Flag asset transfers and care timelines before you consult
Ask whether care is imminent, whether a home or savings need protecting, and whether any assets were transferred in the last five years — then send financial documents and the completed intake straight to your CRM.
The exact intake your medicaid and long-term care planning leads complete
This is the real 8-question guided intake for Medicaid and Long-Term Care Planning — the same flow your customers finish before you ever pick up the phone.
What a qualified medicaid and long-term care planning lead should tell you
Legal planning to help a senior or disabled person qualify for Medicaid to cover nursing home, assisted living, or in-home care costs, including protecting a home or savings and addressing any asset transfers made in the last five years.
- Seeking Help With Medicaid
- Person Needing Care Age
- Person In Nursing Home,
- Want Protect Home, Savings,
- Person (Or Their Spouse)
- There Spouse, Minor Child,
- Help With Legal Documents
- Person Needing Care U.S.
The questions your team needs answered
Every medicaid and long-term care planning intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Are you seeking help with Medicaid eligibility or planning to pay for long-term care (like a nursing home, assisted living, or in-home care)? | This confirms the lead actually needs Medicaid or long-term care planning rather than an unrelated elder law matter, so it carries the heaviest weight in the score. |
| Is the person needing care age 65 or older, or living with a disability that may qualify for Medicaid? | Age or disability status determines basic Medicaid eligibility, so it filters out inquiries that fall outside the program's requirements. |
| Is the person currently in a nursing home, about to enter one, or expected to need long-term care within the next 12 months? | An imminent nursing home admission signals a time-sensitive case that needs faster attention than a purely prospective planning inquiry. |
| Do you want to protect a home, savings, or other assets while planning for Medicaid or long-term care costs? | Wanting to protect a home or savings points to a substantive planning engagement rather than a simple eligibility question. |
| Has the person (or their spouse) given away money or property, or transferred assets to someone else, in the last 5 years? | Recent gifts or transfers raise look-back period risk, which materially changes the complexity and strategy of the case. |
| Is there a spouse, minor child, or disabled child who depends on the person needing care? | A dependent spouse or child changes the planning approach because of spousal impoverishment and dependent protections under Medicaid rules. |
| Do you need help with legal documents for care planning, such as a power of attorney or health care decision form? | A "yes" flags a higher-value, higher-urgency lead you’ll want to reach first. |
| Is the person needing care a U.S. citizen or a lawful permanent resident (green card holder)? | Citizenship or lawful permanent resident status is a threshold Medicaid eligibility requirement, so a 'no' here meaningfully lowers fit. |
How Cliont scores medicaid and long-term care planning leads
Every answer is weighted automatically — no manual review required.
Value signals
- Seeking Help With Medicaid: yes
- Person Needing Care Age: yes
- Person In Nursing Home,: yes
- Want Protect Home, Savings,: yes
- Person (Or Their Spouse): yes
- There Spouse, Minor Child,: yes
See the lead your team receives
Medicaid and Long-Term Care Planning Lead
From first click to qualified lead
Follow people and businesses seeking counsel through one smooth, guided flow.
They land & meet you
Your video greeting plays instantly — a real face instead of a blank form.
They explain the matter
Smart questions adapt to their matter and capture the full scope.
They share the documents
The facts, dates, and any paperwork come attached, so you can assess the matter before the consultation.
You get a ready lead
Scored and qualified — waiting for you to win it.
Built for medicaid and long-term care planning workflows
| Cliont capability | Medicaid And Long-Term Care Planning application |
|---|---|
| Weighted scoring logic | Answers about imminent care, asset protection goals, and five-year asset transfers each carry their own weight, so a crisis Medicaid case scores differently than an early-stage asset protection inquiry. |
| Conditional question flow | A 'no' to seeking Medicaid or long-term care help still lets the intake capture document requests like power of attorney, without treating that lead as a full planning case. |
| Document upload capture | Prospective clients can upload financial records and any existing power of attorney or health care directive before the consultation, so you review look-back and asset details in advance. |
| CRM routing | Leads with an imminent care timeline and active asset transfer concerns route to your CRM as high-priority, separate from lower-weight document-only requests. |
Common medicaid and long-term care planning lead scenarios
Imminent nursing home admission
The intake flags cases where care is expected within 12 months alongside a live Medicaid eligibility need, so time-sensitive files surface first.
Asset protection for a healthy senior
A prospective client wants to shield a home or savings before care is needed, without an imminent admission — a different planning timeline than a crisis case.
Recent gifting complicates eligibility
A transfer of money or property in the last five years signals a possible look-back issue, which the intake surfaces for review before any consultation is booked.
Dependent spouse still at home
When a spouse or disabled child depends on the person needing care, the intake highlights the spousal or dependent protection angle that changes the planning approach.
Document-only inquiry, no Medicaid need
Someone wants a power of attorney or health care form but isn't pursuing Medicaid or long-term care funding, which scores lower than an active planning case.
Connect Cliont to your workflow
Send leads
HubSpot, HighLevel, Salesforce, JobNimbus
Book matters
Google Calendar, Outlook Calendar, Calendly
Notify your team
Email, SMS, Slack
Automate follow-up
Zapier, Webhooks, API
Simple, transparent pricing
Choose the plan that works for your business.
Professional
Unlimited intake forms and leads for your growing business.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Advanced analytics dashboard
Pay Per Lead
Only pay when you receive a qualified lead.
- Unlimited intake forms
- Custom video greetings
- AI-powered voice bot
- English + Spanish support
- Automatic lead scoring
- Digital estimates & e-signatures
- Photo, video & file upload
- Charged only for submitted leads
More elder law intake templates
Medicaid and Long-Term Care Planning lead-intake FAQs
Can the intake surface look-back period concerns before I take the case?
Yes. The intake asks directly whether the person or their spouse gave away money or property or transferred assets in the last five years, so you see potential look-back exposure before scheduling anything.
Does the intake distinguish crisis planning from proactive asset protection?
It does, by separately asking whether care is needed within the next 12 months and whether the goal is protecting a home or savings, so you can tell a nursing-home-admission case apart from early planning.
What if someone only wants a power of attorney, not Medicaid help?
The intake asks about legal documents like a power of attorney or health care form separately from Medicaid eligibility, so document-only requests don't get scored the same as active long-term care planning matters.
Does citizenship or residency status get checked?
The intake asks whether the person needing care is a U.S. citizen or lawful permanent resident, since that affects Medicaid eligibility and is weighted into the lead's overall score.
How does a dependent spouse or child factor into the score?
If a spouse, minor child, or disabled child depends on the person needing care, that answer raises the lead's priority since spousal and dependent protections often shape the planning strategy.
Is this intake specific to Medicaid, or does it cover other elder law matters?
This intake is built for Medicaid and long-term care planning specifically; related needs like asset protection, guardianship, or veterans' aid and attendance benefits are handled by separate intakes in your Elder Law library.
Turn medicaid and long-term care planning visitors into qualified cases
Give every medicaid and long-term care planning visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book a consultation.