October 1, 2024

Practice Tip: How to Handle Spend-Down on Items That Take a Long Time to Pay For

When assisting clients with Medicaid planning, particularly when a married individual is applying for Medicaid, one of the primary concerns is how to efficiently spend down assets to get below the Community Spouse Resource Allowance (CSRA) threshold. The goal is to do this as quickly as possible to expedite Medicaid eligibility without triggering a penalty. One effective way to spend down assets is by making home improvements, which Medicaid does not penalize. However, the process of completing these improvements and paying for them can be time-consuming, creating challenges in timely Medicaid qualification.

Here’s a strategy that can help you navigate this issue, ensuring that funds are spent down appropriately without unnecessary delays or risks.

The Spend-Down Dilemma

In Medicaid planning, timing is crucial. When a married couple is involved, and one spouse is applying for Medicaid, it’s necessary to reduce their countable assets quickly to qualify for Medicaid. While purchasing exempt items like home improvements is a legitimate and beneficial spend-down strategy, the time it takes to complete these improvements—and therefore, spend the money—can significantly delay Medicaid eligibility.

Moreover, paying contractors upfront for work that may take months to complete can be risky. If the work is delayed or not completed satisfactorily, the funds may not be recoverable, leaving your client in a precarious financial position.

The Solution: Structured Payments via Cashier’s Checks

To address this dilemma, you can use a structured payment plan facilitated by cashier’s checks. This approach allows your client to secure the benefits of the spend-down without the delays or risks associated with upfront payment for unfinished work. Here’s how it works:

  1. Obtain a Fixed-Price Contract:
    Begin by securing a contract from the contractor that specifies a fixed price for the home improvements, not just an estimate. The contract should clearly outline the work to be done, the total cost, and the payment schedule. This ensures that the cost is predictable and meets Medicaid’s criteria for a valid spend-down expense.
  2. Negotiate Payment Terms:
    Discuss with the contractor how they prefer to be paid relative to the project’s completion stages. Common payment structures include:some text
    • Half upfront and half upon completion.
    • One-third upfront, one-third mid-way, and one-third at completion.
  3. These staggered payments ensure that the contractor is incentivized to complete the work, while also protecting your client’s interests.
  4. Use Cashier’s Checks for Payment:
    Once the payment terms are established, your client should go to their bank and obtain cashier’s checks for each payment installment. When a cashier’s check is issued, the bank immediately pulls the funds from your client’s account and holds them in the bank’s account to honor the checks. This process is crucial because:some text
    • The money is immediately withdrawn from the client’s account, effectively reducing their assets for Medicaid purposes.
    • The funds are secured by the bank and will only be released to the contractor upon successful completion of each payment milestone.
  5. This method provides a balance between ensuring the funds are spent down promptly for Medicaid eligibility and protecting the client from paying in full for incomplete work.
  6. Documentation and Compliance:
    Keep meticulous records of the contract, payment schedule, and cashier’s checks. These documents will be vital in demonstrating to Medicaid that the spend-down was legitimate and timely, ensuring compliance and avoiding any potential issues with eligibility.

The Benefits of This Approach

By structuring the payments this way, you can help your clients achieve Medicaid eligibility more swiftly while minimizing the risks associated with long-term home improvement projects. The use of cashier’s checks ensures that the spend-down is recognized by Medicaid as the funds are immediately removed from the client’s account, while the structured payments provide security against incomplete or delayed work.

This strategy not only expedites the Medicaid qualification process but also offers peace of mind to your clients, knowing that their financial interests are protected even as they invest in necessary home improvements.

Conclusion

In Elder Law, particularly in Medicaid planning, it’s essential to be both strategic and cautious. The method of using cashier’s checks tied to a structured payment plan for home improvements is a practical solution that addresses the timing and risk concerns inherent in the spend-down process. By implementing this approach, you can help your clients navigate the complexities of Medicaid qualification with greater confidence and efficiency.

For more practice tips and personalized guidance on handling complex Elder Law cases, consider joining The Elder Law Coach program, where we provide the resources and support you need to excel in your practice.