Articles Posted in Elder Law

One of the most common and devastating misconceptions about elder law estate planning is that it is too late to save money from nursing home costs. On the contrary, there are crisis planning tools that may save substantial assets from being spent on nursing home costs, even after the client has already entered the nursing home. Almost always, if there are assets left, much can be saved.

There are only three ways to pay for nursing home costs – your own assets, long-term care insurance (owned by less than five percent of the population), or Medicaid provided by the government.

Many people know about the “five-year look-back period” and assume nothing can be done without advance planning. The five-year look-back rule means that if you gave any gifts away within the last five years, when asking for Medicaid to pay for nursing home costs, the gift amount creates a penalty period, which results in a period of ineligibility for Medicaid coverage.

“Elder Law Estate Planning” is an area of law that combines features of both elder law (disability planning) and estate planning (death planning) and relates mostly to the needs of the middle class. Estate planning was formerly only for the wealthy, who wanted to shelter their assets from taxes and pass more on to their heirs. But today estate planning is also needed by the middle class who may have assets exceeding one million dollars, especially when you consider life insurance in the mix.

Estate planning with trusts became popular starting in 1991 when AARP published “A Consumer Report on Probate” concluding that probate should be avoided and trusts should be used to transfer assets to heirs without the expense and delay of probate, a court proceeding on death. Trusts are also widely used today to avoid guardianship proceedings on disability, protect privacy, and reduce the chance of a will contest in court.

As the population aged, life expectancies increased, and the cost of care skyrocketed, the field of elder law emerged in the late 1980’s to help people protect assets from the cost of long-term care by using Medicaid asset protection strategies.

Spend-down. Look-back. Penalty Period. Uncompensated Transfer. These are just some of the terms Medicaid uses to determine eligibility for long-term care coverage. Medicaid is a combined federal and state program that pays for long-term care at home (community Medicaid) or in a nursing facility (institutional Medicaid). Asset, income and gift rules vary for community Medicaid versus institutional Medicaid.

To qualify for community Medicaid, an individual cannot make more than about $1,700 per month and cannot own more than about $30,000 in assets. A married couple cannot make more than about $2,300 per month and cannot own more than about $40,000 in assets. Applicants can “spend down” excess income to the allowed amount by paying for medical expenses.

To qualify for institutional Medicaid, an individual can keep $50 per month (the excess goes to the nursing home) and cannot own more than about $30,000 in assets. For married couples, the spouse at home can keep about $3,700 per month and can own between about $75,000 and $130,000 in assets. If the spouse at home makes more than $3,700 per month, she may have to contribute some of the excess to the spouse’s cost of care. For married couples, the residence, up to value of about $1,000,000 and one car are exempt (not counted as assets). Everyone can have a burial trust worth up to $1,500 or any amount in an irrevocable pre-paid funeral trust.

Federal workers are currently reminding the country’s health care workers that withholding treatment due to an individual’s disability is frequently illegal. Withholding services in such a way is illegal even if resources are few.

The US Department of Health and Human Services’ Office for Civil Rights is currently informing providers that civil rights liberties for disabled individuals are still “full force” despite the COVID-19 pandemic. As part of a statement, the Department stated that civil rights law remains regardless of what happens including pandemics and that it is vital that the country works to make sure that fairness exists for all patients.

Additionally, the Department stated that the pandemic has illuminated the disparities that exist in the healthcare system and provided healthcare workers with the chance to resolve these disparities. 

A 90-year-old woman is a recent victim of elder abuse. The financial scammers hacked into the woman’s account and removed $20,000. Frequently, financial abuse scammers present themselves as technical support or service representatives who offer to resolve issues connected to compromised email or bank accounts or even the renewal of software licenses.

In reality, people who are 60 years of age and older are routinely subject to targeting from financial scammers because elderly adults are more financially secure. Elderly adults also routinely experience difficulty with more and are more trusting than younger people. Scams of this nature are growing in number. The Internet Crime Complaint Center recently reported that fraud involving tech support is the third most common type of fraud involving elder adults.

Two years ago, the Internet Crime Complaint received almost 10,000 complaints involving tech scams targeting older adults who encountered over $116 million in losses. Elderly adults represented 66% of the total reports involving tech support fraud.

One new study found that many LGBTQ+ individuals worry that prejudices held by long-term care facility staff could continue placing these elderly individuals in an environment rife with discrimination and misunderstanding. Many elderly LGBTQ+ individuals even feel the need to go “back into the closet” due to fears about being treated worse by long-term care staff. 

These findings come thanks to a new review that examined 20 recent studies between 2000 to 2019. Each of these studies focused on older individuals as they adapt to long-term care settings. This review also found that long-term care staff is often unfamiliar with the challenges faced by same-sex Americans.

The LGBTQ individuals who are currently transitioning to nursing homes and long-term care facilities are the first “out” generation who lived through the Stonewall Riots and marked the first generation to live openly. This generation also weathered the HIV outbreak along with a great deal of other trauma and discrimination. 

The Department of Health and Human Services through the Centers for Medicare & Medicaid Services recently notified states that they have one more year to utilize funding from the American Rescue Plan to bolster both community- and home-based services for Medicaid recipients who require long-term care support and service. The policy represents the most recent action by the Biden administration to improve the field of health care as well as to help individuals receive in settings of the patient’s choice while also reducing reliance on care from institutions.

A Secretary from the Health and Human Services has commented that all individuals deserve the dignity to reside in their home and surrounding community and that the existing Administration remains focused on guarding these rights. Due to funding from the President’s American Rescue Plan, the secretary also commented that the organization is focused on expanding community- and home- based services for aging and/or disabled adults throughout the country. The secretary also noted that the Department is working with each state to make sure that the state has adequate time as well as support to improve their home care systems.

The Centers for Medicare and Medicaid Services has commented that the Biden  Administration is focused on increased community- and home-based care for the elderly and disabled. Due to the additional plan, the Center has commented, additional funds will support individuals with Medicaid to live in a location that they choose. With the extension, the Center is focused on meeting state concerns, giving states the necessary resources to improve care connections in communities and homes.

State audits have the potential to impact 15 million individuals including 6 million children losing their health insurance. Some state workers are concerned that they might lack the resources to aid people in finding new insurance coverage. 

The existing federal public health emergency will expire this year, which will subsequently trigger a requirement that state workers must examine Medicaid to determine who qualifies as eligible. Over the last two years, these audits have been suspended. With the resumption of these adults, up to 15 million individuals are losing their medical insurance.

The Role of the Biden Administration

Congressional efforts to revise the country’s mail service might come at the cost of an even more nuanced issue involving Medicare.

The Postal Service Reform Act of 2022 would help to free post office costs by resolving the unusual and challenging legal requirement to fund 75 years of retirement health benefits in advance. In return, this Act would require future Postal Service retirees to participate in Medicare.

The Congressional Budget Office reports that the movie would save postal retirement as well as healthcare programs more than $5 billion and add more than $5 billion in costs to Medicare from now until 2031.

Over the last few years, Covid-19 has caused many people to think deeply about health issues. Now that the height of the pandemic has passed, many people are left wondering how this has impacted long-term care insurance.

A noticeable increase in long-term care insurance has occurred following the summer of 2020 as reported by many medical experts. Many people who previously rejected long-term care coverage have since changed their opinions.

What Is Long-Term Care Insurance?

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