The Michigan Department of Community Health announced today that Detroit nursing homes would receive $1.7 million for improvements. See this Free Press article for coverage. I have never visited a nursing home that did not have a dedicated, but heavily-burdened staff. And obviously there is no end to the needs of the nursing home residents. I can imagine that in Detroit in particular, there would be certain areas that would feel an acute scarcity. I am glad that the patients and staff of these facilities will be receiving some help.

One very important matter for retiring seniors is the decision of when to begin receiving social security benefits. This helpful calculator from AARP can help in the decision-making process. But be forewarned: there is a lot of information on the internet suggesting that you should delay receiving benefits as long possible. And this is not without some merit as your benefits will be higher and theoretically provide better cashflow through your retirement the longer you wait to begin receiving benefits. However, in many cases the modest monthly gain for waiting is not offset by the years of foregone benefits. Consider it this way: If you retire at 65 with a household income of about $50,000.00, you can immediately begin receiving about $1,750.00 per month. If you choose to wait until age 67 to begin receiving social security, your monthly benefit will be about $1,988.00 per month. Think you should wait for the extra $238.00 per month? Well, in order to receive that additional $238.00 per month, you will not receive $42,000.00 in benefits ($1750.00 x 24 months = $42,000.00). The additional $238.00 per month will take you a little more than 176 months to make up the difference between the total of what you would have received with the earlier election and waiting to have the higher monthly payout.

Several reforms to Michigan’s Blue Cross Health Insurance are currently pending in the Michigan Legislature. Proponents hope that these reforms will help reduce the costs of health care in Michigan, while advocates for the health insurance industry voice concerns about declining revenues and increased costs. The issues are complicated, but it seems fair to say that health care is only getting more expensive as the system continues to absorb the shock of a growing retiree population. The system is further strained here in Michigan by increased demands for individual coverage, a demographic that provides financial difficulties for insurers because of the disproportionate number of high-risk cases. Employment based coverage provides greater opportunity for insurance companies to manage risk because the varied population is more likely to include healthy individuals who opt for coverage because it is paid for at least in part by the employer. The key is of course sustaining the highest quality of care for the greatest number of people. As noted in Crain’s Detroit Business:

“Throughout the process one point has become clear, that more and more people are finding themselves in need of individual coverage, but the system does little to help them. As the bills go back to the House, we are hopeful that there will be meaningful solutions on this important issue,” Blue Cross said.

Blue Cross officials have said the individual market needs new rules to accommodate a growing number of people expected to join it over the next five years. The Blues argued for the high-risk insurance pool, which would require assessments from competing insurers after two years.

The push and pull of the legislative process is a reasonable mechanism for working out these controversial and complex topics. There is no easy solution to the pressure that health care costs place on the economy as a whole or the individual retiree’s monthly budget. The key is to remain informed and involved in the process.

When one spouse requires long-term care in Michigan, the Department of Human Services will do an assessment of the couple’s total resources. Without any planning or asset positioning, the spouse at home will be permitted to keep 1/2 of the couple’s assets as of the date the spouse needing long-term care entered either the hospital or long-term care, with a maximum of $104,400.00 and a minimum of $20,880.00 (in 2008). For example, a marital estate valued at $100,000.00 in non-exempt assets will be limited to $50,000.00 that the at-home spouse can keep. The remainder will have to spent on long-term care or converted to exempt assets before Medicaid will provide assistance with the cost of long-term care.

One simple estate planning technique to overcome this problem is to place the marital home in a revocable living trust before any health problems arise. Instead of being excluded from the total value of the estate, under Michigan law, the equity value of the home held in a living trust will be counted as an asset. So a couple with $100,000.00 in the bank and a home in a trust worth $150,000.00 will be treated as though they have $250,000.00 in assets when the asset declaration is completed. This couple will therefore be entitled to keep the full $104,400.00.

There are several cautions to using this technique. First of all, the home must be returned to the name of a natural person (not the trust) before applying for Medicaid. Failure to do so promptly can have horrific consequences. Second, relying on this technique can leave the home exposed to estate recovery. A more comprehensive asset protection plan is necessary well in advance of disability to be certain to avoid estate recovery. Third, this technique will not help with a home valued at more than $500,000.00. A variety of different asset protection techniques can be utilized in those circumstances. But for a married couple hoping to secure assets through retirement, placing a home in a revocable living trust can be quite helpful.

