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

Is your Planning Stuck in Limbo?

Posted by Dennis Sullivan & Associates on Thu, Jul 27, 2017

How does the debate over Health Care Reform affect you and your estate plan?

Everyone is talking about health care reform: whether it’s the House bill, Repeal & Replace, Skinny Repeal, it can make your head spin.  One question on everyone’s mind is how changes to health care will affect them.  We at Dennis Sullivan & Associates are keeping up to date on all the changes, and will cover the process through a series of blogs to explain where health care reform is now, how it affects you and what the future may hold.  For more information on the current law of the land, you can download our Report: Senior & Boomers Guide to Health Care Reform

 


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Eventually, both the House and Senate must vote on the same bill.

The battle continues in Washington over the repeal or replacement of the Affordable Care Act (ObamaCare) and as we are witnessing; this can be a messy process. 

Why Republicans are trying so hard to repeal and replace ObamaCare and how they are going about it:

ObamaCare, you may remember, was passed by the Democrats in 2010 with no Republican support. Ever since, Republicans have campaigned on repealing the program, which was unpopular with many Americans. “Repeal and Replace” was their rallying cry to voters to help them win back control of the House in 2012, then the Senate in 2014, and finally the Presidency in 2016. If the Republicans are not able to fulfill this major promise, some may be in danger of losing their seats in the next election, as they would likely be blamed for the problems with ObamaCare if they don’t fix them. These are the political reasons.

Democrats admit that ObamaCare has problems and needs a major fix to survive. But they are not on board with repeal and replace of such a signature piece of legislation, while Republicans try to find a way to pass new legislation.

The Legislative process:

The normal legislative process is that a bill begins in the House, where it is written, discussed and approved by a committee before the House votes on it. If it passes the House, it is then sent to the Senate. The Senate can vote on the same bill, make amendments to the House bill, or create its own bill. Eventually, both the House and Senate must vote on the same bill, so if there are differences, members of both the House and Senate meet in committee to resolve them. Once a bill passes both the House and Senate, it is then sent to the President who can sign it into law or veto it.

Right now, there is a House bill on health care that has passed the House, and a Senate bill that has not passed the Senate. Discussions and amendments are still occurring with the Senate bill in hopes it will pass soon. The public posture is that this messy legislative process is making the bill better.

Further complicating this process is that while the Republicans have a majority in both the House and the Senate, they only have 52 Republican Senators. 60 votes are required to overcome the filibusters and pass new legislation, so they are attempting to pass health care legislation through the Budget Reconciliation process. It only requires 51 votes, but it limits the legislation to budget-related items only. They would not be able to include provisions some Republicans want in a full repeal and replace bill—for example, letting insurance companies sell across state lines to increase competition, lower prices and create better plans; and allowing the government to negotiate lower drug prices. Issues like these would have to be voted on later.

For the Senate bill to pass in Reconciliation, 50 Republicans must vote for the bill, since no Democrat or Independent is expected to vote for the bill. Vice-President Pence would break the tie if needed.

So far:

The Senate rejected a proposal from Republican lawmakers to repeal Obamacare on Wednesday July 26, 2017, marking a significant milestone in the Republican Party's years-long political crusade to gut former President Barack Obama's legacy health care law.

 

What does the future hold?

We aren’t sure what the future American Health Care Act is going to look like, not sure anyone does, but luckily protecting yourself and your loved ones from expensive long term care doesn’t have to be so uncertain.  With asset based long term care products, there are ways to insure your control over your future long term care and insure you have something left over for your spouse, children and loved ones. Don’t let your long term care plan sit in limbo. Stay tuned we will discuss more about what the future looks like in our next blog post.

 Click here for more information on  Estate Planning and Asset Protection

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.

If you would like more information on Medicaid, the Affordable Care, or the impact of new health care laws on your planning, request your free preview of our guide, the Senior & Boomers’ Guide to Health Care Reform & Avoiding Nursing Home Poverty. 

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 Act, Announcements, Dennis Sullivan, Elder Law, Estate Planning, Estate Planning Recommendations, Estate Planning Tip, Financial Planning, Health Care, Health Care Ruling, Medicaid, Medicaid penalties, Medicare, Obama, Obamacare, Retirement, care costs, coverage, unreimbured medical expenses, surviving spouse, senior, coverages, applying for medicare, elder care

What to Know Before You Enroll in Medicare

Posted by Dennis Sullivan & Associates on Fri, Feb 10, 2017

WHAT TO KNOW BEFORE YOU ENROLL IN MEDICARE

 Three critical things to know to keep your healthcare costs in check and make smart decisions.

