Medicaid Planning; New Free Medicare Checkup

We can't say this enough times: Medicaid planning is not an easy thing to do. Until January 1st, 2011, the only routine exam Medicare covered was the “Welcome Exam”. This exam is only for brand new beneficiaries. Now, a new annual wellness visit has been established under the Affordable Care Act. This free Medicare checkup was a big step in Medicaid Law, but can be very misleading.

How to get your free Medicare wellness checkup; Boston, Raynham, Andover Massachusetts

William Schmitz, a retired engineer from Maine, was upset when he found out Medicare Law had defeated him once again and denied his claim when he went for what-he-thought was a free physical. “When I asked the doctor’s office what had happened, they clued me in that I was mistaken about the difference between Medicare’s wellness exam and a physical”, William said.
In order to get this free check up, don’t just set up an appointment for a physical. Specifically ask for the free Medicare wellness visit, billing code G0438. Medicare does not cover the cost of a physical.

Medicare wellness visits and doctors; Elder Law Attorneys Cohen & Oalican

As always with Medicare planning: be cautious and double-check with your doctor. All doctors do not have to offer these Medicare wellness visits. Also, Medicare does not have the authority to tell a doctor what services to offer. If the beneficiary’s doctor will not perform this check up, the beneficiary has the right to go to another doctor. It is always good to choose a trustee to get the proper help you need with Medicaid planning.

Attorneys Cohen & Oalican specialize in Elder Law; where protecting your assets and your dignity is their core mission.

Your Retirement; Estate Planning and Medicaid Planning

Happy retirement ideas are a little different for everyone. For some, it might be relaxing and spending time with family. Others may want to travel the world while others might want to stay in their hometown and work a meaningful part-time job. Regardless of what your retirement plan is, proper estate planning and Medicaid Planning is a must.

Managing Assets; Elder Law Attorneys Cohen & Oalican

Medicaid imposes a period of ineligibility if you transfer assets before you enter a nursing home. This is very complicated and confusing to do without guidance from an elder law attorney. Properly transferring assets will help you protect your spouse and protect your home.

Choosing a Trustee; Estate Planning

A good estate plan will take care of you if and/or when you cannot take care of yourself anymore. If done properly, it will also take care of your family after you die. Family, good friends, banks or trust companies and attorneys are only a few of the routes you can go. There are no perfect choices, but try to choose somebody who is relatively experienced in investments and public health benefits programs and regulations. Elder law attorneys Cohen & Oalican can help with all your estate planning needs.

Attorneys Cohen and Oalican specialize in Elder Law; where protecting your assets and your dignity is their core mission.

Medicaid Law; Making it Hard for Men to Enter a Nursing Home

Recent studies prove that it is a lot harder for a man to find a bed in a nursing home than it is for a woman because of Medicaid law. Most people just don’t think about problems like this coming up when Medicaid Planning.

Nursing Home Population; Elder Law Attorney’s Cohen and Oalican, LLC.

Like the elderly population itself, nursing home residents are mostly female. An Elder Law report in 2010 stated that two-thirds of nursing home residents are women. The problem with that for men is: Medicaid will ONLY cover semiprivate rooms in a nursing home, so since a man can’t bunk with a woman, men are forced to wait for a bed to open up in another man’s room.

Family’s Search for Other Nursing Home Options

These numbers are definitely something you can’t dispute, but they definitely make an already hard process even more difficult. Someone who is leaving from their own home can probably wait for a bed, but what about somebody who’s leaving a hospital or a rehab? You then might have to settle for a place far away from the family or something not as nice as you’d prefer.

Attorneys Cohen and Oalican specialize in Elder Law; where protecting your assets and your dignity is their core mission.

Is Your Spouse Entitled to Your Social Security Retirement Benefits?

