Massachusetts Estate Planning & Asset Protection Blog

The High Cost of Seniors Living Longer

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Sep 05, 2014

 

The Cost of Living Longer | Massachusetts Eldercare Attorney

 

 planning, estate, eldercare

 

A Pachyderm of Problems

Every day, we see clients for whom long-term care is the elephant in the room. They feel they can’t afford the costs, but they also feel they can’t afford not to have it either. So their solution is to pretend they don’t see the elephant and try to ignore the problem until it goes away on its own. This unfortunately often leads to our metaphorical elephant trampling their life savings and any future inheritance they are trying to leave behind. The older you are, the more expensive a long-term care policy gets and if you get sick before you have long-term care protection in place, it’s too late. Insurance companies are looking out for their bottom line, and an already ill senior will scare them off.

The costs for these policies are rising faster than inflation too. Therein lies the conundrum for Boomers and seniors: They’re living longer than their parents did but that means they need more money to make it through “old age”. Finding long-term care is a tough and complicated process. You’ll need to find a place that cares for people with your (or your loved one’s) circumstances. You need to find a place with the right facilities and staff, a place that leaves you with a good, safe feeling. And you have to be able to afford it too. This is not any sort of one-size-fits-all situation. Everyone has their own specific services and conditions that they or their loved ones will need met. Remember, what we call “long-term care” is a broad category, with options ranging from live-in facilities to your own home.

Lurking Complications With Long Term Care

The greatest threat to the financial security of Boomers and seniors is the cost of long-term care (and Obamacare will not assist with this). Assisted-living facilities are now climbing toward the $7,500-a-month mark. Many have started bundling more services together, rather than charging for each individually. Bundling might be a good idea from the nursing home’s perspective, but just like pre-packaged cable TV you will wind up paying for a lot of services you don’t need and don’t want. A private room at a nursing home will range from $500 - $600 a day.

The cost of home healthcare is rising, too. Some people choose independent-living apartments. These facilities typically don’t require lump-sum payments, and residents can contract with home health-services independently. Medicaid may be there for those who qualify but if you ever want to learn the true meaning of “jumping through hoops” just try qualifying! The best thing, of course, is long-term care insurance, but that’s getting more expensive too as companies raise their rates while cutting back on their coverage. In addition, this insurance is getting more complicated, now encompassing aspects such as protection of the surviving spouse, caregiver issues, scams/ID theft, and making sure you have an advocate to fight for your rights in a system that’s slanted against you.

In short, we’re living longer, and unlike previous generations, people are generally not living with or even near their children. Seniors are going to need more money for this longer life and for any unforeseen medical problems that may arise.

A Magic Trick No One Wants to See

Do you know the fastest way for a Boomer or senior couple to become an impoverished Boomer or senior couple is? Simple, one of them just needs to become ill before they get long-term care insurance. We see it every day, people who’ve worked hard and saved money all their lives are forced to see it wash away in a flood of medical bills as they age. It is truly heart-breaking, because, if you’ve managed to squirrel some money away, you could probably have afforded long-term care. 

The Downside to Living Longer

Our life expectancies are going up these days and so is the cost of healthcare, the distance seniors are living from their children and families, and the financial pressures on Medicare and Medicaid. The new Affordable Care Act, in fact, stipulates $500 billion in Medicare cuts over the next decade! Where do you turn if you or your spouse gets ill? Home health care? Adult day-care? Assisted-living? A nursing facility? Respite-care services, which allow the caregiver to drop off the senior for a limited period? Who’s going to pay for it? And for how long?  These are the questions to ask now, while you still have time to plan. If you haven’t purchased long-term care before you or your spouse become ill…forget about it. No one will insure you once you’re sick! If this happens to you, you’re going to be out of time, out of options, and very quickly out of money. And if you’ve planned to leave something for your heirs, there may be nothing left to leave to them other than a pile of bills. 

 

It’s an old (but true) cliché: those who fail to plan, are planning to fail. When it comes to healthcare expenses as you age, you fail to plan at the risk of yourself and those you love.  

