Elder Law

NY Elder Law Estate Planning: Alternatives to Nursing Home Care

Published on: January 29, 2019 | by Ettinger Law Firm

One of the biggest anxieties many Americans may face is entering into a nursing home or other skilled residential care facility at some point in their lives. Not only does residency in a nursing home mean less autonomy, but also potentially pay a tremendous financial price. Depending on the location, living in a nursing home can cost between $60,000 and $300,000 a year, with the median being $97,455 a year for a private room.

Not surprisingly, studies show that most older Americans prefer to remain in their own homes as long as possible and this results in a lot of care being delivered by skilled professionals and family members in the patient’s home. As a result, these caretakers often shoulder the greatest burdens for the patient such as transportation, meal prepping, and household chores, which can quickly monopolize someone’s time.

As a result, families need to be considerate to one individual who may be spending more of his or her time helping to take care of the elder than others and whether his person is properly compensated for all the hard work that goes into that. Furthermore, what may seem like a fair and equitable division of responsibilities at the present can end up anything but in a a few years or even months when major life events happen.

Centers for Medicare and Medicaid Studies Issue Guidance to States on Service

Published on: January 27, 2019 | by Ettinger Law Firm

The Centers for Medicare & Medicaid Services (CMS) recently released a “Dear State Medicaid Director” letter highlighting ten opportunities for states to better serve individuals dually eligible for Medicare both and Medicaid. The letter states that these these opportunities are newly available to states through Medicare rulemaking or other CMS burden reduction efforts and can be used to help better the lives of an estimated 12 million Americans dually eligible for Medicare and Medicaid.

Medicaid is an important source of medical coverage for individuals dually qualified Medicare beneficiaries as the former covers services the latter does not, such as long term care in nursing homes or assisted living facilities. Additionally, Medicaid aids in cost reduction for Medicare by helping pay Medicare premiums and cost-sharing, which may be high for low income individuals.

The outlines in the letter include new developments in managed care, using Medicare data to inform care coordination and program integrity initiatives, and reducing administrative burden for dually eligible individuals and the providers who serve them. Many advocacy groups have welcomed CMS’s efforts to forge closer ties with state administrators to improve the Medicare Part A Buy-in Program and simplify the eligibility and enrollment processes for Medicare Savings Programs.

IRS Issues Notice on ABLE Accounts

Published on: January 21, 2019 | by Ettinger Law Firm

The Internal Revenue Service recently issued a notice to people with disabilities who are employed that for the first time they can now deposit extra money into their ABLE accounts without losing Social Security, Medicaid, or other government benefits. Annual contributions to ABLE accounts are currently capped at $15,000 but under new legislation passed in late 2017 individuals with disabilities who are employed may now accrue at least some of their wages as well.

This year, Americans living in the lower 48 states may now deposit an additional $12,140 from their income which means workers with disabilities are allowed to save up to $27,140 in their ABLE account in 2018. Hawaii residents can save an additional $13,390 and Alaska residents can save an additional $15,180, according to the release put out by the IRS this month.

Additionally, the IRS has announced that workers with disabilities and an ABLE account may now qualify for a Saver’s Credit to help reduce their federal tax bill. Formerly known as the Retirement Savings Contributions Credit, the Saver’s Credit gives special tax breaks to low and moderate income taxpayers saving for retirement. The Saver’s Credit can be taken for contributions to a traditional or Roth IRA, a 401(k), SIMPLE IRA, SARSEP, 403(b), 501(c)(18) or governmental 457(b) plan.

Understanding the Law: What are the rules for Medicaid eligibility?

Published on: January 15, 2019 | by Ettinger Law Firm

With the skyrocketing costs of medical care and nursing homes, few people can afford to pay out of pocket costs to live in a long term care facility in their later years and most will eventually need to qualify for Medicaid to do so. Medicaid has essentially become the default funding source for for nursing home care and the long-term care insurance of the middle class in the United States.