Social Security will provide your retirement benefits to your spouse, ex-spouse or surviving spouse in certain circumstances. Here is a breakdown of the circumstances where the spouse would be eligible to collect Social Security benefits:

• If the marriage lasted 10 years your spouse would be entitled to your Social Security benefits
• You must be at full retirement age for your spouse to collect
• Your spouse must have filed for Social Security Benefits for themselves

Social Security will automatically pay your spouse a larger benefit if he/she could receive more based on their own earnings. Your spouse can also elect to take your benefits first before taking their own.

Social Security Benefits for an Ex-Spouse; Elder Law Attorneys Cohen and Oalican, LLC.

Your ex-spouse is entitled to half of your retirement benefits as long as you were married for over 10 years. An ex-spouse can receive benefits before you have even applied for Social Security benefits, unlike your current spouse.

Social Security Benefits of a Surviving Spouse

Your spouse is entitled to your full benefits if they are at full retirement age. Even if you were divorced before you deceased your spouse is still entitled your retirement benefits if you were married for more than 10 years. If your spouse is over 60 but below retirement age, they will receive a reduced amount. If they are under 60 they will only be able to receive benefits for special circumstances such as caring for a disabled child or if they are disabled themselves.

Attorneys Cohen & Oalican specialize in Elder Law; where protecting your assets and your dignity is their core mission.

Millions still working at 70 years old

Medicaid planning is getting more and more difficult these days. Millions of Americans are working a lot longer than their 63rd birthday (the average age Americans claim benefits). The truth is: Social Security benefits are not made to last as long as people are living, as life expectancy is getting longer.

Elderly worker percentages growing fast; no early retirement

Your early retirement is becoming a thing of the past. Erma Paliani finally retires at 92. "I didn’t expect to work this long,” Paliani says, who worked as a secretary for the government for 67 years. (Carole Fleck - AARP Bulletin) The percentage of people over 65 that are still working is growing faster than any other age groups.

Proper estate planning; Elder Law Attorneys Cohen and Oalican, LLC.

The best way to avoid this situation yourself is by proper estate planning. Durable powers of attorney are a critical piece of any estate plan. They will make financial decisions on your behalf if you were to become ill or incapacitated. Elder Law Attorneys Cohen and Oalican can advise you on how to choose an agent and how best to draft your power of attorney.

Nursing Home Rights and Eligibilty

Nursing homes can be very costly. Medicaid is just about the only insurance that will cover nursing home expenses, although some private insurances will pay a certain amount. Nursing Home eligibility rules are not so easy to understand. There are rules that can help protect your home and protect your spouse when using Medicaid.

Nursing Home Resident's Rights; Elder Law

The rights of nursing home's residents are no different than the rights of any citizen. Unfortunately, nursing home residents aren't always treated as they should be. In 1987 laws were passed for elder law by Congress that help protect you or your spouse while in a nursing home.
Here are just a few laws that were passed:

• Resident has the right to see all of their records
• Residents must be informed of services available and how much they will cost
• Residents can share a room with their spouse
• Residents can get up and go to bed whenever they want

Disputes in the nursing home

There are certain steps that can be taken if needed when you feel you or your spouse or loved one has been mistreated.

• Talk to the nursing home staff
• Talk to nursing home supervisor/administration
• Request a meeting with nursing staff
• Talk with the ombudsperson that is assigned

If all else fails contact Elder Law Attorney's Cohen and Oalican, LLC.
Attorneys Cohen & Oalican specialize in Elder Law; where protecting your assets and your dignity is their core mission.

Supplemental Needs Trusts

Supplemental needs trusts are created for disabled children to provide luxuries that aren't available through public assistance. This is also known as a special needs trust. These trusts are setup so that beneficiaries are allowed to receive gifts or settlements without losing their eligibility for public benefits.

Public Benefits Restrictions for Supplemental Needs Trusts; Elder Law

Supplemental needs trusts need to comply with certain rules/restrictions so that public benefits will not be jeopardized. There are two ways to go about this:

• A "Payback" program can be setup where the state or Medicaid will be paid back at the time of the beneficiaries death.
• A "Pooled Trust" can be setup (a non-profit agency manages resources "pooled" between many disabled beneficiaries.)

