Medicaid, Elder Law & Asset Protection: What You Need to Know Before It’s Too Late

In this episode of Talk Law Radio, elder law attorney Todd Marquardt dives deep into the complexities of Medicaid, long-term care planning, and asset protection through trusts. Drawing from over 18 years of experience and recent continuing legal education, Todd explains the differences between Medicare and Medicaid, eligibility rules, and strategies to protect your assets while still qualifying for benefits.

Elder Law, Medicaid, and Community Support Insights
Introduction and Segment 1: Elder Law and Medicaid Overview
Host Todd Marquardt, an elder law attorney with over 18 years of experience in San Antonio, opens the show by encouraging listeners to explore archived episodes that delve into complex and misunderstood legal issues, especially those related to taxes and federal regulations. He highlights his ongoing commitment to continuing legal education, often completing double the State Bar of Texas requirement of 15 hours per year.

Todd introduces the focus of the episode: elder law—a field encompassing legal counsel and representation for older adults and their families regarding health and long-term care planning, public benefits, legal capacity, estate affairs, and tax matters. He cites the National Elder Law Foundation’s definition to emphasize the wide-ranging and intricate issues involved.
Medicaid becomes a central topic as Todd explains its critical role in elder law, particularly given the rising costs of long-term care for an aging population. He distinguishes Medicaid from Medicare, noting that while Medicare covers hospitalization and some medical expenses, it does not pay for extended nursing home care—Medicaid sometimes does. Todd outlines how Medicaid eligibility and application processes have evolved, moving from in-person meetings to predominantly online, mail, or fax submissions, all requiring substantial documentation. He encourages listener engagement through calls and questions.

Segment 2: Navigating Public Benefit Programs and Medicaid Qualifying Events
After a brief break, Todd returns to share updates from recent continuing legal education on elder law, aiming to inform his audience about the latest developments. He details how different life changes—such as aging, disability, or changes in health status—can trigger transitions between public benefit programs. Medicaid, he explains, is not a single program but a set of benefits within various programs targeting different age groups and needs.
Todd walks listeners through scenarios where individuals may need to transition between Medicaid programs, such as children aging out, adults developing new health challenges, or increased care requirements. He notes that Medicaid is federally funded but state-administered, resulting in varying rules and eligibility criteria.
Key points include:
•Life events (aging, moving, health changes) can necessitate a shift in benefit programs.
•Some Medicaid programs involve waitlists and strict income/resource limits, though exceptions exist.
•Assets, household composition, and the ability to create trusts can impact eligibility—planning is important.
•The Medicaid estate recovery program may reclaim costs from beneficiaries’ estates after their death, though exceptions apply.
•Different agencies (Social Security, Veterans Affairs, Texas Health and Human Services) oversee different programs and forms.
•Applying for Medicaid is document-intensive, requiring proof of income and assets. Todd underscores the challenge of affording long-term care—such as $8,000 per month for 36 months in a nursing home—and the value of legal advice in navigating these complex processes.
He shares a personal anecdote about his grandmother’s Medicaid experience, illustrating the confusion families may face and the importance of understanding qualification rules (e.g., the $2,901/month income limit and $2,000 resource limit for nursing home Medicaid in Texas, with certain exemptions).

Segment 3: “Sinners and Saints,” Adult Protective Services, and Community Recognition
Todd uses the “Sinners and Saints” segment to address elder abuse, neglect, and exploitation, drawing on input from Adult Protective Services. He clarifies terminology (alleged perpetrators, allegations) and underscores the legal mandate for everyone to report suspected mistreatment of older or disabled individuals.

The host calls on listeners to suggest community members or organizations deserving recognition for positive contributions, especially in the aftermath of the Texas Hill Country floods. He highlights various organizations providing aid, including the American Red Cross, Catholic Charities of San Antonio, Team Rubicon, Salvation Army, World Central Kitchen, and local volunteers.
Medicaid updates are also discussed, such as the redu