Posted by Jerrold Bartholomew on August 1, 2008
Question: I approached my local Veterans’ Administration office for information about the Aid and Attendance Pension. They told me I had too much money to receive the pension. But I have reoccurring medical expenses of more than $1,000.00 per month. Is there anything I can do?
Answer: This is a delicate situation. On the one hand, some estate planning could allow you to qualify for the Aid and Attendance Pension. On the other, you would be mistaken to think that qualification for the Aid and Attendance Pension alone is sufficient. You need to be planning ahead for Medicaid long-term care at the same time that you are qualifying for veterans’ benefits. Read the rest of this entry »
Posted in Asset Protection, Assisted Living, Disability Planning, Estate Planning, FAQ, Financing A Nursing Home Stay, Financing Assisted Living Costs, veteran's benefits | Tagged: annuity, annuities, Medicaid Qualification, Michigan, Michigan Elder Law, veteran's benefits, Oakland Elder Law Attorney, Lapeer Elder Law Attorney, Macomb Elder Law Attorney, Wayne County Elder Law, Medicaid Long Term Care, FAQ, FAQ: Medicaid Qualification, Medicaid Pre-planning | No Comments »
Posted by Jerrold Bartholomew on May 19, 2008
The reality is that families faced with the chronic illness or disability of a loved-one often have few options but a traditional long-term care facility. Aside from the financial devastation that this usually entails, there is the fact that a traditional nursing home is a difficult place to be in. It is good therefore to see nursing home alternatives emerging, such as described in this story about a new nursing home developing near Grand Rapids, Michigan:
Differing from a traditional “hospital-style” nursing home, the so-called green house concept features smaller facilities designed to create a home-like setting with private rooms, baths and other amenities. Residents still receive the daily assistance and medical care they need, though their activities are not regimented nor predicated on their medical needs.
While the article is silent on the cost of care at this facility, it is not unreasonable to assume that it will be more expensive than traditional nursing home care. If it were otherwise, the article would be trumpeting both higher quality care and lower costs. The fact is that this sort of care remains out of reach for most seniors whose savings would be quickly depleted by the cost of this higher level of assistance. Perhaps the best chance most seniors will have at this sort of care is begin planning early in order to maximize assets.
Posted in Financing A Nursing Home Stay, Nursing Home Crisis Planning, Seniors | Tagged: Asset Protection, financial independence, Financing A Nursing Home Stay, Life Care Planning, Medicaid, Michigan, nursing home costs, Nursing Home Stay, Pre-Planning | No Comments »
Posted by Jerrold Bartholomew on April 24, 2008
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, a person making significant donations to a church could be ineligible for Medicaid for several months after all other assets have been spent down. An elder law attorney helps families cope with these bizarre rules and avoid such unfortunate results.
Posted in Asset Protection, Disability Planning, Estate Planning, Financing A Nursing Home Stay, Medicaid Qualification, Nursing Home Crisis Planning, Pre-Planning for Long Term Care, Transition to Nursing Home / Medicaid | Tagged: Asset Protection, charitable giving, Detroit Elder Law Attorney, Elder Law, Genesee Elder Law Attorney, Lapeer Elder Law Attorney, long term care, Macomb Elder Law Attorney, Medicaid Qualification, Michigan Elder Law, Michigan Nursing Home, Nursing Home, Oakland Elder Law Attorney | No Comments »
Posted by Jerrold Bartholomew on April 24, 2008
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.
Read the rest of this entry »
Posted in Asset Protection, Disability Planning, Estate Planning, Financing A Nursing Home Stay, Financing Assisted Living Costs, Medicaid, Medicaid Qualification, Pre-Planning for Long Term Care | Tagged: Asset Protection, creditor protection, Estate Planning, irrevocable trusts, long term care, Medicaid Qualification, revocable living trusts, veteran's benefits | 2 Comments »
Posted by Jerrold Bartholomew on March 31, 2008
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 one. 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.
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Posted in Asset Protection, Disability Planning, Estate Planning, Financing A Nursing Home Stay, Long Term Care Insurance, Medicaid Qualification, Nursing Home, Pre-Planning for Long Term Care, legal | Tagged: Asset Protection, Elder Law, Estate Planning, long term care, Medicaid, Nursing Home, nursing home costs, Pre-Planning, qualified funds, retirement, tax deferred funds | No Comments »
Posted by Jerrold Bartholomew on March 21, 2008
Yesterday, I learned of a case where a small insurance policy caused an extended period of ineligibility for Long Term Care Medicaid. This means it will be a long time before the nursing home bill gets paid, if ever.
Posted in Disability Planning, Estate Planning, Financing A Nursing Home Stay, Medicaid, Medicaid Qualification, Nursing Home, Transition to Nursing Home / Medicaid | Tagged: law, legal, life insurance, medicaid eligibility, Medicaid Qualification, Nursing Home | No Comments »
Posted by Jerrold Bartholomew on March 6, 2008
Under previous Medicaid policy, applicants for long term care were given the benefit of a doubt most of the time. In some cases, a demonstrated intent to complete asset conversion, which is the process of converting non-exempt assets into exempt or excluded assets and is the heart of Medicaid planning, would be enough to pass scrutiny.