Supplemental Needs Trusts Restrictions on Income Paid to Beneficiary; Cohen and Oalican, LLC

There are restrictions on how funds in a supplemental needs trust can be spent. A beneficiary can lose one dollar of SSI benefits for every one dollar paid to them. Attorneys Cohen and Oalican can draft a trust to limit a trustee's discretion. They can also setup the trust to NOT limit their discretion, but properly counsel the trustee on how their money should be used.

Attorneys Cohen & Oalican specialize in Elder Law; where protecting your assets and your dignity is their core mission.

Medicaid Planning 101; protecting your home

If you receive Medicaid assistance, once you die the state has to try to recoup whatever moneys you have received for your care. This is also known as “Estate Recovery.” The first place they will look will be your home. There are ways to protect your home from recovery by the state by transferring assets.

Trusts; Cohen & Oalican, Boston, Raynham and Andover Massachusetts

Transferring your home to an irrevocable trust is one way to protect your home. If your house is sold the money must stay in the trust. If done right, $250,000 in taxable gain can be excluded for the settlor. Be careful though; once your house is in the irrevocable trust you can not take it out.

Protect your home with Life Estates; Elder Law

The easiest way to protect your home from estate recovery is by setting up a life estate. A life estate is when 2 or more people own a property. You will have primary ownership of the home for life. The second owner has ownership interest in the home but can not solely take the home until you die. At death, the home will be directly passed to that person that has interest in the home. Once the house is passed on to the other interested party, the state can not recover the home to repay Medicaid expenses.

Attorneys Cohen & Oalican specialize in Elder Law; where protecting your assets and your dignity is their core mission.

Medicaid Planning 101: Trusts

Revocable trusts are considered as assets that cannot be transferred without being counted towards your Medicaid eligibility. Irrevocable trusts are trusts that cannot be changed. Therefore you will not be penalized if you were to include irrevocable trusts into your Medicaid planning.

Testamentary Trusts; Cohen & Oalican LLP, Boston, Raynham and Andover Massachusetts

Testamentary trusts are a great way for community spouses to leave assets to their surviving spouse that is in a nursing home. The assets can be used for estate planning for certain things that are not covered by Medicaid, including specialists, therapy, legal fees or transfers to a different nursing home.

Income-only Trusts; Elder Law

Income-only trusts are used for just that; income. This trust is made so it will pay an income to you for the rest of your life. When you die the rest of your assets will be transferred to your beneficiaries. These funds are protected and are not counted as assets. If you do end up going to a nursing home the income will go to the nursing home to pay for your stay.

Attorneys Cohen & Oalican specialize in Elder Law; where protecting your assets and your dignity is their core mission. 

Medicaid Planning 101: Transferring Assets

Last week in part one of Medicaid Planning 101, we briefly explained that it is possible to transfer assets in advance so that you could protect them. This article will go more in depth of how this can be done.

Remember: you should always talk with an Elder Law Attorney before you make any estate planning decisions.

Medicaid Eligibility; Elder Law Attorneys Cohen & Oalican, Boston, Raynham and Andover Massachusetts

There is a 60 month look back period if you have just transferred assets. The length of the penalty depends on how much you actually transferred. The penalty is: assets you have transferred divided by the average cost of a nursing home in your state. This penalty does not start until you actually move into the nursing home.

Transfers that are permitted by Medicaid

• Transfers to your spouse
• If you have a child that is under the age of 21
• A sibling that has part ownership of your home
• If you had a child that lived with you for at least 2 years who cared for you
• A disabled child

While most asset transfers will be penalized, any of the above transfers are allowed and cannot be penalized.

Attorneys Cohen & Oalican specialize in Elder Law; where protecting your assets and your dignity is their core mission.

Reverse Mortgages; Should I?