Sources estimate that up to two-thirds of nursing home patients are covered by Medicaid, which was created to act as a safety net to the country’s poorest citizens. The definition of who qualifies as poor under Medicaid varies from state to state. In New York, individuals may only have up to $15,150 “countable assets” such as cash, stocks, bonds, investments, vacation homes, and savings and checking accounts to qualify for institutional or nursing home care. The spouse of the individual applying for Medicaid is allowed to have $123,600 in assets.

Certain assets are not counted towards these eligibility requirements. Some of the most important exemptions are the individual’s personal possessions like clothing and furniture, a single motor vehicle used for transportation, and the individual’s principal residence as long as he or she intends to return there at some point. For those over income an asset limits, New York does offer a variety of programs to help individuals qualify for Medicaid benefits.

Yes, You Need One: Reasons for A Last will and Testament

Published on: January 11, 2019 | by Ettinger Law Firm

Having a last will and testament is something that every single person needs to have, regardless of how substantial or modest they feel their estate may be. This because a last will and testament does much more than spell out who receives what part of an estate. A last will and testament can and should go on to set out contingencies for many practical scenarios and life events that the average person can find himself or herself in.

First and foremost, a last will and testament allows individuals to direct portions of their estate to whomever they choose. When individuals pass away without a will it is known as intestacy and will be distributed according to the laws of the state where that person resides. Generally, this means that the deceased’s property will be distributed among his or her immediate family, regardless of what his or her final wishes would have been.

Once a person passes away, his or her estate will generally need to pass through probate court, known in New York as Surrogate’s Court. Without a last will and testament, this process can be more costly and time consuming than if the deceased had clearly expressed to the court his or her final wishes on how to divide the estate in question.

Authorities Warn about New Social Security Scam Calls Targeting the Elderly

Published on: December 28, 2018 | by Ettinger Law Firm

Authorities across the country are warning of new scams targeting elderly Social Security over the phone, where individuals claiming to be government representatives try to collect sensitive information under the guise of a computer glitch causing issues with benefits. The Social Security Administration has made it very clear that under no circumstances will it call or send emails to beneficiaries asking for personal information, such as Social Security numbers, dates of birth or other private information, and advises people to not respond to such messages.

Other scams include callers asserting that beneficiaries need to pay a fee to unlock their Social Security number because of criminal activity and will also need to confirm their Social Security number. The Federal Trade Commission recently confirmed an increase in this type of scam and beneficiaries should be on the lookout for this type of illicit activity.

The AARP Fraud Watch Network recently announced it has had more complaints to its helpline in the past few months from consumers targeted by Social Security impostors than the older IRS scams that harassed thousands, if not millions, of Americans since 2013. According to the office of the Treasury Inspector General for Tax Administration, those IRS scams stole more than $73.6 million from almost 15,000 victims over the past five years.

Major Insurance Company Pulls Gym Membership Program

Published on: December 20, 2018 | by Ettinger Law Firm

As of January 1, 2019, approximately 1.2 million seniors across will lose their SilverSneakers coverage on Medicare Advantage plans that give them access to gyms and health centers without any additional membership costs. The controversial business decision will affects plan holders in California, Connecticut, Illinois, Indiana, Iowa, Kansas, Missouri, Nebraska, Nevada, North Carolina, and Utah who have Medicare Advantage plans with UnitedHealthcare.

An additional 1.3 million seniors across nine states with Medicare Advantage plans with Medicare supplemental (Medigap) insurance will also lose their access to the SilverSneakers program. States affected by this move include Arizona, California, Connecticut, Illinois, Indiana, North Carolina, Ohio, Utah and Wisconsin. Although the benefits were optional with UnitedHealthcare, millions of seniors nonetheless took advantage of the option to visit gyms and fitness centers for exercise.