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  1. The importance of enrolling in Medicare on time

It sounds like a no-brainer, but most people don’t realize that the effects of procrastination in their enrollment can cost them a rise in their part B premiums (these are the premiums that cover medical services) by 10% for each year they were eligible for Medicare but didn’t enroll. The “Initial Enrollment Period” is 7 months long, beginning three months before your 65th birthday and ending three months after. You may still enroll during the “General Enrollment Period” (from January 1 – March 31 of each year), however coverage won’t begin until July and be advised that you may have a late penalty. 

Another item to note: if you’re already receiving Social Security benefits before your 65th birthday, you may be automatically enrolled in Medicare (you’ll receive notification in the mail via a Medicare card in the 3 months before your 65th birthday if you are automatically enrolled) Special enrollment periods are available for  people who are either working as a volunteer abroad or still working at age 65 with employer-provided healthcare coverage.

  1. Which plan is right for you?

There are two main plan choices for a Medicare enrollee – the “original” Medicare plan or a Medicare Advantage Plan. Read on to discover the basic components of each plan and which is best for your needs.

 The “Original” Medicare Plan includes:

  • Part A: hospital coverage
  • Part B: physician/medical insurance
  • Part D: optional, provides prescription drug coverage
  • Enrollees can also opt to add on a private ‘Medigap’ plan which will pay for more of what Medicare doesn’t cover

 Medicare Advantage Plan, sometimes a better option than the Original Medicare Plan, are regulated by the US government although they are offered by private insurers. These plans are required to offer at least as much coverage as the original Medicare Plan and many often include prescription drug coverage as well as vision, dental or hearing coverage.

The Medicare website offers a helpful tool – the Medicare Plan Finder to help you compare your plan options. Whichever plan you choose, be aware that you may choose a different plan the following year.

  1. Take Advantage of the Available Services

Screenings and preventative care may sometimes be available at no extra cost, in addition to the wellness benefits included in your coverage. One annual wellness visit to your primary care doctor is included at no extra charge in your membership. You may also be eligible to other perks such as discounts on gym membership.

 In conclusion, following the tips above to make the most of your Medicare enrollment can enable seniors to live a longer and healthier life.

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.

If you would like more information on Medicare, the Affordable Care, or the impact of new health care laws on your health care coverage, request your free preview of our guide, the Senior & Boomers’ Guide to Health Care Reform & Avoiding Nursing Home Poverty.  

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.

Sources: Fox BusinessNews

Tags: Medicare, seniors, elder care, Elder Law, Health Care, applying for medicare, health, care costs, medical expenses

What will 2017 bring to Seniors and Persons with Disabilities? - Part I

Posted by Dennis Sullivan & Associates on Thu, Jan 19, 2017

What will 2017 bring to Seniors and Persons with Disabilities? - Part I

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Donald Trump’s election and Republican majorities in both houses of Congress surprised much of the nation. With control of legislative and executive branches of government, the expectation is Republicans will finally be able to push through long-awaited legislation, as well as follow through on promises made by candidate Trump. And they are expected to move quickly.

We will summarize some key issues to watch out for in 2017 that affect seniors and persons with disabilities and continue to provide updates throughout the year.

What the Election Outcome Means in Congress

The House has remained in Republican control—about 45% Democrat and 55% Republican. The majority rules, so while the Democrats may have loud opposition, they don’t have a lot of power. Currently, Republicans are mostly united, but those in the Freedom Caucus (Tea Party Republicans) are deciding how they will interact with the Republican establishment. If they split, votes may be needed from Democrats to pass legislation.

The Senate is 48 Democrats and 52 Republicans. 60 votes are needed to prevent a filibuster (where senators can talk for hours and delay votes). But with budget reconciliation, only a simple majority (51) is needed to pass legislation in the Senate. Because they are all budget-related programs, the Republicans will try to reform Medicaid, Medicare and the Affordable Care Act (Obamacare) through budget reconciliation. Individual Republican senators will have a lot of power, as some may insist on additions or deletions to secure their vote. If the Republicans do not stick together for the majority, votes may be needed from Democrats. (Note: Budget reconciliation was used to pass the Deficit Reduction Act of 2005 and OBRA 93, which enacted big cuts that changed elder law—the lengthening of the transfer penalty, the change in the time of when that penalty applies, the move from trust.)

