Medicaid planning intake that captures the 5-year transfer history up
Ask prospective clients about their care timeline, asset and income picture, and any gifts or transfers made in the last five years before they book a consultation. Collect power-of-attorney or guardianship documentation upfront so you know who actually has authority to act.
The exact intake your medicaid planning leads complete
This is the real 7-question guided intake for Medicaid Planning — the same flow your customers finish before you ever pick up the phone.
What a qualified medicaid planning lead should tell you
Legal planning to structure a person's assets, income, and legal authority so they can qualify for Medicaid coverage of nursing home or in-home long-term care, factoring in the five-year lookback period and any dependents relying on the person's income or home.
- Help Medicaid Pay Long-Term
- Person Who May Medicaid
- Person Expected Long-Term Care
- Person Have Assets Or
- Person (Or Their Spouse)
- There Spouse, Minor Child,
- Have Legal Authority Act
The questions your team needs answered
Every medicaid planning intake asks these — and why each one matters.
| Question | Why it matters |
|---|---|
| Are you looking for help planning for Medicaid to pay for long-term care (like a nursing home or in-home care) for yourself or a family member? | Confirms the inquiry is actually about Medicaid long-term care planning rather than general estate planning, so it doesn't get routed to the wrong practice area. |
| Is the person who may need Medicaid a U.S. resident and currently living in the United States? | Medicaid eligibility rules are state and residency specific, so confirming U.S. residency early avoids booking a consultation you can't actually act on. |
| Is the person expected to need long-term care within the next 12 months, or already receiving it? | Whether care is needed within 12 months separates urgent nursing-home placements from early, exploratory planning that carries different weight. |
| Does the person have assets or income that might affect Medicaid eligibility (for example, savings, investments, a home, or retirement accounts)? | The presence of savings, a home, or retirement accounts is what actually creates a Medicaid eligibility problem worth taking on. |
| Has the person (or their spouse) given away money or property, or sold anything for less than it was worth, within the last 5 years? | Gifts or below-market sales in the last five years directly determine lookback-penalty exposure, the core issue in most Medicaid planning matters. |
| Is there a spouse, minor child, or disabled child who depends on the person’s income or home? | A dependent spouse or child changes which asset and income protections apply, so it shapes the strategy before you even meet. |
| Do you have legal authority to act for the person (such as power of attorney or guardianship), or are you the person needing care? | Confirming power of attorney or guardianship upfront tells you whether the person on the intake can actually authorize planning decisions. |
How Cliont scores medicaid planning leads
Every answer is weighted automatically — no manual review required.
Value signals
- Help Medicaid Pay Long-Term: yes
- Person Who May Medicaid: yes
- Person Expected Long-Term Care: yes
- Person Have Assets Or: yes
- Person (Or Their Spouse): yes
- There Spouse, Minor Child,: yes
See the lead your team receives
Medicaid 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 planning workflows
| Cliont capability | Medicaid Planning application |
|---|---|
| Weighted lead scoring | Recent asset transfers combined with meaningful savings or investments push a lead's score up, so cases with real lookback exposure surface ahead of low-asset, no-transfer inquiries. |
| Document upload capture | Prospective clients can attach power of attorney or guardianship paperwork before the consultation, so you know who's legally authorized to act on the matter. |
| Video intake widget | Family members can describe a parent's care timeline and living situation on camera instead of typing it out, which suits the sensitive, often stressful nature of Medicaid planning inquiries. |
| CRM routing | Leads where legal authority is confirmed and care is needed within 12 months route straight to your CRM as consultation-ready, rather than sitting in a general inbox. |
Common medicaid planning lead scenarios
Nursing home placement imminent
The prospective client's parent needs care within the next 12 months and holds meaningful savings and a home; intake flags this as high-asset, high-urgency and surfaces whether power of attorney is already in place.
Recent gifts or asset transfers
A family gifted cash or sold property below market value within the last five years, raising lookback-penalty concerns; intake captures the transfer history so you can assess exposure before the consultation.
Protecting a dependent spouse or child
A spouse or disabled child still lives in the home and relies on the applicant's income; intake flags this dependency so you can see whether spousal or hardship protections might apply before you meet.
Early inquiry, no care needed yet
The caller is exploring Medicaid planning years ahead of any anticipated care need; intake still records the asset picture, but the lower urgency weighting keeps expectations realistic for both sides.
No legal authority established
A family member is inquiring on someone else's behalf without power of attorney or guardianship in place; intake surfaces this gap so you can address authority before scheduling time.
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 estate planning and probate intake templates
Medicaid Planning lead-intake FAQs
Does the intake ask about the five-year Medicaid lookback period?
Yes — the catalog includes a direct question about gifts, transfers, or below-market sales made in the last five years, which is central to assessing penalty-period exposure before you pick up the phone.
How does the intake confirm who has legal authority to act?
One question asks whether the person completing the intake holds power of attorney or guardianship, or is the individual needing care themselves, so you can see authority status before booking a consultation.
Will the intake flag cases where care isn't needed for years?
Yes — the question about whether care is expected within 12 months or already underway carries real weight, so inquiries that are further out score lower without being disqualified outright.
Does the intake account for a spouse or dependent still living in the home?
There's a dedicated question about a spouse, minor child, or disabled child depending on the applicant's income or home, which matters for spousal and hardship protections under Medicaid rules.
What documents should prospective clients upload before the consultation?
You can request power of attorney or guardianship paperwork, recent asset statements, and records of any transfers made in the past five years, so the consultation doesn't start from zero.
Can this intake handle both nursing home and in-home care inquiries?
Yes — the first question distinguishes whether the person is planning for long-term care such as a nursing home or in-home care, and that context carries through the rest of the fields.
Turn medicaid planning visitors into qualified cases
Give every medicaid planning visitor a guided intake instead of a dead contact form — and get a scored, qualified lead before you book a consultation.