Time & Life Update Newsletter

February 2015 Newsletter

Posted by Dennis Sullivan & Associates on Feb 27, 2015 11:24:00 AM

Medicaid is About More than Just the Finances

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Something we always seem to need to remind clients of when we talk about Medicaid eligibility is that Medicaid isn’t just about the finances.  Meeting the income and asset limits are not the only requirements when applying, applicants also need to be medically eligible for Medicaid assistance.

What does that mean?  It means an applicant must establish the need for nursing home level care, needing assistance with the activities of daily living.  It’s one of the reasons why the planning that we do is so vital.  If you run out of money before your health is bad enough to require long-term care, you won’t be able to get MassHealth to help you.  Unfortunately it is an all too common scenario, one which we were reminded of last week.

We received a call from Jane regarding her dad, Donnie, who has been living with Jane for the last several years.  Donnie is bipolar but he functions well when he takes his medications.   It often is a struggle, however, to get him to take that medication.  Jane works during the day so she can’t always at home to monitor her dad.

Jane explained that her dad becomes somewhat agitated and occasionally wanders when he hasn’t taken his medication.  When I asked about his ability to walk, eat, bath, dress and toilet on his own, Jane replied that this isn’t Donnie’s problem.

Jane called because she wants to move her father to an assisted living facility, feeling that he now needs more supervision than she can provide on her own.  Donnie has only a few thousand dollars to his name, and he is planning to apply for Medicaid to pay for his care.

There are several problems with Jane’s plan.  She hasn’t even begun to look at facilities but when she does, she will likely find the choices very limited since it is not easy to get into a facility on Medicaid right away.  Most assisted living facilities try to use their Medicaid “slots” for their longtime residents who have spent down assets while at their facility.  Although there are a few that will take a person on Medicaid right away, none happen to be in Jane’s immediate area.

I told Jane the best solution for now is to hire someone to come to her home for a few hours a day when she is at work to keep an eye on Donnie.  The cost won’t be covered by Medicaid, but that’s one of the reasons that getting government benefits is so tricky.  The rules are complicated and the government – not you – decides whether it will provide you with assistance.  And in Jane and Donnie’s case, the answer is “not yet”.  The’ll have to go it alone for now.

Click Here to Download the Senior & Boomers Guide to Health Care Reform & Avoiding  Nursing Home Poverty

 


Don’t Forget About Rover

Who Will Care For Your Pets When You’re Gone?

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If you have a dog, cat or other pet, you know that the unconditional love and affection our pets devote to us improve the quality of our lives in ways nothing else can. This is why they deserve our respect and dedication even after we pass away or become incapacitated.

Unfortunately, if a pet owner becomes unable to care for his or her pets, they often end up living on the street. Thousands of pets are orphaned every year in the United States. To prevent your pets from adding to this sad statistic, you need to plan now for their care in the future.

One way to do this is to include your pets in your estate plan. This can be as simple as incorporating provisions for them into your Will or Living Trust. A Durable General Power of Attorney will allow an agent of your choosing to spend funds that have been allocated to your pets as he or she sees fit in the best interest of your pets.

The income is made available as ongoing Trust funds or as a gift given directly to the agent.
The first, and often easiest, way to make sure your pets are cared for is to include a request that your pets be placed with a willing friend or family member. This is done in the same way you would appoint a guardian for a child. In addition, most states allow for money from your estate plan to be set aside for the benefit of pets so that there is minimal, if any, expense for your pets’ caretaker.

Another option is to appoint a Trustee to care for your pets. This Trustee can either keep the pets in his or her own home or find someone else with a suitable, loving home to serve as caretaker. This type of “Pet Trust” also provides the Trustee with funds to be used for the pets’ benefit.

If a suitable Trustee is not available, you may want to research local animal shelters and adoption centers. If sufficient funds are allocated for the care of the pet, some locations will accept pets that are donated through Trusts and care for them until a devoted home can be found for them.

Considering Pet Insurance?
You may have noticed that in recent years veterinary science has advanced by leaps and bounds. Veterinarians today offer treatments that were unheard of only a few years ago. Treatments, such as organ transplants, once only used on humans are now available for pets. Veterinarians also have access to more advanced technology that can detect problems that, in the past, would have gone untreated. For pet owners, this means higher costs per visit and possibly expensive procedures.

