Medicaid Planning Lawyer

Special Needs Planning With Special Needs Trusts

Published on: April 11, 2019 | By McCulloch & Miller, PLLC

It is important to understand the basics of special needs planning, so that you can plan for your child’s future. There are many issues to address, but an experienced Houston estate planning professional will be able to help.

Special needs planning is challenging. It’s important to have a strong team to work with. An estate planning attorney with experience in helping special needs families will be able to guide you through the process. They will also likely have access to other professionals to help.

A recent Forbes article, “Special Needs Kids Require Specialized Estate Planning,” says that if you have a child with special needs, it’s critical that you look at your planning options with your estate planning attorney and discuss your child’s health, capabilities and prognosis. You can then customize a plan that works for your child, with as much flexibility as possible.

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;

The Big Mistake People Make About Medicare and Assisted Living

Published on: October 16, 2017 | By McCulloch & Miller, PLLC

A large percentage of Americans require assisted living care at some point during their senior years. Their understanding of how that gets paid for is way off base. It’s a hard lesson to learn.

Approximately one-third of Americans (34%) thought that Medicare would cover their nursing home costs, as reported in a survey from the Associated Press-NORC Center for Public Affairs Research. Another third, 27%, may have been a little smarter to say that they weren’t sure.

That’s not true, says WRAL’s recent post, “Expect Medicare to cover assisted living? Think again.” These results may correlate with the fact that only 37% of Americans think they’ll need any care in their later years, but in reality, about 70% will require this care.

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.

Long-Term Care Insurance: Good Investment for Houston Families

Published on: December 1, 2015 | By McCulloch & Miller, PLLC

Nursing home and other long-term care expenses can be a financial burden for most families. And although long-term care insurance policies can help offset those expenses, LTC premiums are on the rise and can be quite costly. It can take careful planning to determine if LTC premiums can be paid for, without dipping into retirement funds.

When people purchased their policies 10 to 15 years ago, nursing home costs were about $150 or $200 a day. In some parts of the county, today’s costs can exceed $400 a day, or $12,000 per month for higher levels of care.

The expense incurred by the insured going on claim has caused the long-term care insurance industry to downsize. Those companies still offering policies are bumping up the premiums amid the rising cost of long-term care.

Medicare 2016 Premium Concerns Loom

Published on: October 23, 2015 | By McCulloch & Miller, PLLC

As a direct result of complex relationships between Social Security and Medicare and a number of other unforeseen issues, 2016 will be an expensive year for some seniors, according to Forbes' recent article, "Untangling the Medicare Premium Mess — And What It Means For You." Medicare laws require it to increase premiums annually to cover increases in per capita costs. This would typically be about $16, which most seniors can manage.

Except that 2016 will not be a normal year. Most retirees have their Medicare premiums deducted from their Social Security benefits, but because inflation was so low this year, there won't be a cost-of-living increase in 2016 for Social Security. And the law says that if Social Security benefits don't rise—you guessed it—neither can the Medicare premiums.

That means about 70% of Medicare beneficiaries won't see the premium hike. However, that leaves the entire burden of this year's Medicare cost increases on the remaining 30%. Those guys are going to be hit with 50% premium hikes.

What Is Your Houston Family’s Long-Term Care Plan?

Published on: October 8, 2015 | By McCulloch & Miller, PLLC

Do you have a plan for long term care? It can be costly and prohibitive for many families, especially for dementia care. Several key points about long term care are clarified in a recent article from The Arizona Daily Star, “Costs pile up fast for dementia care.”

Don’t count on Medicare. The median annual cost for a private room in a skilled nursing facility in Tucson last year was more than $90,896. Assisted living costs about $45,000. In a 2015 annual Cost of Care survey, results showed that Americans paid approximately $16,060 more per year in 2015 for a nursing home than they paid in 2010.

Remember that Medicare doesn’t pay for long-term care, including home care, aside from 100 days of skilled services or rehabilitative care. After that, it’s up to the family to figure out how to pay. The options include long-term care insurance, public assistance through Medicaid programs for people over 65, Veterans Aid, or private pay. On average, an American turning 65 today will incur $138,000 in future long-term services. This cost could be financed by setting aside $70,000 today.

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.

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.