Rhode Island Medicaid Counselor for Long Term Services and Supports

When a loved one needs long term care, the cost can be overwhelming. In Rhode Island, the average cost of a private nursing home room is around $14,000 per month. While Medicaid’s Long Term Services and Supports (LTSS) program can help cover these costs, the application process is anything but simple. Families are often faced with stacks of paperwork, strict financial eligibility rules, and confusing requirements from the Department of Human Services (DHS).

That is where a Medicaid counselor comes in. A Medicaid counselor is a professional who helps families navigate the complex Medicaid system, ensuring that applications are filed correctly and that assets are protected whenever possible. At McCarthy Law, we provide attorney-led Medicaid counseling in Rhode Island, focusing exclusively on LTSS Medicaid. Unlike state caseworkers, who can process applications but cannot give legal advice, we offer strategic guidance, hands-on application assistance, and long-term advocacy to give families peace of mind during a stressful time.

What Is LTSS Medicaid in Rhode Island?

Medicaid is a joint federal and state program that provides health coverage for individuals with limited income and resources. In Rhode Island, one of the most critical parts of the program is Long Term Services and Supports (LTSS) Medicaid, which helps cover the cost of extended care when someone can no longer live independently.

LTSS Medicaid is different from regular health insurance. It can help pay for:

• Nursing home care when 24/7 skilled nursing and supervision are needed
• Assisted living waivers covering a portion of the care costs in licensed assisted living facilities
• Home and community-based care services that allow individuals to remain at home while still receiving necessary support

Qualifying for LTSS Medicaid requires meeting strict financial eligibility standards. The state reviews income, assets, and even past financial transactions to determine if an applicant qualifies. Medicaid requires applicants to contribute a portion of their income toward care costs, known as the patient share. McCarthy Law can help determine how much you must pay towards your care, how to protect a maximum amount of your assets, and even assist with placement in a high quality facility in Rhode Island.

Because of the complexities associated with Medicaid eligibility, even families who believe they qualify often run into challenges. A small mistake, missing document, or misunderstanding of the rules can lead to delays or denials, leaving families responsible for thousands of dollars in care costs. This is why many turn to a Medicaid counselor for guidance through the process.

What Does a Medicaid Counselor Do?

A Medicaid counselor’s role goes far beyond simply filling out forms. At McCarthy Law, our Medicaid counseling services are designed to give families both clarity and confidence in a system that often feels overwhelming. When it comes to Rhode Island’s LTSS Medicaid, we provide:

• Eligibility review – analyzing income, assets, and past financial history to determine whether a client meets LTSS Medicaid requirements and guiding families through allowable strategies to achieve eligibility
• Application preparation and filing – organizing, preparing, and filing all required paperwork with the Department of Human Services (DHS) to ensure nothing is missed
• Patient share calculation – working directly with families and facilities to determine how much of an applicant’s income must go toward care costs so that they can accurately plan and protect assets as much as possible
• Facility coordination – communicating with assisted living facilities to confirm waiver eligibility and addressing private-pay requirements during the approval period, as well as coordinating with nursing homes to ensure proper billing while Medicaid is pending
• Advocacy with DHS – responding to DHS requests, tracking the application, resolving issues, and assisting with appeals if necessary

With our attorney-led approach, families do not just get an application submitted. They gain a dedicated advocate who understands both the legal and practical side of Medicaid eligibility.

Do Medicaid Counselors Cost Money?

Yes, private Medicaid counseling is a professional service that comes with a fee. It is important to understand what families are paying for and why many find it to be a valuable investment.

Rhode Island’s Department of Human Services (DHS) does provide caseworkers who process Medicaid applications at no cost. However, they cannot offer legal advice, create asset protection strategies, or advocate for you if problems arise. Their role is limited to reviewing and approving paperwork.

