Today’s Q&A on ElderCareMatters.com is about Nursing Home Medicaid and Transferring Assets

Can I transfer my assets to my children just before I go into a nursing home and still qualify for Nursing Home Medicaid?

Answer:  Probably not. Under the 60-month Lookback Rule, eligibility for Medicaid may be denied if the person going into the nursing home transferred assets for less than fair market value within 60 months before his application for Nursing Home Medicaid benefits.

And be very careful about giving away assets: once you have given away your assets, you cannot get them back by legal action. Don’t rely on your children to “do the right thing” and hold the assets for you in case you need them.

If you need help with Elder Law, Estate Planning, or other Elder Care Matters, you can find thousands of Elder Law and Estate Planning Attorneys from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

And you can find thousands of elder care / senior care articles about a wide range of elder care matters on ElderCareMatters.com/ElderCareArticles.

Elder Law & Estate Planning Attorneys
Kevin Pillion, Esq.
Life Planning Law Firm, P.A.
Sarasota, Florida
An ElderCare Matters Partner


Today’s Q&A on ElderCareMatters.com – What are some Do’s and Don’ts about planning and preparing for your aging parents’ elder care needs?

 

Would you please provide us with some Do’s and Don’ts about planning and preparing for our aging parents’ elder care needs?

Answer:  As people live longer, health care costs will continue to rise. If you have elderly parents, now is the best the time to talk to them about planning for their future and discuss their legal and financial options. Some of the areas of discussion should include: the current status of your parent’s medical condition; the state of their finances; the status of their health care and long-term care coverage, if any; and the current status of their legal documents. The following advice will help ensure you have a legal and financial plan in place.


Do

Do speak to your parents

Sit down and talk with your parents. Gather as much information as you can about their financial and medical health. Once you have this information, you’ll be better prepared to see a professional.

Do ensure your parents are receiving appropriate medical care

Many seniors do not take care of their medical conditions properly. Make sure that your parents have their annual checkups, are taking any required medications, and are following through with the advice of their physician.

Do consult with an elder law attorney

An experienced elder law attorney will assess your parent’s legal and financial situation. He or she will devise a plan to pay for any unexpected health care costs or needs that may arise. This may involve the purchase of long-term care insurance, or a Medicaid plan, if insurance cannot be obtained or is unaffordable. An elder law attorney will ensure that all necessary legal documents, such as a last will and testament, power of attorney, health care proxy, living will and living trust, are complete and up to date.

Do meet with a financial planner

A skilled financial planner will assess your parent’s finances and ensure that their assets will be invested appropriately. A financial planner will take into consideration their age, medical and financial status.


Don’t

Do not do it yourself

If you do it yourself, it can cost you in the long run. Be cautious of online websites that offer do-it-yourself legal documents. Legal documents for seniors are not “one-size-fits-all” and can be quite complex.

Do not accept gifts from your parents without consulting a professional

If gifts are not made properly, accepting monetary gifts from your parents could cause them to incur gift taxes, and may cause you or a recipient to incur capital gains taxes. Further, gifts can have adverse Medicaid consequences in the event that nursing home care is needed within a five-year period.

Do not be your own geriatric care manager

Hire a geriatric care manager, who will assess your parent’s situation, create a care plan, coordinate and monitor services. Many elder law attorneys have a geriatric care manager on staff, or can refer you to one.

Do not delay

All legal, financial and medical documents should be organized and easily accessible, so if you need them in an emergency, you will know where to find them quickly. Ensure all insurance policies are current. And review all legal documents periodically in case they need updating.

If you need help with Elder Law, Estate Planning,  or other Elder Care Matters, you can find thousands of Elder Law and Estate Planning Attorneys from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

Elder Law and Estate Planning Attorneys
Ronald A. Fatoullah, Esq., CELA
Ronald Fatoullah & Associates
Great Neck, New York
An ElderCare Matters Partner


Estate Planning Mistakes to Avoid – Today’s Q&A on ElderCareMatters.com

 

Would you please share some estate planning mistakes that we should avoid?

Answer:  Drawing up your estate plan is a major step, and it requires a lot of thought. You need to be thorough yet deliberate when you write up the numerous documents that make up your ultimate estate plan. Despite this incredibly important life decision, there are many people out there who forget to include certain aspects in their estate plan, or they make outright mistakes that cost their family when the estate plan is executed.