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Posted in Financing A Nursing Home Stay, Medicaid, Medicaid Qualification, Nursing Home Crisis Planning, Transition to Nursing Home / Medicaid | Tagged: application process, asset conversion, Asset Protection, legal, life insurance, Medicaid, medicaid application process, medicaid planning, Nursing Home | No Comments »
Posted by Jerrold Bartholomew on March 5, 2008
Many Elder law attorneys advise loving couples to pursue divorce as a method of asset protection. I have never found the technique necessary and, frankly, find the approach ethically questionable. Alternatives exist for both pre-planning and crisis planning that avoid the murky waters of a consensual divorce between an otherwise happily-wed pair. It is my view that you should not have to pretend to be something that you are not in order to protect assets. I always counsel my clients to disclose everything on the Medicaid application. Failure to do so can be considered fraud and even carry federal penalties. It is my job as an estate planning to arrange my client’s estate in a manner that allows qualification. But that is not a matter of hiding assets–nor is it a manner of simply spending down. I have helped countless couples protect their estates from the cost of long-term care and there has never been a reason to resort to divorce.
Posted in Asset Protection, Financing A Nursing Home Stay, Medicaid, Medicaid Qualification, Nursing Home Crisis Planning, Pre-Planning for Long Term Care | Tagged: Asset Protection, crisis planning, divorce, Elder Law, law, legal, Michigan Seniors, Pre-Planning | No Comments »
Posted by Jerrold Bartholomew on March 4, 2008
This article provides some preliminary answers to an important question for today’s retirees and elderly: Is long term care insurance a good idea?
In general, I advise clients to get long term care insurance. The effects of being unprepared for this financial tsunami are too overwhelming to do otherwise. But be careful and be informed.
Among your first questions should be the extent of the coverage and the anticipated premium schedule. It is not uncommon to see nursing home care costs increase 10% or more in a single year. It is therefore important to understand how much coverage is needed and how much adequate coverage will cost.
Once you have that information, consider this: a properly drafted and funded asset protection plan will give you all of the benefits of your assets, but fully protect them from the cost of long term care after five years. When you look at the premiums, the escalation of long term care costs, and the uncertainty of the future, an asset protection estate plan combined with 5 years of long term care insurance makes the most sense for many people.
Posted in Asset Protection, Estate Planning, Financing A Nursing Home Stay, Insurance, Long Term Care Insurance, Nursing Home, Pre-Planning for Long Term Care | Tagged: cost increases, Estate Planning, Long Term Care Insurance, Pre-Planning, premiums | No Comments »
Posted by Jerrold Bartholomew on March 1, 2008
States have begun to encourage all citizens to obtain long term care insurance as part of the Deficit Reduction Act. No one likes paying premiums on insurance, but for those of modest means, the premiums are especially burdensome and the benefits, considering that Medicaid is available when the assets run out, negligible. According to this article from the Wall Street Journal, “States Draw Fire for Pitching Citizens on Long Term Care Insurance,” the broad encouragement to obtain long term care insurance is generating profits for the insurance industry at the expense of people who cannot afford it:
The state endorsements are “the single best thing that has happened to the long-term care industry,” says Jesse Slome, executive director of the American Association of Long-Term Care Insurance. Total premiums collected for long-term care, or LTC, policies were $10 billion in 2007, up 21% from $8.2 billion in 2004.
Critics are sounding alarm bells. They argue that the financial benefits of LTC insurance for many target customers are negligible to nonexistent. Their income and assets are so low that they would quickly qualify for free care under Medicaid.
I have seen people with long term care insurance who had little to gain from having it, and I did not ask how much the premiums were–money that had been squandered. It is certainly common to see premiums of more than $3,000.00 per year.
My view is that long term care insurance can certainly be a good idea, but that decision cannot be made without the a thorough consultation with an elder law attorney. Why? Qualification for Medicaid is a specialty in of itself. The law is nuanced and subject to change. Whether one should have long term care insurance is a fact sensitive determination that should be made in the context of an overall estate plan with clearly defined goals. I can tell a client how soon they can qualify for Medicaid (which will be sooner than you think) and what value long term care insurance will have. A one hour consultation can easily save tens of thousands of dollars–by protecting assets or avoiding unnecessary insurance.
The key is to match estate planning goals with the best means available to achieve those goals. Frequently, a combination of long term care insurance along with an asset protection plan will make the most sense for people who are pre-planning their long term care needs. But if one cannot afford or cannot obtain long term care insurance, an asset protection plan is an excellent substitute and generally, a comparative bargain.
Posted in Asset Protection, Disability Planning, Financing A Nursing Home Stay, Long Term Care Insurance, Pre-Planning for Long Term Care | Tagged: Asset Protection, Deficit Reduction Act, Elder Law, Estate Planning, Long Term Care Insurance, Medicaid, Michigan Elder Law, Michigan Seniors, Nursing Home, Pre-Planning | No Comments »
