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 | Jul 31, 2018 | Medicaid, Medicaid Planning
Moving grandfather to the nursing home was hard enough. But applying for Medicaid at the same time? Very stressful, but it is even worse if you submit incomplete or incorrect paperwork. This could delay much-needed Medicaid benefits. Read on to learn more about the supporting documents to submit with a Medicaid application.
The Application
Medicaid consists of more than one program. For example, there’s a program for children and a different one for nursing home residents.
Alabama Medicaid maintains online applications, as well as forms that might need to be attached. Paper applications are available at local Medicaid offices.
Sometimes documents must be attached to the application. For example, if the applicant needs an authorized representative to help with the application, Appendix C should be attached to paper applications.
Make sure you use the right application, filled out completely with all attachments.
The Supporting Documents
The first thing to understand is that Medicaid wants documents going back five years from the date of application (the Look Back Period). The applicant should submit bank statements or balances (monthly for the first 12 months of the Look Back Period, quarterly for months 13-24, and June and December for months 25 through 60). Medicaid will also want to see proof of gross income, including VA benefits, Social Security benefits, rental income, pensions and retirement funds, wages, and interest. In addition, some or all of the following documents from the Look Back Period will be required:
| Annuities |
Life insurance policies |
Power of attorney |
| Long-term care policies |
Receipts and titles |
Bonds |
| Wills |
Trusts |
Social security card |
| Promissory notes |
Stocks |
Burial contracts or policies |
| Conservatorship papers |
Property deeds |
Medicare care |
| Loan documents |
Retirement account statements |
Any other documents that are requested |
| Guardianship documents |
Medicare Part D policies |
|
The applicant should keep copies of all supporting documents, as well as the application and any correspondence sent or received.
Sound Complicated? It is, but We Can Help.
The attorneys at Miller Estate and Elder Law assist clients with applying for Medicaid benefits. We also help with Medicaid planning and estate planning. For a free consultation with an experienced Alabama attorney, contact us at 256-251-2137 or use our convenient Contact Form.
We also offer free guides, videos, and workshops.
We have offices in Anniston and Birmingham and serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
by Bill Miller | Jul 13, 2018 | Medicaid, Medicaid Planning
Both Medicare and Medicaid are government programs that help eligible individuals with medical costs. Because of the similar names, though, people have trouble knowing which program they need. Let’s take a look at how each program handles two important things: eligibility and services.
Medicare and Medicaid Eligibility
Medicare is offered only to those 65 or older or people with End Stage Renal Disease (ESRD). Medicaid offers benefits from children to pregnant women to nursing home residents.
People can check online or with their local Social Security office to see if they are qualified for Medicare. Typically, most people are enrolled in Medicare Parts A and B when they turn 65.
The application process for Medicaid is more complicated. Benefits are based on income and resources. Medicaid looks back at applicant’s finances for five years from the date of application. Some applicants may find they are not eligible for benefits, or their benefits are delayed, because of transactions like transferring assets to their children.
So, a person over the age of 65 with limited income and resources might be eligible for both Medicare and Medicaid.
Medicare and Medicaid Services
Medicare is divided into four parts:
- Part A – Inpatient care at a hospital or skilled nursing facility.
- Part B – Some preventive care, outpatient care like doctor’s appointments.
- Part C – Advantage plans that combine Part A and Part B benefits, as well as the option to include drug coverage.
- Part D – Prescription drug coverage.
Medicare recipients choose which plan they want, usually based on their needs and how much they can pay for the premiums.
Medicaid, on the other hand, pays for care like that received at a hospital or skilled nursing facility, federally-qualified health center, rural health clinic, freestanding birth center, and so on. This is by no means a comprehensive list of the services offered by Medicaid. In fact, states typically offer the following programs to help the following groups:
- Children,
- Parents and caretaker relatives,
- Pregnant women,
- Elderly and disabled persons,
- Nursing home residents, and
- Patients with breast or cervical cancer.
So, Medicare and Medicaid both offer benefits that cover medical care. However, Medicaid benefits target segments of our population that may not be covered by Medicare.
Learn More About Medicaid Eligibility.
