Medicaid, Long-Term Care Insurance, and Legal Strategies Explained
Feb. 19, 2026
Planning for long-term care can feel urgent even when no one wants to talk about it. A sudden fall, a new diagnosis, or a spouse who can no longer manage daily tasks can raise the same questions at once.
How will care be paid for, what happens to the home, and which choices may limit options later? Medicaid, long-term care insurance, and legal planning tools all work differently, and the right path often depends on timing as much as money.
At the Law Offices of Julie A. Schejbal, CHTD, in Maryland, we work with people who want a clearer way to think through coverage, eligibility, and planning steps before a crisis leads to rushed decisions. We proudly serve clients in Dunkirk, Maryland, and the surrounding areas of Calvert County, Prince George's County, Charles County, and St. Mary's County. Call us today.
Medicaid and Long-Term Care Basics
Medicaid is a needs-based program that can help pay for long-term care when an individual meets medical and financial eligibility requirements. It often arises when nursing home care is on the table, but some programs also support care at home or in community settings.
Eligibility isn’t only about income, because asset rules can matter just as much, especially for married couples. Since Medicaid is administered by states under federal guidelines, details can vary and should be reviewed in light of Maryland rules.
Long-term care planning also involves defining what "care" really means for your family. It may include custodial help with bathing, dressing, or eating, as well as supervision for safety and memory support. Medical insurance that covers doctor visits may not cover ongoing daily assistance, which is why families look at the full range of options.
Medicaid Eligibility Issues That Affect Long-Term Care
There are rules governing certain transfers of property or money because Medicaid may review past transactions when someone applies for long-term care assistance. The review is meant to prevent last-minute giveaways that shift costs to the program. Common eligibility pressure points often include:
Monthly income and benefit sources: Income may include Social Security, pensions, and retirement distributions, and how income is handled can differ depending on the care setting and the program type.
Countable assets and exemptions: Some assets may count against eligibility while others may be treated differently, such as a primary residence in certain situations or specific types of personal property.
Transfers and gifting concerns: Moving assets to family members, even with good intentions, can trigger problems if it falls within the period Medicaid reviews.
Married couple protections: Rules may allow a spouse at home to keep certain income or resources, but the details can be technical and should be confirmed for your facts.
Documentation and verification: Applications often require records that show ownership, account activity, and changes over time, so missing paperwork can slow everything down.
Because these rules can affect timing, planning often starts with a careful inventory of what exists today and what changes might happen soon. That can include the risk that one spouse will need care first, or that a house sale, inheritance, or retirement account distribution will change the financial picture.
Long-Term Care Insurance Features That Matter
Long-term care insurance can help pay for care services when a policyholder meets the policy’s benefit triggers, which are often tied to needing help with daily activities or requiring supervision. When comparing policies or reviewing an existing one, key features often include:
Daily or monthly benefit amount: This is the cap on what the policy pays during a coverage period, and it affects how much out-of-pocket cost remains.
Benefit period: Policies may pay for a set number of years or up to a maximum pool of dollars, which can shape how long coverage lasts.
Elimination period: Many policies require a waiting period before benefits begin, which can mean the family pays initial costs.
Inflation protection options: Some policies increase benefits over time, which may matter if care is needed years after purchase.
Covered settings and services: The contract may list which settings qualify, such as in-home care, assisted living, or nursing facility care, and the terms can be narrow.
Care coordination requirements: Some policies require specific assessments, plan approvals, or licensed provider involvement, which can affect when benefits begin.
Insurance can be a strong tool when it’s in place early and the coverage aligns with likely care needs. That’s where legal strategies may come into play, especially when Medicaid might be needed sooner than expected.
Records to Gather Before Making Long-Term Care Decisions
Families often wait to collect paperwork until a facility requests it or an application is due, which can create stress when time is tight. It’s usually easier to start with a set of core records that show identity, income, assets, and recent transactions.
If you’re preparing for a planning meeting or an application, four categories of records usually matter:
Identification and legal status documents: This may include photo identification, Social Security cards, Medicare information, and any citizenship or residency documentation that applies.
Income verification: Gather award letters, pension statements, retirement distributions, and other records that show regular income sources.
Asset ownership and account statements: Collect bank, brokerage, and retirement statements, along with deeds, vehicle titles, and information on any life insurance policies.
Transaction history and major changes: Pull statements that show deposits, withdrawals, transfers, gifts, and any recent sale or purchase activity that could raise questions later.
Good records don’t always lead to a desirable outcome, but they do reduce confusion and help your adviser spot issues early. They also help the family coordinate among insurance benefits, private-pay options, and the timing of a Medicaid application.
Experienced Legal Counsel
To discuss Medicaid planning, long-term care insurance, or related documents, contact the Law Offices of Julie A. Schejbal, CHTD. We proudly serve clients in Dunkirk, Maryland, and the surrounding areas of Calvert County, Prince George's County, Charles County, and St. Mary's County.
A consultation with us can clarify next steps and what information to gather. Call us today to get started.