 

At the Estate Planning & Asset Protection Law Center, we provide a unique education and counseling process which includes our unique 19 Point Trust, Estate and Asset Protection Review to help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones, click here for more information. We provide clients with a unique approach so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

Click Here to Register For Our Trust, Estate & Asset  Protection Workshop 

 

Tags: living will, Estate Planning, Estate Planning, asset protection, Massacusetts Estate Tax, long term care, life insurance, Medicaid, MassHealth, in-home care, marriage, Estate Planning Tip, seniors, assisted living, life-care plan, hospice, Massachusetts, assets, in home, incapacity, asset, home, surviving spouse, Estate Planning Recommendations, in-home care, long term care insurance, Inheritance

Great News About Long Term Care Planning for You and Your Loved Ones

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Aug 01, 2014

More Good News: Estate Planning and Long-Term Care Planning

 Medicare family

Our firm has helped people and their families with long-term care planning for more than 20 years. While helping people, it is very important to help focus  on the health, long term care and estate and life planning needs for the individual and family. This is a holistic approach that helps families plan for obtaining the best quality care in their home, the community or perhaps assited living. Many people we help are also concerned  about the devastating cost of a Medicaid spend down of assets due to a long-term nursing home stay.

 

We have also had other success in Medicaid crisis planning relying on other strategies that are available in Massachusetts law,unlike some other states, that allow  citizens to pay part of their costs with their assets and eventually qualify for long-term care assistance to the Medicaid program.

 

Some people also have a long-term care insurance policy to help pay fort care at home, in the community and many times their plan will even will provide a care coordinator. Thus, we do recommend you contact your insurance advisor to look into the possibility of obtaining long-term care insurance while you can still qualify under medical underwriting.

 

If any of these topics concern or interest you please contact our office at 781-237-2815 to consult with our attorneys or request a copy of our Seniors and Boomers Guide to Health Care Reform & Avoiding Nursing Home Poverty for $14.95 or is available from www.DSullivan.com. We would be happy to be your guides on your Estate Planning/Elder Care journey.

 

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique educational and counseling approach so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

Click Here to Register For Our Trust, Estate & Asset  Protection Workshop

Tags: Estate Planning, Estate Planning, Elder Law, asset protection, long term care, Medicare, durable power of attorney, estate reduction, Estate Planning Tip, estate, estate tax, Massachusetts, senior, Medicare, asset, Estate Planning Recommendations, Dennis Sullivan, long term care insurance

Medicaid is No Walk in the Park Part 2|Massachusetts Elder Law Attorney

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Wed, Nov 20, 2013

Medicaid is No Walk in the Park 

Part II

Walk in the Park

 Last time we were examining Kate’s problem getting Medicaid for her mom.  Specifically, the issue was a joint account held by mother and daughter.

Into that account, Kate deposited her income which she used to pay for household bills, such as utilities, real estate taxes, homeowner’s insurance etc.  She took some of Mom’s income and transferred it to that joint account in order to pay some of those bills.  She explained that both of them were living in the household so they both contributed to the costs.

“Not a problem”, I told Kate.  “But, if you are claiming that the account isn’t Mom’s, you have the burden of proving that.  Medicaid assumes that it was Mom’s account and she put your name on it, not the other way around.  You must trace that account back to when it was just in your name, before you added Mom as a co-owner.  Only then will Medicaid be satisfied that it isn’t Mom’s.”

Kate listened carefully.  “So, is that it”, she asked.   No, actually there was more.

If we are successful in showing Medicaid that it isn’t Mom’s account, then the transfer of Mom’s income to that account to help pay the bills would now be a transfer for less than fair value.  Why is that?  Because Mom is transferring money out of her name to an account that we have just proved is Kate’s, not Mom’s.

Isn‘t  Kate then caught up in a classic Catch-22?  She seems to lose either way. Well, no.  Not really.  There is a way out.  Remember, the money transferred to the joint account is Mom’s share of the household expenses.  As long as we are able to prove by a clear paper trail what that money was spent on, then Medicaid won’t assess a penalty.

I asked Kate if she is able to do all that.  She was hesitant to reply.  She told me she hadn’t kept detailed records with the expectation that she would need to prove all this to anyone.  But, she said she would do her best.

