Massachusetts Estate Planning & Asset Protection Blog

Is your Planning Stuck in Limbo? (part 2)

Posted by Dennis Sullivan & Associates on Tue, Aug 01, 2017

How does the debate over health care reform affect you and your estate plan?

35274856603_c2af85ca10_b.jpg In our last post we discussed the importance of keeping up with the constant changes happening in health care reform. We will continue to examine how the on-going deliberations in Washington may affect you, your future health care and your estate.  We at Dennis Sullivan & Associates are keeping up to date on all the changes, and making sure you stay informed on all the important details.  For more information on the current law of the land, you can download our Report: Senior & Boomers Guide to Health Care Reform.   

The Senate has dealt a devastating setback to Republican efforts to repeal and replace Obamacare, defeating a GOP "skinny repeal" bill early Friday morning. With the "skinny repeal" bill off the table, lawmakers are unsure of where the health care debate is headed. 

Senate Majority Leader McConnell and his staff are trying to find a balance between conservative Republicans, who want a full repeal of ObamaCare and a replacement that has lower health care costs, and more moderate Republicans who want to preserve its more popular benefits.

The deal-making process is in full swing, with the additions of opioid funding and allowing health savings accounts to be used to pay for insurance premiums. Some Senators are for potentially leaving in some taxes to pay for more generous benefits, after weeks of being criticized by Democrats for offering “tax cuts for the rich and Medicaid cuts for the poor.” Conservatives want to cut more from the regulations and many from Medicaid expansion states are uneasy about future cuts to Medicaid.

Senator Ted Cruz of Texas has offered an amendment called the “Consumer Freedom Option” that would allow insurance companies to sell any health coverage plan they wish as long as they provide one plan that satisfies the “essential benefits” mandates of Obamacare. While the Cruz amendment appeals to conservatives who want to provide consumers with lower cost options, moderates are concerned it could negatively impact those with pre-existing conditions. Supporters have suggested that federal subsidies could help ensure that premiums don’t increase for those who are seriously ill. The CBO is currently scoring this amendment.  

President Trump, along with Senator Rand Paul of Kentucky and Senator Ben Sasse of Nebraska, has even offered to repeal ObamaCare for now and replace it later.

Of course, no one is going to get everything they want so there must be compromises. Majority Leader McConnell has said that if the Senate is not able to pass a bill soon, Congress will have to pass a bipartisan measure to shore up the imploding health insurance markets.

And so, the Civics lesson continues. The process is at work.  As we see here the process can be long, unstable and worrisome.  Luckily for you your estate planning doesn’t have be. We at Dennis Sullivan and Associates make your estate planning and asset protection worry and stress free.  Once you have a plan in place you will feel confident knowing it will protect you, your family and your life savings.  You can enjoy life to the fullest knowing you and your family are protected no matter what unknowns lay ahead. 

 

At the Estate Planning & Asset Protection Law Center, we help people and their families protect their home, spouse, life-savings, and legacy for their loved ones.  We provide clients with a unique educational and counseling 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: Affordable Health Care, Affordable Health Care Act, Announcements, Elder Law, Estate Planning, Financial Planning, Health Care, Health Care Ruling, Medicaid, Medicare, Obamacare, Retirement, applying for medicare, Medicaid penalties, care costs, care, coverage, coverages, disenrollment, elder care, enrollment, elder care journey, federal, health, health Care act, life-care plan, long term care, medicaid qualification, medical expenses, proposed changes, senior, unreimbured medical expenses, seniors

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 | Plan Ahead for Long Term Care

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Mon, Feb 11, 2013

If you were ever a Boy Scout or Girl Scout, you remember the motto: Be Prepared.

That motto still makes sense: be prepared, especially where your health and your finances are concerned.

The following are important issues to discuss with your attorney before a crisis.

FAMILY DYNAMICS

I always tell clients that, when considering long-term care needs, they need to consider family dynamics. Are there squabbles or resentments? If so, these will probably intensify in a crisis situation.