A recent article in The Economist explained how some senior citizens used Facebook to fight back when their investments in Asset Backed Commercial Paper ended up in bankruptcy court. Sometimes the innovations wrought by the internet can be a little startling, even if pleasantly so. The idea that a broad spectrum of investors, including many elderly, might form a coalition on Facebook and force a corporation to hear (and heed) their complaints is an astonishing example of how much has changed. Not only has the internet brought people together in wonderful new ways, but the phenomenon has spread to all parts of society, including the elderly:

Following the example of their children and grandchildren, some small investors formed a group on Facebook, a social-networking site, to trade information, provide mutual support and plot strategy. Brian Hunter, the group administrator, says the site turned out to be an “amazing tool”. People who would never have met in real life, from pig farmers and retired loggers to MBA students and pastors, created a formidable interest group.

I find the internet a fascinating world of possibility. There is no limit to the connections that can be formed or the information that can be harnessed. Although written several years ago (and updated more than once) I would recommend The World is Flat to anyone hoping to see the breadth of what has changed through the influence of the internet.

Sue Schiebel has written an excellent article on Medicaid Planning. While her article concerns MassHealth, which is the Massachusetts Medicaid program, the rules and ideas explained are the same in Michigan. She writes:

A lot of middle-aged people don’t realize Medicare, the federal health insurance program, pays for a very limited amount of skilled nursing home care. As we live longer, that means more of us will have to spend our own money for long-term care or must rely on MassHealth, the state health insurance for low income people. Many people wind up doing both — first using up many of their own assets to “spend down” to Medicaid limits so they are financially eligible for state help.

Medicaid qualification is a complex area of the law. To highlight just one counter-intuitive aspect, consider that donations to a church or charity are treated as gifts under the law. One making such a gift is technically creating a period of ineligibility for Medicaid. Strictly speaking, one could then have no means to pay for a nursing home after all other assets have been spent down. An elder law attorney helps families cope with these bizarre rules and avoid such unfortunate results.

Many of my clients are uneasy about placing their assets into a trust as part of an asset protection plan. In order to demystify the process and help you understand why you might consider having a trust drafted for your specific needs, I would like to explain some of the reasons you might consider having a trust and little bit of how a trust works.

Trusts are an important part of elder law and estate planning. Elder law is really the art and science of preserving personal and financial independence for seniors. Many forces threaten a senior’s independence, from ailing health to limited finances to extensive regulatory systems. The goal in creating comprehensive estate plans is to extend resources as much as possible and to create options. How is this possible? The right trust agreement is an important tool for achieving this goal.

Consider that property–whether a house, a car, or cash in the bank–can be owned by a trust. What this means is that a trustee will have control and legal title of property held in trust and a duty to manage that property according to the terms of the trust. This method of holding property has great flexibility and a number of important advantages.

To understand how this is possible, one must begin to see that under the law, ownership itself has many facets. It is possible, for example, not to own something for purposes of an obligation to a creditor, but at the same time to have full use and enjoyment of that same property. This apparent contradiction can be explained by the fact that beneficial enjoyment of property is not the same as simple ownership.

In general we tend to think about ownership like a baseball umpire thinks about a play at first base. Either the first baseman was holding the ball before the runner crossed first base or he wasn’t. In the same way, your name is either on the bank account number 5555551111 or it isn’t. Or so the everyday understanding of ownership goes.

If bank account number 5555551111 is held in trust for your benefit, whether you can be said to own that account will depend on whom you ask, when, and what the trust agreement says. The fact of the matter is that you can get very different answers about who owns what from the IRS and DHS, particularly with regard to property held in trust. In this way the rules of ownership with a carefully drafted trust will quickly start to seem more like juggling than baseball: you have control of the ball and sometimes you have the ball in your hand, but if you are a good juggler (or, to continue the analogy, you have a good trust) you will not be holding the ball at the critical moment. That is perhaps a tangled analogy, but it shows the delicate balancing that can be accomplished with a properly drafted trust (or a lot of practice juggling).

To give a more concrete example of how the various aspects of ownership can be effectively handled by a trust, consider that it is possible to have a trust with the following terms:

1. The principal placed in the trust will be unavailable for purposes of long-term care. Therefore, from the time property is placed in the trust, it will be out of the original owner’s name and the five year look-back period will begin to run.

2. For tax purposes, the principal held in the same trust will be owned by the original owner. The trust will not have to file a separate tax return, pay the higher rates that complex trusts are subjected to, or otherwise incur any additional tax liability for the original owner beyond the interest, capital gains, etc. that the original owner would otherwise have had.

3. The income generated by the principal held in the trust will be payable to the original owner. The assets held in the trust will therefore continue to provide support and income throughout retirement, but at the same time at least 50% of the assets held in the trust will be protected from the cost of long-term care. After 5 years, the entire principal will be protected from the cost of long-term care.

4. In some cases, this same trust can return the assets to the original owner. But only when the original owner decides it is necessary to do so.

A trust then, can be a legal document that allows you to enjoy your assets, but also to protect them. An attorney who understands the way that a trust will be read by the IRS, the Department of Human Services, the Department of Veteran’s Affairs and other government agencies can teach you how to juggle your finances and preserve your financial independence.

