Elder Law

Monday, June 16, 2014

Factors that impact Medicaid Eligibility

Joint Bank Accounts and Medicaid Eligibility

Like most governmental benefit programs, there are many myths surrounding Medicaid and eligibility for benefits. One of the most common myths is the belief that only 50% of the funds in a jointly-owned bank account will be considered an asset for the purposes of calculating Medicaid eligibility.

Medicaid is a needs-based program that is administered by the state.  Therefore, many of its eligibility requirements and procedures vary across state lines.  Generally, when an applicant is an owner of a joint bank account the full amount in the account is presumed to belong to the applicant. Regardless of how many other names are listed on the account, 100% of the account balance is typically included when calculating the applicant’s eligibility for Medicaid benefits.    

Why would the state do this? Often, these jointly held bank accounts consist solely of funds contributed by the Medicaid applicant, with the second person added to the account for administrative or convenience purposes, such as writing checks or discussing matters with bank representatives. If a joint owner can document that both parties have contributed funds and the account is truly a “joint” account, the state may value the account differently. Absent clear and convincing evidence, however, the full balance of the joint bank account will be deemed to belong to the applicant.

Working with a knowledgable team of legal and financial advisors will help make sound financial decisions now and in later years. 


Friday, May 16, 2014

Understand the Veteran's Aid & Attendance Benefit

Veteran’s Aid & Attendance Benefit: Get Trustworthy Advice

Many veterans are unaware of the Aid and Attendance benefit, a component of the Veteran’s Administration Improved Pension that was designed to provide much-needed financial help to elderly veterans and their spouses. Even veterans who know about this pension benefit, however, are frequently targeted by scam artists attempting to take advantage of elderly or infirm veterans and their families.

By educating yourself about the Aid and Attendance benefit and learning how to recognize a scam, you can ensure your family gets the help it deserves without falling prey to veteran’s pension fraud.

What is the Aid and Attendance benefit?

The Aid and Attendance benefit provides additional financial benefits to veterans and their surviving spouses, over and above any other veteran’s pension they receive.  The benefit is available if the veteran or spouse requires a regular attendant to accomplish daily living tasks such as eating, bathing, undressing, taking medications, and toileting.  The benefit is also available to veterans and their surviving spouses who are blind, who are patients in a nursing home due to physical or mental incapacity, or who are living in an assisted care facility.

The Aid and Attendance benefit is not limited to veterans with service-related injuries.  Furthermore, it provides assistance to a veteran who is independent but has a sick spouse.  In these situations, the pension benefit provides financial assistance to compensate for the income depletion caused by the care needs of the sick spouse.


How to avoid Aid and Attendance benefit scams

The most common scams target veterans through seminars and other types of outreach programs about the Aid and Attendance benefit.  Usually, they promise to file a claim with the Veteran’s Administration on behalf of the veteran, for a fee, but the claim is never filed or is filed incorrectly.  Not only does this type of scam harm the veteran financially, an incorrectly filed claim could damage the veteran’s ability to get approval of a correctly filed application.

Another type of scam targets homeless veterans.  The scam artist promises to file an Aid and Attendance benefit application for the veteran, in exchange for a monthly fee taken out of the veteran’s benefit check.  The veteran agrees to have the check mailed to the scam artist’s home or business address, and the scam artist takes the entire check or continues to take a monthly fee without performing any work for the vet.

Jim Ruggiero is an Accredited Attorney with the Department of Veterans Affairs. If you or a family member has questions about the Aid and Attendance benefit or any other aspect of veteran’s pensions, please contact Ruggiero Law Offices LLC at 610-889-0288. 

 


Monday, May 12, 2014

First Party Trust- useful tool in Medicaid Planning

First Party and Third Party Pooled Income Trusts, Explained

Generally, a "pooled trust" holds assets for people that have a disability, and/or elderly individuals. The trust is established and run by a not-for-profit organization, which will establish separate accounts for each individual within their system. However, the money of all of the individuals served is added together (in other words, it is pooled together) for investment and management purposes.