Pet insurance can help you cover these new costs. It is best used to protect against unseen catastrophic expenses, not procedures you can easily pay for on your own. Pet insurance allows you to worry about your pet’s health and not how you are going to pay for it.

Some good advice when looking for pet insurance is to shop around and find the policy that best fits your needs. Remember to not only pay attention to the monthly or annual cost, but to note the differences in deductibles, co-pays and caps, which may limit payouts by incident, annually or the animal’s lifetime. Make sure that you understand the exclusions. The conditions most likely to afflict your pet are often the ones most likely to be excluded from your policy.

A few things to consider:

  • It is possible to spend more money on your pet if you have insurance than if you did not have insurance.
  • One alternative to pet insurance is to put the money you would spend on premiums into a savings account.
  • Dogs tend to wind up in the veterinarian’s office twice as often as cats.
  • Purebreds tend to have more hereditary weaknesses than the average pound puppy or cat.
  • Free-running animals have more accidents and contract more illnesses than pets that are kept under control.


Regardless of whether you decide to get pet insurance or not, it is always a good idea to think about the future. Put yourself at ease and know that you will be able to take care of your pet no matter what happens.

 

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

Tags: long term care, Medicaid, MassHealth, Nursing Homes, family, trusts, caregiver, insurance, medicaid qualification, 2015, trustee

Will You End Up Like Terri Schiavo or in Court needing a Guardian & Conservator? | Massachusetts Elder Law Attorney

Posted by Massachusetts Estate Planning & Elder Law Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Jun 28, 2012 8:48:00 AM


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You may have heard that guardianship and/or conservatorship as a bad thing - something to be avoided. In a perfect world, we could move through our lives from cradle to grave without such things as guardianships and conservatorships. But in order to achieve this perfect world, we have to do advance planning to provide for our own care if we become incapacitated. Also, we need trustworthy and responsible family members to assist us, if we need help.

As attorneys we are increasingly running into the following situations:

1.      Seniors come to us, often brought by their children or children-in-law, when mental incapacity has set in.  Although they appear to have willing and able family members who can take care of them, assist with making personal care and living decisions, or manage their finances, the seniors do not have the documents in place to empower these helpers as their agents. 

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If you need information and help to assist a family member with dementia or Alzheimer’s visit www.BostonMemoryLawyer.com where you will be given free online access to the Complete Alzheimer’s Resource Kit, a $197 Value. 

2.      Seniors have documents in place, but the people named are dead or no longer available, willing or appropriate to serve.  They may also be concerned about changes in the law, changes in their health, and changes in their financial situation.  It is good practice to review your financial and legal documents on a periodic basis.  To help clients keep up with changing situations we created the Life Time Protection Program, which provides clients with a yearly review, updates at no cost due to changes in the law, and the ability to contact our office with any questions or concerns they may encounter.  We help people make sure their critical health care proxy, HIPPA document, and list of emergency contacts are not only up to date, but available 24/7, anywhere in the world AND we pay for our clients to have access to this service because we believe it is so important. 

With important medical privacy laws such as HIPPA becoming more strictly enforced by hospitals and medical facilities, making sure you have the right authorization is more critical than ever.  Without proper authorization, your loved ones, including your spouse, children, and parents, may not be able to assist you when you need it most.  If you don’t have the proper authorization you may not be able to help loved ones when they need you.  Because of the strictness of HIPPA, it is more critical than ever that you have current and effective health care proxies, HIPPA release forms, and durable powers of attorney.  Clients should contact our office in order to review and update their documents over the mail or to schedule an appointment.

Crisis Situations

Another increasingly common situation is where seniors do not have agent-delegation planning in place and end up in a medical or living condition crisis where they are putting themselves or others at risk. Loyal family members and friends are very concerned, but nobody has the power to assist once they find out.  No one should end up like Terri Schiavo.  Ms. Schiavo did not have complete health care documents spelling out her wishes in the event of her incapacity or irreversible terminal illness.  Her husband and parents waged war through years and years of heartfelt legal battles…not to mention heartbreak, tears and hard feelings.  If you do not have the appropriate healthcare and disability documents your loved ones may be subjected to the same hardships as Terri Schiavo’s family in the event of your incapacitaty. 