One thing to watch is who is going to run Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) and the Social Security Administration, especially considering how much is related to Supplemental Security Income (SSI). The people now in charge of staffing these agencies are conservative. For example, the person in charge of staffing the political positions at the Social Security Administration has called for privatizing Social Security in the past. Donald Trump has repeatedly said he doesn’t want to change Medicare and Social Security, but that may be changing. (See below.)

Tax Policy

Tax changes are expected as part of the budget reconciliation process. We are not sure yet if 2017 will bring major tax reform or just tax cuts, but tax rates are expected to decrease for both individuals and businesses. Candidate Trump called for elder care and child care tax deductions and/or credits. He has also stated his plan to eliminate the federal estate tax, then charge capital gains tax on everything over $10 million, with exemptions for family farms and small businesses.

We may also see some changes to the ABLE Act (Achieving a Better Life Experience), which passed in December 2014 and amended Section 529 Plans. Currently, ABLE allows people with disabilities developed before the age of 26 and their families to set up tax-exempt savings accounts, which can be used to cover qualified disability expenses such as, but not limited to, education, housing and transportation. Revisions in 2017 may raise the age to 46, allow those working to put in more money, and allow rollovers of these accounts. 

Medicare Reform

President-elect Trump started by saying he was going to protect Medicare and Social Security. After meeting with House Speaker Paul Ryan, he said he will modernize Medicare. Reince Priebus, incoming chief of staff, recently insisted that Mr. Trump won’t meddle with Medicare or Social Security. Instead, he has said he will focus on 1) improving the economy, which will reduce the debt and ease entitlement concerns and 2) save Medicaid, Medicare and Social Security without cuts while eliminating fraud, waste and abuse. 

But he is already encountering resistance from Republicans, who for years have claimed that a major overhaul to Medicare and other entitlements are needed to ensure they don’t go bankrupt; that entitlement reform is critical to reducing debt; and the longer they wait, the harder it becomes to solve the problems. Obama administration officials warned just last year that a central Medicare trust fund is projected to run out of money by 2028.

Yet Republicans are also encouraged by what some of the President-Elect’s Cabinet picks could mean for future entitlement reform. Representative Tom Price (R-GA), who replaced Paul Ryan as Budget chairman and sought to overhaul entitlement programs, is Trump’s pick for Health and Human Services secretary. Representative Mick Mulvaney (R-SC), a fiscal hawk and Freedom Caucus co-founder, will lead his White House budget office.

So, we will have to wait and see if President-elect Trump, his Cabinet members and leading Republicans will find a way to agree. Some reforming of Medicare may be part of the 2017 budget reconciliation, but with ObamaCare repeal and replace, tax reform and infrastructure as the immediate priorities, solving the decades-long problem of deficits in Medicare and Social Security will likely have to wait until after 2017.

In the meantime, we are seeing a tilt toward Medicare Advantage plans. These managed care plans (offered through HMOs) often have lower costs and provide benefits not covered by traditional Medicare and Medicare Supplement Plans, such as health club memberships and preventative educational programs for those with diabetes and other chronic diseases. 

A long-term goal for Medicare, which has been around since its founding in 1964, is premium support. Basically, the consumer would choose a plan from those offered through an exchange. The government would provide subsidies to companies, they would lower the premiums and then people would choose their plans. It’s not likely that this will replace Medicare as we know it, but it is an idea being discussed.

Medicaid Reform

President-elect Trump has called for block granting Medicaid. House Speaker Paul Ryan has called for it, too, and Republicans are looking at whether they can reform Medicaid through budget reconciliation.

Those who want to reform Medicaid are focusing on the FMAP, the federal percentage match that states receive through federal funding. This is based on per capita income of the state. For example, a rich state like New Jersey is a 1:1 ratio, while a poor state like Mississippi is about a 3:1 ratio. This means for every one dollar that Mississippi spends on Medicaid, they will receive three free extra dollars from the federal government. This can impact states’ budget decisions. For example, if the governor of Mississippi needs to cut costs, he will more likely cut education or infrastructure by one dollar, rather than cut Medicaid spending by one dollar and lose the three free extra dollars.

The idea of block grants has been around for about 30 years. They are attractive because there are fewer federal rules to comply with and the states can use the money however they wish. But block grants shift more costs onto the states, and governors tend to oppose that.

