Archive for the ‘Long Term Care Planning/ Medicaid Planning’ Category
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July 20, 2011
It is a common problem. One spouse’s health is declining. The other spouse is relatively healthy but is having trouble continuing to provide care for the unhealthy spouse at home. Something has got to give. Soon some kind of long-term care facility will be necessary. But how will they afford it?
According to the 2010 Market Survey of Long-Term Care Costs conducted by Metlife, the annual cost of a semi-private room in a Cleveland area nursing home was $75,190 and a private room was $87,600.
Moreover, counter to popular belief, Medicare will not cover prolonged nursing home care. Medicare Part A provides limited coverage for skilled nursing care if certain requirements are met. However, even if your level of care meets Medicare’s eligibility requirements, Medicare Part A only covers the cost of a skilled nursing facility for up to 20 days, with the possibility of an additional 80 days on a co-payment basis.
Again, according to Metlife, which based their statistics on the Centers for Disease Control and Prevention, the average nursing home stay is 2.4 years. Moreover, most nursing home stays are not covered by Medicare at all, as most nursing home residents do not require skilled nursing care, which is a prerequisite to Medicare Part A coverage.
Since Medicare will not cover the costs of long-term care, many couples will need to turn to Medicaid.
Medicaid is a health insurance program funded with state and federal money, administered by the Ohio Department of Job and Family Services. For those who qualify, Medicaid covers the cost of long-term care. So how do you qualify your spouse for Medicaid while preserving sufficient resources for you to live on as well?
The planning strategies available to you will depend on timing. Has your spouse entered a hospital or nursing home and stayed for 30 plus days? If not, there will be more planning options available then if you wait until after this time has passed.
To put it plainly, when your spouse applies for Medicaid, a resource assessment will be conducted, which takes into consideration all of your property as a married couple, regardless of whose name the property is titled in. The ill spouse will be able to keep $1,500 and the healthy spouse will be able to protect only one-half of the couple’s assets (excluding your home, car, personal affects and other exempt assets) up to a maximum of $109,560.
However, if the couple employs planning techniques, they can often save additional assets and enable the healthy spouse to keep additional monthly income. Remember, giving assets away will result in a penalty period, and should not be done absent the advice and guidance of an elder law attorney. See http://www.randallperla.com/blog/why-do-i-need-to-plan-for-medicaid-ie-why-can%e2%80%99t-i-just-give-my-assets-to-my-children/ One planning technique that may be available to a married couple is the revocable trust. See http://www.randallperla.com/blog/before-applying-for-medicaid-a-married-couple-should-consider-a-revocable-trust/
For information on additional planning strategies available to married couples, stay tuned to this blog and consider meeting with a Medicaid Planning attorney.
Elizabeth L. Perla, Esq.
Law Offices of Randall M. Perla
19443 Lorain Road
Fairview Park, Ohio 44126
Phone (440) 333-2503
Fax (440) 333-9650
perlalaw@wowway.com
www.randallperla.com
Cleveland Medicaid Attorneys
Cleveland Elder Law Attorneys
Cleveland Medicaid Planning Attorneys
July 18, 2011
As discussed in http://www.randallperla.com/blog/personal-caregiver-agreement/ a Personal Care Agreement, also known as Caregiver or Caregiving Contract, Family Caregiver Agreement, or Personal Service Contract, is an agreement between a senior and another individual who promises to provide care for the senior in exchange for compensation. There are many advantages to a Personal Care Agreement. Some of the advantages include:
- Provide compensation to a trusted loved one who may have had to quit a job, forgo job opportunities or otherwise spend considerable time and energy providing care.
- Minimize problems among relatives as to who will provide necessary care and how it will be paid for.
- Allow the senior to stay in his or her home longer and delay entry into a long-term care facility.
- Avoid gift tax, estate tax and probate on property transferred via Personal Care Agreement.
- Transfer money and assets to a caregiver instead of a long-term care facility and have Medicaid pay for future long-term care needs.