Alternatively, seniors may have excellent voluntary delegation planning in place, but the seniors are noncompliant about what they now need to do for their own safety and care. For example, they may need to live in an assisted living community or nursing home, but they voluntarily check themselves out and depart. They are free to make their own decisions, even though imprudent or unsafe, so they can walk right out and put themselves in danger. If they have access to an automobile, they put the general public at risk as well.  If you or a parent would like to learn more about senior living options please contact our office at (781) 237-2815 and request information about Life Care Planning and Senior Living Options.  We have helped clients find the living situation that is right for them, and get the care they need without sacrificing their hard earned life savings to pay for it. 

Adult Protective Services

In emergencies, where the seniors are unwilling to cooperate and their intransigence is putting themselves or others at risk, often the first call should be to Aging Service Access Point (ASAP). ASAP is a state agency, typically within the department of "human services" or "elder services". ASAP generally will appoint a social worker or staff person to investigate, perhaps with local police in order to gain access to the senior and entry into the home.

Seeking Court Protection

Whether or not ASAP gets involved, and whether or not the case is an emergency or just a situation where the senior needs help and is not willing or able to sign voluntary agent-delegation documents, the solution is often a guardianship and/or conservatorship over the senior, if he or she meets the applicable standards of incapacity.

Guardianship

elder law, alzheimer's disease lawyer, estate planning attorneyTerminology varies from state to state, but in general, guardianship (sometimes called "guardianship of the person") applies to probate court appointment of a fiduciary ("guardian") to make decisions in regard to the protected person's personal care.  A guardian generally does not have control of the protected person's finances, although state law or the specific terms of the guardianship may authorize the guardian to hold small amounts of the protected person's funds if no conservator has been appointed and the protected person does not have a durable power of attorney.

Conservatorship

Conservatorship refers to probate court appointment of a fiduciary ("conservator") to administer the finances of the protected person. Conservatorship is much like trusteeship, although the powers of and restrictions on the conservator are defined by statute and regulation, rather than a voluntary trust agreement or trust declaration, and are typically are much less flexible than the powers authorized for trustees. Conservatorships are also analogous to durable powers of attorney. However, one of the key differences between conservatorships, trusts and durable powers of attorney is that conservatorships are court-supervised and directly accountable to the court. It is common for conservators to be required by state law and regulations to account annually to the probate court. Such accounting needs to be accurate to the penny.  

A conservator does not have plenary power to do whatever financial transactions he or she feels are warranted. For example, a conservator needs specific court authorization to sell real estate in most states.

Imposing Minimum Restrictions

For a guardian and/or conservator of an adult, the probate code generally imposes a standard that the protected person's rights are to be removed to the minimum degree necessary to protect him or her. This is because the removal of personal rights and liberty by the court is analogous to a civil form of imprisonment. Where a protected person is capable of making some kinds of decisions safely and prudently in regard to his or her living conditions, care, or finances, the theory is that his or her rights to make such decisions should be preserved as long as possible. On a practical level, keeping seniors involved in their care and financial decisions also helps to keep them engaged with life, reality, and higher mental functions, so this legal construct is very consistent with practical experience in care giving for seniors who are in a process of deteriorating mental capacity. There is a growing movement nationwide to maximize decision-making by adults who are under guardianship and/or conservatorship.

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Although attorneys correctly advise clients to plan to avoid unnecessary guardianship and conservatorship, there are many situations where a guardianship and/or conservatorship is appropriate and very beneficial. Court supervision in difficult cases can be beneficial to impose financial accountability and to bring about sound decisions for the care of a protected person. Under modern guardianship and conservatorship theory, courts impose the minimum restrictions on protected persons that are needed to accomplish the personal safety and prudent financial management that are the goals of these court-supervised protective measures.

Estate Tax Increase Pending

Since Massachusetts continues to tax all estates over $1 million, it is important to make sure your planning is current so that a completely avoidable estate tax is not triggered at the first death due to the TEMPORARY extension of the Bush estate tax law.  Please note however, that the temporary extension is set to expire at the end of 2012.  As a result, without congressional action a federal estate tax of up to 50% will also apply to all estates above $1 million after January 1, 2013.

Review & Update to Maintain Control of Financial & Health Care Decisions & Reduce Taxes

For clients, once we receive your information we will contact you to arrange for updates to be done via mail or to schedule an appointment to come in and to review your situation in person.  The entire process is quick and painless and you will have the peace of mind of know you are prepared for 2012 and beyond, even with the federal estate tax increase scheduled for January 1, 2013.  

