Medicaid Planning

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).

How to Prepare for Long-Term Care Costs in Houston

Published on: August 15, 2016 | By McCulloch & Miller, PLLC

The cost of long-term care can take a huge bite out of retirement savings, exhaust family resources and create strain on relationships. Don’t count on Medicare, but do plan in advance.

At least seven out of ten Americans age 65 and over will need long-term care at some point. Most people simply underestimate the cost of long-term care, or they think that Medicaid will cover the costs. Your best defense against long-term care costs: advance planning with professional help.

The Memphis Daily News article, “Long-Term Care – Not for Everyone,” says that Medicare does little for these costs and only for a short time period. Medicaid doesn’t apply until the assets of an estate are spent down, so many people must pay for these costs out-of-pocket. The article says that there are only two ways to address these expenses: with your investment/retirement portfolio and with long-term care insurance. Most people review the cost of long-term care insurance and elect to roll the dice, but when that first round of expenses hits, they probably will wish they’d bought it long ago. Now it’s usually too late to buy it. If you can afford to self-insure, you can save your estate and yourself some serious money.

U.S. Department of Justice Creates Several New Elder Justice Task Forces

Published on: May 27, 2016 | By McCulloch & Miller, PLLC

Nursing homes that give substandard care to residents are the target of new Elder Justice Task Forces intended to move faster in targeting and penalizing certain facilities.

The National Review reports in "DOJ Task Forces Target Elder Fraud in Health Care" that teams from several Elder Justice Task Forces deployed by the U.S. Department of Justice will go after heath care providers who commit crimes against residents and patients, most of whom are elderly and vulnerable.

The Elder Justice Task Forces have a goal of coordinated, joint investigations to allow for quicker enforcement actions and prosecutions. These Task Forces combine federal, state, and local resources from law enforcement, the U.S. Department of Health and Human Services, state adult protective services agencies, long-term care ombudsman programs, U.S. attorneys' offices, state Medicaid fraud control units, and state and local prosecutors' offices.

Don’t Dive into Texas Medicaid Without a Full Understanding

Published on: May 5, 2016 | By McCulloch & Miller, PLLC

People think that Medicaid will solve all financial problems if they or a spouse will need expensive medical care late in life. It's not that simple.

Concerns about outliving assets or having all their wealth spent on nursing home care has led many Houstonians in different economic brackets to take steps to qualify for Medicaid as part of their estate planning. But Medicaid was not designed to be the first source for health care costs.

Remember that your income and assets have to be at a very low level to qualify for Medicaid. This program isn't a right or an entitlement—even if your tax dollars paid for it. Medicaid provides assistance for ongoing living needs and services provided by home care or, in advanced cases, at a nursing facility.