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What is a Medicaid Crisis and What Are Your Options?

What is a Medicaid Crisis and What Are Your Options?

Imagine that your parent or another aging loved one suddenly finds themselves in need of nursing home care. If they haven’t already planned for the potential cost of long-term nursing care, they could find themselves in an incredibly compromised and vulnerable position. Because of the strict income and asset limitations that dictate who is eligible for Medicaid, your parents (or even you) may end up blowing through your life savings in order to pay for the cost of long-term care.

It is well known that Medicaid has a 5-year lookback period, so those who find themselves in immediate need of long-term care often assume there is nothing they can do to get qualified.

Fortunately, that is a myth. With the help of a qualified elder law attorney, Medicaid Crisis Planning could help you or your loved ones preserve some of their assets while becoming eligible for Medicaid.

What is Medicaid Crisis Planning?

About 70 percent of American seniors will need some type of long-term care planning, many of whom will find themselves in nursing homes. Because of the high nursing home costs—the median annual cost of a private room in a nursing home is over $100,000—it is important to meet with an elder law attorney to work out a detailed plan to prepare for this situation long in advance.

If, however, you find your loved one facing an unexpected health emergency that will likely require nursing home care, you do have options. For people who have assets significantly higher than the Medicaid threshold, the best of these options is Medicaid Crisis Planning. Medicaid Crisis Planning is a way to avoid spending down your entire life savings when faced with an immediate or near-immediate health situation.

How Does Medicaid Crisis Planning Work?

With Medicaid Crisis Planning, the person facing a nursing home visit gifts a large part of their assets—sometimes up to 50 percent—to a Medicaid Asset Protection Trust, or in some cases directly to a child or another loved one. The rest of the person’s assets are then converted to an income stream through a Medicaid Compliant Annuity (or in some states a promissory note) After these transfers are completed, the patient applies for Medicaid to cover the nursing home cost.

In most cases, the application will be approved subject to a penalty period.  That penalty period is based on the amount of the gift they have made to their child or other loved one (and any other transfers for less than fair market value that have been made in the past 5 years). During this period of ineligibility, (penalty period) the person will privately pay for nursing home care using their monthly income, as well as the funds produced by the annuity or payments from the promissory note or annuity. Once the ineligibility period has expired, Medicaid will start paying the monthly nursing home bill.

While the applicant will need to use some of their life savings initially, in the long-run, they will be able to salvage some of what they’ve worked a lifetime to accrue.

Long-Term Care Planning

With proper long-term care planning, you and your loved ones can be protected from having to spend down your entire life savings when faced with an unexpected nursing home admission—without the need for Medicaid Crisis Planning. An elder law attorney will help you protect your assets and guide you through which financial moves to make (or NOT make) as you age. For example, it may be advised that you set up a Medicaid Asset Protection Trust or purchase assets that are exempt from Medicaid.  This can prevent you from incurring a penalty, should you need to apply for nursing home Medicaid in the future.

The sooner you start planning for the cost of long-term nursing care, the better.  As it goes, an ounce of prevention is worth a pound of cure.

Whether you are interested in long-term care planning or find yourself in need of Medicaid Crisis Planning, it is important that you work with an experienced estate and elder law attorney. Elder law matters are as complicated as they are essential, so choosing the right professional can make all the difference.

At Miller Estate and Elder Law, we have many years of experience with long-term care planning and Medicaid Crisis Planning. Call (256) 251-2137 to speak with a member of our legal team today or contact us using the brief form below.


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Providing Care After an Alzheimer’s Diagnosis: Caring for Aging Parents

Providing Care After an Alzheimer’s Diagnosis: Caring for Aging Parents

When a parent or another loved one receives an Alzheimer’s diagnosis, the news lands like a devastating blow. Knowing that you will soon watch someone you love lose their memory and struggle with daily tasks is emotionally wrenching. In addition, your loved one will eventually need intensive dementia care, which can put heavy strains on a family—both psychologically and financially.