Our team’s ultimate objective is to help you and your family to accomplish your estate planning and asset protection goals.  If you’ve recently signed your estate planning documents you are included in the Lifetime Protection Program at no cost for the first year.  If you have a friend or family member who would like our help please let us know!  If your friend or family member becomes a client you get One FREE YEAR Membership in the Lifetime Protection Program. 

If you have any questions or would like to discuss questions raised in this newsletter please feel free to contact our office. 

We encourage you to attend a free educational workshop hosted at the Estate Planning & Asset Protection Resource Center in order to learn more about how a review by our dedicated team of professionals can help identify problems in your existing planning as well as where opportunities for improvement may exist.  You CAN create a plan to protect your spouse, home, and life savings.  To register call (800) 964-4295 (24/7).

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Tags: long term care, Alzheimer's Disease, Estate Planning, Lifetime Protection Program, elder care journey, durable power of attorney, Health Care, health care proxy, Elder Law, HIPAA, seniors, non-family caregivers

Will Medicare and Social Security Be There When YOU Need Them?

Posted by Dennis Sullivan & Associates on Jul 8, 2011 1:18:00 PM

Approximately 55 million retirees, the disabled, and children who have lost parents receive Social Security benefits. More than 46 million Americans are covered by Medicare. As the number of new Medicare and Social Security beneficiaries rises sharply with the upcoming wave of retiring Baby Boomers, can these programs continue to be viable?  Experts predict that Medicare will be exhausted by 2024 and Social Security will be bankrupt in 2036.

"The financial shortfalls confronting both Social Security and Medicare are substantial and -- absent legislation to correct them -- quite certain," wrote Charles P. Blahous III and Robert D. Reischauer, two trustees of Social Security and Medicare.   "Elected officials will best serve the interests of the public if financial corrections are enacted at the earliest practicable time."  Solutions that are undertaken early can be more of a gradual cure as opposed to last-minute, painful remedies like high tax increases and deep benefit cuts.

What’s Happened?

The sluggish economy is hurting Medicare and Social Security because fewer people are working and contributing payroll taxes that fund these programs.  Medicare also suffers the high cost medical care.  In addition, people are living longer and having costly procedures like bypass surgeries and hip replacements later in life.

What Does Medicare Cover?

Medicare is our countrywide health insurance program for people 65 or older and is financed by payroll taxes paid by workers and employers.  It is also partially funded by monthly premiums deducted from Social Security checks.  Medicare assists with the cost of health care but does not cover all medical expenses or most long-term care. The program has 4 parts:

  • Hospital Insurance:  for inpatient care, some in-home care and hospice care;
  • Medical Insurance:  for doctors' services and other miscellaneous medical services and supplies not covered by hospital insurance;
  • Medicare Advantage:  These plans are available in many areas so that people with Medicare Parts A and B can choose to receive all their health care services through one of the provider organizations under Part C.
  • Prescription Drug Coverage:  for doctor prescribed medications.

What Is The Government’s Response?

American seniors have worked hard, contributing to Medicare and Social Security for decades.  With the looming U.S. deficit at issue, however, those benefits are now at risk because Congress is considering dangerous cuts to Medicare and Social Security.  There are many efforts in place to fight for cuts to be made to wasteful government spending instead of hurting these valuable programs.

According to reports, the Social Security benefits for disabled Americans and their dependents would be the first to dry up with funding scheduled to run out in 2018.  The part of the fund that pays retirees, however, has enough money to stay solvent until 2036.

If nothing is done to remedy this before then, benefits will have to be cut by 23 percent or the Social Security payroll tax increased to16 percent or some combination of the two.   

Recommendations?

For future planning, the best advice for maximizing Social Security benefits is to continue to work as long as possible and to delay retirement to age 70, if possible.  It is also a good idea to have some long-term care insurance - just in case.

Along with this, understanding strategies that married couples should use is key.  Many people benefit from claiming later and too many claim early – not usually a good idea.  In some instances, the lower-earning spouse should claim as early as possible and the higher-earning spouse as late as possible.

To get an idea of your monthly Social Security benefit, login to the Social Security website. (Visit the Social Security Administration’s benefit calculators website.)  Also, read The National Academy of Social Insurance’s report, ‘When To Take Social Security: Questions to Consider.’ (Read the report from the National Academy of Social Insurance here.)

