Elder Planning and Title 19


Elder planning, elder care, Title 19 (sometimes written as Title XIX), nursing home needs, hospice care, visiting nurse needs can be complicated. As we and our loved ones get older, medical insurance can become a huge financial burden. There are many programs to help insure the elderly; however, it is important to be very careful when choosing which programs to use. Certain programs may require credit checks, background checks, collateral, large deposits, real estate or even liquidation of assets.  Additionally, long term care insurance may provide a wonderful benefit, but if not purchased properly can waste thousands of dollars and forfeit coverage under the insurance.

Title 19 insurance is a very useful and beneficial program if used properly. Depending on your loved one’s assets, he/she may be eligible for the government to pay for community or long term care. However, if assets are mismanaged, even accidentally, the state is very unforgiving and will deny benefits.  Additionally, the state will quickly force your loved ones to liquidate all of their assets and place them in a facility of their choosing. Proper planning can protect your loved ones’ assets and well-being.

A common term used in the industry is “spend down”. However, if you misspend an asset or transfer it inappropriately, both you and your loved one will be assessed a penalty by the Department of Social Services. This penalty could be financial, or even require litigation to return a wrongfully disposed asset. Before you put a loved one at risk, contact Allinson & Associates, LLC for competent and experienced advice before seeking any government funded elderly assistance program.

We can assist you with any or all of the following:

  • Title 19 Planning

  • Title 19 Applications

  • Spend Downs

  • Department of Social Services Filings

  • Redeterminations

  • Asset Protection

  • Applications to Skilled Nursing Facilities

  • Long Term Care Insurance including the Connecticut Partnership for Long Term Care

Title 19 Planning

Title 19 is sometimes referred to as Title XIX or Medicaid in Connecticut. Title 19 is a social welfare program that provides many medical entitlements for individuals that cannot otherwise afford them. This program pays for skilled nursing care, rehabilitative care, long term facility care and medical expenses.

Title 19 is administered by the Department of Social Services (DSS), which determines eligibility based on criteria set forth in their Uniform Policy Manual (UPM). One policy used to determine eligibility is commonly referred to as the “5-year Lookback.” This means that DSS looks back five years from the date of the application to review all the assets the applicant owned during that period. This can include stocks, bonds, cash, vehicles, real estate or any other assets. In order to qualify, an applicant cannot have over a limited number of assets.

Therefore, in preparing for Title 19, an individual may need to spend down assets to become eligible for the benefit. After reviewing the five years of assets, DSS may issue a penalty or deny the application if the assets were not managed properly or were inappropriately spent down.

Please contact us before filing the Title 19 Application, Redetermination, or even spending down assets. A small mistake can create a major problem that you and your family cannot afford.


Title 19 Applications

Currently, Title 19, also known as Title XIX or Medicaid in Connecticut, has a long and detailed application. Title 19 provides skilled nursing care, rehabilitative care, long term facility care and certain medical expenses to individuals who are eligible. The Title 19 application is filed with the Department of Social Services (DSS) who researches the five-year history of the assets listed to determine eligibility.

The application process is lengthy and very detailed. Depending on your situation, your spouse or caregiver may be entitled to a portion of assets. On the other hand, DSS may require a spend down of your assets prior to granting eligibility. Connecticut requires full disclosure of assets before the application can be granted. This process requires diligence and experience in this process. If a request for information is not replied to by its due date, DSS will deny the application. Do not risk a costly mistake, contact us immediately to help with your Title 19 filings.


Spend Downs

In Connecticut, the Department of Social Services (DSS) requires all individuals receiving coverage for skilled nursing care, rehabilitative care, and long term facility care, and/or medical expenses under Title 19 have assets under a certain threshold. This means that the individual cannot have more assets than the amount set by DSS. Unfortunately, our loved ones sometimes receive more in income per month than this threshold. In this case, DSS requires a monthly spend down, where the assets must be spent below the threshold by the end of the month. If there is a bank error, poor time management, or even if someone forgets, DDS may stop the benefits completely. Often, the only way to reestablish the benefits is to file a brand new application.

In other circumstances, our loved ones may inherit or receive another benefit whereby DSS requires a spend down. This process is very time intuitive and requires that the medical bills and canceled checks be produced to DSS to prove the spend down of assets to below the set threshold.

A spend down can also refer to the initial spending of assets to bring our loved ones’ assets below the DSS set asset threshold. There are certain items, such as a prepaid funeral trust, medical expenses, legal fees, and a few others that are exempt and count as acceptable for spend down. Other items, while necessary to our loved ones, may not be approved. Prior to spending down assets for DSS, be sure you contact us.


Department of Social Services Filings

The Department of Social Services (DSS) often requests additional information after reviewing an application for Title 19. In Connecticut, you may see the program that provides skilled nursing care, rehabilitative care, long term facility care, and/or medical expenses referred to as Title 19, Title XIX, or Medicaid. Regardless of how it is written, it is essential to be diligent during this process.

When DSS sends a request, there is limited time to respond. If your response is not timely, or if your response gets lost, you may have to start over with a new application. Do not risk a rejection. Contact us today.



Every year, the Department of Social Services (DSS) requires a review of the Title 19 benefits. In Connecticut, you may see the program that provides skilled nursing care, rehabilitative care, long term facility care, and/or medical expenses referred to as Title 19, Title XIX, or Medicaid. This annual review is commonly referred to as a redetermination. During this process DSS has a specific form they require to be completed. Additionally, they may ask for additional information.

If the DSS redetermination is not completed properly, you or your loved one will lose your benefits. Additionally, during the time DSS requests additional information, the benefits may also halt. Do not risk the care your loved ones need and call us today.



Asset Protection

As we all age, we think about protecting our assets so that we can leave a legacy for our loved ones. There are a few steps to take to protect the assets you’ve worked so hard to get. You can use a variety of estate planning tools, such as a will, trust, or other financial products. Now is the best time to put some protection in place. Call us today to discuss your plan.


Applications to Skilled Nursing Facilities

If you or a loved one needs the service of a skilled nursing facility in Connecticut, you may want to have the admission documents reviewed by an attorney first. Often these contracts create third party liability or additional responsibilities. Occasionally, they may require a surety or other financial responsibilities. Other times, they may assign responsibility to a cosigner to provide care in instances that they do not. These documents are generally long and confusing and are designed to protect the nursing home. Before signing anything, ask for a copy and schedule an appointment at Allinson & Associates, LLC today.


Long Term Care Insurance including the Connecticut Partnership for Long Term Care


In Connecticut, there are several ways to protect your assets. The Title 19 (Medicaid) process can be very confusing and costly. Under the Connecticut Partnership, private insurance companies offer long term care insurance. It is very important when choosing long term care insurance to verify that the policy is part of the Connecticut Partnership.

Long term care insurance generally pays for your long-term care needs up to the policy limits. Once exhausted, Title 19 (Medicaid) would cover the remainder. The amount that the insurer pays on your behalf can be used to extend the threshold amount of your allowable assets under Medicaid. This can sometimes allow gifting or other transfers that would not otherwise be permitted by the Title 19. Unfortunately, not all insurances meet these requirements and currently, the long-term care insurance must be part of the Connecticut Partnership to qualify.

When using these benefits, you must be very careful to document your expenses. If you think Long Term Care Insurance may be right for you, or if you already have coverage, call us immediately. We will guide you every step of the way and make sure your benefits are protected.