Although it’s unlikely that you will be able to provide all the care necessary for a parent diagnosed with dementia, many children do take on a large share of the burden of looking after their parents. For most people, caring for aging parents or loved ones who have received an Alzheimer’s diagnosis is a whole new experience, and one that is very overwhelming. Knowing a few basics about dementia care can help ease the burden.

Everyday Care for Those Diagnosed with Dementia

Because people with Alzheimer’s will start to experience changes in memory and their ability to think clearly, they will need help performing many everyday tasks. The inability to perform what used to be simple tasks can prove quite frustrating, and understandably so. Here are some ways you can help support a loved one who is struggling with dementia:

  • Establish a routine. For people with Alzheimer’s, doing the same thing at the same time every day can help them stay focused on and involved in their own lives. Furthermore, certain tasks need to be performed at a time when the patient is most alert, so it’s important to schedule these at that specific time each day.
  • Help your loved one write down tasks and reminders. Writing down the things they need to do and remember will encourage them to take responsibility for their life, and will also help keep their mind sharp.
  • Allow the person to do as much as possible by themselves. Although Alzheimer’s patients will need more and more help as their disease progresses, it’s important to allow them as much independence and autonomy as possible.
  • Provide choices. Providing the person with simple choices, like the choice between two shirts to wear, can help them feel empowered and stay focused.
  • Reduce distractions. Make sure the environment your loved one lives in is free from distractions, particularly during mealtime or conversations. Otherwise, they may get confused.

Safety Considerations for People Diagnosed with Alzheimer’s

As well as helping the person with their daily tasks, providing them with a safe environment is an important part of dementia care. Here are a few things you can do to prevent them from getting injured:

  • Lock away potentially dangerous objects, such as cleaners, medicines, matches, or knives.
  • Remove anything that the person could trip over, such as extensions cords or small rugs. Also, install handrails or grab bars to help the person maintain their balance.
  • Keep the thermostat on a lower setting so that the person won’t accidentally burn themselves.
  • Insert safety plugs into unused electrical outlets.

Legal Concerns

In addition to providing care for a loved one diagnosed with dementia, there are also important legal considerations that come with looking after their affairs. At the first word of an Alzheimer’s diagnosis, you should contact an elder law attorney to ensure the proper legal documents are in place so you can focus on providing care, and not a lengthy and costly legal process. Drafting documents while your loved one is still coherent is essential, though there are limited options for those whose loved ones have already lost significant cognitive function.

At Miller Estate and Elder Law, we have many years of experience helping people whose loved ones have received an Alzheimer’s diagnosis. Use the brief form below to download a copy of our free guide: Caring for Aging Parents or call (256) 251-2137 to speak with a member of our legal team today!



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What is a Trust…and Do I Need One?

What is a Trust…and Do I Need One?

Most people know that a will is an important piece of the estate planning puzzle, but there are many misconceptions about trusts. Most people believe that trusts are reserved for the very wealthy. While it’s true that not everyone needs a trust, it is hardly limited to those with multi-million dollar estates. Depending on your estate planning goals, assets, and wishes, a trust may be a very viable option for you—even if your estate is modest.

But, what is a trust…and how do you know if you need one?

What is a trust?

A trust is a legal contract that ensures the proper distribution of assets to the trustor’s beneficiaries. Assets can be distributed in the exact manner you wish them to be. The individual creating the trust—called a ‘trustor’ or ‘grantor’—places title to his or her assets into the ownership of the trust. The process of transferring assets to the trust is called ‘trust funding,’ and is an essential part of successful trust creation. The trustor will also name a person to manage and administer the assets held in the trust, called a ‘trustee.’ A well-organized and regularly maintained trust has the potential to save your loved ones from certain headaches, like probate court, and can offer tax benefits for inheritances, as well as more privacy and control over your assets.

General Guidelines

Generally speaking, trusts may be a viable option for you if you have a net worth of $100,000 or more, a considerable portfolio of real estate and other tangible assets, or detailed instructions for how you’d like your assets to be distributed to your beneficiaries when you pass away. It’s important to note that these recommendations are not set in stone, as each circumstance is highly unique, and even those who don’t meet these guidelines may still benefit from drafting a trust.

