The Elder Law Coach

Ep. 63 Seven Steps To Run A High‑Closing Medicaid Meeting

• Todd Whatley

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We share a seven-step intake method that turns stressed family stories into a clear Medicaid plan, backed by simple tools that raise trust and close rates. From appreciation to a confident close, we show how to ask, verify, and present value with precision.

• leading with gratitude to set tone
• letting clients talk to build trust
• drilling down on status of care, assets, income
• summarizing facts and confirming in writing
• setting fee ranges tied to value protected
• analyzing and explaining the Medicaid plan
• using whiteboards and checklists to simplify
• closing on net savings after fees
• Miller Trust tips for income cap states
• using a free intake toolbox to streamline

Email Trisha@TheElderLawCoach.com and tell her you want the initial meeting toolbox that Todd talked about


Check out our new website www.TheElderLawCoach.com.

SPEAKER_00:

You're tuning in to the Elder Law Coach Podcast, the definitive resource for attorneys delving into the world of elder law. With your host, Todd Watley, a certified Elder Law attorney, past president of the National Elder Law Foundation, and renowned coach with a quarter century of specialized experience. Whether you're an established attorney looking to refine your expertise, or an emerging lawyer seeking a successful foray into elder law, this is your masterclass. Now, let's get started with the Luminary in the field. Here's Todd Watley.

SPEAKER_01:

