Medicaid Planning

San Antonio Medicaid Planning Lawyer

The challenges of developing a good financial plan for the years when we might be in physical and mental decline are significant. The costs of long-term health care add up rapidly. Furthermore, contrary to what many people believe, Medicare–the government program providing health care services for the elderly–does not cover many long-term health costs. Nor does standard private health insurance. Medicaid planning may end up as a necessary tool of a good long-term health care plan. 

Medicaid is commonly seen as a health care program for the poor. But the reality is that the costs of everything from assisted living to hospice and all other expenses associated with our decline can make people from a range of income brackets reliant on government assistance. There are rules to follow though, and a San Antonio Medicaid planning attorney can help you protect your assets while still getting the help you need.


Don’t until the last minute to build a financial strategy around the use of Medicaid for long-term health care expenses. The Law Office of Paul D. Hardy understands Medicaid planning and can help. Call us at (210) 405-1985 or reach out online.


The nature of Medicaid as a program for the poor means there are limits on the income a person can earn and still qualify. As of 2022, Texas rules limit that to a little over $2,500 in monthly income and $2,000 per month in assets. For a married couple, the income limit doubles.

Income includes not only employment wages, but any payments from a pension, alimony or a government program. Assets can include stock ownership, bank accounts and any real estate that is not actually lived in by the potential Medicaid beneficiary. 

Furthermore, Texas, like all other states has rules in place that seek to prevent people from simply getting rid of all the assets in order to get on Medicaid. Understanding these rules and the alternatives that are allowed, are the key to a successful Medicaid planning strategy.

Look Back & Spend Down

When a person applies for Medicaid, Texas will use a five-year “Look Back” window. What is being investigated are any income or asset transfers that took place in this period. This includes money that might have been given away or assets that were sold for less than their market value. 

If the state determines that money or assets were essentially given away, the applicant will not only be denied access to benefits, but penalized in the form of a longer waiting time to become eligible for application again. 

Furthermore, the “giveaways” can include money that the applicant doesn’t even think of as being handed out. An example might be payments made to someone who helped you as a caretaker. If there is no written agreement outlining pay and services, it might be classified as a giveaway and subject the applicant to penalty. 

One way the “look back” problem can be addressed is through the legal approach of “spend down”. What happens here is that the state looks at the amount of money an applicant has that’s over the income limits. For the purposes of discussion, let’s presume a single applicant has $3,000 in monthly income–or roughly $500 more than the limit. 

Medicaid can treat this $500 as essentially a deductible. After an applicant pays the $500 on qualified medical services and documents those expenses, Medicaid benefits can kick in. 


A San Antonio Medicaid planning lawyer from the Law Office of Paul D. Hardy can work with you to set up the appropriate legal mechanisms to finance your long-term health care needs. Call us at (210) 405-1985 or reach out online today.


How a Miller Trust Works

Another option for those who earn too much to qualify for Medicaid, but still need help, is to turn to a Miller Trust. Also known as a Qualifying Income Trust, this where your attorney sets up an irrevocable trust wherein the money you put in can only be used for eligible long-term health care expenses. At the point in which the money runs out, Medicaid kicks in.

A Miller Trust can work well for an applicant that has a spouse who does not yet require long-term care. One of the eligible expenses the trust can pay is what’s called the Minimum Monthly Maintenance Needs. As of 2022, a spouse still living on their own can receive over $3,400 per month from the Miller Trust.

Medicaid is there to help us when we need it, and we certainly need it at the point we require long-term health care. It’s important to have a sound strategy already in place for asset protection by the time you apply. 


The Law Office of Paul D. Hardy can work with you to put that strategy in place and give you peace of mind.Call the office at (210) 405-1985 or contact us online to set up a free consultation. 


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Attorney Hardy is ready to help with all of your Estate Planning needs.

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Frequently Asked Questions

  • Isn’t Estate Planning for People Who Are Rich?

    No! The word “estate” can conjure up images of a sprawling yard and luxurious mansion, as though we’re on the set of Downton Abbey. Reality is different. Your estate is simply the money and property you own at the time of your death. Estate planning consists of the various legal mechanisms that are used to ensure your wishes are known and respected, that you get the best possible tax treatment based on your goals and that prudent steps are taken to protect your assets as much as possible in your final years of life.

  • Can You Avoid Probate With a Will?

    A will alone will not be enough for your heirs to avoid going through probate court, with its attendant fees. The way to keep your assets out of probate court is through the establishment of a living trust.

  • What Happens Without a Will?

    When you die without a will, your estate becomes subject to the intestacy laws in the state of Texas. The state seeks to place your assets in the hands of living spouses, children, siblings and parents and has clear guidelines for different family scenarios. The problem is that the law for an entire state is simply not able to anticipate the particular wishes of a deceased person. That’s why it’s strongly advised to put your last will and testament into writing. That way, everyone knows what your wishes are, and courts will be able to enforce it.

  • What Are the Benefits of a Trust?

    Staying out of probate court is just one of the advantages that a living trust can offer. A trust can be structured so as to minimize your tax exposure ,while still allowing you to gift money into it while you’re alive. If you believe the benefits to your beneficiaries are best deferred to a later date or spread out over time, you can appoint a trustee who can administer that after your passing. A trust offers you flexibility and allows your beneficiaries to avoid dealing with probate court .