If you are considering drafting a Personal Care Agreement for Medicaid planning purposes, please review the following 8 Key Tips:
1) Put in it writing. The agreement should be in writing and signed and dated by both parties.
2) Be specific. A proper agreement should set forth the specific services that will be performed, and if possible the days and hours of care.
3) Be fair. The services provided must have real value. Hence, attending birthday parties, celebrating holidays, and Sunday visits should not be included, especially if you are related, as those types of services are expected to be done for family and friends without compensation. Instead, services should include things you would hire someone to perform for you, like grocery shopping, cooking, laundry, cleaning, bathing, taking you to the doctor, etc. Moreover, the compensation for these services should be based upon the going rate and should differ depending on the level of skill needed to perform each service.
4) Termination terms. Make sure the agreement states when it is to begin and that either party can end the agreement with sufficient notice.
5) Forward Looking. The agreement must be for future services and should not include compensation for past services rendered.
6) Payment. Monthly or weekly payments are preferred over lump sum payments.
7) Keep good records. The services provided and the dates and hours of care should be kept in a log. Moreover, the caregiver should report the income for tax purposes.
8) Don’t wait. The closer the agreement is executed to the time of Medicaid application, the less legitimate the agreement appears.
If you are drafting a Personal Care Agreement for Medicaid planning purposes or if there is a chance the senior will need Medicaid assistance to pay for long-term care in the future, it is a good idea to have an elder law attorney review the agreement prior to execution. An elder law attorney can also help you explore other Medicaid planning opportunities as well as assist you with the Medicaid application process.
Elizabeth L. Perla, Esq.
Law Offices of Randall M. Perla
19443 Lorain Road
Fairview Park, Ohio 44126
Phone (440) 333-2503
Fax (440) 333-9650
perlalaw@wowway.com
www.randallperla.com
Cleveland Medicaid Attorneys
Cleveland Elder Law Attorneys
Cleveland Medicaid Planning Attorneys
Cleveland Personal Care Agreement Attorneys
Cleveland Family Caregiver Agreements Attorneys
Cleveland Personal Service Contract Attorneys
June 29, 2011
Under Ohio law, there are certain individuals that you are required to financially support and cannot abandon. Those people are your spouse, your child who is under age 18 or handicapped child under age 21, and your aged or infirm parents or adoptive parents who lack the ability or financial means to support themselves. Failure to provide support is a crime and a misdemeanor of the first degree. However, although this law has been in effect since 1974, I could not find a case where it was used to prosecute an adult child for not providing financial support for an aging parent.
So why the lack of enforcement? Beyond the fact that our jails are over-crowded enough as it is, is the fact that with skyrocketing health care costs, it simply isn’t feasible to require adult children to cover the cost of their parent’s astronomical long-term care costs.
According to the 2010 Market Survey of Long-Term Care Costs conducted by Metlife, the annual cost of a semi-private room in a Cleveland area nursing home was $75,190 and a private room was $87,600.
Moreover, counter to popular belief, Medicare will not cover prolonged nursing home care. Medicare Part A provides limited coverage for skilled nursing care if certain requirements are met. However, even if your level of care meets Medicare’s eligibility requirements, Medicare Part A only covers the cost of a skilled nursing facility for up to 20 days, with the possibility of an additional 80 days on a co-payment basis.
Again, according to Metlife, which based their statistics on the Centers for Disease Control and Prevention, the average nursing home stay is 2.4 years. Moreover, most nursing home stays are not covered by Medicare at all, as most nursing home residents do not require skilled nursing care, which is a prerequisite to Medicare Part A coverage.
Since Medicare will not cover the costs of long-term care, and 70% of people over 65 will need long term care during their lifetimes, many people will need to turn to Medicaid.
Medicaid is a health insurance program funded with state and federal money, administered by the Ohio Department of Job and Family Services. For those who qualify, Medicaid covers the cost of long-term care.
And thankfully for adult children all over Ohio and the United Stated, Medicaid does not required adult children to support their aging parents. Under federal law, states like Ohio, who administer the program, are prohibited from looking at the finances of an applicant’s adult children when determining eligibility. Hence, you will not be required by Medicaid to contribute to your aging parent’s long term medical costs.