LEGAL ISSUES

Are your legal documents up to date? If so, you're in the minority. In addition to discussing inheritance issues, I always discuss with my clients any changes they may need to make in their will or trust. Family circumstances are always changing - births, deaths, divorces, self-destructive behavior by heirs, second marriages, etc. If your documents aren't appropriate for NOW, they're not appropriate - period!

THE DOCUMENTS - ADVANCE DIRECTIVES, DURABLE POWER OF ATTORNEY, HEALTH SURROGATE, LAST WILL & TESTAMENT, LIVING WILL

These documents have to meet legal requirements, and must leave no room for doubt. And if you try the do-it-yourself approach, they may not be recognized as legal.

ARRANGING FOR FINANCIAL DECISIONS TO BE HANDLED IF YOU CAN'T

If you don't do this, you could be subjecting your family to a long and tortuous Guardianship proceeding in court. And if you don't do it right, you may be disqualified from receiving Medicaid or Veterans' benefits.

FIRST-STEP FINANCIAL ISSUES

How do I pay for long-term care insurance? Many people don't even realize they may be entitled to Medicaid or Veterans' benefits, or other resources.

CAREGIVER ISSUES

You'll need to know about community resources, housing options, caregiver options, Care Managers, etc.

No doubt you've got questions. We have the answers.

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.

We encourage you to attend one of our free educational workshops. Call 800-964-4295 to learn more about what you can do to enhance the security of your family and legacy. 

 lawyer, attorney, bostonClick Here to Register For Our Trust, Estate & Asset  Protection Workshop

 

 

Tags: living will, health care proxy, HIPAA, Estate Planning, Elder Law, Health Care, family, seniors, life-care plan

Boston Elder Law Attorney | The Veteran’s Benefits Maze

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Wed, Jul 11, 2012

So, someone you love desperately needs help; that was how I got started in the VA benefits maze...

Someone I assisted was a living widow of a wartime veteran - and she needed help to pay for long term care expenses. I had heard that there was some type of veteran's benefit available, but I didn't know exactly what it was or how to get it. To make matters worse, I should've known about VA benefits - after all, I am a full-time lawyer who works with seniors, helping them with estate planning, disability issues, and Medicaid assistance - a type of law practice called "elder law."veterans benefits

The truth is, I had actually looked into the VA's Aid & Attendance benefit, but I had been frustrated at the time and energy that it would take me to become professionally able to use the skill. Quite frankly, I needed to pay attention to the work I already knew how to do to help my clients.

Then one day all that changed and I had a rude awakening! By the time I got the call that someone I knew and cared about needed veteran's benefits to pay for care, I had gone to several different legal education classes about those VA benefits, and I still didn't know how to get that pension.

Unfortunately, that wasn't good enough. I'm an elder law attorney, and I needed to find the answers to help out my friends. I did eventually "pay the price" in time, money, and effort to learn the little-known VA rules for nursing home benefits for the over-65 wartime veteran and/or veteran's survivor spouse. Now I can help you and your family to understand when and where that VA benefit is available to help with long term medical care expenses.

As an elder law attorney, most of my clients are between 65 and 101. They are the honest, hard-working people who fought in our wars, worked in our factories, and sent their kids to college. They live on two Social Security checks and a very modest pension. They are frugal people who paid off their homes and cars, and they live without debt. Most of them were living well and happy until the wrecking ball of dementia or long term physical disability struck them. Now, the healthy spouse and the caregiving children are scrambling to find out how to pay the monthly $12,000 to $15,000 nursing home bill. They are panicked, lost, and alone.

That is where the elder law attorney comes into the picture. It is our job to help our clients and client families to get the best financial savings, best health care, and best protection for the client and other healthy family members. Families call us because they are worried that unless they find some long term care help, they will soon be out of money - and when you're out of money, you're out of options.

My firm's job is to safeguard our client and our client's family, so that they may never be out of money, and never out of options. We are their trustworthy guide through the minefield of health care, insurance, taxes, finances, Medicare, Medicaid, veteran's benefits, family dynamics, and end-of-life issues.

It is a high-stakes game, and I learned long ago - there is one law for the unrepresented person, and a seemingly totally different law for the empowered person who is represented by a capable advocate. My firm is that capable advocate for the scores of families we see every year!