So here are a few tips when you are drawing up your estate plan.  Try to avoid the following missteps:

  • Never assume your finances are “too simple” for an estate plan. The fact of the matter is, any accounts or financial assets are a bit complicated, and they need to be protected in an estate plan.
  • Waiting too long before tackling your estate plan. Many people may incorrectly assume that so long as you write up your estate plan at some point, then you’re okay. But that’s exactly what’s wrong with this line of thinking: what if that point never comes? What if you unexpectedly are disabled or suffer catastrophic consequences that incapacitate you? Getting to your estate plan as early on in your life as you can is the best approach.
  • You have digital assets. Don’t forget about these. Your Facebook and Twitter accounts, as well as other online accounts, are all assets and you can dictate what happens to them when you’re no longer around.
  • Remember your pet! If you have a dog, a cat, or any pet really, then you can draw up provisions and plans for how that pet is cared for and who assumes responsibility for it.

If you need help with Estate Planning, Elder Law or other Elder Care Matters, you can find thousands of Elder Law and Estate Planning Attorneys from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

Estate Plan and Elder Law Attorneys
Richard B. Vincent, Esq.
Vincent, Romeo & Rodriguez, LLC
Englewood, Colorado
An ElderCare Matters Partner


St. Louis Elder Law Attorney Answers Today’s Question on ElderCareMatters.com

What does a Will do and how do you avoid probate?

Answer:  A Will allows the person creating it — the Testator (a man who creates a Will) or Testatrix (a woman who creates a Will) to: 1) identify the person, referred to as the “Personal Representative”,(I recommend naming at least two people – the first appointee and then a back-up (Successor) who will pay any last bills, collect any claims, pay debts and file lawsuits if necessary and ensure the instructions in the Will are carried out; 2) provide instructions about how assets are to be distributed – for example, “first to my spouse, and if he/she dies before I do, then in equal shares to my children”; 3) nominate a guardian for any minor or disabled children and 4) create a “Personal Property List” that allows the Testator/Testatrix to list personal or sentimental items to be given by the Personal Representative to the person identified to receive the item (i.e, your black velvet painting of Elvis).

HOWEVER, creating a Will is just the first step to avoiding having your assets supervised for distribution through the Probate Court. Once a Will is created, beneficiary designations must be made for all assets — bank accounts and certificates of deposit (CDs) should have “Pay Upon Death” designations, securities, including stocks, bonds and mutual funds should have a “Transfer Upon Death” designations; U.S. savings bonds have forms for naming beneficiaries. Life-insurance, retirement accounts and IRAs have forms enabling beneficiaries to be named. Real estate should have beneficiary, or lady bird deeds or deeds that name joint owners who will inherit by survivorship created and filed with the Recorder of Deeds office. A beneficiary can be a person, a trust, charity or other entity. The key is to make sure all assets have some type of designation that identifies who is to inherit the asset and that such designation is consistent with one’s Will — inconsistencies between beneficiary designations and instructions in a Will can cause enormous problems, hurt feelings, and end up landing one’s estate in probate to have such inconsistencies sorted out.

Although there are many websites, downloadable forms and resources for creating a Will, it is advisable to see an attorney to ensure that your wishes are reflected in your Will in such a way that they will be carried out, to find out the options you have for distribution of your estate and how to handle sticky or difficult situations — such as leaving assets for the benefit of a disabled child; how to ensure that if a child dies before you, that his/her share will go to who you want to receive it and answer questions you may have and not even know to ask.

If you need help with Elder Law or other Elder Care Matters, you can find thousands of Elder Law and Estate Planning Attorneys from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

Elder Law Attorneys
Debra K. Schuster, M.H.A., J.D.
Debra K. Schuster, P.C.
St. Louis, Missouri
An ElderCare Matters Partner


Arizona Geriatric Care Manager Answers Today’s Question on ElderCareMatters.com

 

Arizona Geriatric Care Manager Answers the Following Question on ElderCareMatters.com: How do I know that my parent or loved one needs help with elder care matters?

Answer:  Here are a few signs that someone needs assistance with elder care matters:

  • Social activity has decreased and relationships are failing
  • Participation in activities like; clubs, dining with friends or religious services seems to be diminishing
  • House cleaning and organization aren’t important anymore
  • Personal hygiene and appearance is not clean (i.e. clothes are dirty, hair not combed, men not shaving)
  • Getting behind on bills; mishandling of finances (i.e. purchasing more than one subscription of magazine or newspaper, purchasing from TV, easily donating to would-be scammers)
  • Driving habit and skills are downright scary
  • Increase in alcohol consumption
  • Poor management of pain medications
  • Changed eating habits resulting in weight loss, no appetite or is missing meals
  • Inappropriate or obnoxious behavior (i.e. being unusually loud or quiet, paranoid or agitated)
  • Phone calls are made at inappropriate times or repeat phone calls about the same issues; same conversations
  • Constantly repeating themselves
  • Does not participate in holiday and family celebrations or events anymore

If you need help with geriatric care management or other elder care / senior care matters, you can find thousands of Elder Care Professionals from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find some of America’s TOP Elder Law Attorneys and Estate Planning Attorneys on 2 new websites sponsored by the national ElderCare Matters Alliance – ElderLawAttorneys.us and EstatePlanningAttorneys.us.

