Medicaid Planning

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.

Will You Need to Apply for Medicaid?

Published on: April 14, 2016 | By McCulloch & Miller, PLLC

People put off thinking about or planning to apply for Medicaid because there is nothing pleasant about it, from coming to terms with being ill and impoverished to sharing a nursing home room with a stranger, according to USA Today in "Navigating Medicaid for elder care can be as painful as the ailments." Depending on the policies of your state, you may not be able to spend your final days or years at home.

Up to 30% of Medicaid funding covers long-term care, which is roughly $100 billion annually. More than two-thirds of older adults will require some personal assistance before they pass away, and nearly 50% will need care to such a level that they'd be eligible for private long-term care insurance or Medicaid.

If you want to explore sheltering assets so you can qualify for Medicaid sooner rather than later, then you should talk to a qualified Medicaid attorney. You don't want to be without expert counsel, especially when making hard decisions on how to allocate money you've saved all your life.

Medicaid Planning: Estate Planning AND Elder Law Skills Required

Published on: October 7, 2015 | By McCulloch & Miller, PLLC

The Huffington Post published an interesting article on the ethical and legal issues posed by two related legal practice areas, “Some Legal Issues at the Intersection of Elder Law and Estate Planning.” There are legal and ethical issues that arise when determining courses of action in both areas.

One is whether to dispose of assets through pre-need planning to qualify for means-tested government programs such as Medicaid that might pay, for example, the cost of long term nursing home care. This is very complicated, and you should work with a qualified elder law attorney.

If you want to maximize eligibility for means-tested governmental benefits, a common income reduction technique is to create a Qualified Income Trust (QIT), also called a “Miller Trust.” There are also other types of "special needs trusts" that can be created without reducing government benefits. Again, this is a highly complex area that requires help from an elder law attorney.

Life Estates May Help Protect Houston Homes

Published on: July 3, 2015 | By McCulloch & Miller, PLLC

Let's take a closer look at what a life estate is and how using one could help you save your family home.

Home is where the heart is. The thought of losing your home can be devastating. What options do you have to prevent this from happening?

Motley Fool’s recent article, titled “What a Life Estate Is And How It Could Save Your Home,” tells us about life estates.