Types of Trusts

To further answer the question “what is a trust,” and determine whether a trust will fit your unique needs, it’s important to understand the different types of trusts that exist, and what makes them different. The most common types of trusts include:

  • Revocable (aka ‘Living’) Trust: This flexible trust allows you to cancel, maintain, and make amendments to the trust while you’re still alive. A revocable trust isn’t subject to probate, but doesn’t always protect assets from creditors, as the trustor still legally owns the assets that have been transferred to the trust.
  • Irrevocable Trust: Contrary to a revocable trust, irrevocable trusts are not able to be revoked or amended without the consent of all beneficiaries named in the trust. While this certainly limits the flexibility of the trust, it better protects the trustor from creditors and lawsuits. Additionally, an irrevocable trust can help minimize estate tax liabilities.
  • Testamentary Trust: Also referred to as a ‘will trust’ this type of trust is generated from a last will and testament, becoming effective (and irrevocable) after the trustor passes away. Testamentary trusts ensure that assets are distributed to beneficiaries at a designated time—known as the ‘trust expiration,’—which is prompted by a triggering event, such as the beneficiary turning a certain age. Because this trust is part of a will, it must go through probate before the trust can be created.
  • Charitable Trust: This type of irrevocable trust allows you to leave behind a legacy of giving. Charitable trusts are often established to reduce estate and gift tax liabilities. A charitable remainder trust (CRT) carries the added benefit of providing a source of income to you or your beneficiaries during the trust term. At the time of your passing, all remaining assets will then be distributed to the designated charity.
  • Special Needs Trust: Parents and guardians of children and adults with a disability can use this type of trust to protect a beneficiary’s eligibility for needs-based government programs, like SSI and Medicaid. This allows trustors the ability to provide financially for these beneficiaries when they are no longer around to physically care for them.

While creating a trust isn’t for everyone, it is a valuable part of an estate plan for many, providing an additional layer of protection for your legacy, and the future security of your loved ones. The flexibility, problem-solving, and variety that a trust provides makes it an attractive option for those seeking a well-rounded estate plan.

Educating yourself on trusts is only the first step. When it is time to create your trust, working with an experienced estate planning attorney will ensure that your trust is established and funded properly. Contact usvia the brief form below to get started today, or learn more about protecting your assets by signing up for Miller Estate and Elder Law’s FREE estate planning workshop.



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My Spouse Needs to go to the Nursing Home…Now What?

My Spouse Needs to go to the Nursing Home…Now What?

You’ve been married to your spouse for decades. Lately, you’ve noticed that they are losing the ability to look after themselves. You realize that they may soon need nursing home care. You know this requires a lot of planning. Are you prepared?

When a spouse needs nursing home care, most people find that they are ill-prepared for the expenses associated with it. Paying out-of-pocket is expensive. After all, you’ve worked a lifetime to purchase your home and build your nest egg you should be able to pass those down to your children and grandchildren…not lose them to the nursing home. Your other options are to apply for Medicaid, or use long-term care insurance. Sadly, long-term care insurance is often overlooked until it’s too late to get it, leaving Medicaid as the only option. However, Medicaid eligibility can be tricky, and most people wonder how their assets might be impacted.

What Happens to My Income?

If your spouse has to go to a nursing home, all of their income will go to the nursing home.  You can keep all of your income but in many cases that is not going to be enough.  Without proper long-term care planning and a loss of your spouse’s income, your life savings could be drained in a matter of months if you have to pay out-of-pocket. Becoming eligible for Medicaid is challenging, with inhibitive income and asset limitations that may leave your spouse unqualified to receive these benefits. As the spouse who is not going to apply for Medicaid (also known as a “community spouse”), your income will not be factored in to eligibility. However, your spouse’s monthly income (which cannot exceed ~$2,523 per month ) will be used to determine Medicaid eligibility, and to pay for care, if approved. This leaves you at home with just one income to cover all of your expenses.

What About My Other Assets?

The other consideration when determining Medicaid eligibility is the assets that are owned by you and your spouse, regardless of whose name they are held in. The Medicaid applicant cannot own assets valued over $2,000 to qualify, not including your primary home or car. You, as the community spouse, can keep half of your assets, up to a maximum of $137,400.