Well, the end of my story is a happy one. We did get my friend a widow's pension of $1,094 per month to help her pay for her $6,000 per month assisted living fees. That way, she was able to afford several more months of private-pay nursing home care - and the dignity that comes with it.

For more information go to www.SullivanVeteransReport.com, which contains important information on the “Hidden Benefit” available to veterans and their spouses, and the steps you should be taking right now to find out if your loved one qualifies. For useful information on Alzheimer’s disease including care tips and resources please visit www.BostonMemoryLawyer.com. You will be given access to the Complete Alzheimer’s Resource Kit, sold nation wide for $197, absolutely free.

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.

Register NOW for a Trust, Estate, & Asset Protection Workshop

and receive a free Unique Self-Guided 19-Point Trust, Estate, & Asset Protection

Legal Guide with accompanying DVD!

Tags: Estate Planning, Nursing Home Costs, Alzheimer's Disease, Elder Law, Nursing Homes, elder care, assisted living, veterans benefits, estate tax, life-care plan, elder care journey

Boston Elder Law Attorney | Part Two - Feeling the Pressure of Caring for Mom & Dad?

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Jul 06, 2012

ANSWER:

Dear Feeling Pressured,

elder law, estate planning attorney, boston lawyer, massachusettsIsn't family wonderful.  Your sister's enthusiasm to pass responsibility on to you and your children is comical.  One of the caregiver tips from Alzheimer's Master Caregiver Jo Huey, in the Complete Alzheimer's Resource Kit, is to maintain your sense of humor.

You mentioned in your letter that you noticed a "significant decline" in your father's mental heakth.  It is critical for your family to stay on top of the situation, it is possible that your mother may be hiding her concerns from the family.  She is dealing with many new challanges as a result of your father's declining mental health.  Perhaps she does not want you to think she feels you should be responsible for their care.  I want to be sure that you and your mother are clear that she does not have to handle your father's care alone.

After a lifetime of caring for each other, spouses are often reluctant to ask for help from children or an outside agency.  The epxectation, responsibilities and even the change in roles can be overwhelming.  In your father's case, he has become dependent rather than a provider. 

As Elder Law professionals, our main conern isn't that you move in with your mother and provide support but that your mother receives support from somewhere.  Your parents may be at "that stage", when it is time for you and your family to make a family plan.  We have helped a number of families in Massachusetts with our unique Life Care Plan.  We like to think of the life care plan as a GPS that guides you and your family along the often times difficult Elder Care Journey.  For more information on how a Life Care Plan from Dennis Sullivan & Associates can provide peace of mind for you and your loved one register to attend a free educational workshop hosted by our team of Estate Planning & Elder Law professionals. 

Your mother may be so upset by your sister's phone calls because the calls make her aware of the seriousness of the situation.  The behaviors you see on a visit are likely very different from the burdens of day to day care.

Remember, being a good daughter does not mean you have to surrender your own life.  It does however, require that you take some action to ensure your parents are safe and comfortable as the progress down the Elder Care Journey.  There are resources and help available, and our job as elder law professionals is to help families find and make the best choices for their unique situation.

Feeling Pressured, we wish you and your family all the best.

Sincerely,

The Dennis Sullivan & Associates Team

 

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

Tags: Alzheimer's Disease, long term care, Baby Boomers, Nursing Home Guide, in-home care, Health Care, family, elder care, assisted living, life-care plan, elder care journey

Massachusetts Elder Law Attorney | Feeling the Pressure of Caring for Mom & Dad?

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Jul 06, 2012

Question:

I am the youngest of 7 children.  boston estate planning attorneyBeing the youngest, I was very close with my parents.  In fact, I still live within 7 miles of their home.  I am a single mother with 2 kids of my own still living with me and I work a full-time job. Because of my close proximity to my parents, I have spent the most time with them.

Recently, my older sister, who is 18 years my senior, noticed that my father's mental health is not as sharp as it used to be.  I do agree with her that he has shown some decline.  That however, is not the problem.  The problem is that she is telling my mother that I should move into their home so that I can take care of them.