Please keep in mind, though, that because Medicaid’s resource limit is so low (currently $1,500) without proper planning, your parents will have to deplete all their resources before they can qualify. There are many planning opportunities available in order to not only preserve as much of your parents’ savings as possible but also to improve the financial situation of your parents’ spouse, should they need long term care. A Medicaid Planning attorney can help you explore your Medicaid planning options.
So what do you think, should adult children be required to help support their aging parents? Please post your thoughts.
Elizabeth L. Perla, Esq.
Law Offices of Randall M. Perla
Cleveland Medicaid Attorneys
19443 Lorain Road
Fairview Park, Ohio 44126
Phone (440) 333-2503
Fax (440) 333-9650
perlalaw@wowway.com
www.randallperla.com
June 23, 2011
What are your biggest fears as you face aging? The following are 3 widespread aging fears that you may be struggling with:
1. Running out of money.
2. Becoming a burden to your family.
3. Losing control of your life, ie. being forced to move into a nursing home.
What can you do to quash these fears?
Step One is to take stock of your situation.
1. Finances- Take a piece of paper or spreadsheet and list your assets, debts, and income.
2. Health- Do you have any current health problems or, given your family history, do you have any health expectations?
3. Goals- What lifestyle do you envision? If your health declined, do you see yourself receiving care at home, living with a relative, entering a facility, etc.?
Step Two is to seek counsel and make a plan.
Sometimes it takes a village. You may wish to seek out a financial advisor to assist you in meeting your financial goals. If your health is declining, you may wish to seek out a care coordinator to explore your care options. You should also consider seeing an attorney. An attorney can ensure that you have basic estate planning documents in place like a will, health care and financial powers of attorney and can also advise you whether it is in your interest to engage in additional planning. Maybe a trust is right for you. Maybe you should be engaging in long term care planning. You won’t know until you have explored your options and sought out competent counsel.
Long term care planning can be a particularly valuable method to ensuring peace of mind. The goal of long term care planning hits right at the fears listed above. Long term care planning looks at your available resources, your health and your preferences for health care and crafts a plan to avoid becoming a burden to your family or losing control of your care environment.
Step Three is to not let denial, apathy or laziness prevent you from getting started.
It’s no secret that no one likes getting older or the new challenges that come with aging. But if we’re lucky we all reach are golden years. Make sure that your seniority is spent how you want it to be.
So what are your greatest aging fears and what have you done to quash them? Please share below.
Elizabeth L. Perla, Esq.
Law Offices of Randall M. Perla
Cleveland Long Term Care Planning Attorneys
19443 Lorain Road
Fairview Park, Ohio 44126
Phone (440) 333-2503
Fax (440) 333-9650
perlalaw@wowway.com
www.randallperla.com
June 1, 2011
- You can expect a benefits determination to be made within 30 to 45 days after the application is submitted to the Department of Job and Family Services.
- You will receive a Notice of Approval or Denial. The Notice must contain a clear statement of the agency’s action and the reason for it. If you are approved, it will also contain the date that aid begins and the amount of the aid. If you are denied, it must contain the means of challenging the decision.
- If you are unhappy with the ruling or if you do not receive an approval or denial in a reasonable amount of time, you can request a State Hearing. Requests can be made by the applicant orally or in writing and must be made within 90 days of the notice being mailed. If the request is not being made by the applicant himself, it will need to be made in writing by an Authorized Representative with a written authorization designating the Authorized Representative by the applicant.
- You may wish to consider hiring an attorney to represent you at the State Hearing in order to examine the agency case file, utilize witnesses, exhibits and other supporting evidence, cross-examine witnesses, and prepare a written brief.
Elizabeth L. Perla, Esq.
Law Offices of Randall M. Perla
Cleveland Medicaid Planning Attorneys
19443 Lorain Road
Fairview Park, Ohio 44126
Phone (440) 333-2503
Fax (440) 333-9650
perlalaw@wowway.com
www.randallperla.com
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