“As long as we can back up what you are saying with a clean paper trail”, I told Kate, “then we should be able to straighten out your Medicaid denial.”  Kate certainly had plenty of motivation to get to work.  The$ 40,000 nursing home bill that Mom owes would motivate just about anyone.

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique educational and counseling approach so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

Click Here to Register For Our Trust, Estate & Asset  Protection Workshop

Tags: asset protection, Medicaid, MassHealth, medicaid qualification, assets, Medicaid penalties, asset, 2013

Medicaid is no Walk in the Park |Boston Elder Law Attorney

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Mon, Nov 18, 2013

Medicaid Is No Walk In The Park

Walking in the Park, Thinking

Kate told me, “Mom has no money.  She’s never had any money.  But Medicaid still denied her application and now I owe the nursing home $40,000.”  I knew there had to be more to her story.  Sure enough, there was.

It’s a very common belief that, because Mom and Dad never had much money, the Medicaid application process should be a piece of cake.  Maybe it should be but the reality is it just isn’t the case. Kate’s dilemma was proof.

Kate told me that she and her Mom had lived together her entire life.  In fact, Mom and Dad transferred the home to Kate.  When I heard that, I immediately thought this could be her problem right there.

I asked how long ago the deed had been transferred.   “10 years ago”, was Kate’s reply.  That was clearly outside the 5 year Medicaid look back period so could not have triggered a Medicaid transfer penalty.    It had to be something else.

“Does Mom have any accounts with her name on it, that, in your mind, you don’t consider hers”, I asked.  That’s when Kate told me that she had a joint account with Mom but she insisted the money in that account was all hers, not Kate’s.

I learned that Kate’s income is deposited into that account, from which she pays the bills.  Mom’s income, she told me, goes into a separate account in Mom’s name, the only account Kate considers to be owned by Mom.  I explained to her that this was mostly likely the cause of her Medicaid denial.

Next time I’ll share with you why and what we could do to fix the problem.

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique educational and counseling approach so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

Click Here to Register For Our Trust, Estate & Asset  Protection Workshop

Tags: asset protection, Medicaid, MassHealth, medicaid qualification, assets, Medicare, asset, 2013

Mass Health and VA Aid and Attendance 2013 | MA Elder Law Attorney

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Jan 18, 2013

Every year brings change, sometimes small sometimes big.    Many of the government benefit programs that we work with frequently, such as MassHealth’s Medicaid program and the VA Aid and Attendance program, underwent slight changes as the clock turned to 2013. 

Medicaid and VA Aid and Attendance are needs based programs.  There are certain income and asset limitations.  These numbers typically are tied to the Social Security increases.  When Social Security benefits get a cost of living adjustment so do these other programs.  In 2013 the increase for Social Security is 1.7%.

Accordingly, under MassHealth’s Medicaid porgram, an applicant must spend down countable assets to less than $2000 in order to qualify.  However, in the case of a married couple, the healthy spouse can keep "countable assets" up to a certain dollar limit.  This year that number is $115,920.

VA rates also have increase in 2013.  A single veteran qualifying for Aid and Attendance benefits can now receive a maximum of $1732, an increase of $29 per month.  A married veteran who needs care can qualify for as much as $2053 per month of tax free income and the widowed spouse of a veteran can receive up to $1112.

For more information about  whether MassHealth’s Medicaid program or VA benefits may be available to you or your loved one call (800) 964-4295 (24/7) and register to attend one of our free, educational workshops.

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique education and counseling approach so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

Again, we encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

elder law, senior, family, estate planning, massachusetts, boston

Click Here to Register For Our Trust, Estate & Asset  Protection Workshop

Tags: asset protection, Medicaid, MassHealth, seniors, veterans benefits, elder care journey, Elder Law, asset, Attorney

Massachusetts Elder Law Attorney | How Does Medicaid Treat Assets Held In Joint Accounts?

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Mon, Dec 03, 2012

How does Medicaid treat assets held in joint accounts?

