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

Massachusetts Elder Law Attorney | How Does MassHealth Treat the Home?

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Wed, Jan 02, 2013

The home is very often the biggest single asset our clients own and in some cases the only asset.  Many of the MassHealth rules apply specifically to the home that don’t apply to any other asset so it is a focal point of our guidance as elder law attorneys.  Additionally, the home is treated differently from a tax standpoint (capital gains and estate tax) so we must consider taxes when advising our clients on the best course of action.Medicaid, Medicare, MassHealth

Many people tend to initiate a “do it yourself” strategy in trying to protect the home by transferring it to a child or selling it “for $1”.  This strategy is dangerous on a number of levels.  There isn’t a one size fits all solution, which is to say it isn’t always the right choice or always the wrong one.  The answer is “it depends”.  Many wrongfully assume that a transfer is “OK” because the home is an exempt asset under MassHealth rules but even a transfer of an exempt asset is subject to a MassHealth penalty.

seniors, health care, Medicare, Medicaid

The Congressional Budget Office (CBO) is reviewing a new proposal to increase the look back period for Medicaid from 5 years to 10 years.  This would mean that you may end up paying more from your savings if you need nursing home care.  The CBO is also reviewing the impact of decreasing the home equity exemption from $750,000 to $50,000, which means your home could be lost if you or your spouse go to a nursing home.  It is more important than ever that you take the important steps now to protect your spouse, home and life savings before it's too late.  You can protect your home and life savings by taking action now, before these new rule changes take effect.  If you do not, you could end up costing your family its life savings.

Click here to get a free sneak preview of the “Senior and Boomer’s Guide to Health Care Reform & Avoiding Nursing Home Poverty”, which contains information on how Massachusetts Seniors and Boomers will be impacted by the Affordable Care Act!

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

Seniors, Attorney, Elder Law, Estate Planning

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

Tags: Estate Planning, Elder Law, MassHealth, family, Massachusetts, assets, home

Massachusetts Elder Law Attorney | What is a "But For" Letter?

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Mon, Dec 24, 2012

We talked last week about MassHealth’s transfer penalty, but what exactly is a “but for” letter?  As I explained , the MassHealth penalty doesn’t start when the transfer of assets is made, but only after the other requirements are met, meaning the application is filed and all MassHealth, attorney, elder lawthe other MassHealth requirements are met.   A “but for” letter is the written communication from MassHealth stating that but for the transfer penalty you would have been eligible to receive benefits.  It tells you exactly when the penalty starts and how long it will be.  The State will not pay for your care during the time frame of the penalty.  You’ll need to find other means to pay for the care.

Click here to get a free sneak preview of the “Senior and Boomer’s Guide to Health Care Reform & Avoiding Nursing Home Poverty”, which contains information on how Massachusetts Seniors and Boomers will be impacted by the Affordable Care Act!

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.

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

Tags: MassHealth, Massachusetts, caregiver, Elder Law, Attorney, health, legal, home, but for, letter

Massachusetts Elder Law Attorney | Does MassHealth Permit a Family Member to be Paid to Provide Care?

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Thu, Dec 20, 2012

We tell our elder law clients that family members are allowed to receive payment for their duties as caregivers.   Family members who wish to be paid as caregivers should be conservative when determining a fee.  Fees should be less than or equal to the current fair market value of an outside aide service.  Also, family caregivers must be realistic when determining the amount of hours worked.  For example, if the family member holds a full time job, he or she may not charge for care given while at work in their full time employment.MassHealth, elder law, Massachusetts  Family members may not be paid in advance (in a lump sum) nor may they be hired retroactively for services already provided.  If there is no family caregiver agreement in place, the family member may not be paid for past services.  MassHealth presumes that the care was provided by the child “out of love” with no expectation of financial compensation.

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.

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.

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: MassHealth, Massachusetts, caregiver, Elder Law, Attorney, health, legal, aide, home

Massachusetts Elder Law Attorney | Can Paying for Home Health Aides Cause a MassHealth Penalty? (Part 2)

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Wed, Dec 19, 2012

Can Paying for Home Health Aides Cause a MassHealth Penalty? (Part 2)

There are two components to properly paying a home health aide hired without the assistance of an agency:

1. Enter into a Caregiver Agreement with the aide – this agreement lays out the duties of the aide and the rate.  In short, it provides New Jersey MassHealth  with a record that an individual was hired to care for the eventual applicant and that the money withdrawn from the applicant’s account was used in return for a service (i.e.; transferred for value).  Some aides may be hesitant to sign due to their fear of the IRS or INS (immigration).  We explain to our elder law clients that the purpose of this agreement is to document payment for services forMassHealth, Medicaid an eventual MassHealth  filing, not to report the aide to a government authority.  This, of course, does not excuse the applicant and the aide from reporting income.  We do not provide advice on IRS and INS reporting rules, nor do we offer any guarantees that MassHealth  will not communicate with other government entities, however, we do tell clients that, to our knowledge,it has never happened and is not likely given how expansive “the government” is. 

2. Maintain receipts – simply buy a book of receipts from an office supply store.  Have the aide sign a receipt each time he/she is paid noting the dates of services for which payment is being made and the services performed

It should be noted that hiring a home health agency is never a problem for MassHealth.  The contract with the agency is proof of the services provided and payments are made to the agency, not to the aide.  A red flag for MassHealth  are checks made payable to an individual.  When they see checks to “Jenny Smith” they assume it is a gift to Jenny, who, they presume, is a family member.  You know that Jenny has been working for years taking care of Mom, but remember that MassHealth  doesn’t know that, and again, a verbal statement, unsupported by supporting documentation, will not be enough.

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

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

 

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

Tags: MassHealth, Massachusetts, caregiver, Elder Law, Attorney, health, legal, aide, home

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