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Major Change to Medicare Rehab

If you or a loved one qualify for Medicare and have been in the hospital and then discharged to a nursing facility for rehab, you are familiar with Medicare’s rehab policy.  Medicare will pay for up to 100 days of rehab services in a nursing facility; however, the patient must make improvements during that time to remain eligible for coverage.

In one of the biggest changes to Medicare in recent years, the federal government has agreed to remove the requirement that the patient show progress or improvement during rehab to remain eligible.  The change is a result of a recent settlement, which must still be formally approved by the court, in Jimmo v. Sebelius.

Once the settlement is approved, Medicare must revise its policies to make it clear that a Medicare beneficiary’s coverage for rehab services “does not turn on the presence or absence of an individual’s potential for improvement” but rather depends on whether or not the beneficiary needs skilled care, even if it would simply maintain the beneficiary’s current condition or slow further deterioration.

Of course, Medicare will continue to only pay for up to 100 days of services.  If you or a loved one have questions or concerns regarding how to pay for nursing home, assisted living or independent living costs in the future, contact our office and schedule an appointment to meet with one of our attorneys.  We can educate you regarding the programs available to pay for care, review your estate and finances, assist you with planning for and applying for government programs, such as Medicaid, and counsel you regarding the legal and practical issues you may face during this time of transition.  Call us today.

It’s Official: “Everyone Does It” Not A Valid Defense

The Missouri Court of Appeals bars a former State employee from benefits due to improper personal use of the State computers.  The “everyone does it” defense was completely rejected by the court, as was the “I didn’t know it was wrong” defense.  You can read the opinion here: http://www.courts.mo.gov/file.jsp?id=56432.

Undue Influence: It’s Criminal

As of today, undue influence constitutes the crime of financial exploitation of an elderly or disabled person under RSMo 570.145. This puts Missouri among a growing number of states that are strengthening their stance against elder abuse, and it is a strong stance indeed. If the amount of money involved is $50 or more, the crime is a felony, and as the amount of money involved increases, so does the penalty.

This law applies to all people using a durable power of attorney, guardians, conservators and trustees who take financial advantage of elderly or disabled persons. Anyone who is an agent under a power of attorney or who has been given authority over the finances of another person needs to take notice of this new elder law. It is more important than ever to consult an attorney before taking any action that affects the finances of an elderly or disabled person. We can help caregivers and children as they act as agents for their parents, and we can help you or your loved one create an efficient and effective plan. We can help, contact us.

Financial elder abuse, along with physical elder abuse, often goes unreported. If you suspect that someone may be taking advantage of or abusing an elderly person, contact the Missouri Department of Social Services hotline at 1-800-392-0210.

Can you write your own will?

Did you know that the vast majority of handwritten wills are not valid in Missouri?  Missouri’s requirements for a valid will are very strict.  If you do not follow the formalities exactly, then your handwritten will is not a will at all.

Your will is important and you want to ensure that your wishes will be followed.  Our office can help you craft a will that reflects your goals and objectives and that will be recognized under Missouri law.

In life, some things have to be precise- your will is one of them.  Contact us today to learn how we can help.

Does A Will Avoid Probate?

No! Wills are your instructions to the probate court about what to do with your property. Property passing through a will goes through the probate process. The probate process is, essentially, a formal method to make sure that your bills are paid and that your beneficiaries receive the property that you are leaving to them.

So, what are the benefits of a will if it doesn’t avoid probate?

1 – A will allows you to control who receives your property after you die. Do you want to give all of your money to your spouse, your children, or only some of your children? Do you want to make sure that a disabled child, your parents or other dependent is taken care of? Is providing for your place of worship, school or charity important to you? A will can ensure that your wishes are followed. A will can also provide for contingent beneficiaries if a beneficiary unexpectedly predeceases you.

2 – Wills save your family money, as they can authorize many shortcuts that streamline the probate process. Wills can allow your executor to proceed without probate court hearings, waive the surety bond requirement, and allow the court to authorize independent administration. Without a will, your family may have to endure the long form of probate – supervised administration.

3 – A valid will is the only legal way to nominate a guardian for your minor child or children. If you have minor children, you know how important they are. Without a will, your opinion will not legally count. Neither the court nor your family members will have the benefit of your insight when determining who will care for your children and who will manage their money. You can also use your will to create a trust for your children’s education and support.

4 – Wills are the lowest cost planning option. They can be simple and yet very effective. Wills cost less than trusts or other sophisticated legal documents. A simple will, drafted by a licensed attorney, is the baseline protection that everyone with a child, home or bank account needs.

5 – Wills never expire during your lifetime, they are good for life. The will you create today has no expiration date. A valid and proper will can provide for the transfer of current assets as well as any property you may accumulate in the future. This is not to say that you should never review your will. Any time you have a major life change, you should make sure your will still reflects your wishes.

6 – Your will is a roadmap for the probate judge and your executor to follow. You direct how your property is handled and distributed. Without a will, your property will be distributed according to the intestate laws – these are the laws that provide the general default plan for people who die without a will. These default rules do not authorize any of the allowable shortcuts and may or may not fit your wishes regarding who receives your property.

7 – Your will shows your family that you care. A valid will makes everything easier, simpler and more streamlined. It eliminates hassle and gives your family the tool that they need in a crisis. The last thing a family wants to deal with during a time of mourning is a complicated and messy legal situation, especially one that could be avoided.

If you would like to learn more about what a will can do for you and how it is an integral part of an estate plan, contact us.