Beginning next year, UnitedHealthcare will instead offer seniors with Medicare Advantage supplemental policies will get 50 percent off memberships at thousands of gyms across the country, telephone access to wellness coaches and access to various online communities and health-related resources. Seniors with UnitedHealthcare Medicare Advantage plans can join Renew Active, the company’s health and fitness program which offers a network of over 7,000 locations members can visit for no additional cost and even qualify for evaluations from personal trainers and online brain-training programs.

More Insurers Offering Medicare Advantage Plans to Help Seniors get Healthcare

Published on: November 24, 2018 | by Ettinger Law Firm

When open enrollment begins for Medicare, many seniors across the country will notice an expanded range of health care plan options, including those offered by private insurance companies through Medicare Advantage. With more Americans than ever considering and signing up for these Medicare alternatives, more insurance companies than usual are selling more Medicare Advantage plans for 2019, some offering lower or no premiums and improved benefits.

According to the Centers for Medicare and Medicaid Studies (CMS), an additional 14 new insurance companies will sell 3,700 plans for 2019, an estimated 600 more than offered to beneficiaries in 2018. CMS estimates that total enrollment for Medicare Advantage plans will grow to 23 million people in 2019, a 12 percent increase over the previous year and may grow to serve one-third of all Medicare enrollees in the next decade.

Medicare Advantage plans have been attractive to seniors due to the extra benefits these types of coverage options offer. Many of these private insurance plans can save seniors money because premiums, deductibles, and additional costs are lower than what beneficiaries pay with original Medicare offered by the federal government. One of the main downsides to Medicare Advantage Plans is that they require enrollees to seek care within a restricted network of health care providers.

What is the Best Trust for Special Needs Planning?

Published on: November 13, 2018 | by Ettinger Law Firm

Caring for a child with a disability creates challenges beyond our lifetime and often takes resources beyond what federal safety net programs can offer in order for our loved one to live the most comfortable and dignified life possible. While rules governing these federal programs place certain income restrictions on disabled persons to qualify, there are sanctioned trusts allowed specifically for special needs planning that allow for first party and third party benefits to supplement federal assistance.

In 2010, Congress passed the Achieving a Better Life Experience (ABLE) Act allowing beneficiaries to have up to $100,000 in a 529 special needs trust and retain Social Security Insurance benefits. Beneficiaries can also retain Medicaid coverage so long as the trust does not exceed the amount for a 529 college savings plan. The ABLE Act allows these trusts to be created so long as the beneficiary’s disability is established prior to the age of 26-years old.

Disabled persons can also create and fund their own first party special needs trusts through a (d)(4)(C). Funds for first party special needs trusts often come from sources such as a personal injury settlement, workers’ compensation award, or an inheritance left directly to the beneficiary. An amount equal to the annual federal gift tax exclusion (currently $15,000) can be deposited annually in the account while still maintaining the beneficiary’s eligibility for Medicaid and Supplemental Security Income

Calculating your Break Even Point with Social Security Benefits

Published on: November 5, 2018 | by Ettinger Law Firm

Figuring out the best time to claim Social Security benefits is an important part of retirement planning that can have long lasting impacts on the type of lifestyle individuals and their spouses can expect to enjoy in their Gold Years. Depending on when individuals decide to take their Social Security benefits, from the ages of 62 to 67, it can mean the difference of hundreds of dollars per month to thousands of dollars of the course of a lifetime.

While the conventional wisdom is to wait as long as possible to claim benefits, and hopefully reach maximum payouts, for many beneficiaries there comes a time known as the “break even point” when the amount of benefits claimed would be essentially the same regardless of the amount received per month. This happens because the program is designed to give individuals more or less the same payout over their projected lifetimes, known as “actuarial neutrality.”

Determining one’s break even point is a fairly straightforward process but should take into account certain other factors that may artificially inflate any projected payout, namely excluding cost of living adjustments. Including projected cost of living adjustments will only create artificially high numbers that may not end up being actual benefits received.