Retirement assets (401ks, IRAs, etc) are considered available assets for purposes of Medicaid qualification in Michigan. In simple terms, that means that those funds have to be spent down until the threshold for asset eligibility is met. In the case of a single person, asset eligibility is generally about $2,000.00, with some additional allowances for the homestead, modest life insurance and funeral expenses. In the case of a married person, the threshold is higher, and will be between $20,880.00 and $104,400.00, depending on the couple’s assets before entering the nursing home. For more details, see The Basics of Medicaid Qualification, below.

In order to avoid having to spend these assets on the cost of care, it is very common to annuitize the retirement assets. For a variety of reasons, I think this is something to avoid whenever possible. First of all, the return on such annuities is low. With inflation likely to increase in the present economic climate, it is difficult to recommend a long-term investment with a low return. An additional concern is that current law requires an annuity to pay out in level installments and in an actuarially sound manner. The days of the deferred annuity with a substantial amount held until after the passing of the owner are gone. Furthermore, under current law, the state of Michigan must be named as the remainder beneficiary after the community spouse or a disabled child. It is true that an annuity will provide secure retirement income for a community spouse, but it should be considered an alternative of last resort in light of these considerations.

Retirement assets present some of the most difficult problems in elder law, but there are solutions. With some intricate planning, one can use a solely for the benefit of trust, for example to preserve the tax-deferred funds and obtain qualification. This is an important alternative for families to consider so that retirement assets are not unnecessarily depleted by the cost of long-term care or restricted to minimal returns and subjected to estate recovery.

Estate Planning often involves transfer of real property. Care must be taken to avoid incurring unnecessary property taxes as an asset protection plan is carried out.

One of the biggest obstacles to overcome is the so-called uncapping of property taxes. In Michigan, property taxes can only increase by a fixed percentage each year, regardless of the increase in fair market value of the real estate so long as the real estate is owned by the same person or joint owners. For those who have held real property for a long time, this rule has helped to keep their property taxes down.

When real property is transferred to another person, such as through a sale or a gift, the property tax values will generally be reset at the fair market value of the real estate at the time of the transfer. Knowing the exceptions to these rules and how to retain sufficient interest in the property by the grantor can be critical to obtaining the best possible asset protection result without incurring additional property taxes.

One example of how an uncapping of property taxes can be avoided is through the creation of joint tenancy. Under MCL 211.27a (h), the creation of a joint tenancy does not create an uncapping under most circumstances:

A transfer creating or terminating a joint tenancy between 2 or more persons if at least 1 of the persons was an original owner of the property before the joint tenancy was initially created and, if the property is held as a joint tenancy at the time of conveyance, at least 1 of the persons was a joint tenant when the joint tenancy was initially created and that person has remained a joint tenant since the joint tenancy was initially created. A joint owner at the time of the last transfer of ownership of the property is an original owner of the property. For purposes of this subdivision, a person is an original owner of property owned by that person’s spouse.

One way of reading this paragraph would allow for avoiding the uncapping of property taxes indefinitely. If Annie and Barrie own property that they transfer to Charlie by creating a joint tenancy, no uncapping results. Furthermore, if Annie, Barrie and Charlie convey to Annie, Barrie, Charlie and Danny as joint tenants, one could argue that Charlie is an “original owner” for purposes of MCL 211.27a(h) and that at the passing of Annie and Barrie, Charlie and Danny will continue to pay property taxes at the “capped” rate, i.e., without regard to the fully appreciated value of the property. So what prevents Charlie and Danny from conveying the property to Eve as joint tenants and continuing to avoid the uncapping of property taxes?

This technique is one example of how a careful understanding of Michigan’s property tax law can result in significant savings and maximize the value of an asset protection plan.

Retirement for many people is defined as the time when they are able to live off of the income from their assets combined with Social Security and perhaps a pension. But anything from a car accident to a stay in long term care can quickly deplete retirement assets and jeopardize the fruits of a lifetime’s work. This can be particularly devastating for a married couple when one of the spouses falls ill and the assets of both must be devoted to the care of the other. Medicaid law permits the Community Spouse (the spouse not in long-term care) to retain a maximum of $104,400.00 in non-exempt assets, but without planning, in many cases that amount can be lower.

Modern estate planning offers solutions to this problem and provides financial security in retirement. This form of estate planning is far more than naming beneficiaries on accounts or providing a list what is to go whom. It is a matter of restructuring an estate to be sure that assets are protected and preserved for their intended purposes. These techniques allow security, tax benefits, and even asset protection for one’s heirs.

One often hears of estates consumed by the cost of long term care. See, for example this story. A modern estate plan can help you to ensure that you will receive the benefits of your assets without exposing those assets to the claims of creditors or the cost of nursing home care.