by Bill Miller | Jun 17, 2018 | Elder Law, Estate Planning, Medicaid
Elderly people often want to remain in their homes as long as practical. But their caregivers and loved ones face some tough decisions. How can they keep Grandma Ruth safe while respecting her rights? Sometimes, Medicaid home and community-based waivers provide the best solution to a difficult situation.
Avoiding the Move to a Nursing Facility
Long-term nursing care doesn’t have to mean you have to pack up and move to a nursing home. When it’s appropriate for a patient, in-home care is preferred over residential care. For one thing, it’s less expensive. Depending on the level of care needed and the location, costs may be as follows:
Nursing home care – between about $200-$235 per day, or approximately $6,000 – $7,000 per month.
Assisted living care – about $2,930 per month. Care for patients with severe Alzheimer’s or dementia may cost $830 more per month.
Adult day care – averages around $47 a day. Again, it’s more expensive in some areas than others.
In-Home Care – typically costs $17 to $22 per hour. Monthly cost, of course, varies depending on the number of hours the paid caregiver works. At 4 hours a day, 20 days a month, the cost would range from $1,360 to $1760.
So, How Can Medicaid Help?
Home- and community-based services are available to qualified Medicaid applicants. The Alabama Elderly and Disabled (E & D) Medicaid Waiver program offers waivers to people age 65 or older, or disabled. Those who qualify may have the state manage their care or may choose their care providers through a program called Personal Choices. This is sometimes called self-directed, participant direction, or cash and counseling.
The waivers are used to pay for in-home or community-based care. The program will not pay for 24/7 in-home care, though.
Use of Medicaid waivers for in-home care helps individuals while also reducing costs for Medicaid. However, participants in the program must first be qualified to receive Medicaid benefits.
Eligibility Is the Issue.
The attorneys at Miller Estate and Elder Law assist clients with applying for the right public benefits, like the Alabama Elderly and Disabled (E & D) Medicaid Waiver program.
For a free consultation with an experienced Alabama attorney, contact us at 256-251-2137 or use our convenient Contact Form. We have offices in Anniston and Birmingham and serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
by Bill Miller | Jun 16, 2018 | Estate Planning, Special Needs, trust
As the caregiver of someone with special needs, you’re called upon to make important decisions on a daily basis. Those decisions may be life-changing for you and for your loved one. Often, therapists, medical specialists, and other advisers help plan the best care for individuals who require extra care. It’s also important to talk to an attorney who understands the needs of disabled individuals. It may be time to establish a special needs trust to provide funds for immediate and long-term care.
Is a Special Needs Trust Different from Regular Trusts?
A trust generally involves three parties:
- the trustor who signs a trust document to create the trust;
- the trustee who manages the trust assets and distributions to beneficiaries; and
- the beneficiary who receives distributions from the trust.
In some trusts, one person may serve all three roles. However, a special needs trust is for a beneficiary with conditions that require a high level of care. The trust, then, may be structured to allow the beneficiary to be eligible for public benefits, like Medicaid.
Who Can Benefit from a Special Needs Trust?
Special needs trusts may provide significant assistance for the following types of beneficiaries:
- People under age 65 who may need government benefits like Medicaid or SSI in the future.
- Individuals who suffer from one or more conditions that limit independence or require long-term or substantial treatment.
- Someone who will need assistance when you are no longer able to assist.
What Can We Pay with a Special Needs Trust?
Trustee of special needs trusts must spend trust funds for the benefit of the beneficiary. Trustees should know what state and federal law allow. Consulting an attorney is a good way to get started. In fact, the attorney who drew up the trust or who is representing the trust, may be able to give you more information the trust. Trust documents provide guidance to trustees, as well as the attorney representing the trust.
How Will I Know if I Need a Special Needs Trust?
Keep the following things in mind:
- A special needs trust may provide additional financial security to you and your loved one.
- Anyone drafting a special needs trust needs to understand the needs of the disabled person.
- Special needs trust can negatively affect eligibility for programs like Supplemental Social Security Income (SSI) or Medicaid if not properly written.
Have Questions? We Can Help.