For Medicare to remain viable for the next 75 years payroll taxes would have to be increased by 24 percent or current benefit payments cut by 17 percent.  The longer the US waits to address the pending shortages in Medicare and Social Security, the more painful it will be.  Delaying good fiscal planning for Medicare’s future now may mean cuts for current beneficiaries rather than diminishing them for people who enter the program in the future.

This could mean that by age 65 or older the average individual could need $300,000 set aside for medical expenses and $300,000 for long-term care if you do not buy a long-term care insurance policy. 

The bottom line here is simple.  Social Security and Medicare will probably be around for many years to come; however, these programs should start to be viewed as supplements rather than primary sources of retirement income and health insurance. 

To learn more about your options, call us at 781-237-2815 or to attend an upcoming Trust, Estate & Asset Protection workshop, call 800-964-4295 or register online .

For more information on how you can plan ahead to maximize your retirement earnings and protect your assets, visit our website to download our free guide on “The 7 Biggest Mistakes in Retirement & Estate Planning.” 

 

 

Tags: in-home care, long term care, Medicare, social security, Retirement, Nursing Home Costs

What is "Life-Care Planning" and Does It Apply To Me?

Posted by Dennis Sullivan & Associates on Jun 24, 2011 4:08:00 PM

Life-Care Planning is a new area of elder law that helps families respond to the challenges presented by long life, illness and disability.  Life-care planning is about being an advocate for your loved one in every long-term care setting and assisting the family with those overwhelming decisions.

A Life-Care Plan includes the following:

  • Legal Care, estate planning, including wills, trusts, powers of attorney and advanced directives; Medicaid planning; guardianships; and protection of the elder's right to safe and effective care for which he/she is entitled.

  • Care Coordination, which includes locating in-home help and services, coordinating home health care and long-term care, family education and decision-making support - for the rest of your loved-one's life.

Life-Care Planning in Practice

Picture you and your wife and your close friends Kathy and Joe - all in your late 60s.  You get together often and enjoy talking about wintering in Florida, lots of golf and enjoying your retirement years.

One day, Joe suffers a serious stroke which leaves him partially paralyzed.  He will need full-time care.  Joe's wife, Kathy, however, cannot provide the full-time care he needs on her own so she seeks the help of their daughter.  The daughter is very willing to help, but she has a family of her own and is subject to her family's needs as well.  Therefore, Kathy will have to get some in-home care for Joe to supplement what she and her daughter can do.

The end result here is that Kathy and Joe’s lifestyle has completely and unexpectedly changed.  Their financial stability is now also at risk with the high cost of in-home care, which is quickly depleting their savings and putting their other assets in jeopardy.  If this continues, Kathy faces the real possibility of becoming an impoverished spouse if she lives long into her senior years. 

Time to Assess Your Situation

This is truly a heartbreaking situation, but not an uncommon one.  Fearing the same thing could someday happen to you, you and your wife decide to consult with your estate planning and financial team. 

You have no children, so you cannot count on them to help in case of a debilitating illness or injury.  Imagine your legal and financial team reviewed your current assets and retirement plan.  You have paid off your house, faithfully saved money in your 401(k) accounts, and have a healthy IRA.  You even have a cottage on Cape Cod.  A devastating illness, however, is no match for the typical American’s retirement savings. 

The current cost of a nursing home is $12,000 per month, $144,000 per year and $720,000 for a 5-year stay in today’s dollars.  In-home care costs are considerably less, at about half the cost of a nursing home stay.  At these rates, a long-term care situation, even for one person, can easily wipe out a couple’s savings.  In addition, a lien could be placed on your homes, preventing you and/or your spouse from selling them or obtaining a reverse mortgage or home equity loan.  (Watch Dennis Sullivan explain how you can take control of your legacy, not leaving your estate to nursing homes or the IRS.)

Moral of the Story:  Plan Ahead - Consider all the options.

After considering your age and the fact that you were both in good health, your estate-planning attorney might recommend looking into long-term care insurance.  To reduce your premiums you might decide to buy a “shared” care plan.  With a shared care plan, a couple can buy a plan for a set amount to be shared.  So instead of buying two $300,000 plans, a couple may choose to buy one $500,000 plan to share, which can save some premiums.  The benefits of such a plan include:

  • The confidence knowing you could handle an unexpected life event if it occurred.

