Questions to Ask Before Paying Anyone for Medicaid Help

Families facing long-term care costs are often frightened, short on time and unsure whom to trust. That makes them targets for both honest professionals who charge fair fees and others who overpromise, overcharge or sell products the family does not need. Asking the right questions before paying anyone for help is the best protection. This guide lists those questions, explains what good answers sound like, and describes the red flags to watch for. We do not recommend particular firms; we explain how to evaluate anyone you are considering.

Figures change periodically. Double-check current amounts before relying on them.

First, know what is free

Before paying anyone, remember:

• Applying for Medicaid is free. There is no charge to file with the state.
• The state agency must help applicants who need help completing the application.
• Free public programs such as Area Agencies on Aging, Aging and Disability Resource Centers, the free Medicare counseling program (SHIP) and the long-term care ombudsman program explain options at no cost.
• Free legal aid may be available for low-income families, especially for denials and appeals.
• Help with VA claims is available from accredited veterans service officers at no cost.

Paid help is worth it when it adds something free help cannot: planning advice, protection of assets for a spouse, handling of past transfers, trusts, appeals, or simply the time and experience to get a complex application right the first time.

What paid help typically costs

Published fee surveys and price lists show a wide range. As a rough guide:

Costs depend on the state, the type of professional and the complexity of the case.

Questions about qualifications

1. What is your training and credential in Medicaid planning? Ask whether the person is a Certified Medicaid Planner (CMP), an attorney, or holds another relevant credential, and whether the credential is current. A CMP has passed an exam on Long-Term Care Medicaid rules and must complete continuing education.
2. How many Long-Term Care Medicaid cases have you handled in this state in the past year? Rules differ by state; local experience matters.
3. Do you handle cases like ours? For example, married couples, a home, a business, a Miller trust, a past gift or a denial.
4. Are you an attorney? If not, who drafts legal documents? Trusts, deeds, powers of attorney and some agreements must be prepared by an attorney. Non-attorneys should work with one for any legal document and should not give legal advice.
5. Are you accredited by the VA? If VA benefits are involved, only accredited representatives, agents or attorneys may help prepare VA claims.

Questions about the service

1. What exactly is included? Get a list: review of finances, planning recommendations, preparation of the application, responses to verification requests, communications with the caseworker, appeals.
2. What is not included? Common exclusions: fair hearings, legal documents, renewals, tax advice.
3. Who will do the work? The person you meet, or someone else? Who will be your contact?
4. How will you communicate with us, and how quickly?
5. What will you need from us, and by when?
6. What happens if the application is denied? Will they help with a reapplication or a hearing, and at what cost?

Questions about fees

1. How is the fee set? Flat fee, hourly, or a combination?
2. What is the total likely to be? Ask for an estimate in writing.
3. When is payment due? Up front, in stages, or after approval?
4. What happens if we end the engagement early? Is any part refundable?
5. Do you receive any commission or payment from anyone else? For example, from the sale of an annuity, insurance or a financial product, or from a facility. A professional who earns commissions on products they recommend has a conflict of interest that should be disclosed.

Questions about the plan

1. What do you recommend, and why? A good answer explains the rule, the options and the trade-offs.
2. What are the risks? Every plan has some.
3. How will this affect the spouse at home, our home and estate recovery?
4. How will this affect VA benefits, taxes or other benefits?
5. What if the rules change?

Red flags

Be cautious if anyone:

• Guarantees approval. No one can guarantee what a state agency will decide.
• Pressures you to sign or pay right away, or says an offer expires today.
• Advises hiding assets or leaving things off the application. Applications are signed under penalty of perjury. See Hiding assets.
• Charges only to fill out and submit forms without planning or follow-up. Filing itself is free and the agency must help.
• Sells a product as the solution (an annuity, insurance policy or trust) before reviewing the whole situation, or does not disclose commissions.
• Says they are “from Medicaid” or “approved by the state.” Private professionals are not part of the Medicaid agency.
• Asks for power of attorney over your finances or to be named on accounts.
• Will not put the agreement in writing.
• Offers “free” VA pension help and then recommends moving assets into products, especially without explaining Medicaid consequences.

See Scams and red flags.

Getting the agreement in writing

A written engagement agreement should include:

• the names of the client and the professional;
• the services included and excluded;
• the fee, how it is calculated and when it is due;
• refund terms;
• how communications will work;
• any conflicts of interest, including commissions;
• how either side can end the agreement.

Read it before signing, and keep a copy.

Checking a professional

• Credentials: ask for the credential and check with the credentialing body that issued it.
• Attorneys: each state’s attorney licensing authority can confirm whether an attorney is licensed and in good standing.
• Insurance and annuity sellers: the state insurance department licenses agents and takes complaints.
• References: ask for references from families with similar situations, while respecting that professionals must protect client confidentiality.

When something goes wrong

If you believe a professional misled you or sold you something improper:

• keep all documents and communications;
• raise the problem with the professional in writing;
• for attorneys, file a complaint with the state’s attorney discipline authority;
• for insurance or annuity sales, file a complaint with the state insurance department;
• for financial exploitation of an older adult, contact Adult Protective Services;
• if the problem involves a Medicaid application, tell the caseworker in writing about any error.

Comparing two or three professionals

It is reasonable to speak with more than one professional before choosing. A simple comparison table helps:

Write down the answers during each conversation. The lowest fee is not always the best value; what matters is the experience offered, what is included and whether the professional explains the plan clearly.

Preparing for the first meeting

Bring a summary of income, a list of assets with approximate values, information about any gifts or transfers in the past five years, the deed to the home, any trust or power of attorney documents, and any notices from the Medicaid agency. The more complete the picture, the more useful the first meeting, and the more accurate any fee estimate will be.

Getting experienced help

The right professional can save a family far more than the fee, by protecting assets for a spouse, avoiding a penalty or winning a hearing. The wrong one can cost a great deal. Asking these questions, and comparing answers from more than one professional, is time well spent. A Certified Medicaid Planner is trained specifically in Long-Term Care Medicaid and can work alongside an attorney when legal documents are needed.

Questions the professional should ask you

A careful professional will ask as many questions as you do. Expect questions about the person’s health and likely care needs, marital status, every source of income, every asset and how it is titled, gifts and transfers in the past five years, existing legal documents, the home and who lives there, and the family’s goals. A professional who recommends a plan after a few minutes, without asking these questions, may be selling a product rather than giving advice.

Frequently asked questions

Is it normal to pay a planner before approval? Many professionals charge a flat fee in stages, with part due up front. Be cautious about paying the full amount before any work is done.

Should I choose the cheapest option? Not necessarily. Compare what is included, the experience offered and the likely total cost.

Can the nursing home’s business office do this for free? It can often help file the application, but its interest is getting paid, and it generally does not give planning advice.

Is Medicaid planning legal? Yes. Using the rules as written is legal. Hiding assets or lying on an application is not. See Is Medicaid planning legal?.

Related guides

• Questions to ask a Certified Medicaid Planner
• Benefits of a Certified Medicaid Planner
• Scams and red flags
• Getting Help hub

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.