Hi there, my name's Todd Watley, certified elder law attorney and the elder law coach. Thank you so much for joining me today. Today we're going to do something that um has kind of popped up, and it's it's one of those things I'm like, I just do it. You know, after doing this for 27 years, um, I just do this and I don't even think about it. But as you may or may not know, I have recently gotten my series 65. And so I've started doing some financial planning meetings with clients. And in my first meeting, I was like, oh, what do I do? What do I say? How do I do this meeting? And my coaching clients that have been with me, you know, I can understand initially, but then even later on, they're like, Todd, how do you do the initial meeting? And it just really dawned on me that there is a process to do that. I just walk in, sit down, and just do it. But it's just kind of autopilot for me. But if you're new to this, this is going to be something new. And I wanted to give you a step-by-step method of how I do the initial meeting. And my close rate is pretty amazing, to say the least. Okay. I mean, almost 100% of everyone who comes in and particularly does a Medicaid meeting, they end up hiring me because I've just gone through this so many times. I know what works. Okay. And I want to mention real quick, there is a special free deal at the end of this video. Okay. So stick around to the very end. I'll do this as quickly as possible, but thoroughly. But there is a very special deal at the end of this to help you through this. Okay. So the initial meeting, there's basically seven steps here. Okay. And I will tell you from the start, it's not tremendously overwhelming, but typically you will do the first four steps in your first meeting, and then the last three steps will be done in a second meeting. Okay. I do all but seven in one meeting just because I've done this for so long and I can analyze the facts and do it. You will get to the point where you can do all of this in just one meeting. Okay. But initially, just you know, take notes, look at the notes on the podcast or the YouTube video, and you'll see there are seven different steps. The first four, first meeting, the last three, second meeting, if you're just now starting out. Okay. So the seven steps, real quick, are number one, appreciate that they are there. Okay. And I I think a lot of people miss that. And sometimes I even on a super busy day, I'm like, oh my God, I've got another meeting. You need to appreciate that they are there. Number two, let them talk. Okay. And I think this is one thing that a lot of attorneys, most professionals, don't do very well. Number three, drill down on the facts. Number four, summarize the present situation. Number five, analyze the plan. Number six, explain the plan. And number seven, close the deal. Okay. So let's go through those real quick. So number one, I think when you first start this and your first few clients come in, you really do appreciate them being there. Okay. And once you get into this and your your schedule picks up quite a bit, it gets to the point where you're like, oh my goodness, I'm so busy. I've got to do another meeting. And that may be the nature of things when you are busy. We tend to sometimes do that, but I want you to just take a second before each meeting that you do, particularly each initial meeting. I want you to take a second, take 10 seconds to just sit there and think, these people had options. They've done their research, they've taken their time from their day to drive to my office to schedule this time and sit down with me. Okay. Of all the people in the world to solve this problem, they are sitting down with me. And I think if you take a few seconds to just step back and realize what this meeting is, this is someone putting their trust in you to say, here is my situation, and I'm hoping that you can solve it. Okay. That's a huge responsibility. That's a huge honor that you should take with you into every single meeting to say, these people chose to come see me, and I can solve their problem and I'm going to solve their problem. And with that mindset, you're going to walk into this meeting with a whole different view, attitude. And typically one of the first things I say is, hey, good to see you. Thanks for coming in. And I truly do mean that. Thanks for coming in. Thanks for choosing me. Okay. And I think we need to just have a mindset of appreciation when we go in to these meetings so that everything's on a better kill. Number two, let them talk. Okay. This is one thing that I learned a long time ago. And it's frustrating sometimes. You've you've got to sit there and hold your hands, bite your tongue. But research, repeated research has shown that a conversation where the person talks the most, they view as a great conversation. So if I'm in the study and there's a you know a person there who's a control person and we do a conversation, the meetings where I talk the most, when I review that conversation, I think that I got the most. And that's pretty much counterintuitive. But when they talk and they explain what's going on, they they feel like they've been heard and they feel like they have gotten their issues out there. And a lot of professionals don't do this, particularly doctors. You know, they are on a time crunch. They've got to get in, get out, and be done. Sometimes in five minutes, their entrance program says, We're only paying so much. And so they've scheduled so many clients to come in, they have five, maybe 10 minutes to do everything. And I tell myself, my associates, and my coaching clients, I'm like, look, you need to give them at least five minutes, maybe 10 minutes, of just let them talk. And the way that you initiate this, when