  • The knowledge that if one of you became ill or injured, you would have the resources to be cared for in your own home and not be forced to move into institutionalized care.

  • Asset protection insurance – your retirement savings would not be jeopardized. (Caution:  You must still protect your assets from financial exposure in excess of policy limits.)

Life can change in the blink of an eye, and although you can’t be prepared for everything, you can prepare for long-term care expenses as long as you coordinate your planning to cover risks and provide you with the flexibility and lifestyle that suit your comfort level and budget.

Our Recommendations

In our experience of more than 25 years helping people and their families in this area, it is the combination of the legal and financial protection, which is best.  In-home care insurance pays for your family member to stay at home and also provides a care coordinator to make sure that he/she is taken care of and the level of care is maintained. 

In addition to insurance, it is also very important to have all their assets protected with a protective trust in case an extended nursing-home stay is unavoidable. With the right legal protection of your home and life-savings, your spouse and your legacy will be safe.  You will never become a victim of nursing home poverty.  You will have done all you could to protect yourself, your spouse and your legacy.  If this makes sense to you, please let us know; we will help you get started.  To learn more about protecting your home, spouse, family and life savings, attend a free, educational Trust, Estate & Asset Protection Workshop . Register online or call 800-964-4295 (24/7) for upcoming dates.

Tags: life-care plan, in-home care, long term care, Protective Trusts, Retirement

Medicare vs. Medicaid and The Rise of Alzheimer's Disease

Posted by Dennis Sullivan & Associates on May 4, 2011 5:40:00 PM

Do you know the difference between Medicare and Medicaid?  For ANY senior it is vital to know the difference.  Your future may depend on it, particularly with the new statistics regarding Alzheimer's Disease and other incurable, long-term care illnesses.

According to the World Alzheimer Report 2010, Alzheimer's Disease is taking a terrible toll on the world – not to mention on individual families and their life savings.  With no cure on the horizon, the problem is only expected to get worse.

According to Dr. Daisy Acosta of Alzheimer’s Disease International, “This is a wake-up call that Alzheimer's disease and other dementias are the single most significant health and social crisis of the 21st century.”

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What’s even worse is that dementia is on the rise, and in the US almost half the seniors over age 80 have this tragic disease.  For more information about what you can do to make your life as a caregiver better today, read our free Alzheimer's Resource Guide, or call our office for options about how to pay for care.

So what does this have to do with Medicare & Medicaid?

Medicare provides health care benefits for people over 65, the blind, and the disabled; while Medicaid provides medical benefits for the poor.

Medicare is mainly a type of public health insurance for those age 65 and older. It is their primary health insurance coverage. Many seniors do not realize that Medicare does not pay for long-term care.  Actually, it is excluded! The confusion is easy to understand because Medicare does pay for rehabilitation. So, if a senior citizen is enrolled in the traditional Medicare plan and is hospitalized for a stay of at least three days, and is then admitted into a skilled nursing facility, Medicare may pay - for a short while. But once those Medicare benefits hit 100 consecutive days, you've hit the maximum.

In some cases, Medicare may not even cover the full 100 days. There must be some actual improvement in your condition, otherwise Medicare will decide that it is a long-term care need, and they'll cut you off. Medicare really only cares about you if you can get better. Since diseases like Alzheimer's and Parkinson's have no known cure today, rehabilitation is not possible, so Medicare will not pay for nursing home care if you have Alzheimer's or Parkinson's.

Unlike Medicare, Medicaid will pay for Alzheimer's, Parkinson's, or dementia-related diseases or a decline in functioning due to the aging process. You must, however, exhaust all your resources (including your spouse's as well) first before you will be eligible.  Medicaid, however, is paid for by both federal and state funds but is "administered" on a state level. The federal government covers between 50-80% of the program costs within the state, and the state pays the rest. Therefore, rules can vary from state to state (even county to county) rather dramatically.  Also, the law enables you to take steps to protect your home, life-savings and spouse so they are not impoverished if you go to a nursing home.

So, as you can see, Medicare is health insurance, and Medicaid is public long-term care coverage, but often there are stages in between that require examination and discussion.  For more information, download our free elder guide The Massachusetts Elder Guide to Medicaid, Nursing Homes and Asset Protection or watch Dennis Sullivan being interviewed about how to avoid nursing home poverty on the national talk show, "Ask The Lawyer."

