Medicaid and Long-Term Care Planning

Long-term care decisions can be emotional and financially challenging, especially when you or a loved one needs nursing home or assisted living support. If you’re unsure how to pay for long-term care, you don’t have to figure it out on your own. 

At Butler Law, I help families across South Carolina, including those in Myrtle Beach, Conway, Horry County, and Georgetown County, plan for the future with confidence. I take the time to clearly explain your options so you can make informed choices that protect your family, your assets, and your peace of mind. 

I’ve worked with individuals and families in every stage of life—from adult children planning care for aging parents to retirees safeguarding their homes and savings. My experience and compassionate approach set us apart.  

As an estate planning attorney, I focus on practical solutions that help you qualify for Medicaid benefits while keeping your long-term goals in view. I’ll gladly help you build a plan that fits your needs today and protects your loved ones tomorrow. 

Why Medicaid Planning Matters

The costs of nursing home or assisted living care can be staggering. In South Carolina, a private room in a long-term care facility can cost thousands of dollars every month. Many families assume Medicare will cover these expenses—but that’s not the case. Medicare provides only short-term rehabilitation coverage, not ongoing custodial care. 

That’s where Medicaid comes in. Medicaid can cover long-term care costs, but eligibility rules are strict. Many people mistakenly believe they must spend down or give away all their assets to qualify, but that’s not true. With thoughtful planning, you can protect your home, preserve savings for your spouse, and still receive the care you need. 

My firm guides clients through every step of the Medicaid process, from determining eligibility to applying for benefits. I’ll help you understand what you can keep, what needs to be restructured, and what documents must be prepared to protect your assets before care is needed.

How I Help with Medicaid and Long-Term Care Planning

Every family’s situation is unique, so I begin by learning about your financial goals, medical needs, and family dynamics. I then create a plan tailored to your specific circumstances. 

My Medicaid and long-term care services include: 

Medicaid Eligibility Review 

I review your income, savings, property, and other resources to determine if you meet South Carolina’s Medicaid guidelines or what adjustments may be necessary to qualify. 

Asset Protection Planning 

I help clients legally protect their assets while maintaining eligibility for Medicaid. This can include converting countable assets into exempt assets or creating trusts that protect property for your spouse or children. 

Medicaid Applications and Appeals 

Filling out Medicaid paperwork can be confusing and time-consuming. I handle the application process for you, making sure all required documentation is complete and accurate. If your application is denied, I assist with appeals and hearings. 

Long-Term Care Planning 

Whether you’re planning years in advance or facing an urgent care decision, I’ll guide you through your options. Together, we can discuss strategies for paying for care, preserving inheritance, and protecting family property. 

Nursing Home and Assisted Living Guidance 

I can help review admission contracts and discuss strategies for managing costs and benefits. I also advise family members on their rights and obligations when a loved one moves into a long-term care facility. 

My goal is to help you protect your family’s financial security while gaining access to quality care. 

Understanding South Carolina Medicaid Rules

Medicaid eligibility and benefits are governed by both federal and state laws. In South Carolina, specific rules determine who qualifies for long-term care coverage and how assets are counted. 

Here are a few important points: 

• Income limits: In 2025, an individual applying for long-term care Medicaid in South Carolina generally must have an income below a set threshold (which adjusts annually). Those with higher incomes may still qualify with a Qualified Income Trust (also known as a “Miller Trust”). 

• Asset limits: A single applicant can own only a limited amount of “countable” assets. However, certain assets—like your primary home (up to a specific equity limit), one vehicle, and personal belongings—are excluded. 

• Spousal protections: When one spouse enters a nursing home, the other spouse (called the “community spouse”) can keep a portion of the couple’s joint assets and income. This rule helps prevent financial hardship for the spouse still living at home. 

• Five-year lookback: Medicaid reviews all financial transfers made within the past five years before applying. Gifts or transfers made for less than fair market value may trigger a penalty period delaying eligibility. 

• Estate recovery: After a Medicaid recipient passes away, the state may seek reimbursement from their estate for benefits paid. Proper planning can help reduce or prevent recovery efforts in some cases. 

Because these laws are detailed and subject to change, personalized legal advice is key to avoiding costly mistakes. I’ll make sure you understand how the rules apply to your situation and what steps can protect your family’s future. 

Common Misconceptions About Medicaid

Many people delay Medicaid planning because of misinformation. Let’s clear up some of the most common myths I hear from clients: 

• “I’ll lose my house if I apply for Medicaid.” 
  Not necessarily. Your primary residence is usually exempt while you or your spouse lives there. 

• “I can just give away my assets to qualify.” 
  Medicaid reviews all transfers within five years, so giving away property could delay eligibility. Planning ahead is essential. 

• “I’m too wealthy to qualify.” 
  You may still qualify with the right planning strategies, such as setting up trusts or adjusting how assets are titled. 

• “I don’t need to plan until I need care.” 
  Early planning gives you more options and flexibility, but even last-minute planning can help protect assets and secure benefits. 

At Butler Law, I take time to explain your choices clearly so you can avoid stress and financial loss.