There are typically two types of pooled trusts. The first type is sometimes referred to as a "first party" trust. In this type of trust the disabled person places his or her own assets into the trust. Doing so will cause those assets to be non-countable for government benefit programs, such as Medicaid. The trustee of the trust (the not-for-profit organization) can use that person's money to pay for things that Medicaid will not cover. So, the assets are still there for the benefit of the person but their use is restricted. In this type of "first party" trust, any assets that remain when the person dies must be paid to the state up to the amount that the state has paid out for the person's care under the Medicaid program.

The second type of pooled trust is referred to as a "third party" trust. This means that the money did not come from the disabled person. For example, a parent with a disabled child could leave that child's inheritance to a pooled trust for the benefit of the child. The benefit is that the money would still be there for the child but would not disqualify the child from receiving SSI or Medicaid because the money would not be counted for these government programs. Unlike the first party trust, upon the death of the disabled person (in this example, the child) any remaining assets do not have to go to the state but can pass to any other beneficiaries that the parent wanted to have them.

Whether a pooled trust would be of any benefit to you depends upon many factors. Ruggiero Law Offices LLC would be happy to schedule a meeting to your family needs.

 


Tuesday, February 4, 2014

Family business

Family Business: Preserving Your Legacy for Generations to Come

Your family-owned business is not just one of your most significant assets, it is also your legacy. Both must be protected by implementing a transition plan to arrange for transfer to your children or other loved ones upon your retirement or death.


More than 70 percent of family businesses do not survive the transition to the next generation. Ensuring your family does not fall victim to the same fate requires a unique combination of proper estate and tax planning, business acumen and common-sense communication with those closest to you. Below are some steps you can take today to make sure your family business continues from generation to generation.

  • Meet with an estate planning attorney to develop a comprehensive plan that includes a will and/or living trust. Your estate plan should account for issues related to both the transfer of your assets, including the family business and estate taxes.
  • Communicate with all family members about their wishes concerning the business. Enlist their involvement in establishing a business succession plan to transfer ownership and control to the younger generation. Include in-laws or other non-blood relatives in these discussions. They offer a fresh perspective and may have talents and skills that will help the company.
  • Make sure your succession plan includes:  preserving and enhancing “institutional memory”, who will own the company, advisors who can aid the transition team and ensure continuity, who will oversee day-to-day operations, provisions for heirs who are not directly involved in the business, tax saving strategies, education and training of family members who will take over the company and key employees.
  • Discuss your estate plan and business succession plan with your family members and key employees. Make sure everyone shares the same basic understanding.
  • Plan for liquidity. Establish measures to ensure the business has enough cash flow to pay taxes or buy out a deceased owner’s share of the company. Estate taxes are based on the full value of your estate. If your estate is asset-rich and cash-poor, your heirs may be forced to liquidate assets in order to cover the taxes, thus removing your “family” from the business.
  • Implement a family employment plan to establish policies and procedures regarding when and how family members will be hired, who will supervise them, and how compensation will be determined.
  • Have a buy-sell agreement in place to govern the future sale or transfer of shares of stock held by employees or family members.
  • Add independent professionals to your board of directors.

You’ve worked very hard over your lifetime to build your family-owned enterprise. However, you should resist the temptation to retain total control of your business well into your golden years. There comes a time to retire and focus your priorities on ensuring a smooth transition that preserves your legacy – and your investment – for generations to come.


Wednesday, November 27, 2013

Using a trust to help plan for long-term care

Planning for long-term care involves the consideration of many factors.  There are a number of reasons that trusts can be used as part of an individual’s long-term care plan.  Sometimes an individual may place assets inside of a revocable living trust.  If the individual becomes incapacitated, the trustee will have the ability to manage the trust assets immediately, and those assets can be used for the care of the individual.  Revocable trusts are more commonly used as part of planning for an individual’s death to deal with issues such as probate (or multi-state probate), or privacy.

Irrevocable trusts are more commonly used in planning for an individual’s long-term care.  If an individual does not have a long-term case insurance policy, they are self-insured for any long-term care needs they may have.  That means it is up to the individual to pay for all of the costs associated with long-term care.  Medicaid is the federally-funded, state-implemented program which pays the costs of long-term care for individuals who qualify.  To qualify for Medicaid, an individual must generally have a very limited amount of assets in his or her name. 

