Medicaid Planning

Beatles Lyrics: Can Your Houston Family Still Afford You?

Published on: April 9, 2015 | By McCulloch & Miller, PLLC

"Will you still need me? Will you still feed me? When I'm 64?" The Beatles first released these quaint, clarinet-fueled lyrics in 1967 when the loving answer to these questions was a resounding, "Yes!" Traditional marriage vows echo this sentiment in that they presuppose a relationship span that encompasses young and old age, wellness and serious illness, wealth and poverty. However, as modern aging has come to be defined by living longer with chronic care needs, and providing long-term care has shifted to the public sector, with two thirds of long term care services paid for by Medicaid, loving spouses may be forced to answer, "No," to these questions. The future of elder care may depend on divorce.

Aging and care are already expensive and stressful, and even the young Beatles in 1967 wondered if love now would translate into care in old age. It should.

In case you haven’t heard, long-term care needs are expensive. In 2014 the average annual cost of a semi-private room in a skilled nursing facility was $83,114! The majority (70 percent) of people over 65 need some level of long-term care at some point—whether that will be provided in a home, an assisted living center, or a nursing care facility, according to The Huffington Post in a recent article titled “Is Divorce the Best Option for Older Americans?”

Possible Medicaid Changes Could Lead to Higher Asset Levels

Published on: April 2, 2015 | By McCulloch & Miller, PLLC

In all states, federal Medicaid law provides special protections for the spouses of Medicaid applicants. But states decide how much the non-institutionalized spouse may keep, within a range. Connecticut's allowance — $23,844 — is the lowest. And legislators are calling for an increase.

If this legislation succeeds in reducing the amount of money assigned to the institutionalized spouse, he or she would become eligible for Medicaid assistance more quickly.

The CT Post report, in an article titled “Legislature asked to raise asset level for Medicaid spouses,”says that the bill would affect couples with assets of about $24,000 to $100,000. Right now, when a person tries to qualify for Medicaid, couples will split their assets evenly, and the nursing-home-bound spouse must spend down his or her portion to $1,600. This means if a couple has $60,000, each spouse is attributed $30,000, and the one heading to the care facility must get his or her share down to $1,600. [Note: These numbers can and do vary state by state.] This is typically accomplished by paying for initial nursing home care. Under the state’s new proposal, the community spouse would be able to keep $50,000 in assets.

Finances and Medicaid Planning: What Houston Seniors Need to Know

Published on: February 27, 2015 | By McCulloch & Miller, PLLC

In continuation of the series on estate and life planning, this column focuses on how Medicaid factors into financial planning for long-term care.

Seniors need to have a plan in place for long-term care, should they need care assistance in the future. A recent article in The Victoria (TX) Advocate titled “How does Medicaid factor into financial planning?” recommends that seniors need a strategy to pay for the costs of long-term care. In some instances, however, some individuals may have to rely on Medicaid if they don't have enough income to purchase long-term care insurance, the assets to pay for care themselves, or they are uninsurable.

Medicaid planning was often thought of as a viable tool for long-term planning. However, estate planning attorneys are now rethinking this strategy. Medicaid planning—which was, in essence, planning to make asset transfers, used to be the primary tool used by seniors considering long-term care costs. However, law changes and the advent of new financial products and plans will work better, they say. Medicaid "planning" is actually a misnomer as most seniors don’t plan to go on Medicaid, but rather experience an urgent care need, and there aren’t any other options. A better alternative is to obtain a long-term care insurance policy.

Can You Get Out of Dodge?

Published on: February 10, 2015 | By McCulloch & Miller, PLLC

One attorney calls it the "Get out of Dodge plan"—the best way to keep your assets intact before applying for Medicaid to cover nursing home costs. New Jersey is one of the most restrictive states when it comes to permitting residents to preserve assets for their benefit while Medicaid pays for nursing home care. In the Garden State, there are steps that should be taken before applying for Medicaid, the government insurance program for people of all ages who are too poor to afford health care including long-stay nursing home care. Nursing homes can cost $120,000 a year in New Jersey, sometimes more.

Even though Medicaid is a federal program that's regulated by each state, the way in which the money is distributed can vary. Restrictive states are siding with protecting public money over letting individuals and their spouses keep assets, the Asbury Park Press article titled "Protecting assets: Three things to know before Medicaid" explains. So your retirement strategy can be quite different based upon your state of residence. Not everyone can Get Out of Dodge, meaning not everyone can move into a second home in Florida.