Geriatric Care Management
Heather Frenette, RN, MSN, CMC
Desert Care Management, LLC
Gilbert, Arizona
An ElderCare Matters Partner


Is money received from a Personal Care Contract subject to self-employment taxes?

Is money received from a Personal Care Contract subject to self-employment taxes?

Answer:  Yes,  money earned under a Personal Services Contract (PSC, for short) is subject to the self-employment tax.  You should consult with a tax specialist to see precisely what your tax liability is in your particular state.

If you need help with this or other elder care / senior care matters, you can find thousands of Elder Care Professionals from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find some of America’s TOP Elder Law Attorneys and Estate Planning Attorneys on 2 new websites sponsored by the national ElderCare Matters Alliance – ElderLawAttorneys.us and EstatePlanningAttorneys.us.

Personal Care Contract
Ivan Michael Tucker, Esq.
Law Office of I. Michael Tucker, PLC
Altamonte Springs, Florida
An ElderCare Matters Partner


Difference between an Elder Law Attorney and an Estate Planning Attorney

What is the difference between an Elder Law Attorney
and an Estate Planning Attorney?

Answer:  The difference between an Elder Law Attorney and an Estate Planning Attorney can be quite substantial. An Estate Planning Attorney traditionally focuses on dealing with what happens to a client after the client passes away. They would often deal with avoiding probate, minimizing estate taxes and distributing assets to the client’s loved ones exactly as the client wanted them to be distributed – to name a few. However, Elder Law Attorneys not only focus on estate planning issues (a very important part of elder law) but they also deal with issues that face clients during their lives. An Elder Law Attorney will help protect assets for a client if there is ever an incapacity issue. Elder Law Attorneys will often deal with Medicaid issues, Veterans’ Benefits, Special needs counseling and Long Term Care Issues – to name a few.

You can find some of America’s TOP Elder Law Attorneys who can help you with your family’s Elder Care Matters on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.
Elder Law Attorneys & Estate Planning Attorneys
Elder Law Attorney Jim Thomas
Law Office of Carol Thomas
Saginaw, Michigan
An ElderCare Matters Partner


What is a Professional Fiduciary? Today’s Q&A on ElderCareMatters.com

What is a Professional Fiduciary?

Answer:  You probably know an older adult who is all alone. Perhaps this person is single, widowed, or divorced. Maybe he never had children or is estranged from them. Possibly her siblings have all passed away. Whatever the reason, it is often difficult for individuals in this situation to decide who to appoint as their power of attorney or health care surrogate in the event they can’t make decisions for themselves. All too commonly, these folks simply avoid completing appropriate documents and then are stuck if they lose capacity.

In other cases, there is plenty of family who could take over if needed, but they live far away or are fully committed to their own professional and personal responsibilities. Often, family is willing but not able. That is, they would not be a good choice to step into our shoes due to the lack or appropriate skills or the potential for conflict with siblings or other relatives. Perhaps a wife is concerned about her husband being the successor Trustee to their trust because he is a wonderful artist but not interested in finance.

Enter the professional fiduciary. A fiduciary is a person who assumes responsibility for a position of trust. Fiduciaries can serve by court appointment or by private agreement. Court appointed fiduciaries are known as guardians or conservators. In addition, personal representatives of estates are appointed by the Court. Fiduciaries serve by agreement as daily money managers, trustees, representative payees, or as agents under financial or health care powers of attorney. A fiduciary can be an individual or a corporate entity like a bank’s trust department.

Professional fiduciary services range from those that are less restrictive to those that essentially have the professional step into the shoes of an incapacitated person. It is almost always best to start with the least restrictive alternative, allowing the older adult to retain as much independence and decision-making authority as possible.

The least restrictive type of professional fiduciary is the Daily Money Manager (DMM). They handle day-to-day finances and can be retained by the person who needs the assistance or by a family member serving as Agent under a Power of Attorney. DMMs often serve as the eyes, ears, hands and feet of the older adult, allowing them to retain maximum control of their own affairs.

Next along the continuum are professionals who serve as Agent under a Power of Attorney or Health Care Surrogate document, or who serve as Trustee under a trust. These arrangements must be made in writing while an individual has the legal capacity to make such an appointment, even if the services of the fiduciary will not begin until the individual lacks capacity. There are restrictions (which vary by state) regarding who may serve as a professional Agent or Trustee. The responsibility of the fiduciary in these situations is to carry out the instructions in any written documents (e.g., trust, POA, Advance Health Care Directive, etc.) or, where appropriate and allowed by law, to use substituted judgment or the best interest standards to handle the incapacitated person’s affairs.