Schedule a free consultation with the attorneys at Miller Estate and Elder Law Our attorneys know how to help people like you. Just give us a call at 256-251-2137 or use our Contact Form to set up an appointment. Serving clients in the greater Anniston area, including Birmingham, Talladega, and Gadsden.
by Bill Miller | Jun 14, 2018 | Elder Law, Estate Planning, Medicaid
A job transfer took Harriet from Michigan to Alabama. The move was stressful, as most moves are. However, Harriet’s relocation was more complex than most. As an only child, Harriet was the only source of reliable help for her mother, who lived in a nursing home in Michigan. Harriet began making plans to move her Mother, but was concerned about her Medicaid benefits.
Medicaid Benefits
Although the funds for Medicaid flow from the federal government, individual states act as administrators of those funds. However, states are allowed to customize some rules and regulations. This flexibility means the rules for receiving Medicaid differ depending on your state of residence.
Fortunately, there are processes in place to move a Medicaid recipient from one state to another. Unfortunately, that process is not as easy as it could be.
Not Exactly a Transfer
First, the Medicaid coverage in the former state cannot just be transferred to the new state. Each state has different eligibility rules, and the recipient must meet the requirements of the new state. Also, Medicaid recipients are not allowed to have coverage in more than one state. So, establishing residency in the new state is the first step. The recipient then can cancel coverage from their former state and apply for Medicaid in their new state.
Requirements Related to Moving
The good news is that it’s probably not impossible to qualify for Medicaid in a new state. Although requirements vary, most states eligibility requirements are similar. A person who is already qualified for Medicaid in one state stands a good chance of qualifying in another state.
No length of residency requirement. States are not allowed to place length of residency requirements on applicants. An applicant can establish residency simply by moving to the new state.
Coverage can be retroactive. Naturally, it takes some time to get approval from the new state’s Medicaid agency. Fortunately, there should be no gap in coverage because Medicaid can be granted retroactively.
Maintain Medicaid Coverage During a Move.
Harriet was able to safely move her mother to a nursing home in Alabama. She cancelled the Michigan Medicaid benefits and immediately applied for Alabama Medicaid. Her mother’s application was approved, and her coverage continued.
Do you or a loved one need Medicaid assistance? Schedule an appointment with one of the qualified elder law attorneys at Miller Estate and Elder Law Our phone number 256-251-2137. Or you may choose to use our Contact Form to get started on your path to peace of mind.
by Bill Miller | Jun 13, 2018 | Elder Law, Estate Planning
As parents grow older, we become more involved in their lives. But your involvement should go beyond picking up the groceries and mowing the lawn. It’s time to find out if your parent has the right life care plan.
You say tomato, I say tom-ah-to.
‘Life care plan’ is another way of saying ‘estate plan.’ Either way you say it, estate planning is one of the most important processes you’ll go through.
Estate planning documents don’t just set forth how your parents want their property to be disposed of after death. Documents like a durable power of attorney, health care power of attorney, and living will dictate how your loved one’s golden years will unfurl.
The right estate planning documents can:
- protect your parent’s assets so they can pay for long-term care or leave an inheritance to their children;
- keep them from having to go through a guardianship or a conservatorship;
- assist in paying for long-term care; and
- provide critical information to medical providers.
But how will you know if your parent’s plans are right?
Talk to them.
Discussing topics like long-term care and death is never easy. However, your parents won’t be around forever. So, sit down and talk with them, go over any estate planning documents they’ve made. If they’d like, make an appointment with an attorney who can tell them whether their plan is still good to go.
Another benefit to talking to your parents? You give them the opportunity to state their wishes regarding medical treatment, end-of-life care, and funeral arrangements. Talking and planning may give them a great sense of relief.
Help them help themselves.
Maybe you have an older parent facing elder law issues. Maybe you are looking ahead to your own future. Either way, it’s important to know what rights and protections are available for senior citizens. Schedule a consultation with one of our attorneys and find out where you stand. Our phone number is 256-251-2137, or you may want to use the Contact Form on our website. We have offices in Anniston and Birmingham and assist clients in communities like Hoover, Vestavia Hills, Irondale, and Calera.
For more information about estate planning, please take a few moments to check out the videos on our website and YouTube channel.
by Bill Miller | Jun 11, 2018 | Elder Law, Estate Planning
Divorce has been around for a long time. But “gray divorce,” a relatively new term, refers to divorce of an older (gray-haired) couple. As with any divorce, your life will change. And any major life changes mean that it’s time to review your estate plans. Gray divorce may offer a few new wrinkles over a divorce that happens earlier in life.
