What Does Medicaid Planning Cost in Florida, and What Do You Actually Get?

Dennis's search: three kinds of help, three very different things

Dennis is 60, lives in Port Orange, and was doing what a lot of Florida adult children do this year: trying to figure out how to pay for his mother's nursing home care without losing everything she and his late father spent forty years building. He's a composite of the families I meet every month, not an actual client, but his situation is a familiar one in my practice.

The facility's social worker handed him a folder and offered "free Medicaid help." A friend mentioned a non-lawyer "Medicaid planner" who charged less than a law firm. And two elder law attorneys quoted him a flat fee on a free introductory call. Dennis assumed these were three versions of the same service at three price points. They are not. They are legally different in what the person on the other end is allowed to do for his mother, and that difference matters more than the price tag.

Why the facility's "free" help and non-lawyer planners come with real limits

The facility's social worker was being genuinely helpful, but she works for the nursing home, not for Dennis's mother. Facility staff can explain paperwork and answer general questions, and that is useful. What they cannot do, and generally will not do, is advise a family on how to legally restructure assets before applying so that a parent qualifies sooner while protecting more for a spouse or heirs. There is also an unavoidable conflict built in: the facility gets paid faster and more reliably once a resident is approved for Medicaid, which is not a reason to distrust the advice, but it is a reason to get an independent opinion before signing anything or moving money.

The non-attorney "Medicaid planner" is a different problem. Florida's Supreme Court has ruled directly on this: it is the unlicensed practice of law for a non-lawyer to advise a Medicaid applicant on how to structure income and assets to become eligible for benefits. That is not a technicality. Unlicensed practice of law in Florida is a third degree felony. Non-attorney planners are not required to carry malpractice insurance, are not bound by bar discipline rules, and if their advice causes a denied application or a lost asset, the family typically has no legal recourse against them.

What a flat-fee engagement with an elder law attorney typically includes

When Dennis called the two elder law firms, both quoted a flat fee rather than an hourly rate, which is now the norm for Medicaid planning in Florida. A flat fee lets a family know the full cost upfront before any document is drafted, and it removes the incentive for a clock to run longer than necessary. A typical flat-fee Medicaid planning engagement in Florida includes:

• A full financial and asset analysis to identify what is countable, what is exempt, and how close the applicant already is to eligibility
• A written plan describing which legal tools apply, such as a qualified income trust, a Medicaid asset protection trust, a Lady Bird deed, a caregiver personal services contract, or a properly drafted durable power of attorney with Medicaid planning authority
• Drafting and execution of the actual documents the plan calls for
• Preparation and filing of the Medicaid application itself
• Attorney representation if the case is questioned, delayed, or requires a fair hearing before the state

What a flat fee usually does not include: unrelated litigation, probate administration after a death, or ongoing trust administration years down the road. Good firms will tell you clearly, before you sign anything, exactly where the flat fee stops.

Questions Dennis learned to ask before choosing

By the time Dennis finished his three conversations, he had a short list of questions that cut through the sales pitch fast:

• Are you a licensed Florida attorney, and is this engagement covered by a written fee agreement?
• Is the fee flat, or could it grow if the case takes longer than expected?
• Does the fee include filing the actual application, or just the planning documents?
• What happens if the state denies the application or asks for a hearing, is that included or extra?
• Who is actually going to do the work, an attorney or unsupervised staff?

A facility referral or a bargain non-lawyer planner may not welcome those questions. A licensed elder law attorney should answer all five without hesitation.

Weighing the fee against one month of care

Dennis's mother's nursing facility, like most in Florida, costs several thousand dollars a month, and skilled nursing costs continue to rise statewide. A flat fee for a full Medicaid planning engagement, in most cases I see, comes in well under the cost of a single month of that care. The real value is not just the document drafting. It is having someone legally qualified to look at the full picture, tell Dennis's family what is protectable and what is not, and file an application built to be approved the first time rather than delayed by avoidable mistakes.

This article is for general informational purposes only and does not constitute legal advice, nor does reading it create an attorney-client relationship. Florida estate, elder, probate, and real estate law are fact-specific and change over time. Consult a licensed Florida attorney about your individual circumstances. Arthur Simpson, Esq. is licensed to practice law in the State of Florida. Attorney advertising.