Irrevocable trusts can be used, either alone or in conjunction with other planning strategies, to reduce the amount of assets in an individual’s name for Medicaid purposes. By transferring assets into an irrevocable trust, that individual may qualify for Medicaid sooner; and at 5 years after the time of the transfer into the irrevocable trust, those assets are protected from having to be spent on long-term care.  The Medicaid rules are very complex, and implementing a planning strategy using trusts should only be done with a qualified elder law attorney to avoid any potential planning failures or pitfalls.


Friday, November 8, 2013

2014 COLA increases Impact Social Security & SSI

The Social Security Administration has announced the payments to retired and disabled beneficiaries will increase by 1.5% in 2014.  The increase will take effect starting Dec. 31 for Supplemental Security Income recipients and in January  2014 for people receiving Social Security retirement payments.


Thursday, October 31, 2013

Health care directives - Do you know where they are?

You’ve Finally Done Your Healthcare Directives – Now What?

Healthcare directives can be vitally important, as recent cases, like that of Terry Schiavo, clearly brought to light. These important documents can mean the difference between your health care wishes being carried out or family members fighting over whether a loved one should be placed in a nursing home or removed from life support. Healthcare directives usually include both a healthcare power of attorney and a living will, or a form which is a combination of the two. In a healthcare power of attorney, an individual authorizes another individual to make healthcare decisions for him or her if the individual becomes unable to do so. A living will expresses an individual’s preferences about life support.

Once you have executed your healthcare directives, you may be uncertain as to what to do with them. First, you should make copies of the documents and inform others of their existence. In addition to your health care agent, persons you should consider notifying of the directives include family members and your health care providers.  Ideally, the originals should be kept in a place that is both safe and easily accessible.

As part of the estate planning process at Ruggiero Law Offices LLC, we draft authorization for release of medical records and provide online access to your healthcare directives available 24/7 through Legal Vault, a secure registry service. Our clients receive a wallet card that highlights their emergency contacts and hospital access for retrieval of healthcare directives. This is invaluable if you arrive at an emergency room and are unable to communicate with healthcare professionals.

You should review your healthcare directives regularly.  As individuals get older, their preferences about health care and life support change, and it’s important that your directives reflect your current health care wishes.   Of course, life changing events such as marriage, divorce, or the death of a loved one typically require changes in those documents to ensure that the people named in them are still those you wish to make decisions on your behalf and that your healthcare wishes will be carried out.

 

 


Thursday, October 10, 2013

Is driving a safety issue?

 

Turning Over the Keys: Helping older drivers make the tough decision 

We all want to be in control, to go where we want at our leisure.  As we age, however, our senses and reaction times begin to slow which can make getting behind the wheel increasingly hazardous. It is important to be realistic about the driving abilities of loved ones as they reach a certain stage and to prepare accordingly. Not only will it keep seniors safe, but planning ahead will help them financially as they make other arrangements for transportation.

The first step is to reduce the need to drive. Find ways to bring the things they need right to them, like ordering groceries online for delivery and encouraging in-home appointments. Suggest that they invite friends and family over for regular visits instead of going out. They may be surprised by how many things are possible from the comfort of their own home.

For the times your loved ones need to, or want to, venture elsewhere, look into other transportation options. Although there is usually no need to quit driving all at once, look to family, friends, taxis, and public transportation when you can, especially for longer trips. Search home health care agencies, Rover or Rainbow Cab in Chester County PA. 

The time to start making this transition may be sooner than you or your loved ones think. Don’t wait until an accident leaves them with no alternative. It may be time to start talking about limiting driving if they report noticing subtle difficulties, like trouble reading traffic signs or delayed breaking. Seek Guidance from doctors or have a drivers test conducted by Bryn Mawr Rehab hospital.  

Asking a loved one to turn over their keys can be tough but with an open dialogue, the right support system and reasonable alternatives in place to ensure that they can continue to live an active lifestyle, a smooth transition is feasible.  


