Medicare

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Organizing Assets - Preparation for Possible Long Term Care

Nursing care can be administered at home, or when there are more serious medical issues, in a nursing facility.  Without proper planning, both situations may result in a devastating financial crisis for the family.  Nursing home care is often $7,000 to $9,000 per month.  Too often we have seen families wait until the last moment before they seek legal advice in this area - where planning is so critical.

If you are retired and you want to safeguard your assets for the financial security of yourself and your family, you should plan now!  If you are a child of an elder, you should discuss this issue with your parent.  We can not stress enough the need for families to discuss these issues and to plan in advance.

Medical insurance generally will not pay for nursing home care.  Under certain circumstances, Medicare will pay for nursing home care, but only up to ninety days.   However, Medicaid can pay for nursing care administered at home, or in a long term care facility, for the life of the applicant.    Under the current law, an applicant for Medicaid must pass both an "income" and "asset" test to be eligible for benefits.  If the applicant is married, the resources of both spouses are counted.  An applicant may have not more than $2,000 in "countable assets", with a small allowance provided for the spouse.  A residence is often, but not always, considered a "non-countable" asset.  However, the Commonwealth of Massachusetts may also place a lien on an applicant's real estate, including the residence in certain instances, and force a sale within nine months.  The sales proceeds are then paid to the state under the lien.  The Commonwealth may also seek to recover assets from the estate of an applicant after his or her death.  Gifts made within 5 years prior to application may disqualify the applicant from Medicaid benefits.  We have seen parents deed their home to their children under the mistaken belief that such a transfer will safeguard the residence, only to find that they have disqualified themselves from Medicaid benefits.  So, extreme caution must be utilized when making gifts (cash, investments, real estate, etc.) to children and heirs.

Proper planning in this area may save assets which can be utilized to maintain the quality of living of elders, and provide an inheritance to your children and heirs.  Our office utilizes various strategies to lessen the risk of loss of assets to devastating long-term care expenses.  These strategies include the shift of "countable" to "non-countable" assets, use of various trusts and life estates, annuities, long-term care insurance, and controlled gifting programs, to mention a few.  Under the current law, purchase of sufficient long-term care insurance will prevent recovery by the Commonwealth against an applicant's estate assets.  Our office can provide the necessary professional guidance your family needs to properly plan, and lessen the risk of financial loss. 

Please see the article, Self-Financing Long-Term Care, reprinted with permission from The Elder Law Report, © 2000, all rights reserved, for a "case study" of one family's situation and the advantages of utilizing an Elder Law Attorney / Certified Financial Planner.  Of course, every family's situation is different, and the recommendations contained within the article may not be appropriate to your situation.   You should consult with our office before taking any action.  (Clicking the link to the article will open Adobe Acrobat Reader, which will give you the opportunity to print the article or view it on-line.  We strongly suggest that you print it in order to get the most benefit from this case study.  If you don't have the latest version of Adobe Acrobat Reader on your system already, download it here free.)

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Last-Hour Planning - Preparation of Medicaid Applications

If you or a family member has already entered a nursing facility and is "private pay", or is faced with nursing home placement in the near future, contact our office immediately.  While there may be insufficient time to create a full Medicaid plan, many planning opportunities still exist.  It is critical that strategies designed to take advantage of these opportunities be implemented before you exhaust your assets and before you apply for Medicaid benefits.  Do not delay.  We may be able to save a portion of your assets for your family.

You may expect that the Massachusetts Division of Medical Assistance, which administers the Medicaid program, will request copies of the applicant's birth certificate, marriage certificate, proof of current income, and copies of all bank, mutual fund, brokerage, and retirement benefit statements for the past 36 months, along with closing statements for the sale of all real estate within the past 10 years.  Therefore, you should start collecting these documents as soon as it become evident that an application for Medicaid benefits may be necessary.

The Medicaid application is lengthy and complicated.  It asks certain questions which must be answered very carefully.  An improperly completed application can delay eligibility or cause a denial of benefits.  This could result in a family's continued payments to a facility as a "private pay" patient.  Our office has the expertise to do the "Last-Hour Planning", complete the Medicaid application, and deal with the requests for additional information which regularly come from the Division of Medical Assistance after the application is filed.   Call us as soon as possible to schedule an appointment.  We can help you during this difficult and stressful time.

Our office can provide the necessary professional guidance your family needs to properly plan, and lessen the risk of financial loss.