Reverse mortgages seem to be almost too good to be true at first glance. And like everything else that seems too good to be true, it too has its downsides. The closing costs on this type of mortgage tend to be a lot higher than usual. Most instances the closing costs will be “rolled” into the loan, but that means less money for you in the long-run.
Reverse mortgages are getting more and more popular with people that are planning for retirement.

Pros and cons of a reverse mortgage; retirement planning

Here, Elder Law Attorneys Cohen & Oalican will go more into detail to help you learn if getting a reverse mortgage is the right thing for you:

Pros of a reverse mortgage

• Receive a monthly income
• Don’t have to rely on family members for income support
• Extra money for vacation

Cons of a reverse mortgage

• High closing costs
• May affect your eligibility to collect Medicaid
• Loan has to be paid back after your death – home will have to be sold

There are alternatives to a reverse mortgage. You could choose to just sell your home and downsize to a smaller/less expensive home or apartment. You could get a roommate; a roommate – if you can find the right one – will also offer companionship at the same time they are helping with the bills.

Make sure you explore all your options before jumping into anything, especially something that will burden your family. Call Elder Law Attorneys Cohen and Oalican with any questions that you may have. Offices: Boston, Raynham and Andover Massachusetts.

Shopping for long term care insurance; Elder Law, Boston, Raynham and Andover Massachusetts

The cost of nursing home care is expensive. Long term care insurance is purchased to cover your nursing home residence, and can also pay for home care and assisted living. But there can be some problems with this coverage... Probably one of the biggest concerns for long term care insurance is the cost.

Questions to ask when comparing long term care insurance policies; Cohen & Oalican, LLP

There will be lots of questions that you will have when comparing long term care policies, but here are – without a doubt – some of the most important questions to ask:

• This one will be listed first because it is probably the most important; is the long term care insurance company reputable? Are they known to pay claims?
• Look for restrictions in the policy
• How long is the elimination (waiting) period?
• Should you purchase an inflation rider?
• What is the qualification policy?

When should you start looking at policies for long term care insurance?

Deciding when to start looking into purchasing a long term care policy is not an easy decision. It is sort-of a catch-22 situation. If you purchase one when you’re 80 for example, your premium – if they even accept you – will probably way more than you can afford to pay. But, with the way things are changing daily you probably don’t want to look into purchasing a policy when you’re only 50 because you probably won’t need to use it for at least 20 years and who knows what’s going to happen in 20 years…

Attorneys Cohen & Oalican specialize in Elder Law; where protecting your assets and your dignity is their core mission.

Medicaid Planning 101

Eligibility for Medicaid is always changing. Careful Medicaid planning can help you and your family tremendously. More often than you would think, people are rushing around trying to figure out what their next step will be when an unexpected need for nursing care financing pops up. Planning ahead can help you protect your family’s estate.

Long Term Care eligibility

In the U.S. the only plan that will cover long term care is Medicaid. Most people end up paying for nursing home care out of their pocket until they exhaust all their funds and then, and only then, will Medicaid kick in. Medicaid is considered a form of welfare which you can only qualify for if you’re “impoverished”.

Protecting your assets; Elder Law

There is a way to distribute/transfer your assets in advance to protect yourself and your family. Every persons case will be different though, so the need to talk to an attorney that specializes in Elder Law before it gets too late is imperative. Attorneys Cohen & Oalican specialize in Elder Law; where protecting your assets and your dignity is their core mission.

Reverse Mortgages–Part 4

Resources

· AARP - has an excellent section dedicated to reverse mortgages, including a reverse mortgage calculator then can give you an idea before you apply of how much money you might be able to take out of your home.

http://www.aarp.org/money/credit-loans-debt/reverse_mortgages/

· The National Center for Home Equity Conversions - has greater detail, and many supplemental materials.

http://www.reverse.org./

· The names of FHA insured lenders can be requested from the Federal National Mortgage Associations (800) 7-FANNIE (Fannie Mae)

· The attorneys at Cohen and Oalican would be pleased to assist you in evaluating all of your financial options, including Reverse Mortgages.

http://www.cohenoalican.com

Reverse Mortgages–Part 2

How much can I borrow?

