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

What Resources Are Available for The Alzheimer's Family?

Posted by Wellesley Estate Planning Attorney, Dennis B. Sullivan, Esq., CPA, LLM on Nov 7, 2011 4:25:00 PM

With the number of families affected by Alzheimer’s Disease growing daily, it is becoming vital information for almost everyone to learn how to manage this dread disease and its far-reaching ramifications.   

What Are The Predictions? 

Latest studies indicate that the number of Americans with Alzheimer’s Disease could double by 2020 (9 million people) and quadruple (to 16 million) by 2050.

What To Do.

The first step is to tap available resources and become informed about the disease.  The Alzheimer's Resource Kit  (retail value of $197) can be downloaded free and is an invaluable source of information for the patient, family, and caregiver. 

Next, it’s important to build a support network that may include other families dealing with Alzheimer’s, relatives and friends.  Individuals who are suffering from memory loss and their families should, of course, also address the health-related issues with their doctors. While there is no cure yet for Alzheimer’s, there are a variety of treatment options and significant research continues.

Another crucial step is estate and asset protection planning with a reputable elder law attorney. Establishing powers of attorney for both health care and financial matters is the only way a family member can legally make decisions for a loved one if he or she becomes mentally incapacitated. There are multiple other legal issues to discuss during the Alzheimer’s estate planning process, and each individual’s needs vary.

How To Pay for Alzheimer's Care?

Medicare is a type of public health insurance for age 65 and older.  However, Medicare does not pay for long-term care. The criterion is that there must be some actual improvement to your condition. Since diseases like Alzheimer's and Parkinson's have no known cure today, rehabilitation is not possible, so Medicare will not pay.

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) before you will be eligible, that is unless you take steps to protect your home, spouse and life-savings so you can avoid nursing home poverty. We can help. To learn more, call our office.  In addition, visit our website, www.DSullivan.com to download our free elder guide The Massachusetts Elder Guide to Medicaid, Nursing Homes and Asset Protection or watch our educational video on "How To Avoid Nursing Home Poverty."

Take Control - Establish A Life-Care Plan.

With longevity, comes expense.  (We are all living longer and may have many years ahead of us post-retirement, so it is all the more important that we plan ahead for those years.) Life-care planning is an integrated planning approach that addresses the health care, legal, and financial issues of aging and disability.  As such, it is critically important for seniors and their families to begin talking about a life-care plan.  If executed properly, a life-care plan can save seniors and their families lots of trouble and heartache.

The goals of a quality life-care plan include, maintaining the health and well-being of your loved one; assessing long-term care options in the home and outside the home; identifying all sources of income available to pay for care; obtaining eligibility for public benefits programs like SSDI, VA, and Medicaid benefits; protecting assets.   In addition, the life-care plan provides the services of a Geriatric Care Manager (GCM) to assist with the development and implementation of the plan.  It also provides assistance with living arrangements and placements, coordination  of available community resources as well as working with the family to provide support, guidance, and advocacy.

What Are The Special Benefits for Veterans?

The Veteran's Administration (VA) has reported that thousands of Massachusetts veterans may not be receiving the disability benefits they deserve.  One of the VA's best-kept secrets, which is an excellent potential source of funds for long-term care, is a veteran's benefit for non-service connected disability.   

Most VA benefits and pensions are based on a disability that was incurred during a veteran's wartime service.  This particular benefit, however, is available for individuals who are disabled due to issues of old age, such as Alzheimer's, Parkinson's, multiple sclerosis, and other physical disabilities and have the additional requirement of needing the aid and attendance of another person in order to avoid the hazards of his or her daily environment.  

These benefits can be a blessing for the eligible disabled individual who is not yet ready for a nursing home.  A veteran married to another veteran can receive a maximum of $1,949 per month in benefits and a widow can receive up to $1,056 per month (for the year 2011).  The applicant must be “permanently and totally disabled” based on VA standards, which means  he/she need only show that he/she is in need of aid and attendance on a regular basis.  Someone who is housebound or in an assisted living facility and over the age of 65 is presumed by the Veterans Administration to be in need of aid and attendance. 

For more about these benefits, download our free guide entitled, "The Nuts and Bolts Guide to Veterans Benefits".  If you have questions, please call our office 781-237-2815.  To learn more about how to protect yourself, your spouse, your home and life-savings from increasing medical and nursing home costs, you may register online or call 800-964-4295 (24/7) to attend one of our Trust, Estate & Asset Protection Workshops.  Upcoming dates in Wellesley are as follows:

Friday, November 18 @ 10AM & 2PM   

Thursday, December 8 @ 10AM & 2PM

Thursday, December 15 @ 10AM & 2PM.

Tags: Medicare, Alzheimer's Disease, asset protection, Medicaid, veterans benefits

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