By the Templateez Team · Licensed Attorney · June 2026

Elder Law & Medicaid Planning Intake Forms: What to Capture Before the First Consultation

An elder law consultation where the attorney spends forty-five minutes asking preliminary questions about asset values, insurance policies, and family members is a consultation where the actual legal analysis never starts. The client's daughter took time off work to drive her father to your office. They have ninety minutes before a follow-up doctor's appointment. If your intake process has not captured the foundational information before they sit down, you are going to run out of time before you reach the issues that matter — and the family is going to leave without the guidance they came for.

Elder law intake is more complex than most practice areas because it sits at the intersection of healthcare, family dynamics, government benefits, estate planning, and asset protection. A standard client information sheet does not come close. A real elder law intake form captures the full picture your practice needs to advise on Medicaid eligibility, asset preservation, long-term care planning, and the legal documents that should already be in place. Here is what that form should include.

Client and family structure: who is involved and who is making decisions

Elder law matters rarely involve a single person making decisions independently. More often, an adult child is calling on behalf of a parent. A spouse is trying to protect the family home while the other spouse needs nursing home care. A sibling group disagrees about next steps. Your intake needs to map the full family structure because it directly affects Medicaid planning, asset transfer strategies, and who has legal authority to act:

• Client demographics — full legal name, date of birth, Social Security number, marital status, citizenship, state of residence. Medicaid is a state-administered program, and eligibility rules vary significantly by state. Residency determines which rules apply.
• Spouse information — name, date of birth, Social Security number, health status, whether the spouse is the community spouse or the institutionalized spouse. The entire Medicaid planning framework for married couples revolves around this distinction — the Community Spouse Resource Allowance and Minimum Monthly Maintenance Needs Allowance calculations depend on which spouse is applying.
• Children — names, ages, locations, and relationship to the client's care. A child who has lived in the parent's home for two or more years and provided care that delayed institutionalization may qualify for a Medicaid exemption on the transfer of the family home. You cannot identify that exemption if you do not know which children live where and what care they provide.
• Other family members involved in care — siblings, grandchildren, nieces, nephews, or non-family members who participate in caregiving, financial management, or decision-making.
• Decision-maker identification — is the client making their own decisions, or is a family member acting on their behalf under a power of attorney, guardianship, or conservatorship? If the client has diminished capacity, who initiated this consultation and under what authority? This is not a courtesy question — it determines whether you have a client or a prospective client, and who you can take direction from.

Current health and care status: where the client is today

The urgency and direction of the entire engagement depend on the client's current health. A client who is independent and planning ahead requires a different strategy than a client who was just admitted to a skilled nursing facility three days ago and the family is being told private-pay rates are $14,000 per month:

• Current diagnoses — primary and secondary conditions. Dementia, Alzheimer's disease, Parkinson's, stroke, cancer, COPD, heart failure, diabetes. The diagnosis drives both the care plan and the planning timeline. A progressive cognitive decline means capacity issues will worsen, which accelerates the urgency of executing legal documents while the client can still sign.
• Current level of care — independent at home, home care with aides, assisted living facility, skilled nursing facility, or rehabilitation. Each level has different Medicaid implications. Assisted living Medicaid coverage varies dramatically by state. Skilled nursing is the primary Medicaid long-term care benefit.
• Treating physicians — primary care physician and specialists. You may need medical documentation for Medicaid applications, guardianship proceedings, or capacity evaluations.
• Medications — current medication list. Relevant to care cost projections and to understanding the complexity of the client's medical needs.
• Cognitive status — has the client been diagnosed with dementia or Alzheimer's? What stage? Can the client understand and execute legal documents? Has a treating physician assessed the client's capacity? If the client lacks capacity and no power of attorney exists, you may be looking at a guardianship proceeding before any planning can begin.
• Prognosis — what does the treating physician project? Is the condition stable, progressive, or terminal? Prognosis determines whether you are planning for five years of assisted living, an imminent nursing home admission, or hospice care.

Financial snapshot: the full asset and income picture

Medicaid eligibility is fundamentally a financial determination. If you do not have a complete picture of the client's assets and income at intake, you cannot calculate eligibility, determine what needs to be restructured, or estimate the spend-down timeline. Clients and families almost always underestimate what they need to disclose, which means your intake form has to be specific enough to prompt them:

Income sources. Social Security benefits — is the client receiving retirement, disability, or survivor benefits? Pension income — defined benefit pension, monthly amount, survivor option selected or waived. Annuity payments — immediate or deferred, fixed or variable. Investment income — dividends, interest, capital gains distributions. Rental income from investment property. Every dollar of income affects Medicaid eligibility and the patient pay amount once Medicaid is approved.