When a savings or checking account is held by the Medicaid applicant with other parties, all funds in the account are considered the applicant’s so long as he or she has unrestricted access to the funds regardless of their source.  When parent and child, for example, are co-owners Massachusetts will consider the account to be the parent’s unless the child can establish that the source of the funds in the account were his.   If it can be established that  the funds are totally inaccessible to the applicant, then they will not be counted in determining Medicaid eligibility.describe the image

Where joint accounts of a parent and a child exist, we want to know who was the original owner of the account.  If the parent Medicaid applicant placed the child’s name on the account then Medicaid will consider it to be the parent’s account.  If it is vice versa, then as long as the child can prove by documentation it was his/her account it will not be counted but the parent’s name will have to be removed.

Our elder law clients will often say that the account is not theirs because the child’s Social Security number is used for the account.  That does not matter for Massachusetts Medicaid purposes and is not the determining factor as to whether the asset is countable asset or not.

To gain free online access to the Complete Alzheimer's Resource Kit, which contains care tips as well as other useful information on Alzheimer’s disease, please visit www.BostonMemoryLawyer.com.

Massachusetts, elder law, attorney

At the Estate Planning & Asset Protection Law Center, we help people and their families learn how to protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique educational and counseling approach so they understand where opportunities exist to eliminate problems now as they implement plans for a protected future.

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

Tags: asset protection, Medicaid, Massachusetts, Elder Law, Attorney, asset

Massachusetts Elder Law Attorney | How Does Massachusetts Medicaid Treat a Married Couple's Assets?

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Wed, Nov 28, 2012

How Does Massachusetts Medicaid Treat a Married Couple's Assets?

Medicaid combines both spouses’ assets together in determining eligibility.  The healthy or community spouse is allowed to keep a portion of the countable assets after the couple spends down for Medicaid eligibility. This division of assets is known as the Community Spouse Resource Allowance (CSRA) and the maximum amount in 2012 is $113,640.

The CSRA is calculated as follows:  Medicaid considers all countable assets as of the “first moment of the first day of the month of the current period of institutionalization”  of the Medicaid applicant (known as the “snapshot date”).   This is typically going to be the first day of the month that the applicant entered a Medicaid certified nursing facility, an intermediate care facility for the mentally retarded, a licensed special hospital, or a psychiatric hospital.

At the Estate Planning & Asset Protection Law Center of Dennis Sullivan & Associates, we help people and their families concerned with losing their homes and life savings to increasing medical and nursing home costs, taxes and the costs and time delays of probate. We also protect clients from losing control of their own health and financial decisions.

We encourage you to attend one of our free educational workshops to learn more about our process and what you can do to enhance the security of your spouse, home, life savings and legacy.

During our workshop, we will also focus on a review of the top mistakes of Medicaid planning and how to plan to prevent and remedy them.

To register for a seat at an upcoming workshop call (800) 964-4295 (24/7) or register online at www.SeniorWorkshop.com

workshop, Medicaid

Tags: Medicaid, Massachusetts, assets, Elder Law, Attorney, asset

Massachusetts Estate Planning Attorney | Last Mintue Planning to Avoid Nursing Home Poverty

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Nov 09, 2012

Lawrence Case Study

The Lawrence Family initially contacted our office looking for help upon getting referred by their financial advisor.   They were confused because they were told that they should deed their home to the children.  Like many people we have helped, their home was their largest asset.  When asked if they liked the idea of their children paying $150,000 in unnecessary capital gains on the sale of the home, they said of course they did not.  With our advice,  Mr. & Mrs. Lawrence decided not to transfer their home to the children, avoiding that expensive MISTAKE.  Instead, when they sold the home, the sale was tax-free and the proceeds were added to their life savings.asset protection, estate planning

Failure to Act Costs Thousands:

Plan Ahead to Protect Your Life Savings

Unfortunately for the family, they did not follow our other strong recommendation at the time and for a number of years thereafter to protect their life savings from being spent down on long term care costs.  As a result of their failure to plan ahead, their life savings had to be used to pay $16,000 a month to a care facility, a cost that Mr. Lawrence and Mrs. Lawrence incurred when they both ended up in the same long term care community.  Mr. Lawrence was in the nursing home and Mrs. Lawrence was across the courtyard in assisted living. 