At McCarthy Law, our Medicaid counseling is an attorney-led legal service. We provide tailored advice, prepare and file the LTSS Medicaid application, communicate with DHS on your behalf, and coordinate with nursing homes and assisted living facilities to ensure continuity of care. Most importantly, we help protect family assets with legal vessels whenever possible through trusts and other advanced strategies, something state caseworkers are not able to do.

For most families, the cost of hiring a Medicaid counselor is far less than the risk of a mistake or delay. A denial can leave families paying thousands of dollars per month out of pocket. By investing in professional Medicaid counseling, you gain peace of mind, avoid costly errors, and ensure your loved one’s care is covered as soon as possible.

Why Hire a Medicaid Counselor in Rhode Island?

Families often begin the Medicaid process believing they can handle the application themselves. Unfortunately, Rhode Island’s LTSS Medicaid system is one of the most complex benefit programs, and even a small error can have major financial consequences.

• Avoiding denials and delays – Many applications are denied because a single bank statement, signature, or supporting document was missing. Each delay can mean another month of private pay, often costing more than $10,000 in nursing home or assisted living fees
• Understanding state-specific rules – Rhode Island’s Medicaid regulations are unique and change frequently. Having local guidance ensures compliance with current rules
• Managing facility requirements – Assisted living facilities often require residents to private-pay during the Medicaid approval period. A counselor can negotiate with facilities, explain waiver processes, and set realistic expectations about reimbursement once Medicaid is approved
• Protecting family assets – Without planning, families may spend far more of their savings than necessary. A Medicaid counselor helps ensure eligibility while protecting what can legally be preserved for spouses or heirs
• Peace of mind – Families gain the reassurance that someone is watching deadlines, communicating with DHS, and advocating on their behalf, allowing them to focus on care rather than paperwork

In short, hiring a Medicaid counselor is not just about getting through the application. It is about protecting your family’s financial security and ensuring your loved one receives the care they need without unnecessary stress.

How McCarthy Law Provides Medicaid Counseling

At McCarthy Law, we understand that successfully applying for LTSS Medicaid in Rhode Island is life-changing. When done right, Medicaid asset protection strategies and application support protects your loved one’s future and makes sure care continues without interruption. Our role as Medicaid counselors is hands-on, strategic, and deeply client-focused.

Here is what sets our services apart:

• Transparent Medicaid application service – comprehensive, predictable pricing so that you know exactly what you are paying for.
• Legal guidance – every case is managed by one of our experienced elder law attorney who understands Rhode Island’s Medicaid rules and has experience working directly with DHS
• Life care planning – continued advocacy and support beyond the application, including communication with facilities, reviewing care options, and assisting with annual Medicaid recertifications
• Direct DHS advocacy – tracking the file, responding to DHS requests, and stepping in immediately if issues arise
• Compassionate, local support – as a Rhode Island-based firm, we know the local facilities, waiver programs, and state systems inside and out

With McCarthy Law as your Medicaid counselor, you gain valuable support that can change the lives of your loved ones. We sit down with you to determine the best path forward and how to prepare for a variety of options that can unlock new opportunities to age in place, get high-quality care, and achieve a brighter future. 

Take the Next Step with a Medicaid Counselor in Rhode Island

If your loved one is facing the high costs of nursing home care, assisted living, or in-home support, do not try to navigate Rhode Island’s Medicaid system alone. The rules are complex, the paperwork is overwhelming, and a single mistake can cost your family thousands of dollars.

At McCarthy Law, we provide Medicaid counseling for Rhode Island families, focused exclusively on Long Term Services and Supports (LTSS) Medicaid. Our flat-fee service gives you clear expectations, attorney-led guidance, and dedicated advocacy with the Department of Human Services. From the first eligibility review to final approval, we are by your side every step of the way.

Fill out the form below to schedule your free discovery call and learn how our Medicaid counseling services can help secure care for your loved one while protecting your family’s financial future.

Serving families throughout East Greenwich, Warwick, Cranston, Providence, and across Rhode Island.

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