The most restrictive fiduciary arrangement is guardianship (known as conservatorship in some states). Guardianship is a legal tool to provide management for the financial and/or personal affairs of individuals deemed by the court to be physically or mentally incapacitated. The Guardian or Conservator is legally appointed to manage the incapacitated person (or ward’s) property and/or person and all aspects of the guardianship are overseen by the court.

The best way to ensure that your affairs will be handled the way you prefer is to work with an attorney to draft appropriate documents and then keep them up to date. In the event you find yourself or a loved one in a situation where this hasn’t been done or where those named in the documents are unable or unwilling to serve it is wise to consider engaging a professional fiduciary.

If you need help with this elder care / senior care matter, you can find thousands of Elder Care Professionals from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find some of America’s TOP Elder Law Attorneys and Estate Planning Attorneys on 2 new websites sponsored by the national ElderCare Matters Alliance – ElderLawAttorneys.us and EstatePlanningAttorneys.us.

Fiduciary Services
Sheri Samotin, President
LifeBridge Solutions, LLC
Naples, Florida
An ElderCare Matters Partner


What is Estate Planning? Today’s Q&A on ElderCareMatters.com

What is Estate Planning?

Answer:  When someone passes away, his or her property must somehow pass to another person. In the United States, any competent adult has the right to choose the manner in which his or her assets are distributed after his or her passing. (The main exception to this general rule involves what is called a spousal right of election which disallows the complete disinheritance of a spouse in most states.) A proper estate plan also involves strategies to minimize potential estate taxes and settlement costs as well as to coordinate what would happen with your home, your investments, your business, your life insurance, your employee benefits (such as a 401K plan), and other property in the event of death or disability. On the personal side, a good estate plan should include directions to carry out your wishes regarding health care matters, so that if you ever are unable to give the directions yourself, someone you know and trust can do that for you.

If you need help with Estate Planning, you can find thousands of Elder Law and Estate Planning Attorneys from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

Estate Planning Attorneys
Stephen J. Bailey, Esq.
Bailey Law Firm
Birmingham, Alabama
An ElderCare Matters Partner


Health Insurance Claim Denied!…How to Deal With Surprising Insurance Denials – Today’s Q&A on ElderCareMatters.com

What should we do if our health insurance claim for benefits is denied?

Answer:  It’s safe to say that most insureds have dealt with some type of insurance obstacle, whether it was a billing error that seemed nearly impossible to correct, a medication/procedure/treatment that was unfairly denied, or an outright health insurance denial of benefits. While insurance complications like these can be incredibly frustrating, overwhelming, and financially draining, there is another denial tactic used by insurance companies that is absolutely appalling: the insurance denial AFTER an authorization has been granted, and AFTER the procedure is already completed.

How can this be? How is it possible for an insurance company to deny a procedure, after it has already been approved? There are several reasons for this type of insurance denial, and understanding these reasons can help you to (1) prevent denials, and (2) advocate for your benefits even after the denial.

First, you should understand that procedures (for example, a back surgery for a herniated disc) must be considered “medically necessary” to be covered by your insurance company. The law is clear that medically necessary care must be provided, however, there’s a catch: your insurance company can review your case for medical necessity both before and after a procedure. Thus, it is possible for them to come to a different conclusion after your procedure has been completed, which could mean an insurance denial…and a massive and unexpected bill.

So, what can you do to protect yourself against this type of insurance denial?

1. Get it in writing! Be sure to request a copy of your authorization letter from your insurance company, as well as a confirmation letter from your physician stating that he/she plans to perform the same procedure that has been authorized.

2. Know the Code: It is critical that the procedure code listed on your authorization letter is the same code that is billed by your healthcare provider. If your healthcare provider submits a code that is different from your authorization letter, your claim will probably be denied. Watch out for simple coding errors!

3. Appeal the decision: An insurance denial, whether it is before your procedure or after your procedure, is NOT the final word. The appeal process is complicated, but it is often worth the effort! Pay attention to time limits and deadlines, and if you do not feel well enough to file an appeal, you may want to reach out to an experienced attorney for help.

If you need help with this type of health insurance matter, you can find thousands of Elder Law and Estate Planning Attorneys from across America on ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources for Families.

You can also find Elder Law Attorneys on ElderLawAttorneys.us and Estate Planning Attorneys on EstatePlanningAttorneys.us – 2 additional websites sponsored exclusively by the national ElderCare Matters Alliance.

health insurance
Glenn Kantor, Esq.
Kantor & Kantor, LLP
Northridge, California
An ElderCare Matters Partner


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