Another idea floating around is a per capita cap, which would give the states a fixed dollar amount per individual, based on Medicaid standard lines (the blind, aged, and disabled children and adults). It was first proposed by President Clinton, who also wanted block grants. A per capita cap may force the states to control Medicaid costs over time, but there is also a demographic shift to consider—the medical needs and costs for an 85-year-old are much greater than for a 65-year-old. Nursing homes and aging disability provider groups have a huge stake in this and would likely oppose it, as would some governors.

The cost changes may not be felt right away, but they will be noticeable ten years from now and that’s what Congress must plan for. There may be increased waiver flexibility for the states and provider taxes to offset states’ losses. We may also see reforms to make it easier to manage care.

We will be following changes in legislation very closely and will keep you informed as to how these changes affect seniors and persons with disabilities. Check back next week for Part 2 of this blog where we will discuss more anticipated changes in the law including the Affordable Care Act and VA Benefit Rules!

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 learn more about elder care and how changes in the law may affect you,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.

Nursing home care is more than $180,000 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

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

 

Tags: Medicare, Medicaid, seniors, disabled, Elder Law, Affordable Health Care Act, social security, trusts, Estate Planning, New estate tax law, new regulations, retirement plans, Nursing Home, Nursing Home Costs

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 & Marriage, Do They Go Together?|Massachusetts Elder Law Attorney

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Wed, Feb 19, 2014

Medicaid, Marriage, Estate Planning

 

Ted called me concerning his step-mom, Roberta.  Roberta is in the hospital but about to be transferred to a nursing facility where she will remain on a long term basis once Medicare coverage stops.  The conversation quickly turned to Medicaid.

Ted explained that Dad and Roberta have been married 5 years.  Roberta came into the marriage with very few assets.  Dad owns the home where Ted and his brother grew up, worth approximately $500,000, and another $500,000 of additional investments.  His mom died about 10 years ago and Dad, seeking companionship, reconnected with Roberta, an old high school classmate.  Ted told me that Roberta has a daughter with whom she has no relationship and who is no help at all in caring for Roberta.

Ted’s $64,000 question was, “How much does Dad have to spend down towards Roberta’s care before she can qualify for Medicaid?”  He told me that Dad had always intended to leave his assets to Ted and his brother when he dies but now is concerned about whether that will happen.

I asked Ted some preliminary questions.  Neither Dad nor Roberta has any long term care insurance.  They also do not have a prenuptial agreement in place, although even if they did, Dad would have to divorce Roberta to invoke that agreement and protect his assets from being spent down towards her care.

So, where does that leave them?  Next time I’ll tell you.

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

Can be seen at: Click Here

Tags: Estate Planning, Medicare, Medicaid, MassHealth, Health Care, medicaid qualification, 2014

Did You Think Medicare Would Pay For That? | Massachusetts Elder Law Attorney

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Mon, Dec 09, 2013

Rehab, Mass, Masshealth

 

Many people think that Medicare will pick up the tab for most of your rehabilitation, but it doesn't always. Read below to find out more!

A common problem we often see occurs when someone goes into the hospital for surgery and then goes immediately to a skilled nursing facility (SNF) for rehabilitation (rehab).

Most people assume that the rehab stay in the skilled nursing facility will be covered by Medicare. Unfortunately that is not necessarily the case.

 The Medicare rule is that a patient must spend at least three consecutive days, meaning three midnight stays, in a hospital as an inpatient on admitted status in order to qualify for Medicare coverage for the subsequent rehab stay in a SNF.

 Unfortunately, patients may be classified as outpatient on observation status in the hospital and fail to achieve the three day inpatient stay to qualify for subsequent SNF Medicare coverage even though they are in a hospital bed for multiple days and the care they receive is indistinguishable from admitted patient care.  Observation status does not equal admitted status.

 Talk to your admitting physician. Determine whether or not your procedure will qualify as an admitted patient procedure. We have been told that sometimes your doctor may have some discretion to put you on admitted status (and not observation status) depending on the rules that he or she must abide by to comply with Medicare.

 If your doctor has any discretion in this area then he must give you the proper coding and admitted status before you leave the hospital, because after you leave, the record becomes permanent and cannot be changed.

 And a recent October 1, 2013 CMS rule unfortunately does not help Medicare beneficiaries. The new rule indicates that a two midnight standard set out in the new regulations is simply a tool for physicians to apply in making an inpatient admission decisions. Thus, if your doctor believes that you will require at least two midnights in the hospital, your doctor should admit you to admission status. But, you as the patient will continue to need three midnights on admission status to qualify for Medicare coverage in the subsequent SNF rehab stay.

