Medicaid Crisis Planning: Leveraging DRA Promissory Notes, Medicaid Compliant Annuities, Community Spouse Resource Allowance

Recording of a 90-minute CLE webinar with Q&A

Conducted on Tuesday, July 19, 2016

Recorded event now available

or call 1-800-926-7926
Program Materials

This CLE webinar will equip elder law attorneys with real-world, practical techniques to protect the assets of senior clients facing a Medicaid eligibility crisis due to a health condition that requires unaffordable nursing home care. The panel will outline strategies for clients to preserve assets using tools such as immediate annuities, Deficit Reduction Act (DRA) promissory notes, and the Community Spouse Allowance.


Elder law clients rarely plan in advance for Medicaid asset protection. A sudden illness requiring immediate long-term care placement or a degenerative diagnosis that will require extended care can devastate a family. Even at this critical point, there are Medicaid planning strategies that can protect as much income and assets as permitted under the law.

Key approaches include making countable assets unavailable through the use of Medicaid-qualifying annuities, qualified promissory notes, and leveraging the use of the Community Spouse Resource Allowance (CSRA).

The panel will outline best practices for meeting the stringent requirements for short-term annuities to escape being countable assets and subjected to transfer rules according to the Medicaid standards, as set forth by the Third Circuit U.S. Court of Appeals in Zahner.

Listen as our distinguished panel of attorneys experienced in Medicaid asset preservation reviews the eligibility requirements and discusses the most effective current strategies and approaches to preserving the assets of senior clients facing a Medicaid eligibility crisis.



  1. Medicaid compliant annuities
  2. DRA qualified promissory notes
  3. Leveraging the CSRA


The panel will review these and other key issues:

  • Best practices to convert client’s Medicaid-countable assets to exempt assets
  • Use of the Community Spouse Resource Allowance, Medicaid qualified annuities and DRA qualified promissory notes for the client and spouses’ benefit
  • How CSRA, annuities and DRA promissory notes interact with each other in crisis planning
  • Requirements for annuities and promissory notes to meet Medicaid standards for exclusion from countable assets
  • The Third Circuit’s Zahner ruling and other recent court decisions


Ann L. Fowler-Cruz
Ann L. Fowler-Cruz

Cohen and Wolf

Ms. Fowler-Cruz's elder law practice focuses on long-term care planning, asset preservation strategies, Medicaid...  |  Read More

Kelim, Kyla
Kyla G. Kelim

Aging in Alabama

Ms. Kelim focuses her practice on proactive planning involving those in need concerning Medicaid, Medicare and Social...  |  Read More

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