Medicaid Planning

What Does a Houston Medicaid Planning Attorney Do?

Published on: August 20, 2020 | By McCulloch & Miller, PLLC

While Medicaid planning is a term often tossed around, not many people know exactly what the process entails. In general, Medicaid planning is any assistance provided to an individual in advance of their Medicaid application. These tasks widely vary depending on the needs of the person, but may include anything from collecting documents to restructuring assets. Medicaid eligibility is complicated and even a simple mistake in the application may result in being denied benefits. Because of this, people will often consult a Houston Medicaid planning attorney to help them with the process and ensure their family’s assets are maintained while their loved one receives the long-term care they need.

Reviewing Medicaid Eligibility

It is important for an individual to determine their Medicaid eligibility in order to have a full grasp of the potential benefits that they could receive. The consequences of being denied Medicaid benefits can be detrimental not only for the individual, but also for their family. The American Council on Aging provides a free eligibility status checker to determine eligibility.

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.

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.

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?”

Good News for Houston Families: James Earl Jones Tackles Elder Law Topics

Published on: April 6, 2015 | By McCulloch & Miller, PLLC

"In America" discusses elder law and the way that legal standards and details are changing over time.

What exactly is Elder Law? Why is this so important for Americans?

Elder law is a general term that describes the laws and regulations that affect older men and women. This term can relate to the proper care and guardianship of an older person who requires medical attention and can no longer function without assistance. The recent Insurance News Net article, titled “Elder Law is discussed with host James Earl Jones on "In America,” notes that the range of topics elder law addresses includes divorce among adults over 65 years old and law regarding elder abuse.

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.

Massachusetts is Behind on Dementia Care Compliance

Published on: February 24, 2015 | By McCulloch & Miller, PLLC

Arlene Germain, president of Massachusetts Advocates for Nursing Home Reform, said the new rules, once implemented, could substantially improve the lives of nursing home residents. But, she said, “strong oversight and greater nursing home participation are critical to ensure that the law’s benefits are meaningful and widespread.”

The process for dementia care compliance checks in Massachusetts has been slow, as the state handed out its dementia special care checklist for inspectors in December—almost six months after the rules were adopted.

The Boston Globe article, titled “Dementia care lacks oversight in Mass., data show,” says that despite the delays, state regulators are not conducting spot checks for compliance—they’re already just too busy with routine monitoring of more than 400 nursing homes. However, the state health department recently announced that its inspectors would now review dementia care during their annual visits to each facility. But this means some nursing homes may not be subject to these compliance checks for months.