), or Medicaid offices. They have a good understanding of Medicaid eligibility, as well as the alternatives to Medicaid. They do not charge for their services. Like many public employees, they are often overworked and cannot provide the same level of service as a professional in the private sector who is being paid directly. Most importantly, private sector advisors can advise individuals on how to qualify for Medicaid when they are over the income and / or asset limit(s). On the other hand, public sector individuals only provide assistance with the application process. They do not help persons who exceed the Medicaid financial limits to restructure their income and / or assets appropriately to qualify. Therefore, Public Benefits Counselors should only be used when candidates are certain they meet their state’s Medicaid eligibility requirements.


State Health Insurance Programs Counselors

State Health Insurance Programs Counselors, often called SHIPs Counselors, are individuals who are usually volunteers. They are trained by the state to be knowledgeable about the existence of public benefits, such as Medicare and Medicaid. Typically, they do not have a deep understanding of Medicaid eligibility nuances and cannot offer assistance about how to qualify. Rather, they can explain the eligibility criteria and the application process. They are perhaps best suited for individuals whose income and assets are well below the eligibility thresholds for their states. SHIPs Counselors do not charge for their services.


Commission-Based Medicaid Planners

This category of Medicaid Planners, commission-based, is focused on helping individuals whose assets exceed Medicaid eligibility limits. They provide free services to families and individuals and take a commission when they purchase Medicaid-Compliant Annuities to help applicants meet the Medicaid asset limit. While typically very knowledgeable about Medicaid eligibility, they are less familiar with alternatives to Medicaid, and do not have an incentive to advise clients in those areas. Since they are only compensated through the purchase of annuities, they are unlikely to assist individuals who cannot purchase one. Commission-Based Medicaid Planners tend to advertise their services under Asset Protection. One should proceed with caution when working with an Annuity Salesperson / Commission-Based Medicaid Planner.


Insurance Agents

Insurance Agents’ primary goal is to sell insurance products. The purchase of certain insurances can help lower one’s assets so that they meet Medicaid’s asset limit. These are primarily “final expense” insurance policies or burial insurance. In this context, some agents offer free Medicaid planning assistance. However, while useful, it is important to remember that assisting the family is not their primary goal. This is not to say that these individuals cannot provide valuable advice, just that the family should be aware of the potential for a conflict of interests. One might achieve their desired results by working with an Insurance Agent and a Public Benefits Counselor.


Long-Term Care Ombudsmen

The LTC Ombudsman Program is a federally funded initiative aimed at helping to resolve the complaints of individuals that reside in nursing homes, board and care homes, and assisted living residences. While their primary goal is to resolve care issues, they also can provide some counsel on financial matters. They do not charge consumers for their assistance. However, as they are public employees, they will not advise families who exceed Medicaid’s limits on how best to qualify. Instead, they offer factual guidance on the eligibility and application process. They also tend to work mostly with individuals who already reside in nursing homes as opposed to those who are moving into one. Therefore, LTC Ombudsman are most relevant to families who have been privately paying for nursing home care and hope to transition to a Medicaid-funded payment for care.



It is certainly possible to undertake Medicaid planning oneself without professional guidance. There are many books, websites, and software programs that can help. There are also online legal and financial experts who will answer questions on a one-off basis. While certainly an inexpensive option, one must be organized, patient, analytic, and have a fair amount of time to research the matter. The obvious risk is if one makes an error, they will be denied Medicaid.


Medicaid Planners Comparison Table

Not every individual providing Medicaid planning advice is appropriate for every family. Everyone’s situation is different and individuals and families should carefully consider what type of Medicaid planning is most appropriate given their circumstances. The table below enables one to compare the strengths and weakness of the various public and private professionals that offer Medicaid planning assistance.



Elder Law Attorneys Geriatric Care Managers Certified Medicaid Planners Public Case Managers SHIPs Counselors Commission-Based Medicaid Planners Insurance Agents Long-Term Care Ombudsman Self-Planners
Understand Medicaid law Yes Some Some Some Some Some Some Yes No
Familiar with Medicaid alternatives Some Yes Some Yes Yes Some No Some No
Understand individual’s care needs Some Yes Some Yes Some No No Some Yes
Advise clients who exceed Medicaid’s financial limits Yes Yes Yes No No Yes Yes No N/A
Advise clients who do not exceed Medicaid’s financial limits Yes Yes Yes Yes Yes No No Yes N/A
Have broad financial planning experience Some No Yes No No Some No No No
Have potential conflict of interest No No No No No Yes Yes No No
Client dedication Yes Yes Yes No No Yes Some No Yes
Cost High Med High No Cost No Cost No Cost No Cost No Cost No Cost

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