I walk in, hey, I'm Todd Watley, thanks for coming in. What can I do for you today? Is probably my go-to line. The problem with that is probably about 10% of the people, not 10, I'm sorry, 50 percent of the people will say, I don't really know. I I was just told to come see you. Here I am. Okay. So a lot of people don't understand why they're there, particularly if they just put someone into the nursing home and they're all stressed out and everything's going on, and someone says, Hey, go see Todd. They truly don't know why they're there. Okay. And so if they say, Well, I don't know, then my next follow-up is, Well, tell me what's going on. Okay. And just sit back and shut your mouth. Okay. Let them talk. And sometimes I would say 60 to 70 percent of the time, what they say is going to be what you need to know. But there's a good 30% of the time that they're saying stuff that doesn't pertain to this meeting. That's okay. Let them talk. Nod and smile or, you know, you know, be with them, mirror their emotions as you're you're sitting there. Again, one thing, not again, but one important thing is keep your hands on top of the table. This is something that I've learned recently. I love body language. I love, and I'm always trying to learn new things to do. And one thing that um instills insecurity or you know, that you're hiding something is if your hands are under the table. If they're under the table, it kind of sends a message of, oh, what are they doing? You know, what are they hiding from me? Keep your hands above the table, show your palms. Yeah, say, oh, yeah, that's a great idea, but always keep your hands on top of the table, mirror them. If they're happy with something, smile. If they're sad, you be sad. Let them talk. Let them just get it out. And then I will give them typically five to ten minutes of that. And if they have not got to step number three where we're drilling down, I will bring them back in and say, you know, that's interesting, but today's meeting is just an hour and I need to know about this. Okay. And that is a polite way to get them back on track, bring them back in, because remember, these people are stressed out. And this is primarily for a Medicaid long-term care meeting, and they have just done something that they really didn't want to do is put a loved one into the nursing home, or they are needing care, or they've just been diagnosed with Alzheimer's, and things are just crashing around them, and they've come to you for a solution. This is what we're doing. And so you have to bring them back in to say, okay, I appreciate what you just said about your garden last year, but I need to know what's going on right now. Okay. And so that brings us to number three. You have to drill down. Okay. You have to get facts. Okay. And sometimes, like I said, the first five to 10 minutes they are giving you facts, you're you're writing those down or your staff's writing those down. But if they've given you none of these facts, you're like, okay, I understand that, but we're dealing with your husband being in a nursing home or your mom being in a nursing home. I need to know what's her level of care. So when you drill down, there's three things that you need. Number one, the status of their care. Are they in a nursing home? Are they going to the nursing home immediately? Are they going in in six weeks? Or is this a pre-planning meeting? It's like, we probably have five years because the answer to that question is going to determine what you're doing the rest of this hour. Okay. Are we in crisis mode? Are we in almost crisis mode or are we in pre-planning mode? And so you have to understand what is the status of care. And that is, do they need in-home care? Do they need assisted living? Or are they in a nursing home? You've just been told they cannot go home from the nursing home and they need full-on care that's going to be very expensive. And that's what that's how the rest of your meeting goes. Number two, you need to know their assets. Okay. And the way that I bring this up, because that's a very sensitive subject to some people, they particularly don't want to share that, but I would think they're in your office because someone's needing very expensive care, and they kind of understand that Medicaid has to know all of your assets. And so therefore, they are more willing to disclose that. So the way that I bring this up is as you probably understand, Medicaid has to know all of the assets of the person applying. And if they're married, we need to know all of the assets of their spouse. And you just say Medicaid needs to know everything. If we're going to apply for Medicaid, and for me to give you a good plan, I need to know everything that you have. Okay. And you just start going through the list. It's always saying, I'll just tell you how this meeting is going to go many times. People say, Well, I don't have much. Put zero confidence in that statement. Okay. I've seen not much be, truly not much, you know,$300,$3,000,$10,000. And I've seen not much be, well, we only have about$3 million. It's like I would consider$3 million to be not much, but in some people's head, it's not much. But almost everybody will say, Well, we don't have much. Okay, well, define that for me. Tell me what not much is to you. And so you need to go through and get everything that you have. And once you've gone through this a few times, you'll know what to drill down, drill down on. Obviously, checking savings account at their bank, investment accounts, foral investment accounts. And don't skip life insurance. Always ask about life insurance. People forget about life insurance, particularly if it's a paid up policy. They don't make payments on it and they've probably forgotten about