by Bill Miller | Aug 22, 2018 | Medicaid, Medicaid Planning, Medicaid Qualification, Nursing Home
Medicaid, though funded by the federal government, is managed by state agencies. Each agency has the power to customize their program, and this can include imposing co-payments, deductibles, and so on. If you or a loved one receives Medicaid benefits, you need to know how Medicaid handles out-of-pocket costs.
Do I have to pay out-of-pocket expenses?
Many patients are expected to pay co-payments on expenses like:
- Office visits to doctors, optometrists, nurse practitioners, and other healthcare providers).
- Hospital care, including those provided at federally qualified health centers, rural health clinics, inpatient, outpatient, and ambulatory surgical centers.
- Durable medical equipment,
- Medical supplies and appliances, and
- Prescription drugs.
The co-payments are small. However, health care providers cannot deny services if a Medicaid recipient cannot pay the co-payment.
Are any services exempt from out-of-pocket charges?
Yes. Out-of-pocket fees by law cannot be charged for:
- Emergency services,
- Family planning services,
- Pregnancy-related services, or
- Preventive services for children.
Are any groups exempted from paying out-of-pocket fees and co-payments?
Yes, some Medicaid recipients are not expected to pay such fees:
- Children,
- Terminally ill people,
- Nursing home residents,
- Native American Indians with an active user letter from Indian Health Services,
- People receiving emergency treatments, and
- People receiving family planning services.
Check with your Medicaid caseworker to make sure you are not charged for co-payments and out-of-pocket expenses if you are included in one of these groups.
Will Medicaid repay my out-of-pocket expenses?
Not exactly.
Sometimes Medicaid will be awarded retroactively. This means that earlier costs that are eligible for Medicaid coverage may be paid. However, the patient is responsible for contacting the health care provider responsible for anything they paid for themselves. The provider will submit the services to Medicaid and typically reimburse the patient after receiving the payment from Medicaid.
First, You Have to Get Through the Medicaid Application Process.
It’s complicated and difficult, but we can help. We have helped many clients navigate federal and state guidelines to get the benefits they deserve.
The attorneys at Miller Estate and Elder Law assist their clients with all phases of estate planning and incapacity planning. For a free consultation, contact us at 256-251-2137 or use our convenient Contact Form. Although we’re located in Anniston, we also help clients in the Birmingham, Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
by Bill Miller | Aug 17, 2018 | Estate Planning, Special Needs, trust
Julia’s daughter, Jenna, is a happy 17-year old woman. She participates in social activities, attends school, and has a job despite being born with multiple birth defects. While she’s satisfied with the progress Jenna has made, Julie is worried about her future. She wonders if her daughter’s needs can be anticipated and provided for in her estate planning.
The Basics
Typically, an estate plan consists of a Will, a durable power of attorney, and an advanced health care directive like a health care power of attorney. But complete estate plans address all of the testator’s needs and some people need more than the basics.
Julia can provide for Jenna in her Will. She could also have Jenna’s inheritance transferred to a trust for her benefit.
Extra Protection
Parents of a disabled child may have options that ensure their child’s future support.
- Special Needs Trust. This type of trust may calm at least some of Julia’s fears. The trust would be funded with money and assets that a trustee could use for Jenna’s support. However, if the trust is not properly drafted, it could reduce or eliminate Jenna’s eligibility for public benefits like Medicaid.
- Medicaid Income Trust. Also known as a Miller Trust or a Qualified Income Trust, Jenna can transfer some of her monthly income to this trust to remain below Medicaid’s income limits.
- ABLE Account. Julia might consider setting up savings plan called an ABLE account. ABLE stands for Achieving a Better Life Experience. Anyone can contribute to Jenna’s account, and the funds will be used for Jenna’s support.
- Guardianship. Jenna will be considered an adult at age 18, even though she has the mental age of a 10-year old child. If she has not already done so, Julia should talk to an attorney about setting up a guardianship for Jenna. Although disabled people often need to be as independent as possible, they remain vulnerable to people who may take advantage of them.
It can be difficult to find a way to provide for a disabled child’s future while preserving eligibility for public benefits and their own independence.
Consult with an Alabama Estate Planning Attorney.
Another thing Julia could do? Provide a letter of intent for future caregivers that gives instructions for Jenna’s care. While not technically an estate planning document, Julia can keep this letter with her important papers.
The attorneys at Adams & Miller have the experience you need to get the estate plan you and your loved ones deserve. Contact Adams & Miller, P.C. at 256-251-2137 to schedule an appointment or fill out our convenient Contact Form. We help clients in Anniston, Talladega, Birmingham, Gadsden and surrounding communities.
by Bill Miller | Aug 15, 2018 | Elder Law, Estate Planning, Medicaid Planning
Ned was a prominent business man in the community before suffering a devastating stroke. Sally was young and carefree, until she was involved in a catastrophic car accident that nearly took her life. And Jane’s mother, Lucy, was near death and worried about where all her property would go after she passed away. These individuals have something in common: they were involved in emergencies that could have been helped – or were helped – by estate planning.
The Need for Incapacity Planning
Ned and his family had absolutely no warning before he fell ill. One day he was running his business and planning a vacation with his wife. The next, he was lying in the Emergency Room. His family did not know where to turn when handling his complicated finances and his business interests.
Ned had never signed a durable power of attorney, which would have remained active even after his incapacity. If he had, his family would have known who was responsible for taking over his financial affairs. He also had never put together any business succession plans with his associates. They were left scrambling for ways to keep the companies afloat.
The Need to Make Health Care Decisions
Sally’s injuries were life-threatening and life-changing. If she lived, she would face a tough road ahead. Her family had many tough decisions to make – but no one was authorized to make them.