The Lawrences incurred these costs 6 years ago.  If the care had been for two people it would have been much higher.  At todays rates, nursing home care for one person costs and average of $12,000-$15,000 per month.  That's $144,000-$180,000 per year.  The cost is completely avoidable however, and could have been avoided if Mr. & Mrs. Lawrence had come to us in advance. They could’ve protected everything and even passed the Medicaid 5 year look back period.

It’s Never Too Late, Emergency Planning is Possible

All was not lost for Mr. & Mrs. Lawrence.  Fortunately their son and daughter came to us in time to help the family with some advanced asset protection planning. Both children lived out of town, one in Oregon and the other in Europe. But we had a chance to meet with the family before Mr. Lawrence passed away.  Our teams of professionals were able to help protect $500,000 for Mrs. Lawrence from being forced to be spent on her long term care costs. Because of our successful advanced planning to help the family, we enabled Mrs. Lawrence to remain in assisted living, which is not paid for by Medicaid, AND she was able to keep additional funds for living expenses and medical expenses, which would otherwise have been paid to the nursing home for Mr. Lawrence’s care.   Needless to say at this time of crisis when Mr. Lawrence was in his last days, the family was relieved with the results they accomplished.  The planning even survived review by the Medicaid Board as qualified long term care costs to be paid for when the time came.

Are Increased Medicaid Look-Back Periods on the Horizon?

Long term care planning is a very confusing area, especially with the new health care reform, but all families’ have an opportunity to plan ahead and beat the Medicaid program’s 5 year look back. It should be noted that it is critically important for people to get their planning done now.  The look back period was increased from 3 to 5 years a short time ago, and many are now speculating that another increase somewhere in the neighborhood of 8 to 10 years is coming some point down the road.  The good news is that everything can be protected well in advance so families are not forced to spend their life savings, lose their home, and impoverish the spouse to pay for a nursing home.  In every scenario, planning ahead to defeat the five-year look back is much more effective. 

New Guide Reveals How Health Care Reform Impacts You

The stock market, investment, and retirement accounts have fallen in recent years, but medical and long term care costs continue to rise.  In Massachusetts, one-month in a nursing home costs an average of $12,000-$15,000 per month.  Additionally, as a result of the Supreme Court’s decision upholding the Affordable Care Act as there will be a number of significant changes to the health care system in the United States.  Seniors and Boomers, are concerned about how the Affordable Care Act will impact their lives, future, finances, and health care. Because health care reform and increasing long term care costs are on the minds of so many we have written a new book called the Senior & Boomers’ Guide to Health Care Reform and Avoiding Nursing Home Poverty.  The guide contains hidden benefits on how new healthcare laws will affect your family, healthcare, Medicare and Medicaid coverage as well as little known secrets many smart families are already using to avoid nursing home poverty.     

While the boomers are in their 50’s and 60’s now, before you know it, they’ll be moving on to thier 70’s and 80’s. The senior segment of the population is growing five times faster than the rest of the population. Just like the seniors that we serve today, many Boomers have these same concerns.  It is so important for us all to pay attention to what’s going on with health care reform.  This guide was written to be a helpful resource to navigate and understand some of the changes brought about by the Health Care Reform.  With or without health care reform, we all need to take responsibility for our own savings and planning.  People need to be smart about how to protect what is most important to them. At the Estate Planning & Asset Protection Law Center, our professional team has helped many families in Massachusetts protect their home, spouse and life savings, so if and when the time comes to go to a nursing home, people are not forced to spend their life savings down. 

Unfortunately many learn too late that Medicare will not pay for nursing homes.  Medicare only pays for diseases for which there is a cure and the patient can recover.  If you want to learn more, you can read about it in the Seniors & Boomers Guide to Health Care Reform and Avoiding Nursing Home Poverty.

 describe the image

We encourage you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about what you can do to enhance the security of your spouse, home, life savings and legacy.

describe the image

 

 

 

Tags: Estate Planning, assisted living, Wellesley, Massachusetts, Nursing Home, case study, asset, protection

Sign-Up Below To Receive Your Free Report

Follow Me

Browse by Tag



Follow DennisBSullivan on Twitter