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Debt Prevention

Debt Prevention

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Estate Preservation

Estate Preservation

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Urgent LTC Planning

Urgent LTC Planning

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Other Practice Areas

TKW is a boutique firm built on a foundation of excellence that has evolved to provide our clients the white-glove service they deserve.

TKW is a boutique firm built on a foundation of excellence that has evolved to provide our clients the white-glove service they deserve.

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Trust Administration

Trust Administration

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Trust Review

Trust Review

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Estate Planning

Estate Planning

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Personal Injury Law

Personal Injury Law

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Meet TK White LTC Law

TKWhite finds pathways to free or subsidized long-term care through which long-term care patients will not lose everything for which they have worked. We protect our clients, even save them from medical and financial crises, with a responsible and ethical approach that keeps costs from falling onto LTC organizations. With empathy, reliability, and efficiency, we give every one of our clients the individualized attention they deserve.

Tyler White

Kelly White

Outreach and Benefit Coordination Team

We work to make a living, but we give to make a life.

Attributed to Winston Churchill.

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Your Trusted Partner—Planning for Tomorrow, Protecting Today.

Contact us today for a free consultation — we’ll listen, we’ll advise, and we’ll deliver results. Our dedicated team is ready to guide you every step of the way.

Your Questions Answered

What is ALTCS?
A.L.T.C.S. is an acronym that stands for Arizona Long-Term Care System, and it is a branch of Arizona’s Medicaid program (AHCCCS), specifically designed for long-term care. It is no secret that long-term care comes with a hefty price tag, many times more than ten thousand dollars each month, so neither Medicare nor traditional Medicaid would be sustainable if they covered long-term care as a matter of course. Accordingly, ALTCS has strict eligibility requirements that every applicant must meet before qualifying for coverage. The requirements are tough to satisfy, but even those who may qualify organically have trouble navigating the application process, so getting on the program is no small feat. Once on the program, though, ALTCS covers the cost of long-term care for its Members, but for a co-pay that is determined by the ALTCS Member’s monthly income – In the interest of fairness, those who earn more, pay more. ALTCS reevaluates financial eligibility on an annual basis, but staying on the program is nevertheless a lot easier than getting on the program. Most anybody who needs long-term care and lacks long-term care insurance should at least look into the possibility of qualifying for ALTCS.
The short, although sometimes surprising answer, is that, no, Medicare does not cover long-term care. Medicare is designed for acute care, or rehabilitative care, not long-term care. It can get confusing because Medicare does cover up to 100 days of skilled nursing care per incident, but this is only for rehabbing, and the phrase “up to” is operative. Medicare will cover up to 20 days at no cost, then up to another 80 days, for a total of 100 days, with a co-pay that can amount to thousands of dollars each month for those without a Medicare supplement plan. The real dilemma, though, is that Medicare will discontinue coverage as soon as your health plateaus, even if that plateau is at a very poor-health level. As soon as you stop recovering, your care is no longer considered acute, and is instead long-term in nature, so Medicare turns off coverage, whether or not you have other payment arrangements in place. Most people don’t even get the full 20 days, much less the full 100 days of Medicare coverage, so if there is any chance that a hospitalization might transition into a need for long-term care, it makes a lot of sense to begin the ALTCS-Planning while the Medicare coverage is still in place.
Anybody can apply for ALTCS on their own, just like anybody can handle their own bankruptcy, divorce, or business dissolution. Just because you can do it on your own doesn’t mean it is a good idea to do it on your own, though. Particularly when there are some assets to deal with, people who work with an experienced LTC Lawyer should be able to strategize for a spend-down that preserves the most money possible. It is perhaps most analogous to handling complex tax issues on your own. Anybody is allowed to do this, but those who have an interest in using the tax code to their advantage work with CPAs who understand the law and keep up with any changes that IRS rulings may create. In some cases, people hire TKW simply because they don’t want to deal with the arduous application process, even when there isn’t any money to be saved. Here again, with a denial rate that is well north of fifty percent, filing on your own can be a risky endeavor, and many people spend more on long-term care while trying to save money on legal fees than they would have just spent if they retained a LTC Lawyer at the outset.
Those who engage in planning should never lose their home unless they knowingly incorporate it into the planning process. Along with a vehicle, burial trusts, and personal effects, ALTCS permits applicants to keep a primary residence. This is a little misleading, though, because in some cases, ALTCS keeps track of everything it spends on an ALTCS Member, then attempts to recover their losses through the Estate Recovery program or by enforcing a TEFRA Lien. This said, there are many exemptions to enforcement, the most important of which is that married applicants can protect their home simply by transferring ownership to their spouse – ALTCS cannot enforce a lien on a home owned by the spouse, only on a home owned by the Member him or herself. Single applicants have other exemptions available to them, and even when no exemptions apply, good planning should allow many single applicants to keep the home in the family, or at the very least, preserve some of the home’s equity.
A common misperception is that the state will take over a person’s care costs when they run out of money. Sadly, ALTCS is the “state,” and for most, it is the last house on the block. Running out of money doesn’t give anybody a fast pass to eligibility. Everybody must undergo the application process, and even if bills are coming in each month, it could take five months or longer for an application to get approved. Another misperception is that the state takes assets away from ALTCS applicants before providing coverage. To be perfectly clear, ALTCS gives long-term care coverage; it doesn’t take anything from anybody. The rules require applicants to be spent down before qualifying for coverage, but the state doesn’t take money during the spend-down process, the only thing it does is withhold an applicant’s coverage until his or her eligibility is properly and thoroughly proven. Once on the program, ALTCS members must pay a share-of-cost, or co-pay, but this is no different than any other insurance product out there. Members pay their share-of-cost to their provider, then ALTCS pays the shortfall, whatever that shortfall amounts to, so the ALTCS Program is always more of a giver than a taker.
The short answer to this question is that ALTCS is designed to cover LTC costs only for those people who have spent down to the extent that they can no longer afford to pay for their own care. The reality, though, is that only people who neglect to engage in any meaningful estate preservation planning tend to really spend everything down before they qualify. And, to be entirely clear on this point, even spending every last penny doesn’t qualify an applicant for benefits – He or she must still undergo the application process and prove that their funds are depleted, a multi-month process, during which time bills will still be coming in and care homes will expect them to be timely paid. So how much does somebody have to spend before they qualify for ALTCS? Like most answers to legal questions, the answer here is that it depends. Those who start planning earlier tend to save more than those who wait until they have paid for months or even years of care before beginning the planning process. The sooner you begin planning, the more you are likely to save, so proactivity really pays in this situation. In some cases, pre-planning can help even healthy people save money. Where pre-planning is not practical, though, the time to begin planning is as soon as the need for long-term care becomes foreseeable. You can’t qualify until you satisfy the medical requirement, so filing an application before a medical need arises can be a fool’s errand. Instead, healthy people who want to explore long-term care planning in advance can speak to TKWhite LTC Law about pre-planning.