Monthly expenses. Mortgage or rent, property taxes, homeowner's insurance, health insurance premiums (Medicare Part B, Medigap, Part D), prescription costs, home care aide costs, utilities, food, transportation. This is essential for the MMMNA calculation — the Minimum Monthly Maintenance Needs Allowance determines how much income the community spouse can retain.

Real property. Primary residence — address, estimated value, mortgage balance, whose name is on the deed. The primary residence is generally an exempt asset for Medicaid purposes while the applicant intends to return home or while a spouse still lives there, but equity above the state's limit may be countable. Vacation homes and rental properties are countable assets. Capture each property with ownership details, estimated value, and outstanding liens.

Bank accounts and investments. Checking, savings, money market accounts, CDs, brokerage accounts, mutual funds, stocks, bonds. Include ownership type — individual, joint, POD/TOD designations. Joint account treatment for Medicaid purposes varies by state, and POD designations can conflict with a Medicaid plan.

Retirement accounts. IRAs, 401(k)s, 403(b)s, pension plans. Are they in payout status? The treatment of retirement accounts for Medicaid eligibility depends on whether the account is in payout mode — an IRA in payout may be treated as income rather than a countable asset in some states. The distinction matters enormously for eligibility.

Life insurance. Term policies — face value, premium, term remaining. Whole life or universal life — face value and cash surrender value. Cash value above $1,500 is typically a countable asset for Medicaid. A client with a whole life policy with $40,000 in cash value has a countable asset that needs to be addressed in planning.

Vehicles and personal property. Primary vehicle is generally exempt. Second vehicles, recreational vehicles, boats, valuable collections — countable. Business interests — sole proprietorship, LLC, partnership, or corporation ownership. Business assets and their valuation can significantly complicate Medicaid eligibility.

Medicaid planning: the eligibility calculation

This is where elder law intake diverges sharply from general estate planning. The intake form needs to capture enough information for you to begin the Medicaid eligibility analysis at the consultation rather than scheduling a second meeting to discuss what you learned from the intake:

• State-specific Medicaid income and asset limits — these change annually. Your intake process should note the applicable state so the correct thresholds are applied. The federal asset limit for an individual is $2,000 in most states, though several states have adopted higher limits. The community spouse resource allowance ranges from approximately $30,000 to over $150,000 depending on the state and federal adjustments.
• Spend-down calculation — total countable assets minus the applicable asset limit equals the amount that must be spent, transferred, or restructured before the client qualifies. This is the core planning number.
• Look-back period — five years (60 months) under federal law, though certain states have variations in how they apply it. Every transfer for less than fair market value within the look-back period triggers a penalty. Your intake needs to surface these transfers before the Medicaid application is filed, not after the state Medicaid agency discovers them during its review.
• Penalty period calculation — the penalty divisor varies by state (the average monthly cost of nursing home care in that state). A $100,000 transfer in a state with a $12,000 monthly divisor creates an eight-month penalty period during which Medicaid will not pay for nursing home care. The client must have a plan for how care is paid during that penalty.
• Exempt vs. countable assets — primary residence (with equity limits), one vehicle, personal belongings, prepaid burial plans, certain annuities. Everything else is countable unless it can be restructured. Your intake form should walk the client through each category so nothing is missed.
• CSRA — Community Spouse Resource Allowance — the amount of countable assets the community spouse is allowed to retain. Calculated at the time of the institutionalized spouse's application. Your intake needs both spouses' assets to calculate this.
• MMMNA — Minimum Monthly Maintenance Needs Allowance — the amount of the institutionalized spouse's income that can be diverted to the community spouse if the community spouse's own income falls below the threshold. Requires a complete income picture for both spouses.

Estate planning documents in place: what exists and what is missing

Elder law intake must inventory the client's existing estate planning documents because Medicaid planning often conflicts with the estate plan already in place — and because some documents must be executed urgently if the client's cognitive capacity is declining:

• Last will and testament — date executed, who are the beneficiaries, does it pour over into a trust?
• Revocable trust — assets in a revocable trust are countable for Medicaid. If the client has a revocable trust as part of their estate plan, it does nothing to protect those assets from the Medicaid spend-down.
• Irrevocable trust — date created, what assets were transferred in, was the transfer within the look-back period? Irrevocable trusts created more than five years ago may have successfully removed assets from the Medicaid calculation — but the terms of the trust matter. If the grantor retained any interest, Medicaid may still count it.
• Power of attorney — financial — is one in place? Does it include gifting authority? Does it authorize Medicaid planning transactions? A general POA without specific Medicaid planning language may not give the agent authority to implement the plan you design.
• Healthcare proxy / advance directive — is one in place? Who is the designated agent? Does the client have a living will with end-of-life directives? These are urgent if the client is experiencing cognitive decline.
• HIPAA authorization — allows the attorney and designated family members to communicate with healthcare providers. Without it, you cannot obtain the medical records you may need for Medicaid applications or guardianship proceedings.
• Beneficiary designations — on life insurance, retirement accounts, bank accounts (POD), and brokerage accounts (TOD). These designations override the will and trust, and they frequently conflict with the Medicaid plan. A retirement account with a beneficiary designation that passes assets directly to the institutionalized spouse's estate defeats the planning. Review every designation.