Wednesday, September 4, 2013

Medicare vs Medicaid - what is the difference?

Medicare vs. Medicaid: Similarities and Differences

With such similar sounding names, many Americans mistake Medicare and Medicaid programs for one another, or presume the programs are as similar as their names. While both are government-run programs, there are many important differences. Medicare provides senior citizens, the disabled and the blind with medical benefits. Medicaid, on the other hand, provides healthcare benefits for those with little to no income.

Overview of Medicare
Medicare is a public health insurance program for Americans who are 65 or older. The program does not cover long-term care, but can cover payments for certain rehabilitation treatments. For example, if a Medicare patient is admitted to a hospital for at least three days and is subsequently admitted to a skilled nursing facility, Medicare may cover some of those payments. However, Medicare payments for such care and treatment will cease after 100 days.

In summary:

  • Medicare provides health insurance for those aged 65 and older
  • Medicare is regulated under federal law, and is applied uniformly throughout the United States
  • Medicare pays for up to 100 days of care in a skilled nursing facility
  • Medicare pays for hospital care and medically necessary treatments and services
  • Medicare does not pay for long-term care
  • To be eligible for Medicare, you generally must have paid into the system

Overview of Medicaid
Medicaid is a state-run program, funded by both the federal and state governments. Because Medicaid is administered by the state, the requirements and procedures vary across state lines and you must look to the law in your area for specific eligibility rules. The federal government issues Medicaid guidelines, but each state gets to determine how the guidelines will be implemented.

In summary:

  • Medicaid is a health care program based on financial need
  • Medicaid is regulated under state law, which varies from state to state
  • Medicaid will cover long-term care

Join us for a live presentation on Medicare vs. Medicaid on Sept. 23rd at 10 am at the Kennett Square Senior Center.  E-mail info@paolilaw.com for details.


Friday, June 14, 2013

Veteran's Aid & Attendance Benefit

Veteran’s Aid & Attendance Benefit: Avoid Scams and Get Trustworthy Advice

Many veterans are unaware of the Aid and Attendance benefit, a component of the Veteran’s Administration Improved Pension that was designed to provide much-needed financial help to elderly veterans and their spouses. Even veterans who know about this pension benefit, however, are frequently targeted by scam artists attempting to take advantage of elderly or infirm veterans and their families.

By educating yourself about the Aid and Attendance benefit and learning how to recognize a scam, you can ensure your family gets the help it deserves without falling prey to veteran’s pension fraud.

What is the Aid and Attendance benefit?

The Aid and Attendance benefit provides additional financial benefits to veterans and their surviving spouses, over and above any other veteran’s pension they receive.  The benefit is available if the veteran or spouse requires a regular attendant to accomplish daily living tasks such as eating, bathing, undressing, taking medications, and toileting.  The benefit is also available to veterans and their surviving spouses who are blind, who are patients in a nursing home due to physical or mental incapacity, or who are living in an assisted care facility.

The Aid and Attendance benefit is not limited to veterans with service-related injuries.  Furthermore, it provides assistance to a veteran who is independent but has a sick spouse.  In these situations, the pension benefit provides financial assistance to compensate for the income depletion caused by the care needs of the sick spouse.


How to avoid Aid and Attendance benefit scams

The most common scams target veterans through seminars and other types of outreach programs about the Aid and Attendance benefit.  Usually, they promise to file a claim with the Veteran’s Administration on behalf of the veteran, for a fee, but the claim is never filed or is filed incorrectly.  Not only does this type of scam harm the veteran financially, an incorrectly filed claim could damage the veteran’s ability to get approval of a correctly filed application.

Another type of scam targets homeless veterans.  The scam artist promises to file an Aid and Attendance benefit application for the veteran, in exchange for a monthly fee taken out of the veteran’s benefit check.  The veteran agrees to have the check mailed to the scam artist’s home or business address, and the scam artist takes the entire check or continues to take a monthly fee without performing any work for the vet.

If you or a family member has questions about the Aid and Attendance benefit or any other aspect of veteran’s pensions, find a qualified veteran’s pensions attorney or accredited service officer to give you the answers you and your family deserve. 

 


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