 Sound confusing? It is.

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, Medicare, Medicaid, MassHealth, estate, Medicare, 2013, 2014

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

Confused About the Affordable Health Care Act (Obamacare)? | Massachusetts Elder Law Attorney

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Thu, Nov 14, 2013

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We are here to help!

The Affordable Care Act (Obamacare) provides insurance for those who are uninsured, many of whom have, unfortunately, become overcome with confusion, fear, and misunderstanding, that they are avoiding to process all together. We understand that! We are navigating the options for the people we help, but even we are little unsure of the best options for them.

But there is one thing we are sure of, its the new benefits added to Medicare recipients! These added benefits include yearly Wellness visits (an opportunity to talk about your future), and coverage for numerous procedures that were not covered before.

For more information about this confusing topic, visit our website to receive your free copy of our report, "The Senior's & Boomer's Guide to Health Care Reform and Avoiding Nursing Home Poverty."

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.

Make sure you to attend one of our free educational workshops, call 800-964-4295 and register to learn more about Obamacare, Medicare cuts, taxes, & how to avoid nursing home poverty!

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

Click the picture below for some more information on the 
"Senior & Boomers' Guide to Health Care Reform & Avoiding Nursing Home Poverty." 

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Tags: Medicare, Medicaid, MassHealth, Wellesley, medical expenses, medicaid qualification, Medicare, Obama, 2013, Massachusettes, Affordable Health Care, Obamacare

Massachusetts Estate Planning Lawyer | Jill Saved $30,000 - Part Two

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Mon, Feb 04, 2013

Medicaid, Medicare, Fiscal Cliff, Seniors, Estate Planning, MassachusettsLast week we were talking about Jill, who tried to apply for Medicaid for her grandfather, but ran into a snag. She provided the Medicaid caseworker with 5 years of financial records and was told that Granddad still had to spend down another $30,000 from accounts that Jill never knew existed.

When we looked at the statements Jill gave to Medicaid, it was clear that the $30,000 in question was in two Uniform Gift to Minors Act accounts, for which Granddad was acting as custodian for Jill.  We asked her why she gave those documents to Medicaid and Jill didn’t have a good answer. “I just figured I would give them everything and they would tell me when he would be eligible and what I needed to do”, she replied.

It’s a very common response. Many people are under the erroneous belief that the Medicaid application process is a simple one. They know there is a penalty if they gift money but, Jill’s Grandfather hadn’t done that.  He legitimately spent down all the assets so she thought she would just walk into the Medicaid office and tell them that, hand over everything and it would all be fine.  Unfortunately, it rarely works out that way and what you don’t know can really hurt you. You can’t rely on the state Medicaid caseworker because so often they are wrong. That was the case here.

You see, when Granddad set up the UGMA accounts 30+ years ago, when Jill was a young child, he irrevocably transferred the money into those accounts for Jill’s benefit. He remained a custodian of those accounts until Jill reached 21, entrusted to manage those funds for her benefit. We explained to Jill that for Medicaid purposes those funds were no longer Granddad’s so they shouldn’t be counted as his. The caseworker was wrong to tell her to cash out the accounts and spend down the funds for Granddad.

What Jill needed to do now was to transfer those accounts to her name. She was now 45 so that should have happened 24 years ago. I told her that under the UGMA law she was entitled to access those accounts. And if you’re wondering whether the transfer to an account in her name will cause a Medicaid penalty, the answer is no!  The money was transferred out of Granddad’s name more than 5 years ago when he made the irrevocable transfer, so it wouldn’t fall within the Medicaid look back period.

In fact, Granddad was taking the interest all these years, some of which went towards paying for his long term care in his later years. In other words, some of what was legally Jill’s money went towards Granddad’s care already so Medicaid shouldn’t complain about that.

Jill understood what we were saying but asked if we would step in and assist her to complete the process.  Several months later we received a favorable decision.  Jill was able to keep the $30,000 and Granddad was approved for Medicaid.

Jill was appreciative and understood the mistake she made.  We told Jill that her mistake was in relying on the state to steer her in the right direction. Luckily, we were there to save the day and save Jill $30,000.

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 beneficiaries, digital assets, Estate Plan and legacy.

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Tags: long term care, Medicare, Baby Boomers, Medicaid, Health Care, assisted living, medicaid qualification, Elder Law, Attorney

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