To learn more about your options, call us at (781) 237-2815; (800) 964-4295 (24/7) or register online to attend one of our free workshops.  You need to be informed about your particular situation and for that you’ll need some honest, legal strategies to protect yourself, your spouse, and your hard-earned assets for the future. 

Tags: Nursing Home Costs, Alzheimer's Disease, asset protection, long term care, Medicare, Medicaid, MassHealth, Nursing Home Guide, Nursing Homes

Federal Budget Cuts WILL Impact You!! - March 2011

Posted by Dennis Sullivan & Associates on Mar 24, 2011 1:45:00 PM

The federal government is working to decrease spending in 2011 by making sweeping cuts to federally funded programs, in order to avoid a government shutdown. Many of these cuts will negatively impact seniors. The cuts began in House Resolution 1 (HR 1), passed by the House last month.  Next, focus will turn to the 2012 budget where a new round of cuts will likely take place.  Many believe it will target entitlement programs like Medicaid and Medicare.

As professional members of the AARP Legal Services Network, we have provided more than 300 community educational workshops for members of AARP and others to help them understand about problems that may exist in their planning along with signing opportunities for improvement.  By better understanding their planning options, people are able to confidently take steps to protect themselves and their families.  Click here for more information on our upcoming educational workshops.  You may also download Free Elder Consumer Guides on Medicaid & Asset Protection, Nursing Homes & Assisted Living, Alzheimer's, and others.

Six Reasons You Can't Afford To Become a “Disadvantaged Older Adult”
According to the National Council on Aging (NCOA), the proposed spending cuts in HR 1 would harm senior citizens by severely cutting initiatives that help older Americans sustain their economic independence and physical and emotional health. HR 1 includes:

  1. Cuts of approximately $525 million in services specifically for low-income seniors (including a 64% cut to the Senior Community Service Employment Program);
  2. Cuts of approximately $1 billion in funding for Community Health Centers that serve seniors;
  3. Cuts of $390 million for home energy assistance;
  4. Cuts of $305 million for Community Services Block Grants that currently assist 2.3 million seniors;
  5. Cuts of $1 billion to programs that include senior volunteers; and
  6. Cuts of $625 million to the Social Security Administration (estimated to be over $1 billion by the Social Security Administration as noted below).

The NCOA is deeply concerned by the 64% cut to the Senior Community Service Employment Program (SCSE). According to NCOA, this is the only major job program that is targeted specifically to helping disadvantaged older adults who need to remain in or return to the workforce to avoid financial crisis. I don't need to tell you how many of us had nest eggs that we thought would help us avoid this, until the ongoing financial crises changed everyone's plans.  The cut proposed in HR 1 would result in the loss of over 83,000 part-time jobs. "For older adults aged 55-64, who cannot yet claim Social Security, the loss of this program could be particularly devastating," said Jim Firman, president and CEO of the NCOA.

According to the NCOA, the $390 million cut in the Low Income Home Energy Assistance Program will force older Americans to make life and death decisions between buying food and medicine or home energy.  Many of us thought we'd never be in that position, yet find ourselves only one catastrophe away, regardless of how diligent we thought we've been. This is why I am so passionate about helping people get past their fears of the complexity of proper planning.  It IS very complex, but is not addressing your planning really an option?

AARP Greatly Concerned
The American Association of Retired Persons (AARP) who's mission is to improve the quality of lives of all Americans over 50, is greatly concerned with the immediate cuts contained in HR 1.  AARP President W. Lee Hammond testified March 9 in front of the Senate to urge Congress not to cut funding for the Social Security Administration (SSA). As part of his testimony, Lee pointed out that the SSA received nearly 3,225,000 disability claims in 2010, the highest in its 75-year history. But instead of additional funding to assist with the increased workload, the agency is faced with aggregate funding losses of over $1.093 billion.

Hammond noted that AARP is also greatly concerned about the other cuts contained in the proposal, testifying, "We have equal concern for many other vital health care services and economic security programs, including severe proposed cuts to home energy assistance, nutrition programs and Medicare premium assistance for low income seniors. The budget reflects the priorities of this nation, and any budgetary cuts will impact people, not just programs."

It's Not About Money, It's About Quality Of Life  
HR 1 eliminates funding for the Corporation for National and Community Service (CNCS) and the programs it administers, including the Retired and Senior Volunteer Program, the Foster Grandparent Program, and the Senior Companion Program (collectively the "Senior Corps"). CNCS's budget of about $1.1 billion includes $111 million for the Foster Grandparent Program, $63 million for the Retired and Senior Volunteer Program and $47 million for the Senior Companion Program.