What can be borrowed is not a set amount, it is a formula that takes the following into consideration.

1. The age of the borrower.

The older the borrower, the more that can be borrowed.

2. Current Interest Rates

The lower the interest rate, the more that can be borrowed.

3. The equity in the home.

The greater the value of the home, the more that can be borrowed.

4. The location (county) of the home

AARP has a very effective calculator that can help you determine how much money you might be able to take out of your home.

http://rmc.ibisreverse.com/rmc_pages/rmc_aarp/aarp_index.aspx

How is the Reverse Mortgage paid off?

Typically, the reverse mortgage is paid off by the borrower's estate.

The reverse mortgage can also be paid off from the proceeds of the sale of the house if the house is sold before the borrower is deceased.

What if I owe money on my home?

If you do not own your home outright (if there is an existing mortgage) you must pay off that mortgage, however, it can be paid off with the proceeds of the Reverse Mortgage.

 

to be continued…

Top 10 Most Important Cuts to MassHealth for Seniors, the Disabled, and their Families

Continued from March 7th 2011

Here are the major cuts that impact our clients. The following is a link that has a more inclusive list of budget cuts..

http://www.massbudget.org/documentsearch/findDocument?doc_id=614&dse_id=1293

1. Restorative Dental Care

700,000 adults relied on MassHealth for restorative dental care in 2010. Just over 18% were seniors.

2. Reduction in Hours for Day Services to Disabled Adults

Coverage for day services has been cut from six to five hours a day.

3. Personal Care Attendant Services Limited

Many disabled adults require only limited assistance. For instance they might need help getting in and out of bed, dressing and bathing, but are otherwise self sufficient. The 2011 plan establishes a floor. If your need is less than 14 hours a week, you will no longer be eligible.

4. Prescription Advantage Cuts

$26 Million has been cur tom the Prescription Advantage program, Some low income elderly will no longer have subsidies for the portion of their prescription drug costs not covered by Medicare Part D.

5. Respite Services Cut

$12.7 Million in funding will be cut for respite and intensive family support services. These services support the family care givers. Giving parents of disabled children, or children of parents with disabilities support and a safety net.

Stay tuned for the last 5 next week…

Top 10 Most Important Cuts to MassHealth for Seniors, the Disabled, and their Families

 

Introduction

We at Cohen & Oalican feel it is incumbent on us to keep our Elder, and disadvantaged client base abreast of the changes to our state’s Medicaid program, MassHealth in these economically challenging times.

As a result of the recession, politics, changing demographics, and many other factors, there have been some significant cuts to MassHealth, and other Health Reform programs.

Our job is not to comment on politics or right and wrong, but to help our clients who require services to get those services, without compromising their economic status. A large part of this is navigating MassHealth. Appropriate elder law attorney representation is a tremendous safeguard, our advice is to always PREPARE while you or your loved ones are healthy, not REACT. When you are in need of either, please feel free to contact us.

Briefly, Fiscal Year 2011 has seen an increase of less than 3% in funding, at a time when more demands are being placed on the Medicaid system, with healthcare cost inflation (depending on who is doing the estimates) is running anywhere between 5% and 8%. This means that funding, while it has increased, is not keeping up with healthcare inflation, at a time when overall demand on the fund is increasing due to the pure economics of more and more baby boomers retiring, and more and more younger people entering the Medicaid/MassHealth system due to unemployment from the recession.

to continue…

How to Protect Your Home if You Are Admitted to a Nursing Home - Part 3

Medicaid Lien

There is also the distinct possibility of Medicaid putting a lien on your home to compensate for the expenditure on your treatment. If you sell your home while still living, the lien would have to be satisfied by reimbursing the state for the amount spent on your medical care. The only cases where you can claim exemption from this rule is when a spouse, or a minor, disabled or blind child, or a sibling with equity share in the property, is living in your home.

