Certified Medicaid Planner: What They Do and When You Need One

Your parent needs long-term care, their assets are above Medicaid limits, and you've spent three weeks trying to understand spend-down rules, look-back periods, and income trusts on your own. Someone suggests hiring a Certified Medicaid Planner. But what exactly do they do, how much do they cost, and when is an elder-law attorney the better choice?

What a Certified Medicaid Planner Does

A Certified Medicaid Planner (CMP) specializes in structuring a family's finances to qualify for Medicaid long-term care benefits. Their core focus is the eligibility application—making sure your parent meets income and asset requirements without triggering penalties or leaving money on the table.

Typical services include:

• Financial assessment: Reviewing all income sources, countable assets, exempt assets, and potential liabilities
• Spend-down strategy: Creating a compliant plan to reduce assets below state Medicaid limits using legal methods (paying off debt, home modifications, Medicaid-compliant annuities, irrevocable funeral trusts)
• Application preparation: Organizing five years of financial records, completing state-specific forms, and submitting the Medicaid application
• Income trust setup: Coordinating the creation of a Qualified Income Trust (Miller Trust) in income-cap states where the parent's monthly income exceeds $2,982
• Spousal protection planning: Structuring the community spouse's income and assets to maximize what the non-institutionalized spouse can keep

What they don't do: draft legal documents (trusts, deeds, power of attorney), represent families in court, or provide medical care coordination.

What It Costs

Certified Medicaid Planners typically charge a flat fee of $3,000 to $8,000, depending on the complexity of the case and the state. Some charge hourly at $150 to $300 per hour. This covers the full application process from initial assessment through Medicaid approval.

The fee can be paid from the applicant's assets as a legitimate spend-down expense—the payment itself reduces countable assets while funding the professional help needed to qualify.

Medicaid Planner vs. Elder-Law Attorney

These two professionals overlap but serve different functions:

Choose a Certified Medicaid Planner when:

• Your parent's finances are relatively straightforward (Social Security income, a modest bank account, a home)
• The primary challenge is meeting asset and income limits
• You need someone to manage the paperwork-intensive application process
• There are no pending legal disputes or complex trust structures

Choose an elder-law attorney when:

• Your parent made asset transfers within the five-year look-back window that may trigger penalties
• Real estate needs to be protected from estate recovery (irrevocable trusts, Lady Bird deeds, life estate deeds)
• A Qualified Income Trust needs to be drafted (attorneys draft the legal document; planners coordinate its implementation)
• There's a contested guardianship, family dispute, or VA benefits claim involved
• You need representation in a Medicaid appeal or fair hearing

Use both when:

• The attorney drafts the legal instruments (QIT, irrevocable trust, deed transfers) while the planner manages the financial restructuring and application submission

Elder-law attorneys typically charge $300 to $600 per hour. Walking into an attorney's office with your parent's finances already organized—income documented, assets inventoried, five years of bank statements compiled—can save $1,000 to $2,000 in billable hours.

How to Find a Legitimate Planner

The Certified Medicaid Planner designation is granted by the Certified Medicaid Planner Board. When evaluating a planner:

• Verify the CMP certification is current
• Ask for references from families in your state (Medicaid rules are state-specific, so local experience matters)
• Confirm they carry professional liability insurance
• Ask about their success rate—an experienced planner should be able to discuss common denial reasons and how they handle them
• Avoid anyone who guarantees approval (Medicaid eligibility is determined by the state agency, not the planner)

Be cautious of non-certified "Medicaid planners" or financial advisors who offer Medicaid planning as a side service. The eligibility rules are highly technical and vary by state—errors in the application can result in months of delays or look-back penalty calculations that cost the family tens of thousands.

When You Might Not Need Either

Not every family needs a planner or attorney. If your parent's financial situation is straightforward—Social Security income under the state limit, assets well below $2,000, no transfers in the past five years—the Medicaid application can be filed directly with your county social services office at no cost.

Your local State Health Insurance Assistance Program (SHIP) provides free counseling for Medicare and Medicaid questions, and Area Agencies on Aging can help navigate the application process.

The Dual Eligible Coordination Blueprint is designed for families in the middle—those whose situation is complex enough to need a structured plan but straightforward enough to handle the initial financial inventory, screening, and spend-down steps independently before deciding whether professional help is needed.

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