The attorneys at Miller Estate and Elder Law know how to help you with Medicaid eligibility. 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 | Jul 6, 2018 | Estate Planning, Medicaid, Medicaid Planning
At age 98, Jamison truly is his family’s patriarch. His children want him to attend the annual family reunion. The problem? Jamison lives in Alabama. The reunion is in Texas. Although he does not live in a nursing home, Jamison requires some skilled nursing care and is legally blind. They are concerned that Jamison’s Medicaid benefits will not pay for medical services while he is away from Alabama.
Jamison’s family is right to be worried. Although the funds for Medicaid benefits come from the federal government, individual states manage Medicaid for their citizens. Jamison’s Medicaid benefits, then, are administered by Alabama Medicaid. Individual states are allowed to develop their own rules and regulations, as long as they comply with federal regulations.
It’s the Law
Federal law at 42 CFR 431.52 provides that state plans will pay for services provided to Medicaid recipients who are temporarily out-of-state. However, the following conditions must be met:
(1) Medical services are needed because of a medical emergency;
(2) Medical services are needed, and the beneficiary’s health would be endangered if he were required to travel to his State of residence;
(3) The State determines, on the basis of medical advice, that the needed medical services, or necessary supplementary resources, are more readily available in the other State;
(4) It is the general practice for beneficiaries in a particular locality to use medical resources in another State.
The law goes on. States are required to establish procedures so individuals who are eligible for Medicaid under another state’s program can receive medical services.
But It May Not Be Easy
Note that medical costs incurred during an emergency are covered. This means that individuals may be billed for services related to non-emergencies, unless that care fits the other criteria listed above. Also, the out-of-state provider has to enroll as a provider with the Alabama Medicaid Agency. And, finally, some services have to be pre-approved.
Medicaid Is a Complex Program.
Schedule a consultation with one of the attorneys at Miller Estate and Elder Law, 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 in Anniston and Birmingham and assist clients in communities like Hoover, Vestavia Hills, Irondale, and Calera.
by Bill Miller | Jul 2, 2018 | Medicaid, Medicaid Planning
Molly B. has struggled with chronic obstructive pulmonary disease (COPD) for years. Elijah J. has suffered from liver disease for years and now needs a transplant. And after her recent diagnosis, Hannah W. has questions about sickle cell disease. These people have something in common – they might benefit from Medicaid’s Health Home Program.
As a joint federal-state government program, Medicaid offers health benefits to qualifying individuals. Many people think of Medicaid when they face the need for nursing home care. Medicaid is much more than that, though. For example, the Health Home program.
The Details
Medicaid’s Health Home Program connects patients with the right services and resources. It also teaches patients about self-management and provides necessary transitional care. For some patients, Medicaid Health Home provides services to bridge medical and behavioral health services. This is by no means a comprehensive list.
The extra services provided by Health Home are offered, but not mandatory. Patients have the option of not accepting those services.
Eligibility
To receive benefits, the patient’s Primary Medical Provider (PMP) has to be contracted with the regional Health Home group. The patient also has to be enrolled in the Patient 1st Program.
Health Home services provides services in addition to support already received by the patient’s Primary Medical Providers. Patients who suffer from, or are at risk of contracting, the following chronic conditions often need an extra level of coordination between medical providers:
- asthma
- diabetes
- cancer
- COPD,
- HIV,
- mental health conditions,
- substance abuse,
- transplants,
- sickle cell disease,
- BMI over 25
- heart disease,
- Hepatitis C.
Hannah W. worried about how the combination of her sickle cell disease with diabetes would affect her care. Her doctor joined the Health Home program and directed her toward self-management resources and other programs that might help her.
How it Works
The Health Home group in the patient’s region will contact you to discuss their medical needs. They will let the patient know what services are available. The patient then has the right to refuse those services or accept. For example, Molly B. did not feel she needed any additional services and refused those offered by Health Home.
The patient will have to choose a doctor who is signed up with the Patient 1st program. After having been with the same doctor for years, Elijah J. was dismayed to learned that his doctor did not participate in the Patient 1st program. He had to decide whether to stay with him or move to another doctor.
This additional care is not permanent. The patient can cancel at any time.
The Catch? You Have to Be Receiving Medicaid.
The application process for Medicaid is a difficult path for most people to navigate. The attorneys at Miller Estate and Elder Law help many of their clients every step of the way.
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.