Recovery of Estate

As stated earlier, only if a spouse, a minor, blind, or disabled child, or a sibling with a share in the property inhabit the house, can you be exempted from the state claiming it as recompense for your Medicaid expenses of your nursing home treatment. If the spouse of dependent family member move out or dies, the state can again try to claim the property.

There are some situations however, when the value of a home or property can be protected against recovery by Medicaid. These are:

• If you or your spouse owned the home as tenants by the entirety.
• If the house is in the name of your spouse and you have given up your interest in it.
• If the house is in the name of an irrevocable trust.
• If any family member is eligible as a ‘care-taker child’.’ This is applicable when a daughter/son looked after you prior to your admittance to a nursing home and has no other place to live in. The person can then avoid a Medicaid claim on the house after your demise.

It is advisable to have a detailed discussion with an attorney regarding this ‘care-taker child exception’ and whether it can be applicable for any family member in your case. Considering the many legalities and other policy matters involved, the attorney can guide and help you to protect and retain your home and property, against all claims by the state and Medicaid.

For further information visit Cohen & Oalican,LLP Boston Elder Law and Estate Planning Attorneys, Also serving Andover and Raynham Massachusetts

How to Protect Your Home if You Are Admitted to a Nursing Home - Part 2

Part 2

Transfer of your home

The legal transfer on ownership of your home to your children or any other family member may incur a Medicaid penalty, which would affect your eligibility for Medicaid for a certain period of time. It is best to talk to an attorney to find out all the legalities regarding your wish to transfer your property ownership to someone else, before you do it.

There is no penalty involved if you transfer ownership of your home, to the following:

1. To your spouse.

2. Any child of yours who is under 21 years of age, or visually or physically challenged.

3. Into a trust that is formulated for the sole benefit of a disabled person under 65 years of age. This could be for the Medicaid applicant as well, under certain circumstances.

4. A brother or sister of the owner, who has lived in the same home for one year prior to the admission of the applicant in the nursing home and also has an equity share in the property.

5. A child who has been a caregiver and is the offspring of the applicant, who has lived in the same house for a minimum period of 2 years. He/she must have taken care of the applicant during that period to avoid admission to a nursing home.

You may consider selling off your home at the current market value, but you may find yourself ineligible for any Medicaid benefits. You may end up utilizing the money from the sale of your home, for your medical treatment.


For advice with your Medicaid Planning, contact Cohen & Oalican,LLP Boston Elder Law and Estate Planning Attorneys, Also serving Andover and Raynham Massachusetts

How to Protect Your home if You Are Admitted to a Nursing Home - Part 1

How to Protect Your Home if You Are Admitted to a Nursing Home


When you need to obtain Medicaid coverage for your future medical treatment and care, it is not necessary to sell your home. However, if the house is in your sole name, the state may claim your house legally after your demise. When you claim Medicaid to pay for medical treatment in a nursing home, it is possible that the state may try to recover the cost of the benefits provided, by placing a lien against your home. This is termed ‘estate recovery’ and the house you own may be the only item of considerable value left after your demise, given the terms and conditions of eligibility for Medicaid.

So there is a distinct possibility of the state filing a legal claim on your property and home after your demise. It is in your interest therefore, to consult an attorney to get complete information and find out how to protect your home, as soon as you need to be admitted to a nursing home for your medical treatment. Some states have implemented the Deficit Reduction Act of 2005, whereby the home is not looked upon as an asset for the terms of eligibility for Medicaid, if the equity value is less than $500,000. In some states, the equity value limit is $750,000. You can retain your home and property with no limit on the equity value, if your spouse or
any other dependent family members live there.


Cohen & Oalican,LLP Boston. Elder Law and Estate Planning Attorneys, Also serving Andover and Raynham Massachusetts