Certified Medicaid Planner in Pennsylvania: What They Do and What They Cost

What a Certified Medicaid Planner Does

A Certified Medicaid Planner (CMP) is a financial professional who specializes in helping families navigate Medicaid eligibility for long-term care. In Pennsylvania, where Medicaid long-term care rules involve two-tier asset limits, medically needy spend-down pathways, 60-month lookback periods, and a daily transfer penalty divisor of $421.20, the eligibility math is complex enough that many families cannot self-navigate it without errors.

A CMP's core work includes:

• Gathering and organizing 60 months of financial records (bank statements, asset documentation, transfer histories)
• Calculating whether the applicant qualifies under Tier One ($8,000 asset limit for income ≤ $2,982/month) or Tier Two ($2,400 for income above that threshold)
• Identifying and documenting exempt assets (home, vehicle, irrevocable burial reserve, personal property)
• Calculating Community Spouse Resource Allowance (CSRA) for married couples
• Developing a legally compliant spend-down strategy that brings countable assets below the limit without triggering transfer penalties
• Preparing and submitting the Medicaid application to the County Assistance Office
• Responding to requests for information and managing the application through approval

How a CMP Differs from an Elder Law Attorney

The distinction matters because it affects both cost and scope:

A CMP cannot draft legal documents. They cannot prepare trusts, wills, powers of attorney, or caregiver agreements. If the Medicaid planning strategy requires an irrevocable trust, a deed transfer, or a legally binding caregiver agreement, the CMP must partner with an attorney for those components.

An elder law attorney can do everything a CMP does, plus draft the legal documents — but at a significantly higher hourly rate. Pennsylvania elder law attorneys typically charge $300-$600 per hour, with comprehensive crisis Medicaid planning retainers running $5,000-$15,000. A CMP typically charges a flat fee of $3,000-$10,000 depending on complexity.

When a CMP is the right choice: Straightforward cases where the legal documents (POA, healthcare directive) are already in place, assets are primarily liquid (bank accounts, CDs), and the strategy involves standard spend-down techniques — prepaying funeral expenses, paying off debts, making home repairs, converting countable assets to exempt assets.

When you need an attorney: Cases involving real estate transfers, trusts, lookback-period gifts that need penalty mitigation, caretaker-child exemptions, spousal refusal strategies, or contested guardianships. An attorney is also essential when the financial POA itself has not yet been executed — without legal authority to act on the parent's behalf, the CMP cannot access accounts or submit applications.

Finding a CMP in Pennsylvania

The Certified Medicaid Planner designation is maintained through the Medicaid Planning Association. Not every financial advisor who claims Medicaid expertise holds the CMP certification. Verify credentials before engaging:

• Ask for the CMP certification number and verify it through the credentialing organization
• Request references from Pennsylvania families they have assisted (not just national testimonials)
• Confirm their familiarity with Pennsylvania-specific rules — the two-tier asset system, the medically needy pathway, the Pennsylvania resource disregard, and the Community HealthChoices managed care structure
• Ask whether they charge flat fee or hourly, and what the fee covers (some CMPs charge separately for application submission and follow-up)

For families with modest, uncomplicated estates where the legal documents are already in place, a structured self-help approach can replicate much of what a CMP provides. The Pennsylvania Dementia & Memory Care Guide includes Medicaid pre-audit worksheets, asset classification checklists, and spend-down strategy frameworks specific to Pennsylvania's 2026 eligibility rules — giving you the tools to prepare your own application or arrive at a CMP consultation already organized, reducing the billable hours significantly.

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