Wills and Other Documents
Norma divorced her husband, Ray, after 42 years of marriage. However, she just never got around to changing her Will. When Norma passed away several years after the divorce, her family tried to probate her Will. Her ex-husband was supposed to receive all her estate other than a few small bequests to other family members.
Now, by Alabama law your ex-spouse is considered to have “pre-deceased” you if you pass away before changing your Will. It does not matter how long you were married before the divorce. Any bequests to your ex-spouse are revoked as soon as the split is finalized. In Norma’s case, her ex-husband will not receive any of her probate estate.
However, a Will is only one of your estate planning documents.
A power of attorney is a legal document where the principal (you) designates another adult to make decisions for them. With a durable power of attorney, the agent’s authority continues if the principal becomes incapacitated. If you named your spouse as your agent – as many people do – you need to change this document as soon as possible.
Two documents commonly used as advance directives are:
- The health care proxy in which you name someone to make health care decisions for you; and
- The living will in which you state your wishes regarding end-of-life treatment and name someone to speak for you if necessary.
As you might imagine, both documents should be changed as soon as possible.
Norma failed to change her health care proxy after divorcing Ray. She became incapacitated before her death. Ray was unwilling to make health care decisions for her, so her family had to go to court to get authority to act for her. The family was fortunate that Ray was not an unscrupulous person. Armed with Norma’s unchanged durable power of attorney, he could have cleaned out her bank accounts before her death.
Beneficiary Designations
Many, if not all, of your financial accounts and insurance policies allow you to state who will receive the funds in your accounts upon your death. Effective September 1, 2015, beneficiary designations to an ex-spouse are revoked unless the designations were specifically accounted for in the divorce settlement.
However, this does not mean you can forget about changing your beneficiary designations. In Norma’s case, her designations naming Ray were cancelled. However, she failed to name successor beneficiaries. Instead of transferring automatically to her heirs, the funds in her accounts were held up in probate.
Incapacity Planning
Hopefully, an older couple has done at least some incapacity planning. This may include buying long-term care insurance or establishing a living trust. Any plans made for incapacity will need to be untangled during the divorce negotiations.
Funeral and Burial Plans
Older people are more likely to have pre-paid funeral and burial plans. This type of plan will need to be negotiated. Even if a couple spent many years together, it does not mean they want to spend eternity next to each other.
Divorce Is Tough at Any Age.
The attorneys at Miller Estate and Elder Law have the experience you need to get the estate plan you deserve. Contact Miller Estate and Elder Law 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 | Jun 9, 2018 | Estate Planning
Every family is different. Only you can know how to approach your family about something as sensitive as estate planning. But discussions like this will help their peace of mind as they deal with difficult decisions and life events.
How to Help You with Incapacity . . . and How to Pay for It.
Facing the possibility of your future needs is hard. Your family and friends may be able to provide day-to-day living assistance. Discussing how you’d like family members assist you enables them to help without being asked. This may also be the time to share how you feel about in-house and nursing home care.
Let your family know how your long-term care will be covered. For example, do you have funds saved up specifically for long-term care, have you purchased insurance to cover increased medical needs, or have you already started planning your Medicaid eligibility.
Finally, tell your family about any estate planning documents you’ve prepared. Your Health Care Proxy or Medical Power of Attorney, Living Will, and Durable Power of Attorney provide your loved ones with guidance on how to handle medical and financial decisions for you.
What You Want Them to Do with Your Stuff.
We encourage our clients to talk to their families about how to handle their possessions after they pass away. While talking about this is great, it’s even better to have a Will or trust in place that distributes your estate as quickly and painlessly as possible. You don’t have to tell your family every detail of your estate plan. However, make sure your executor knows that you have a plan, where your plan documents are located, and which attorney to contact after your passing.
How to Say Goodbye.
Talking about death can be upsetting. Let your family know you’ve made plans to make your passing easier on them. If you’ve paid for pre-funeral arrangements or have definite ideas about your memorial service, share these now.
It’s never easy to talk to your family about estate planning.
But it is necessary.
If you haven’t made your estate plan yet, don’t delay.
The attorneys at Miller Estate and Elder Law stand ready to assess your needs and develop the right plan to meet those needs. 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 help clients in the Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