Having excess assets or income doesn’t automatically preclude you from qualifying for benefits.  To the contrary, it’s almost always worth at least looking into ALTCS-Planning strategies because there may be tools available to help you qualify.  Medicaid-Planning can involve restructuring your assets, using tools like irrevocable trusts, or employing other techniques to reduce your countable assets or income so they fall within the program’s limits.  Eligibility rules can be complex, but working with an experienced attorney can uncover options that may allow you to qualify while still preserving your assets.  With nothing to lose, it seems better to explore your possibilities than to assume you can’t qualify.

An Income-Only Trust (also known as a Miller Trust ) is a specific type of trust used to meet Medicaid’s income eligibility requirements — Never for protecting assets.  While it can help people with excess income qualify for ALTCS benefits, it does not shield assets from Medicaid’s asset limits.  There are other types of irrevocable trusts, that can be specifically drafted for asset protection, but each trust has its own rules and implications, particularly regarding the look-back period.  It’s essential to have a tailored plan that addresses both your income and asset concerns, and an experienced attorney can help you choose the right strategy – or put better, strategies – for your situation.

Transferring assets to your children may seem like a simple solution, but nothing tends to be as straightforward as it appears.  Medicaid (ALTCS) has a 5-year look-back period, meaning any asset-transfers made within five years of applying could result in a penalty period, during which time you would be ineligible for benefits.  Additionally, gifting assets without proper planning could carry tax and/or legal implications.  It’s important to work with an experienced attorney to explore the best strategies for asset protection while still working towards ALTCS eligibility.

TKWhite LTC Law is not an insurance company, but a law firm, so the direct answer to this question is no, TKW does not insure long-term care costs. This is not to say that there isn’t a very strong link between retaining the firm and qualifying for insurance under the ALTCS program. The last study publicly released indicated that nearly 80 percent of applicants were denied coverage. This comes as no surprise, given the demanding nature of applying for ALTCS, but this statistic is far from true with the firm’s clients. While it is unethical to make any guarantees about eligibility, it is safe to say that the firm’s approval rate is much higher than that reported by the state – Much, much higher. Clients who follow instructions and timely provide TKW with asked-for documentation should have a strong degree of confidence that their application will be approved. Ultimately, it comes down to understanding the rules, the following them. Nobody can be expected to understand all of the rules on their first try, so while TKW doesn’t directly insure long-term care, retaining the firm does ensure that you will have a knowledgeable team on your side to walk with you until your application is approved. In the rare instances where applications are denied, TKW stays with its clients no matter how many times it takes to secure an approval.

By hiring TKWhite LTC Law, you gain personalized, expert guidance through the complex world of long-term care planning, Medicaid eligibility, and estate preservation.  Our firm’s deep industry relationships, tailored solutions, and commitment to providing white-glove service in a world where slowing down to enjoy the company of another is becoming increasingly sparse, will help you not only qualify for LTC benefits, but also protect your assets and legacy.  We handle as much of the process as possible, making it easier for you to navigate medical and financial challenges, while offering peace of mind that your best interests are always our priority.

Yes, it is possible with careful planning.  Medicaid (ALTCS) can help cover long-term care costs, but there are strict eligibility requirements.  With the right strategies, which may include the implementation of various irrevocable trusts and complex financial maneuvers, you can protect your assets and qualify for benefits.  Those who plan early and are counseled on the rules surrounding asset-transfers, spend-down requirements, and the look-back period, tend to save the most.  TKW’s founder has made a career of helping clients navigate these complex issues, and has an experience-based education in every possible way to preserve assets and still qualify to have long-term care paid for.

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