I love my parents, but a move would be ridiculous.  It would disrupt my children's school and social routines and I would be further away from my job.  My mother is on top of the situation in her home, for now, but in time a decision will have to be made. 

My mother has not asked for my help, and I have not offered.  Everytime my sister calls my mother becomes anxious and agitated.  These phone calls really seem to upset my mother.  How do I get my sister to stop with these upsetting phone calls.  My mother and I honestly believe that she is able to handle her own life right now.

From,

Feeling Pressured.

Stay Tuned for Our Answer in Part 2 to follow

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 also invite you to visit www.bostonelderlaw.org for more information on Elder Law and what an Elder Law Attorney can do for you

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.

Register Now and receive a free Unique Self-Guided 19-Point Trust, Estate, & Asset Protection

Legal Guide with accompanying DVD

Nursing home care is more than $140,000 per year! Attend this FREE educational seminar to learn:

  • How to protect your home and assets from the costs of long-term care
  • How to stay out of the nursing home and access in-home care
  • How to make sure your spouse is not left financially ruined if you need nursing home care
  • How to access Veterans benefits to pay for long-term care

       To register or call (800) 964-4295 (24/7 or online at www.SeniorWorkshop.com 

Tags: Alzheimer's Disease, in-home care, family, elder care, life-care plan, elder care journey

Massachusetts Alzheimer's Lawyer | Do I Tell My Loved One They Have Alzheimer's?

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Jun 15, 2012

This is a topic that’s been debated for years, and the experts are no help. Some feel that people with Alzheimer’s should be told, and some feel they shouldn’t.

Perhaps the best way to decide is to think about your loved one’s possible reactions. Will they take it in stride, or will they fall into a deep depression? Will knowing enable them to cope better, or will it make them give up?

 Alzheimer's Disease, elder care, elder care journey, family, life-care plan, Nursing Home Costs, Nursing Home Guide, Medicaid, MassHealth, veterans benefitsIt’s probably best to assume that if you don’t tell them, someone else might slip which might be devastating. Their doctor may be the best one to tell your loved one, if there’s a good relationship (with a family member present). Afterwards, it’s a good idea to call a family meeting and tell everyone at once.

These days, family meetings, especially when legal or financial matters are involved, are not always love-fests, so you might want to hold meetings dealing with these issues without your loved one present; the last thing they needs now is more stress.

Allow your loved one to grieve, allow your family members to grieve, and allow yourself to grieve. You may want to speak with them about early-stage Alzheimer’s support groups, to give them a forum to express their feelings, and to hear other patients’ feelings as well. This will likely help you as well because you’ll meet other people taking care of their own parents.

A few quick tips: Family-members should work as a team. Choose your battles and allow yourself the luxury of an occasional laugh because you’ll need it.

At Estate Planning & Asset Protection Law Center, we practice Elder Law, and we have ways to help you get through these difficult times.  To access the Complete Alzheimer’s Resource Kit and gain free online access to more Alzheimer’s care tips as well as other useful information on Alzheimer’s, please visit www.BostonMemoryLawyer.com.  To listen to an interview with master Alzheimer’s caregiver Jo Huey in which she covers several tips on providing the most effective care for a love one with Alzheimer’s visit our Podcast page.  We also encourage you to attend one of our free educational workshops hosted by our team of professionals in Wellesley, Massachusetts.  To register register online or call (800) 964-4295 (24/7). 

 

Tags: Nursing Home Costs, Alzheimer's Disease, Medicaid, MassHealth, Nursing Home Guide, family, elder care, veterans benefits, life-care plan, elder care journey

Elder Law Perspective on Taking Early Social Security Payments

Posted by Wellesley Estate Planning Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Tue, Jun 12, 2012

Much has been written recently about the pros and cons of taking Social Security early at age 62 vs. waiting till full retirement age (which gradually increases till it reaches age 67 for those born in 1959 and later).  One article discussed why it could be a huge mistake to take Social Security early.  What wasn’t included in the discussion turns out to be a big blind spot.  There is no mention of how long-term care costs might impact the decision.