it. But say, do you have life insurance? Oh, yeah, there is that life insurance policy. Is there cash value to it? That's what Medicaid's going to look at is the cash value. Real estate. Do they have any interest in any other real estate? Oh yeah, I bought a house for my kid. I forgot about that. Okay, well, yes, we need to know that. Are you co-owners? Have you inherited something that your name is still on this asset out there with your siblings or someone else? Vehicles, boats, trailers, RVs. You know, get the county assessment. If your state does county sort of personal property, boats, trailers, RVs, things like that, get the list because whatever's on there, that's what the state's going to see, and that's what they're going to go after. And many times people forget, like the boat. Haven't used the boat in five years, and my son borrowed it, never brought it back, and I don't think about it. And so you get the county obsession and you say, Oh, there's a boat on here. Yeah, I do own that boat. Good Lord, people tell me this stuff. Okay, you've got to tell me what's going on. And so you've got to spend some time there because that's what will trip you up on a Medicaid application, is if they own something and they haven't told you about it. Okay. And then third, we need to know income. Okay. You think, well, that's easy. Well, sometimes it's not, okay, because Medicaid's going to want the original statement from the place paying the income, Social Security. They want that white form that you tear off the ends of it and it unfolds to be about this long. Medicaid wants to see that form. And if they don't have that form, they've got to go down to the Social Security office and get it. They want the an original statement from any source of income, any teacher retirement, any pension fund, anything that they're getting in, look at their bank statements, look at their checking account and see these deposits. That's the best way to see. You'll see Social Security. You'll also see, you know, some pension plans, whatever. Oil and gas. Are they getting an oil and gas, oil or gas royalty payment periodically? If they get it at any point, that is income. Okay. You've got to go in and see what is all of your incomes. Once you've drilled down, this may take some time, but you've got the status of care that determines what plan you're doing. Crisis, almost crisis or pre-planning, and then assets and income. You've got to get those numbers down and have that in so that you can do the plan. Once we've gone through that, and sometimes people don't know it. It's like, okay, well, here's a list. And one of the things that I'm going to offer you at the end is a checklist of items that you need for the Medicaid application. This is a great, you know, I think it's two pages to say, here are the things we're going to need. And it lists all of those things. If you have this or this or this, bring it in, okay? And it's a great way. It's a checklist of things that they're going to need to bring in to you. Once you've done that, I like to summarize the plan and say, okay, think about it. Is this everything that you have? And just go through each account, each piece of land, each investment account, IRAs, other pieces of real estate, personal property, and life insurance. Go through those and make sure. And a lot of times I want the client, and you don't have to do this in this meeting, but at some point, once you they come back for the meeting, or we're now about to apply, I like to put that in a list and I want the client to sign it because I will tell you if an item pops up later on and it's causing a disqualification because they have too many assets, the fingers are going to start pointing. You're going to say, You didn't tell me that. I did tell you that. No, you didn't tell me that. Yes, I did. I remember bringing that up in the meeting. No, you did not. And so having this in writing and signed by the client to say, is this all of your assets? is a great way to give them the sheet and say, it was not on this list. Okay, because that's when it gets ugly and when it gets expensive. If you miss something, if you did not write it down or if you did not get it and it causes a disqualification, you may not know that for three months, four months down the road. And if they were disqualified because you missed something, you're paying the nursing home for those four months. Do the math. Okay. So it is important that you you summarize the present situation with level of care, income, and assets. And many times that's where your meeting is going to stop. It is perfectly okay at this point if this is your first meeting or your fifth meeting and you're still not real sure what to do. It is perfectly okay. People totally understand that it is okay to say, this is a fairly complicated case. I've got the facts. We just discussed it. I'm going to take a week to analyze this situation, come up with a plan and a fee. Okay. And when you bring up the fee, they may ask, well, what's the fee going to be? And if you've done this, you know, 50 times or more, you'll know what the fee is. But if not, just say, you know, I don't know because I've got to analyze this, look at this, figure out exactly what to do, figure out how complicated this is going to be. If I quoted you a fee today, it could be too low. And then I'm going to be mad that I didn't charge enough. It could be too high. That's not fair to you. I want to make sure it's just right. And you can give a range, okay? And I think people understand, and particularly if this is going to shock them, then you want to know this before you go spend more time on it. But my range personally, I will not touch a Medicaid application for less than$10,000. And the most