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The combined pressures of growing need, rising costs, and altered ideas of the best way to live one’s golden years is leading to a revolution in the look and feel of elder care. To be sure, changes in the way seniors in need receive support are still occurring far too slow for some advocates. But it is undeniable that many seniors now are cared for differently than their parents and the trend will only continue in the coming years and decades.

One common suggestion is that communal living spaces (like nursing homes) are closing and being replaced by a growth in at-home caregivers. While that change is occurring, it oversimplifies the new landscape of seniors care. There are different version of at-home support and even communal living.

Senior Villages

When most hear the phrase “estate battle” the mind immediately jumps to fighting between families. Sadly, in the tumult of a passing, it is not uncommon for even close relatives to disagree sharply over how an assets should be divided. However, estate fights can also refer to legal problems related to taxes and the IRS. Tax matters are intricately woven into estate matters, and when problems arise, you can be sure that the IRS will be ready to defend their position in court.

How Much Was Jackson’s Estate Worth?

To understand how these IRS estate battles often play out, one need look no further than continued wrangling over perhaps one of the largest estates in recent memory. Famed entertainer Michael Jackson died in 2009. However, the estate is still fighting with the Internal Revenue Service regarding how many taxes need to be paid.

In December we shared information on proposed changes at the federal level which might limit the tax-saving benefits of charitable deductions. President Obama previously suggested limiting certain charitable tax breaks for high earning individuals. This possible change was just one part of large ideas about re-writing significant portions of the U.S. tax code. Many are hoping to simplify the code in an effort to increase transparency.

The charitable deduction change proposal in particular drew the ire of many when first suggested. Now a large group of sitting U.S. Senators are adding their names to the effort to protect the charitable deduction status quo.

The Senate Letter

The future of providing necessary care and support for New York seniors is a hotly debated topic. The analysis is taking place everywhere, including at the local level. As frequently discussed, one of the primary battlegrounds is that of county-run nursing homes. Long a bastion of care for residents, these facilities are being shuttered by some and transferred to private owners.

But not all New York communities are giving up on the idea of publicly-owned long-term care facilities. One area taking a cautious approach is Genesee County which recently commissioned a committee to study various aspects of long-term care in the community to determine the best course of action with regard to the current county nursing home.

NY Elder Care – A Closer Look

The New York Times reported late last month on a growing trend across the country–discussions about lowering estate tax obligations on state residents. The estate tax is the bite the government takes out of an individual’s assets before they go to heirs. There are two layers of tax, at the federal and state level. Under current law, the federal tax kicks in on all assets over $5.34 million for individuals at a top rate of 40%.

But the federal tax is not the only concern of residents, because many individual states have their own tax, including New York. The New York tax starts far lower–at $1 million. This means that even those residents who have no concerns about the federal estate tax still must account for their obligation under state law.

Lower NY Estate Taxes

For sports fans, all eyes this weekend are planted squarely on New York City with the Super Bowl set to kick off early Sunday evening. Beyond the usual chatter about who will win and lose, many commentators are discussing how this single game will impact the long-term legacy of many players in it.

Of course, at the end of the day, this game represents just a single game in a career. And for many players, that career is relatively short-lived. Football is a demanding sport, and it is not uncommon for players to retire in their late twenties or early thirties. It is only a rare few who play successfully into their late thirties.

This presents an unique dilemma for players who must then find other careers and/or properly manage their affairs early in life ensure financial stability for what is hopefully a many-decades long retirement. As you might imagine, many players are clumsy in this regard, making a plethora of estate planning mistakes that cause harm to themselves and their families down the road.

While the Affordable Care Act attempted to “bend the cost curve”, the cost of long-term care remains high and is projected to skyrocket in the future. In Illinois, the median annual cost for a nursing home with a private room was $125,732. (Genworth Financial, Inc., survey). Figuring out how to prepare for your long-term care as well as how to pay for it are major life decisions. It is important to take the time to consider your options, discuss your thoughts with your loved ones, and take affirmative steps to put your plan into place without breaking the bank.

Insurance Options

Two of types of health insurance that many have enrolled in, Medicare or traditional health insurance, do not cover long-term care. Medicare and traditional health insurance provide only short-term solutions. Medicare and private health insurance will cover only skilled care that is medically necessary and relates to a recent hospitalization. Notably, disability insurance does not cover long-term care and often many policies end when you turn 65 since disability insurance is only to replace lost wages, not pay for healthcare costs.

The New York Medicaid system is the primary source of funding for many seniors in need of long-term care at nursing homes. Medicare does not cover these extensive stays, and the out-of-pocket costs are tremendous. As a result, many seniors enroll in the program to pay for their care.

Payments for long-term care make up a sizeable part of the entire Medicaid budget. As a result, policymakers are often looking at ways of cutting expenses or funnelling more money into the program to pay for those in need. One way that Medicaid law has accounted for ths is via a Medicaid estate recovery program. The basic idea is that the state can re-coup portions of the funds spent on an individual under Medicaid after that person’s passing. This takes the form of the state receiving a portion of the decedent’s assets.

The laws regarding Medicaid estate recovery are quite complex, with exceptions depending on surviving spouses, dependent children and similar details. But, under current rules,recovery may be made on “assets passing under the terms of a valid will or by intestacy, and any other real and personal property and other assets in which the decedent had any legal title or interest at the time of death…”

A somewhat bizarre story out of Europe is leading a few elder care experts in the United States to question whether “shipping away” seniors may be part of the future of long-term care for some families.

As reported by the BBC, one adult daughter in Switzerland ignited an ethical debate recently by deciding to send her mother to a long-term care home in Thailand for support. The daughter explained that her decision was based on both her mother’s specific condition and financial realities. The 91-year old mother apparently suffers from severe dementia, and is unable to remember much of anything about the present. In addition, the cost of care in Switzerland was incredibly high–similar to that in New York–while Thai care was far more affordable. The daughter felt that her mother could receive better services in Thailand where she now lives with a group of other Swiss and German seniors.

A Wave of the Future?

The words “Social Security” remain synonymous with retirement benefits for seniors. Earlier generations grew up with the understanding that Social Security would provide an income net in their golden years, allowing a modest but safe retirement. However, the current generation does not have nearly the same picture of the system. Political debates are daily filled with arguments about the “impending” collapse of the system and the bare bones support given to those on the program.

For many New Yorkers, Social Security represents only a small part of their retirement plans. Still, considerations must be given in estate planning to when one should begin collecting Social Security. There are different options for taking early withdrawals, regular withdrawals, or delaying payments for potential benefit down the road.

In general, payouts range from 75% of “entitled benefit” for payments at age 62; 100% of benefits of age 66; and 132% of benefit at 70. Lawmakers are frequently discussing changes to this scheme, particularly in light of rising life expectancies, and so it is critical to be aware of the potential alterations down the road.

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