Elder Law, Social Security, Long-Term Care, MassHealth, expenseAdvocates of waiting till full retirement age point out that the payment, after adjusting for inflation, can be as much as 75% more than the payout at age 62.  In the case of a married couple, if the spouse with the higher earnings waits till full retirement age to collect and dies first, the surviving spouse will receive the greater of the two payouts.  So a decision to take benefits early could impact the spouse as well.

Of course, no one knows how long either spouse will live and the idea of taking Social Security 5 years early is appealing.  “Give me some money now since I don’t know if the whole Social Security system will go bankrupt.  It will also take approximately 6 to 8 years at the higher payout before the decision to wait becomes the better result in terms of total dollars received and who knows if I’ll live that long.”

Both considerations are valid ones.  However, in the whole analysis, what’s missing is any discussion as to how your Social Security benefit impacts long-term care.  And that can be a huge mistake.  Many retirees are – and will continue to – rely heavily on Social Security benefits as a large part of their retirement plan.  Getting a few hundred extra dollars a month could have a significant impact on their lifestyle.

But, it is so common for people to look at retirement without any consideration at all of how they would pay for a large long-term care expense.  Many Americans will not be able to afford to privately pay for very long and may need to qualify for government needs based benefits, the MassHealth program.

Many of MassHealth’s programs have a strict income cap, $2,094 per month in 2012.  Social Security and pension are typically the income that is looked at to determine eligibility.  These amounts can’t be changed.  Once you lock into a number, that’s it, except for cost of living adjustments (but MassHealth’s income cap is tied to the same Cost Of Living Adjustment).

We have so often had clients whose income exceeds the income cap by only a few dollars.  As a result they are ineligible for many of Medicaid’s community programs that might allow them to stay at home and get government assistance with their long term care needs.  So, in considering whether to wait and take a higher Social Security payout, one might want to consider whether that will make a whole lot of government programs completely out of reach for me.  That may or may not change anyone’s mind but it is certainly information we’d all like to know all the consequences before making such an important and irreversible decision.

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 our 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 invite you to join us for a free educational workshop hosted by our team of estate planning and elder law professionals.  By attending a workshop you will learn more about how you and your family can take advantage of community programs that can soften the financial impact of caring for a loved one.  To register please visit www.MASeniorWorkshop.com or call (800) 964-4295 (24/7).

Tags: Elder Law, long term care, Medicare, Baby Boomers, social security, Medicaid, MassHealth, family, elder care, social security, seniors, assisted living, veterans benefits, life-care plan, elder care journey

Massachusetts Senate Acts to Reform End of Life Care

Posted by Wellesley Estate Planning Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Wed, Jun 06, 2012

LINK: http://www.forbes.com/sites/howardgleckman/2012/05/25/mass-moves-to-require-end-of-life-talks/

From Forbes (May 25, 2012) “Mass. Moves to Require End-of-Life Talks”

WBUR radio and Kaiser Health News are reporting that the Massachusetts Senate has quietly approved a measure requiring doctors and nurses to discuss end of life options with patients who have a terminal illness. Health Care, Elder Law, Loved One, Family Member, Elder Care, aging, reform, The Palliative Care Awareness bill was included as part of a sweeping health reform measure and, remarkably, was not controversial. It was supported by both Republicans and Democrats and by a wide range of advocacy groups, including leading right-to-life organizations.

So far, at least, the fate of the Massachusetts bill is a far cry from what happened when Congress tried to include similar end-of-life discussions in the 2010 Affordable Care Act. There, a measure to pay doctors for having these conversations with all their Medicare patients was killed after Sarah Palin and other GOP critics blasted the law as a back-door way to create “death panels.” Later, the Obama Administration started but abandoned an effort to take a similar step administratively.

Few states have moved to require end of life discussions, although New York has a similar counseling law. However, many states have adopted MOLST (medical orders for life sustaining treatment) or POLST (physician orders for life sustaining treatment) forms that provide a mechanism for patients, their families, and their physicians to write down a patient’s choice of end of life care. In some states, providers such as nursing homes are required to complete such forms for their residents.