Medicare vs. Medicaid: What’s the difference?

The difference between Medicare and Medicaid is important, because Medicare doesn’t pay for nursing home care, except in limited short-term rehab situations.  Medicaid is the only government program that will pay for long-term skilled residential care or nursing home care.  Both programs offer medical care or health care reimbursement, but they serve different groups of people, and the implications for nursing home care, financial planning and elder law issues differ dramatically.

Medicare is similar to standard health insurance for people over 65 years old. If you are over 65, there is no asset or income test in order to qualify for Medicare.  People who become disabled for Social Security purposes, will qualify for Medicare 2 years after the date of their disability, regardless of age.  There are different plans and levels of coverage offered under Medicare with monthly premiums that vary accordingly.  However, after Medicare provides its benefit, that is the end of the Medicare transaction.  Medicare will not seek repayment for medical services that it covered for the Medicare participant.

Medicaid, now known in Missouri as MO HealthNet, is need-based, and there is an asset/income test to be eligible to receive benefits from the program.  Medicaid is run by the Department of Social Services.  This program also has an estate recovery mandate, which means that the State will seek to recover or collect the entire cost of benefits it has paid for a participant.  This program is like a cab – you get in and the meter starts ticking.  Once you qualify and Medicaid, or MO HealthNet, starts paying for your health care or nursing home fees, Medicaid will be keeping a running tab or bill for you.  Medicaid keeps a record of everything they have paid out on your behalf, calculating the total sum of the medical bills/benefits paid by the State for your care.

After a Medicaid participant dies, the bill comes due – the State files a claim against the participant’s estate for reimbursement for everything it has paid out for the recipient during their lifetime.  These are known as Medicaid’s estate recovery provisions; this recovery program is mandated by the federal Medicaid laws.  There are many rules, strict procedures and exceptions regarding how and when the State can recover.  Our lawyers know the rules, and we can help plan to avoid or fight the estate recovery.  There are steps that can be taken to maximize what the family gets and minimize the State’s recovery.  If you would like to learn more about planning for long term care,  contact us today.

Columbia Named the 4th Best Small City for Seniors!

USA Today reported in an article today that Columbia has been named the 4th best small city (out of 259) for senior living!  Excellent access to health care, a vibrant culture, and a strong local economy all contributed to Columbia’s high ranking.  In fact, Columbia’s health care was ranked 3rd in the U.S.

The rankings were compiled by the Milken Institute.  Click here for a detailed report.

Warning Signs of the Real Life Heart Attack

The American Heart Association refers to it as “the movie heart attack”: an overweight man starts panting, grabs his chest and then collapses. In this situation, it is clear a heart attack has occurred.

Most heart attacks do not follow the script. The majority of heart attacks begin gradually with mild pain and discomfort. This can make it much less obvious that a heart attack is happening. For this reason, many people wait several hours before seeking treatment. This could be a fatal mistake.

According to the American Heart Association, some signs that a heart attack is happening are:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath with or without chest discomfort.
• Other signs may include breaking out in a cold sweat, nausea or lightheadedness.

Although the most common sign of a heart attack is chest pain, many heart attacks involve no chest pain at all. In fact, according to an article from the National Heart Lung and Blood Institute, one study found that one-third of patients who had heart attacks had no chest pain.

The biggest lesson, then, is this—if you think you might be experiencing a heart attack, don’t wait.  Call 911 for help immediately.

For more information regarding heart attacks, including risk factors and prevention, see the Heart Attack section at the American Heart Association website.

Will Your Estate be Subject to the “Death Tax”?

This year, the gift and estate tax exemptions are $5.12 million, which means you can transfer up to $5.12 million as gifts or after you pass away, tax free.  At these current levels, relatively few people need to be concerned about the estate tax, also known as the “death tax.”

However, unless Congress takes action before the end of the year, the exemption will revert back to the lowest amount in a decade: $1 million.  Additionally, anything over $1 million will be subject to a 55% top tax rate.  Your home, bank accounts, retirement accounts, life insurance and all of your other assets are all included in your gross estate for estate tax purposes, regardless of whether the assets are held in trust, go through probate, or are jointly owned.  That means many more people may be affected by the estate tax in 2013.

If you would like to discuss the estate tax and how you can minimize the taxes on your estate, please contact us.  We can help you protect your assets.

When Do You File a Will After Someone Dies?

The months after a loved one passes away can be overwhelming, and important deadlines can easily fall through the cracks.  One of the most important steps to take is submitting your loved one’s will to the probate court.  In Missouri, wills must be admitted to the probate court before the one year anniversary of someone’s date of death.  Missouri law prohibits someone from filing a will, becoming executor or opening a probate estate more than one year from a Missouri resident’s date of death.  Other states allow a longer time to submit a will to probate.   But in Missouri, a last will and testament that is not admitted to probate within the one-year period is never recognized as the true last will and testament of the deceased.

This time limit is designed to provide certainty and closure for the families and heirs.  There are, however, other legal methods to transfer or re-title assets of someone who has died, after the one year anniversary has elapsed — these include a statutory Small Estate by Affidavit and a Petition for the Determination of Heirship.

If you have a loved one who has passed away and you need assistance with life insurance, probate, transferring their property, Mo HealthNet or other creditor claims, or winding up their affairs, we can help.  Call us at 573-441-9000 or email us at legal@barchetlaw.com.  We can help you get through this difficult time efficiently and with compassion.

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