Category Archives: Elder Law

Many people, as they approach retirement, begin thinking about how hard they have worked to build their nest egg.  The thought of using the money they worked so hard to save to pay for their future care is not a pleasant one.  According to the U.S. Department of Health and Human Services, 7 in 10 people over the age of 65 will require long-term care.  Therefore, it is incredibly important for those approaching retirement to consider how they will pay for this care.

Did you know that Medicare doesn’t pay for assisted living or nursing home costs?  Fortunately, there are many products on the market to assist with paying for long-term care.  You should speak with your attorney and your financial advisor to determine what options are best for you.  Our office can help you review your estate and finances and determine the best course of action.  Remember, the key is to plan– the longer you wait, the more limited your options.  Call us today.

Let’s start by saying this: annuities can be a legitimate investment and could be the right thing for you.  That said, instances where an annuity is the best financial tool for your situation are rare.

As with any financial product, you should always ask yourself, “does this product make sense for me, or does it only make sense to the person selling it to me?”  This is even truer with annuities.  Scams and elder financial abuse are rampant in the annuity sales industry.  The simple reason is that the sale of an annuity usually generates a large commission for the salesperson.  The sales pitch usually begins with promises of asset protection and high returns with low or no-risk.

Unfortunately, there are “wealth strategy” companies out there that make a living selling annuities to seniors.  In our experience, this problem is only becoming more prevalent.  It is the rare case indeed when a 15-20 year annuity is the best investment for someone over 80 years old.  In addition to annuities sometimes being inappropriate investments, they can also greatly complicate the application process for Medicaid or Veterans Benefits.  In some instances, investing in an annuity can disqualify an applicant from these benefits for years.

If you or a loved one are considering an annuity, please contact our office to discuss how the annuity would fit into your overall estate plan and whether an annuity is really the appropriate investment for you.  We do not sell annuities or any other financial products.  Instead, we serve as an independent advisor who does not stand to gain or lose a commission.  Our goal is to help you create the best financial and estate plan for your individual situation by avoiding probate, minimizing taxes, and ensuring that your assets pass to your loved ones efficiently.

In the event you do choose to invest in an annuity, or need advice regarding other investments in general, be sure to contact a Certified Financial Planner (CFP).  A CFP is a financial professional who has the appropriate education, licensing and background to give you sound financial advice.  Annuity salespeople or “wealth planners or strategists” that hold no professional designations or licenses should be avoided.

You can find a CFP in your area by searching at this website.

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.

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.