I've ever charged, I think is I know I've charged 21. I think I've thought about 24, but I don't think I've done it yet. And so I'll tell them, look, there's a lot of months of work on this. There's at least four to six months of us dealing with the state. I'm going to be able to protect a large portion of your state. If they're married, you can protect almost 100% of it. If they're single, you're going to protect 50%. And that's what I tell people. I was like, look, since you're married, I can use the spousal protection rules and I'll be able to protect almost everything. They're like, really? Yes. Now we're going to have to rearrange some things. There may be some taxes that someone's got to pay, and we may just pay it now and get it over with, but I'm going to be able to protect almost everything. And if you're if you're dealing with a single person, it's like, look, in almost every situation, I can protect 50%. So whatever your number is, if you're dealing with$200,000 and you say, look, I I am pretty sure that I can protect at least$100,000. And then you say, and my fee is going to range somewhere between$10 and$21,000. They're like, that's a big fee, but you're also protecting a whole lot of money. Yes, I am. And so that should not run them off. But if it does, good. They were going to run off at the second meeting after you spent a whole lot of time on this. So we would rather know up front. I don't let my staff tell people before they come in. That will run them off. They're like, oh my goodness,$20,000. What's this guy thinking? You don't let your staff quote prices, only you quote prices after this initial meeting. And just don't quote prices beforehand. Almost always say that there are no absolutes. But when I do public speaking events, people will say, you know, how much do you charge? I'm like, well, somewhere between$10,000 and$21,000. But please understand I can protect everything that you have if you're married, 50% if you're single. And that kind of throws, you know, that's like, okay. So at the end of that meeting, say, look, I'm going to schedule you for a week from today. I'm going to analyze these facts. When you come back a week from today, I will have a plan and I will explain to you that plan and I will have a prize. Great. What's a week? Okay. So you do that. If you're in coaching, get me those facts. We will analyze this together for your first 15, 20, however many that you have. I will help you analyze the plan, be able to explain the plan and come up with the price. And so step number five is analyze the plan. Sometimes, almost always, you'll do this outside of that first meeting. Okay. But like me, if you've done it so many times, as you're going through this, you're analyzing it. And if this is your 3000th Medicaid meeting, then you're like, I got it. Okay, I know what to do. And so personally, I analyze as we're going through it. And then step number six is explain the plan. Be able to explain it. So I've gone through this, someone else is taking notes. I'll review with them. I know what to do. I'll make some quick notes on a piece of paper, but then I'll explain it to them. I have a whiteboard in my conference room. I'll go through and I'll just explain it very quickly to them. And that takes some time. Okay. I don't think I've done a podcast on explaining the Medicaid plan. I need to do it with a whiteboard behind me. And so I will get that done sometime soon. I will get the video of how to explain the Medicaid plan. I I learned this 27 years ago. A very good certified old law attorney, Tim Tecus, good friend of mine. I went and spent two days in his office and he showed me this. And 27 years later, I'm still using the same diagram. It just explains it so well and does such a good job that I still use what he taught me. So step number six is explain the plan and you bring the people back in, sit them down, say, hey, has anything changed? Did you find anything else? Hopefully not, so that it doesn't throw your plan off too much. But you then explain the plan to them and then close the deal. Once you go through this and always make sure that they understand. And one of the early questions, I should have mentioned this earlier. One of the early questions that you want to ask is, what is your understanding of how Medicaid works? Okay. And you hope that they say, I think you lose everything. I think we're going to lose everything. You're like, okay, keep thinking that until we get through this meeting. And a lot of times nowadays I am seeing people do some research. They're like, I know it can be done, but man, it's complicated. Yeah, it is. And so that's why we're here today. This is what I'm going to explain to you. So early on, say what is your understanding of Medicaid? They tell you, and then you're able to solve the problem. You use that in the closing of the deal. It's like, remember, when you came in, your understanding was zero, that you thought you were going to lose everything. I'm going to be able to protect everything if you're married, 50%. Or at this point, you can say 63.2%. Okay, because you've got the numbers, you know, exactly the nursing home cost, you know everything that you need to know. You're able to tell them with specific exactness to say, I'm going to save exactly this much money. And be sure when you run those numbers. And if you're in coaching, I'll I will make sure that you do this. But that dollar amount that you give them, based on your situation, we're going to be able to protect this much money. They're like, wow, that's amazing. Well, how much is the fee? I already took the fee out. This is the money that you're going to get to keep. And my fee happens to be$15,000, but this is your number. My$15,000 came out