But do-it-yourself planning may not be the way to go. Elder law and Medicaid planning is constantly changing, and your assets can easily be wiped out by nursing home costs without careful planning. For example, when a husband places his wife in a nursing home, their home may be excluded from assets that must be spent for nursing home care before Medicaid pays for it. So the husband is still able to live there. However, if the husband dies before the wife enters the nursing home, it gets complicated: the house could be lost to the nursing home for the cost of her care.

Got Medicaid? Get Prepared, Houston!

Published on: January 14, 2015 | By McCulloch & Miller, PLLC

Here are some "Get's" that will help you prepare for the Medicaid application process.

Get going five years before you think you need to. Medicaid has a five-year look back to all your parents' financial dealings. Which means transactions conducted during that time may be counted in determining their program eligibility. With this requirement, it’s good to have your parents' banks' names and numbers accessible. Regulators are looking at two things: if you're hiding any money and if you've given any away.

Also, if one or both of your parents still live in the family home and you’d like to keep it, you should try to transfer ownership or set up a trust at least five years before they apply for Medicaid. Although there are some exceptions, typically if you don’t address this issue, you will be forced to sell the home.

Plan Wisely for Medicaid or Else! One State’s Warning

Published on: December 4, 2014 | By McCulloch & Miller, PLLC

This case has drawn plenty of attention due to its legal and financial implications. Essentially, the case has escalated to the point of a federal judge warning state regulators that she would consider issuing an order to drop Ohio from Medicaid enrollment altogether, leaving the Buckeye State without federal funds to provide medical care for its elderly residents.

The State of Ohio is penalizing seniors by refusing to grant them long-term care benefits because a spouse or close relative has purchased a Medicaid-compliant insurance annuity. Medicaid administrators in Ohio say that an elderly nursing home patient is not entitled to long-term care benefits as long as he or she has a relationship with an individual who has purchased an annuity.

Other cases have been filed in federal courts in Ohio, and one federal judge has warned Ohio officials that she may hold them in contempt if they don’t follow federal law. The latest lawsuits filed against Ohio’s Medicaid administrators were brought by three elderly women whose husbands used their retirement accounts to buy annuities, which State Medicaid investigators say is illegal.

Long-Term Care Planning for Houston Boomers: Medicare vs. Medicaid

Published on: September 4, 2014 | By McCulloch & Miller, PLLC

Although their names are confusingly alike, Medicaid and Medicare are quite different programs.

What is the difference between Medicare and Medicaid? There are strict income and asset guidelines that must be satisfied to be eligible for Medicaid coverage. While Medicare is solely a federal program, Medicaid is a joint state-federal program. Each state operates its own Medicaid system, but it must adhere to federal guidelines to receive federal funds. Federal money pays for half the state’s Medicaid costs, and the state pays the rest.

Long-Term Care Planning

Assisting Loved Ones With Assisted Living in Houston

Published on: April 3, 2014 | By McCulloch & Miller, PLLC

Choosing whether assisted living would be the right option can be a complex decision requiring a dispassionate evaluation of the situation and careful consideration.

The challenges of helping an aging parent plan for their late-in-life care can be strenuous. There are financial, medical and even emotional aspects of this type of planning.

By way of a primer, consider reading (and sharing) a recent Forbes article titled “The Basics: Assisted Living For Your Parent.”

A Medicaid Primer 101 for Houston Families

Published on: March 10, 2014 | By McCulloch & Miller, PLLC

If you have elderly parents, don’t wait to learn about Medicaid — sometimes referred to by a litany of other state names, like Medi-Cal and MassHealth.

What is your Medicaid IQ? Most Americans have heard of Medicaid, since it has been part of the national political debate for some time. A political discussion is one thing, but what does Medicaid mean to your elderly loved ones?

If you have elderly parents, it is high time to learn about Medicaid and how it works.

Medicaid’s Give And Take

Published on: February 18, 2014 | By McCulloch & Miller, PLLC

The fear that the government could one day seize their homes is deterring some people from signing up for Medicaid.

Medicaid comes with a lot of give and take. It is a safety net for those who need it, but it does come with its drawbacks. One drawback many are now discovering is “Medicaid Asset Recovery.”

So, what is “Medicaid Asset Recovery”? In layman’s terms: after you pass away the government can recoup the benefits you received from Medicaid by taking from your remaining assets, which usually means your house.