You might also wonder which assets are included—and which are excluded—in the Medicaid application process. Typically, liquid assets, like bank accounts, insurance policies valued over $1,500, stocks and bonds, mutual funds, and second homes and cars, are considered countable assets. It should be noted that your home and one car are not included. This is because the community spouse would continue to reside in and otherwise utilize these assets. Additional assets that are exempt from Medicaid include personal effects, burial plots, and life insurance policies valued under $1,500.

So, What Are My Options?

If your spouse needs nursing home care now, and you are faced with either having to pay out-of-pocket or qualify for Medicaid, you still have some options. You may be tempted to spend down or transfer your assets, but Medicaid will look back 5-years from your application date to ensure you did not give away money to become eligible. Medicaid qualification is a confusing area of law, so it is best to plan with an elder care attorney who can take the guesswork out of applying for Medicaid and help you to avoid common mistakes that may cause penalties and delays in approval.

If you expect your spouse will need nursing care in the not-so-distant future, it’s best to start planning immediately. This is also a good time to consult with an elder law attorney about best practices for maximizing retention of assets and nursing home care provisions for your spouse. Your elder law attorney may suggest actions like:

  • Paying down existing bills: Medical bills, car loans, credit cards, etc.
  • Home improvements: Repairing plumbing and heating systems, fixing the landscaping, purchasing household goods and furnishings, and making structural modifications.
  • Funeral trusts: Purchase a pre paid funeral plan which in not countable and while takes care of an inevitable expense.

At this point, you’ve probably determined that paying for long-term nursing home care can be complicated at best, with so many variances and challenges depending on your unique circumstances. Proper planning should be implemented sooner rather than later to prevent costly and stressful consequences. Miller Estate and Elder Law can help you strategize in order to yield optimum benefits for you, your spouse, and—ultimately—your entire family.

Watch our FREE webinar to learn more about Medicaid eligibility and how to get your spouse qualified for the care they need, without sacrificing your life savings.

https://millerestateandelderlaw.com/medicaid-qualification-webinar

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Probate Property: Which Assets Must Go to Probate Court?

Probate Property: Which Assets Must Go to Probate Court?

You’ve probably heard horror stories about the nightmare that is probate court. Undoubtedly, friends and neighbors have had to undergo the probate process…and chances are, they don’t have many good things to say about it.

Let us first say, probate isn’t quite as bad as it gets made out to be (though it certainly CAN be for the ill-prepared). Probate is the legal process that authenticates your will in order to properly facilitate the allocation of your assets to your beneficiaries. Upon death, the estate administration process begins, drawing together all the necessary documentation for the distribution and management of your assets, which the probate court then oversees. The most common document utilized is a will.

If an individual passes away without a will—also known as dying ‘intestate’—the estate administration process becomes much more complicated, and a time-consuming, costly probate process is almost inevitable.

Being proactive and drafting a will, as well as understanding which assets must go through probate, can make the probate process much easier, or bypass it altogether.

Which Assets Need to Be Probated?

Whether or not your assets end up in probate is dependent upon how your estate plan is set up. Essentially, any property that does not have a designated beneficiary, or is not set up to pass by operation of law, will inevitably be deemed probate property, and settled in probate court. Some examples of circumstances that lead to probate include:

  • When an individual dies without a will. Without a will present, the estate becomes dependent upon the laws of intestacy, leaving the probate court to adjudicate who will inherit the deceased’s assets.
  • When a person passes away as the single-named owner of titled assets. These assets include items like real estate, investment and bank accounts, vehicles, personal property, collectibles, safety deposit box contents, and other solely titled assets of the deceased.
  • When property does not have a title. If the deceased does not have the compulsory paperwork for assets in their ownership, and the property isn’t clearly named in the will with the deceased’s wishes, the assets become probate property.
  • When the beneficiary predeceases the testator. If your will hasn’t been updated before your named beneficiary passes away, their inheritance will be settled in probate.

Actions You Can Take Now To Avoid Your Assets Being Probated in the Future

As you can see, there are many factors that could land your estate in probate court; however, there are some things you can do now to make a more ironclad estate plan that is specifically designed to keep your assets out of probate, or at least simplify the probate process.