Transfers and gifting history: the look-back audit

This is where many Medicaid applications fail. The state Medicaid agency will review five years of financial records. Every transfer for less than fair market value triggers a penalty unless an exemption applies. Your intake must capture the full history:

• Gifts within the look-back period — birthday gifts, holiday gifts, contributions to grandchildren's education, charitable donations. Families often do not think of these as "transfers" in the Medicaid sense, but they are.
• Transfers to family members — adding a child to a deed, transferring a vehicle title, paying a child's mortgage or medical bills.
• Transfers to trusts — assets moved into irrevocable trusts within the five-year window.
• Promissory notes — loans to family members, whether documented or informal. An undocumented "loan" to a child looks like a gift to the Medicaid agency.
• Caregiver agreements — was the client paying a family member for care? Is there a written personal services contract with fair market value compensation, or were payments made informally? A properly structured caregiver agreement is a Medicaid-compliant transfer. An informal payment to a daughter for "helping out" is a gift that triggers a penalty.
• Personal services contracts — similar to caregiver agreements but broader. Any arrangement where the client paid a family member or friend for services needs documentation showing the services were actually provided and the compensation was reasonable.

Long-term care insurance

If the client has a long-term care insurance policy, it fundamentally changes the planning timeline and strategy. A policy that pays $250 per day with a three-year benefit period buys $273,000 of care before Medicaid planning becomes urgent. Your intake should capture:

• Policy in place — carrier, policy number, date issued.
• Daily or monthly benefit amount — what does the policy pay per day of care?
• Benefit period — two years, three years, five years, or lifetime. This determines how long the policy covers before Medicaid becomes necessary.
• Elimination period — the waiting period (typically 30, 60, or 90 days) before benefits begin. The client must pay out-of-pocket during this period.
• Inflation protection — does the benefit amount increase annually? A policy purchased in 2010 with 3% compound inflation protection has a significantly higher current daily benefit than its original face amount.

VA benefits eligibility

Veterans and surviving spouses of veterans may qualify for VA benefits that supplement or precede Medicaid. These benefits are often overlooked because the client or family does not realize they qualify, or because the elder law attorney does not ask. Similar to the benefits analysis involved in a Social Security disability case, VA eligibility requires specific service and financial information:

• Veteran or surviving spouse status — is the client a veteran? Is the client the surviving spouse of a veteran? Service branch and discharge status (honorable discharge required).
• Aid & Attendance — a pension benefit for veterans or surviving spouses who need assistance with activities of daily living. The income and asset limits are more generous than Medicaid, and there is currently no look-back period for VA pension purposes, though regulations have been tightening.
• Housebound benefit — a lower pension rate for veterans who are substantially confined to their home but do not meet Aid & Attendance criteria.
• Service dates — the veteran must have served during a qualifying wartime period. Capture exact dates of active duty service so eligibility can be verified.

Guardianship and conservatorship issues

If the client lacks capacity and no power of attorney or healthcare proxy exists, the family may need to pursue a guardianship or conservatorship before any planning can proceed. Your intake should identify whether this is a potential issue early, because guardianship is a court proceeding that adds time, expense, and complexity to an already urgent situation.

Has a physician assessed the client's capacity? Is there an existing guardian or conservator? Has a guardianship petition been filed or discussed? Are family members in agreement about who should serve, or is there a dispute? A contested guardianship proceeding can delay Medicaid planning by months while the family litigates in court over who has authority to act. Identifying this issue at intake — rather than discovering it after you have designed a plan that requires someone to execute documents the client cannot sign — saves the family both time and money.

Building the complete picture from the first interaction

Elder law intake is unlike other practice areas because the consequences of missing information are immediate and financial. A transfer you did not discover triggers a Medicaid penalty. A beneficiary designation you did not review undermines the asset protection plan. A caregiver agreement you did not document becomes a disqualifying gift. The intake form is not administrative overhead — it is the foundation of every planning decision you will make for this client.

A thorough intake form also tells the family that you understand the complexity of what they are dealing with. When a daughter sees that your form asks about the community spouse resource allowance, caregiver agreements, and VA Aid & Attendance eligibility, she understands that this attorney has handled these cases before. That confidence is what converts a consultation into an engagement.

When an elder law case transitions to probate, the paralegal intake captures what the estate planning form does not — see our estate probate paralegal intake guide for the fields that keep filings and deadlines on track during administration.

If you handle elder law as part of a broader legal practice, the Legal Bundle includes elder law alongside 37 other legal practice areas, each with practice-specific intake fields.