She also had never signed a durable power of attorney or a health care power of attorney. Because Sally was over age 18, her mother was unable to make medical or financial decisions for her. The medical issues were the most pressing. Her doctors needed to talk to someone who could make decisions about Sally’s care. Finally, Sally’s mother was forced to start a court proceeding to become her guardian and conservator.
The Need to Have a Plan
Jane’s mother would be entering a hospice soon. She knew she was not going to survive her liver cancer. Jane wanted her mother to be as comfortable as possible, but something was bothering Lucy. She had never made a Will. It was important to her that she use her last days to make a good plan for her estate and her heirs.
Jane contacted an attorney who met with her mother. Because her mother was still mentally alert, she was considered to have the capacity to prepare her Will. She knew who her beneficiaries were, and what property she owned. The attorney prepared the Will, which Lucy signed a week before death.
Good Estate Planning is Key.
We can’t always know when something bad is going to happen to us. However, we can have plans in place that will handle those bad times if they come.
The attorneys at Adams & Miller, P.C. know how to help you with estate planning. For a free consultation, contact us at 256-251-2137 or use our convenient Contact Form. We also offer free workshops and guides with more information about topics that matter to you. Although we’re located in Anniston, we also help clients in the Birmingham, Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
by Bill Miller | Aug 13, 2018 | Elder Care Planning, Elder Law, Estate Planning, Medicaid Planning, Medicaid Qualification, Nursing Home
Jackie wanted her mother to have the best care possible. At age 82, Mom needed more assistance than she could get at home, even considering the great in-home nursing options available. As Jackie looked for a nursing home for her mom, she wondered how much her mom’s long-term care would cost? She came face to face with reality: long-term care is expensive!
What are the chances someone will need long-term care?
According to federal government statistics, 20% of people age 65 will need long-term care for more than five years. And if you are 65 right now, you have an almost 70% chance of needing some form of long-term care.
The families of people needing long-term care are affected also. In addition to the stress of caring for another person, they must also find the right type of care. Family members also usually have to struggle to find a way to pay for that care.
What type of care is considered long-term care?
It’s not just residential care at your local nursing home. There are other options.
- In-Home Care. Most older people want to stay in their homes as long as possible. When they need extra nursing assistance, they can often hire skilled in-home care providers.
- Assisted Living Facilities. While this is residential care, as is a nursing home, the resident has greater flexibility and privacy. Assistance, often from a trained nurse, is available if needed.
- Residential Care. Sometimes this type of care if unavoidable. Residents of nursing homes may lose some privacy but make up for it with greater skilled nursing care.
So, how much does long-term care cost?
It depends on where you live and what type of long-term care is needed.
The following figures reflect the 2017 cost for long-term care in Alabama:
- $42,900 – In-home care
- $41,688 – Assisted Living Facility
- $73,000 – Nursing Home (semi-private room)
- $76,650 – Nursing Home (private room)
These costs, of course, are averages and the actual cost may vary. Costs are expected to increase over time.
Start Planning Now.
At Adams & Miller, P.C., we make it our business to put our client’s needs first. We assist our clients in making thoughtful decisions regarding incapacity planning. For a free consultation, contact us at 256-251-2137 or use our convenient Contact Form. We have offices in Anniston and Birmingham and we assist clients in the Leeds, Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
by Bill Miller | Aug 10, 2018 | Estate Planning, trust
David and Amy knew they needed a Will. At least, that’s what they thought. They made an appointment with an Alabama estate planning lawyer to discuss their Wills. Their attorney told them all about trust-based estate plans. David and Amy were surprised to learn that there were other options that better fit their lifestyles.
A Complete Estate Plan Revisited
More than a Will is involved when someone creates an estate plan. Typically, a general durable power of attorney and some form of advanced health care directive are signed along with a Will. And then there are trusts.
For some, a trust should make up the foundation of their estate plan. A Will is still necessary. However, the Will and trust work together and work for the testator.
Advantages to Trust-Based Estate Plans
All trusts involve the following parties:
- The Settlor or Grantor (sometimes more than one),
- At least one Trustee, and
- One or more beneficiaries.
The settlor sometimes also serves as trustee and is a beneficiary. It depends on the type of trust. There are various types of trust that each have a different purpose.
An estate plan that is based on a trust and not a Will offers some useful benefits:
- Avoiding Probate. A will-based estate passes through the probate court. Trusts typically do not. Instead, trust assets may pass directly to the beneficiaries upon the death of the settlor. This, again, depends on the type of trust and the terms contained in the trust document.
- Lowering Taxes. Some estates allow property transfers with little to no tax consequences. This tactic is especially helpful to larger estates.
- Asset Protection. Wills do not protect assets, particularly during the testator’s lifetime. A well-crafted trust-based estate plan, however, can safeguard assets both before and after the settlor’s death. Many asset protection trusts are irrevocable, which makes the trust impossible or at least very difficult to change.
- Protects Personal Information. Wills become part of public court records during probate. Trusts usually do not. A trust-based plan helps protect your personal information and that of your heirs.
Everyone still needs to have a Will. However, it does not have to be the foundation of your estate plan.
Talk to Your Attorney About Trusts.
Schedule a consultation with one of the attorneys at Adams & Miller, PC. You may be pleasantly surprised to discover the options available for your estate plan. Our phone number is 256-251-2137, or you may want to use the Contact Form on our website. We also offer free guides and videos about estate planning and trusts.
We have offices in in Anniston and Birmingham and assist clients in communities like Hoover, Vestavia Hills, Irondale, and Calera.