  • Ensure your will is detailed. While having a will isn’t enough to avoid probate (all wills must go through probate), when a will clearly defines your wishes, it simplifies the process, and makes authorization to distribute your property much less laborious.
  • Establish a living trust. A living trust prevents probate because the trust takes ownership of the assets placed within it and, upon your passing, a named trustee will distribute your estate as stipulated in the trust – without the need/input of the probate court.
  • Title property jointly. Property owned in joint ownership with right of survivorship automatically passes the property to the surviving owner(s), without probate.
  • Name a beneficiary. Assets that have a named beneficiary—for example, your retirement plan, life insurance policy, or transfer-on-death or payable-on-death bank accounts—escape probate by sending items directly to beneficiaries.
  • Give assets away while you’re still alive. Although this is a no-brainer, it deserves an honorable mention. Simply put, if the property is no longer owned by you at the time of death, it doesn’t go to probate. This, however, can cause issues with qualifying for Medicaid if long-term care is needed, so we encourage you to speak with an elder law attorney before giving away money or assets.

At Miller Estate and Elder Law, we pride ourselves on providing clients with a high level of attention to detail that takes all of the guesswork out of estate planning. We create tailored solutions that are based on your specific goals and objectives. Our educational resources and unique programs keep you and your estate plan up-to-date, giving you the confidence needed to be secure in knowing your estate is in good hands.

Contact us today, register for a free workshop, or browse our resources, which address many common questions. With our guidance, you’ll gain peace of mind knowing your estate will be ready for smooth sailing after you’re gone.

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What Does Medicaid Cover…and What Does Medicaid NOT Cover?

What Does Medicaid Cover…and What Does Medicaid NOT Cover?

what does medicaid cover

Medicaid is a government-administered health insurance program that provides coverage to low-income Americans during all stages of life, from birth to age 65+. Given the massive breadth of this program, it should not come as a shock that it’s an incredibly complex system, governed by a confusing set of rules. This article aims to answer the questions, what does Medicaid cover, and what does Medicaid NOT cover?

While Medicaid can support individuals of any age, it’s an especially excellent resource for seniors. Long-term nursing care costs in Alabama average $78,000 per year, and that is for a shared room. However, qualifying for Medicaid can be a challenge. Applicants must meet certain financial and medical eligibility requirements. There are strict income and asset limits, with policies designed to prevent individuals from giving away their assets in order to qualify. A qualified elder law attorney can help you navigate the Medicaid maze, and avoid unsuspecting mistakes that could leave you or a loved one without the coverage they need.

For seniors who qualify, Medicaid is a wonderful program that works in collaboration with Medicare to cover a variety of healthcare needs

What Does Medicaid Cover?

Medicaid covers mandatory healthcare services, including:

  • Hospital care
  • Skilled nursing
  • Home healthcare
  • Doctor’s appointments 
  • Preventative care & wellness screening
  • Transportation to and from medical appointments
  • Diagnostics

Optional benefits include hospice care, case management, prescription drugs, physical or occupational therapy, rehabilitation, dental, vision, and more.

However, Medicaid does have some limitations…

What Does Medicaid NOT Cover?

In most circumstances, Medicaid will not cover medical care provided outside of the United States, though certain circumstances—such as if a foreign hospital is closer than a domestic hospital—may be covered. Like with private health insurances, Medicaid will also not cover services deemed unnecessary, or services paid for by another insurance provider. 

Some other services that Medicaid will not cover include:

  • Free health screening or medical devices that are given away
  • Cosmetic surgery or complications that result from cosmetic surgery
  • Personal comfort items or beauty services

Every state has slightly different Medicaid qualifications and coverage, so the best way to gain comprehensive (and accurate) understanding is to speak with a qualified elder law attorney in your home state.

Miller Estate and Elder Law is happy to offer a number of free resources to help you better understand how Medicaid planning works, and how to avoid going broke paying for long-term care. Gain access to our brief 20-minute webinar about how to get you or a loved one qualified for Medicaid by completing the brief form below, or download one of our free guides.

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