While the Massachusetts proposal is a good one, the 2010 health reform version may have benefited seniors more because it would have encouraged doctors to initiate these important discussions at a patient’s first Medicare check-up. An early conversation, long before a patient has a serious medical crisis, is key first step that helps the patient think about these issues in a non-threatening environment. And while a patient can always amend her wishes as she ages or becomes ill, that initial discussion is an important tool for a doctor to understand her patient’s point of view.

It is not clear if the Massachusetts measure will be included in a House version of the bill, which is expected in about a month. Despite its shortcoming, this is an important initiative. 

For more information on how the Estate Planning & Asset Protection Law Center of Dennis Sullivan & Associates can help you and your family as loved ones progress on the Elder Care Journey we invite you to join us for a FREE educational workshop hosted in Wellesley, MA.  To register for a workshop please visit www.MASeniorWorkshop.com or call (800) 964-4295 (24/7).  We also encourage you to look into our free guides and reports available on our website www.Dsullivan.com

We look forward to seeing you in our next workshop

Tags: Alzheimer's Disease, Elder Law, asset protection, Medicaid, MassHealth, Health Care, elder care, assisted living, life-care plan, elder care journey

Answers for Framingham Veteran's Benefits

Posted by Wellesley Estate Planning Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Fri, Aug 26, 2011

The Question

 My father fought in WWII and died in January 1993. My mom presently lives in an Assisted Living Community.  My mom is 92 years old and cannot live on her own anymore.  Would she qualify for a VA benefit of any kind?  How would I go about obtaining this information to help my mom. Her Assisted Living Community costs her more than $3500 a month. Mom sold her house but once the money runs out I worry what will happen and how she will be cared for?  I would appreciate any information you could give me.

 Answers for Massachusetts Veterans

The good news is as a surviving spouse your mother may be eligible for an “Aid and Attendance” benefit.  In order to qualify for this benefit your mother must have limited assets and low yearly Income for Veteran’s Administration Purposes (IVAP).  You should locate your town or region’s Veteran’s Service Officer who is critical to the filing of an application with the local VA regional office. 

Qualification:

There is a two-part test for qualification, an assets test and an income test.

I. The Asset Test

In order to qualify to receive benefits your mothers total net worth, less certain exemptions allowed by the Veteran’s Association, should be under $50,000 (home, vehicles, life insurance policies).  It may be possible to qualify for benefits if yourVeteran's Benefits Natick total net worth is greater than $50,000 but being under that number greatly increase an applicant’s chances of qualification.

II. The Income Test

The countable income for veterans’ benefits is determined by taking an individual’s gross income and subtracting from that all of their unreimbursed medical expenses to determine their IVAP, which is ultimately used to determine whether or not a person qualifies.  For your mother, a surviving spouse with no dependents, her IVAP cannot exceed $1,056 per month. 

 The cost of an assisted living facility, and even part or all of the cost of an independent living facility, can also be an allowable medical deduction to reduce a veteran’s gross income to a much lower net countable income that may qualify him or her for veterans’ benefits. It is very important to meet with a knowledgeable veteran’s service officer or an experienced elder law attorney for a pre-filing consultation to determine whether or not a veteran may qualify. It is also important to review the estate planning work to see what may be done to assist the veteran in qualifying for this particular benefit. There may be planning steps that can be implemented before applying that will help a veteran or widow to qualify and or obtain an increased benefit.

Determining what is the countable income as measured by the Veterans Administration is very confusing to many individuals in. An attorney skilled in elder law and accredited with the Veteran’s Administration can provide a veteran and the veteran’s family with appropriate pre-filing consultations to determine the appropriate steps that must be taken to be able to determine if it would be right to apply for this VA benefit. 

 If you are in Massachusetts and would like to discuss Veteran’s Benefits more extensively, please call our office at (781)-237-2815 or register to attend one of our free educational workshops.  You can also access our free Nuts & Bolts Guide to Veteran’s Benefits and learn what you can do to maximize your benefit.

Tags: massachusetts estate planning strategies, Nursing Home Costs, Elder Law, Metro West Estate Plan, life insurance, social security, Nursing Homes, Health Care, assisted living, veterans benefits, life-care plan

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