Medicaid Planning

These Texas Estate Planning Strategies Will No Longer Help Avoid Medicaid Penalties

Published on: July 22, 2020 | By McCulloch & Miller, PLLC

When putting together a thorough Houston estate plan, one important consideration is how care expenses will be paid later in life. This includes long-term care planning, which can be one of the most significant expenses for older Americans. For those with limited assets, Medicaid will typically pay for nursing home expenses.

Many people anticipating the need for long-term care have used several methods for gifting assets to others in order to qualify for this benefit. The goal of Medicaid planning is to qualify for Medicaid benefits that cover long-term care, while minimizing the penalty that would result from the transfer. Recent changes to Medicaid laws have rendered several of these methods that were formerly used to achieve these objectives obsolete. Below are a couple of strategies that will no longer be effective, moving forward.

The “Half a Loaf” Strategy

Planning for Medical Expenses During Retirement

Published on: November 18, 2019 | By McCulloch & Miller, PLLC

The unknown about spending in retirement is not just whether it will be higher or lower, but when during the course of retirement, you’ll be spending more or less. If you downsize, housing costs will decrease, but if you travel more, recreational spending will rise.

According to a recent article from Investopedia, “How to Plan for Medical Expenses in Retirement,” healthcare is likely to be the biggest expense in retirement. A survey from Fidelity Investments found that a 65-year-old newly retired couple should budget about $285,000 for medical expenses in retirement. It is better to have the money set aside than to be surprised by the cost. That number also does not include long-term care. Depending on where you live, those costs can range from $18,720 for adult day care services to $100,375 for a private room in a nursing home.

Despite saving and preparing for retirement their entire lives, many retirees aren't mentally or financially prepared for these types of expenses. A survey by HSA Bank found that 67% of adults 65 and older thought that they’d need less than $100,000 for healthcare. However, Fidelity calculated that males 65 and older will need $133,000—and females, $147,000—to pay for healthcare in retirement.

How Does a Medicaid Annuity Work?

Published on: July 1, 2019 | By McCulloch & Miller, PLLC

When one spouse needs nursing home care and the other is healthy, there are several approaches that can be taken to securing Medicaid coverage. An elder law estate planning attorney should be contacted, since every situation is different. For some couples, a Medicaid-compliant annuity may be a solution.

What happens when one person needs long-term nursing home care, but does not have long-term care insurance and the family cannot afford to pay out of pocket? Applying for Medicaid is difficult if you have too much money to qualify, but not enough to allow the healthy spouse to afford to pay their bills.

Doing a “Medicaid spend down” requires the person to become broke, before they are eligible. What happens to the spouse’s lifestyle? One solution is a Medicaid Annuity, as described in U.S. News and World Report’s recent article, “What Is a Medicaid Annuity?”

How Trusts Work in Estate Planning for Regular People

Published on: March 18, 2019 | By McCulloch & Miller, PLLC

You’ve heard the expression “trust fund babies.” However, trusts are not just for the wealthy. They have a number of uses in estate planning and can be helpful at any asset level.

The reality of our own mortality keeps some of us up at night. For others, it’s a disturbing thought that is easily brushed aside. Whichever group you belong to, you need to have an estate plan in place. This is the only way that you can have any say in how your assets are distributed after you pass. Without an estate plan, your family will be subjected to much more stress and financial strain. One part of an estate plan is a trust.

Barron’s recent article, “Why a Trust Is a Great Estate-Planning Tool — Even if You’re Not Rich,” explains that there are many types of trusts, but the most frequently used for these purposes is a revocable living trust. This trust allows you—the grantor—to specify exactly how your estate will be distributed to your beneficiaries when you die, and at the same time avoiding probate and stress for your loved ones.

How Does Medicaid Treat College Savings Funds?

Published on: October 31, 2018 | By McCulloch & Miller, PLLC

Saving for college but needing to receive Medicaid is a complicated equation.

The answer “It depends” is not much of a comfort when considering how college savings accounts will be treated for Medicaid purposes. However, it is, unfortunately, the most accurate answer. There are several factors that must be considered:

What type of account you used to set aside the college money;

Can a Revocable Land Trust Shield Assets from Medicaid?