before I ran this number. And they're like, excellent, let's do it. I mean, the close rate is nearly 100% when you present it that way. Okay. So just in review, real quick, number one, let them talk. Okay. Well, number one, appreciate that they've come to see you. Go in with an attitude of appreciation. Thank you for coming in and realize what you're doing for these people. You are solving a huge problem. Number two, let them talk. Number three, drill down, get the facts. If they did not give that to you during them talking, you want status of care, you want assets, and you want income. Okay. Number four, summarize what they just told you. Here's what I see that you have, here's where your loved one is, here's what's going on. Sometimes that's the last part of your meeting. Okay. Then between meetings, you're analyzing the plan. Or if you're really good at this, you can analyze the plan in the meeting, explain the plan, and then close the deal. So that's how you do the initial meeting. Now, here's my special deal. I want to give you my initial meeting toolbox. It will be these notes. I will turn this podcast into notes and have that so that you know exactly what to do. You can have it in front of you as a reminder. Okay, next we do this, next we do this. I want to give you my Medicaid checklist, all of the items that you're going to need for the Medicaid application. Okay. On that is all the SR, all of the assets, okay? Investment savings, real estate, all of that stuff is there. And what is beautiful about that tool is I give it to them in the first meeting. Okay. Here is the things that you're going to need. And particularly if you've got someone who really seems to be like they're kicking tires, trying to figure out should I hire you? Should I not? Should I use this attorney or that attorney? If you give them this Medicaid checklist, it's going to have your letterhead on it, your name, your information, phone number, email, all of that. They're going to carry that around with them. And your name's going to be in front of them the entire time. And so I have found that to be a huge sales piece to say, here's something that you can take with you. Here is something of value that you get from this meeting. These are the things we're going to need. It should scare them to death. They're like, good Lord, we need all of this. Yeah, we do. And we need to make sure it's exact and current. And this is what we're going to need to apply for Medicaid. And it helps soothe the blow of that$15,000 that you quoted. Okay. It's like there's there's a lot of work in this, and this is just what I need you to do to bring to us, then we'll analyze all this and get it all to the state, explain it, and get this done for you. All right. Um, I will also give you my intake form so that you can get the information that you need from the people. And if you're in a Miller trust state, I will include my Miller Trust cover letter because if you are in a Miller Trust state, a income cap state, one of the things they're going to have to do is a Miller Trust. And even if this is the only thing that you're going to do for them, okay, this still has value. And I typically charge if I'm doing nothing else but the Miller Trust, I charge for that. Yes, they can get the Miller Trust form from the nursing home. But it's running the trust that's the problem. It's not creating it, that's a form. Go to the bank, open up the bank account, all the income goes in there. That's easy. But it's running the trust, making sure that you don't run foul of the Medicaid rules with this MillerTrust. I have a letter that puts all of that into writing. I have them sign it saying, I told you this. Okay. There's some major things that if the Miller Trust gets overfunded, they they can become disqualified. There's some things that they can't spend money for. It it gets really hairy once you get the trust done. It's not just done. You have to run it, and I will give you my MillerTrust letter that will help you make sure that's done correctly and get them to sign off so that it's not your fault if they mess it up. I may throw some other things in there once I think about this, but email Trisha at theyodolawcoach.com and tell her I want the initial meeting toolbox that Todd talked about. We will get you that absolutely free. I normally charge for that, but for the listeners of this podcast, since you've made it with me now, 30 minutes, um, I want to get you something to to say thanks for listening. Okay. I hope this helped. Okay. If there's questions, if there's comments, please let me know. Please like and subscribe. Okay. That's what lets me know that you're there. Let's me know that I'm doing this correctly and I'm I'm putting out content that people like. Please email me, Todd at theelderlawcoach.com, if you have questions about content things. But if it's about coaching, please email Trisha. And as always, I would love to be your coach. If you want to get into this full time and do it right, I would love to be your coach. So email Trisha. She can give you all the information. She can even set up a phone call with me. I would love to talk to you. Go through this and get you what you need so that you can do what is absolutely the best job in the world. All right. Thank you all very much, and we'll see you next time.

SPEAKER_00:

Thank you for joining this episode of the Elder Law Coach Podcast. For those eager to take their elder law practice to new heights and are interested in Todd's acclaimed coaching program, visit www.theelderlawcoach.com. With Todd Watley by your side, the journey to becoming an elder law authority has never been more achievable. Until next time, keep learning, keep growing, and stay passionate about elder law.