An important facet of becoming a senior is also about perspective.  Hopefully we become a little bit wiser, and we can be in a position to give back to future generations. The Foster Grandparent Program connects older volunteers with opportunities to provide one-on-one mentoring, nurturing and support to children with special needs, exceptional needs or who are academically, socially or financially disadvantaged. The volunteers themselves derive significant emotional and health benefits as a result of providing these services. Foster Grandparents may serve between 15 and 40 hours per week, and low-income volunteers receive a small stipend to help defray the costs of volunteering.

In 2010, approximately 29,100 Grandparent volunteers delivered 24 million hours of service to more than 137,000 children.  The Retired and Senior Volunteer Program (RSVP) provides volunteers to work with nonprofit and public organizations, trains seniors to help them live independently, and provides volunteers to mentor more than 16,000 children. RSVP volunteers are non-stipend volunteers. The average federal cost per volunteer is approximately $140 per volunteer. RSVP also raises funds by applying for grants.

The Senior Companion Program provides volunteers who offer companionship and support to thousands of older and frail adults, helping them to remain independent and in their own homes at a cost much lower than institutional care. They transport clients to medical appointments, help shop for food and basic necessities, and provide companionship to offset isolation. Senior Companions, who receive a modest hourly stipend, also provide respite to family caregivers.

It might be a good time to ask ourselves what the impact would be if funding disappeared for these services and we found ourselves scraping by?  Whether you're on the side of the argument that it's not the government's role to take care of these needs, or that it's the proper role of society to provide a safety net for it's citizens is not the debate here.  The fact is that these are lean times for many, cuts are coming, and now more than ever we cannot be complacent in providing for our own needs and those of our families into the future.

What About The Promise of Those Programs You Paid Into All Those Years?  The Targets for 2012

In a March 3 interview with The Wall Street Journal, House Speaker John Boehner said House Republicans' upcoming budget proposal would curb entitlements, including Social Security and Medicare, acknowledging the political risk of taking on such popular programs. Boehner also stated Republicans would do their best to persuade voters that this is a necessary step. 

Medicaid cuts could also be coming. There is support within the Republican party to turn Medicaid into a block grant program. This would mean states would be given a lump sum of money to distribute as they see fit. Once the money is used up, there would be no additional Medicaid enrollees until the next fiscal year.

 

While it's difficult to predict if proposed changes to these programs will make things better or worse, we can be sure of this:  it will be decided by politics.  I don't know many citizens who prefer to have their future well-being decided by politics.

Conclusion

The coming years will bring great economic challenges for our senior population. Looming cuts to programs directly benefitting seniors are on the horizon with more planned for the future. Now more than ever it is important for seniors and their loved ones to work with trusted legal counsel to come up with a comprehensive plan that will cover how they will access health care and how it will be paid for.  While health care is certainly the largest financial and personal concern for most seniors, it is not the only one.  None of us likes to think of the inevitable scenarios as we age, but I've seen too many real life tragedies to be complacent about the need to make these conversations accessible to the general public.  Our team members have degrees in law, taxation, finance and accounting.  We have spent our professional lives understanding and more importantly helping people and their families unravel these complexities so they can confidently take the steps they need to protect themselves and their futures.  But I can't expect the average person to do that on their own.  The dilemma then is who to trust to guide you through the process. 

It is our hope that our educational newsletters and our many workshops will allow you to get to know us, what we stand for, our values and our competencies, so that we may help you make an educated decision when the time is right.  

Please contact us if you would like additional information on any of the topics addressed in this newsletter or if you would like to discuss a specific issue.  To learn more about or to register for an upcoming workshop, call 800-964-4295 or register online.


To comply with the U.S. Treasury regulations, we must inform you that (i) any U.S. federal tax advice contained in this newsletter was not intended or written to be used, and cannot be used, by any person for the purpose of avoiding U.S. federal tax penalties that may be imposed on such person and (ii) each taxpayer should seek advice from their tax advisor based on the taxpayer's particular circumstances.

 

 

 

 

Tags: Estate Planning, 2011, Estate Planning, Nursing Home Costs, Alzheimer's Disease, Elder Law, long term care, Medicare, Medicaid