Published on: May 11, 2018 | By McCulloch & Miller, PLLC

Control of an asset is a key element, when Medicaid considers an individual’s eligibility.

A recent article from nj.com, “What revocable land trusts mean to Medicaid eligibility,” starts with what sounds almost like a warning: it’s not easy to protect or hide assets from Medicaid. A revocable land trust won't help to protect an asset from Medicaid's spend down requirements, because a trust that’s revocable can be revoked or terminated at any time by the grantor.

A land trust is a private agreement with the trustee agreeing to hold title to property for the benefit of the beneficiary or beneficiaries. The creator of the trust is called the settlor or trustor. This person is usually the titleholder to the property, before it’s transferred into the trust.

Are You Saving Enough for the High Cost of Assisted Living?

Published on: March 13, 2018 | By McCulloch & Miller, PLLC

If you haven’t been saving for retirement, maybe you’ll do better if you are focused on saving for assisted living. One well known survey, 2017 Genworth Cost of Care Survey, reports that you’ll need $1,517 a month for adult day health care. Those fees are only going in one direction—up!

Adult health day care is not inexpensive in our country. If all you need is adult day health care, consider yourself lucky. It’s a bargain at more than $1500 a month, compared to $3,750 for an assisted living facility, $3,994 for home care services, and $4,099 for home health aides.

If you want some privacy, the median cost is $7,148 for a semiprivate room at a nursing home and $8,121 for a private room. Will you be able afford it? Wealth Advisor poses this question in its recent article, “Have Clients Planned For Long-Term Care?”

Why You Need Long-Term Care Insurance

Published on: December 14, 2017 | By McCulloch & Miller, PLLC

The cost of long-term care insurance may not be cheap, but the cost of long-term care is extremely expensive, and is only moving higher.

Long-term care insurance is costly, but health care costs for seniors who need long-term care could easily undo decades of retirement planning. Here’s what you need to know about the costs and benefits of long-term care insurance.

The Chicago Tribune’s recent article, “Thinking of buying long-term care insurance? Consider these costs,” reports that a 2015 cost of care survey from insurance company Genworth Financial estimated the national median cost of care for a home health aide to be almost $46,000 annually, while the national median cost for a private nursing room home is more than $91,000 annually.

Medicaid Matters—Here’s Why

Published on: September 26, 2017 | By McCulloch & Miller, PLLC

It is premature for anyone who depends upon either Medicaid or Obamacare to breathe a sigh of life. While recent attempts to repeal Obamacare have failed, both of these programs are being targeted.

Medicaid is far more important to more Americans than most people know. It does provide healthcare for the poor, but it also pays for long term care health care and nursing home care for millions of Americans.

Radio station WTOP in Washington, DC recently posted an article, “Why Medicaid matters to you,” which says that long-term care in the U.S. is extraordinarily expensive: the median annual cost of a private room in a nursing home is more than $92,000. A shared room costs more than $82,000. Expect these prices to continue to increase, since costs have risen by 19% since 2011. Similarly, the median price for care in an assisted living facility exceeds $43,500 and those seniors who want to stay at home with the help of an in-home aide from a home care agency pay $20 an hour or $175,000 a year for round-the-clock care.

Understanding the Basics about Medicare

Published on: April 25, 2017 | By McCulloch & Miller, PLLC

Even if you are still working, once you turn 65, you have to navigate your way through an entirely new and complex health care system. While there’s no HR department, there are resources.

It starts the day you turn 65, and it’s a bit of a challenge. Seniors need to get up to speed fast on the many requirements of Medicare. A recent post of Kiplinger’s, “FAQs About Medicare,” warns that mistakes can be extremely costly and difficult to fix. You’ll want to study up on this in advance.

For starters, if you signed up for Social Security before age 65, you’ll automatically be enrolled in Medicare parts A and B and receive your card three months before your 65th birthday. Part A covers hospitalization and is generally premium-free. Part B covers outpatient care, such as doctors’ visits, x-rays and tests, and costs $134 a month for people who enroll in 2017 (or more for high earners).