Estate Planning & Public Benefits for Individuals with ALS
•Transferir como PPTX, PDF•
1 gostou•2,454 visualizações
Presented on Sunday, October 19, 2014 at the ALS Research Symposium of the ALS Association, Rhode Island Chapter.
Recomendados
Recomendados
Mais conteúdo relacionado
Mais procurados
Mais procurados (20)
Semelhante a Estate Planning & Public Benefits for Individuals with ALS
Semelhante a Estate Planning & Public Benefits for Individuals with ALS (20)
Último
Último (20)
Estate Planning & Public Benefits for Individuals with ALS
- 1. HEFFNER & ASSOCIATES ELDER LAW Estate Planning & Public Benefits for Individuals with ALS Mark B. Heffner, Esq. , CELA Heffner & Associates 615 Jefferson Boulevard Warwick, Rhode Island 401-737-1600 mheffner@hefflaw.com www.hefflaw.com
- 2. HEFFNER & ASSOCIATES ELDER LAW Disclaimer •Materials are for general education and should not be substituted for consultation with a competent estate planning attorney in your state •Materials presented from the perspective of Rhode Island •Rules and practice vary significantly from state to state and are subject to change
- 3. HEFFNER & ASSOCIATES ELDER LAW Lifetime Planning: Health Care Decisionmaking Advance Directive Durable Power of Attorney for Health Care Living Will Selection of Agent Selection of Successor Agent
- 4. HEFFNER & ASSOCIATES ELDER LAW Lifetime Planning: Financial Decisionmaking Joint accounts: Be careful! Durable Power of Attorney for finances Determination of Powers to provide Selection of Agent (aka, “Attorney in fact”) Again, selection successor Agent Ex: Gifting and Estate planning?
- 5. HEFFNER & ASSOCIATES ELDER LAW Lifetime Planning: Financial Decisionmaking Revocable Trust, aka, “Living Trust” Avoids/Reduces “Push-Back” of Institutions with use of Durable Power of Attorney Selection of Trustee & successor Trustee critical Still need Durable Power of Attorney for finances
- 6. HEFFNER & ASSOCIATES ELDER LAW Planning for post-death Will—requires probate Selection of Executor—same person generally as agent under financial DPOA Revocable Trust—if “funded” will avoid probate for those assets Still need Durable Power of Attorney for finances
- 7. HEFFNER & ASSOCIATES ELDER LAW Public benefits available for long-term care Medicare: (limited) skilled nursing home & (potentially unlimited) home care Medicaid: pays for skilled nursing home and (limited) home & community-based services Veterans benefits: (limited) nursing home and Aid and Attendance benefits
- 8. HEFFNER & ASSOCIATES ELDER LAW Medicare skilled home benefit Prerequisite: three day prior hospital admission & continued need for require skilled care Limited to 20 days full payment, up to 80 additional days with co-pay ($152/pay)
- 9. HEFFNER & ASSOCIATES ELDER LAW Medicare Home Care Benefit Home Health Care Service fully covered under Medicare Parts A & B Services must be medically reasonably & necessary and: • Physician established a care plan • Homebound—confined to home • Require intermittent skilled nursing care, PT, OT, or ST • Services provided by Medicare-certified agency
- 10. HEFFNER & ASSOCIATES ELDER LAW Medicare Home Care Benefit No co-payment or specific home health deductible Duration: after initial assessment, can continue if therapist and physician recommend continuation www.medicareadvocacy.org
- 11. HEFFNER & ASSOCIATES ELDER LAW Private Pay costs for nursing home care • Genworth 2013 cost of care survey (www.genworth.com/corporate/about-genworth/ industry-expertise/cost-of-care.html) •Rhode Island: $8516/month •Massachusetts: $10,493/month •Connecticut : $12,638/month
- 12. HEFFNER & ASSOCIATES ELDER LAW What is Medicaid? •It is not Medicare! •Medicare: insurance model; no asset or income qualification requirements •Medicaid: in addition to general criteria (age, blind, disabled) & needing a level of care, must also fall within financial criteria (assets, income, transfer restrictions) •Substantial state to state variations
- 13. HEFFNER & ASSOCIATES ELDER LAW Resources Excluded (Single Person) •Home (equity value limit: $534K) if “intent to return” •Funds otherwise available (limit: $4000) •Vehicle (limit: $4500, unless used for transportation to medical appts) •Life Insurance ($4000 face limit) •Irrevocable Burial Contract, or funds set aside for burial ($1500) •Household goods & personal effects( no value limit, unless exceptional) Available EVERYTHING ELSE
- 14. HEFFNER & ASSOCIATES ELDER LAW Resources Excluded (Married Couple) •Home: no equity limitation if residence of “Community Spouse” (CS) •Vehicle: if used by CS, no limitation on value •CS retains “Community Spouse Resource Allowance” (CSRA)
- 15. HEFFNER & ASSOCIATES ELDER LAW Transfers of Assets Any transfer occurring on or after February 8, 2006 is subject to five year lookback period Q: What types of transfers fall within lookback period? A: Uncompensated (UV) transfers--i.e., those for which fair market value (FMV) not received by applicant or the applicant’s spouse Parent gives adult children each $10,000 Uncompensated transfer: $30,000
- 16. HEFFNER & ASSOCIATES ELDER LAW Veterans Benefits Skilled nursing home: (some) nursing homes with VA contracts, Veterans Home Aid and Attendance benefit—like Medicaid, financial need required www. benefits.va.gov
- 17. HEFFNER & ASSOCIATES ELDER LAW National Elder Law Foundation www.nelf.org Provides interactive state map of Certified Elder Law Attorneys (CELA) in each state Mark B. Heffner, Esq. , CELA Heffner & Associates 615 Jefferson Boulevard Warwick, Rhode Island 401-737-1600 mheffner@hefflaw.com www.hefflaw.com
Notas do Editor
- Discuss what Elder Law is..why applicable Overview: Estate planning..lifetime planning & post-death planning Review of public benefits
- Agent selection can change Entire power can be revoked
- Illustrate through example of house—revocable, change trustee
- Illustrate need for probate with house, avoidance of probate with house, bank account Janet still cares about how things go—in fact, may be greater concern for dispute
- Illustrate need for probate with house, avoidance of probate with house, bank account Janet still cares about how things go—in fact, may be greater concern for dispute
- Homebound: Does not mean completely confined to home. Def: if leaving the home requires considerable effort or is medically contraindicated. Not “no fun rule”: can leave home for trips to doctor, get hair done, go to church, etc. Skilled services are this “which require the skills of technical or professional personnel such registered nurses, licensed practical nurses, physical therapists, and occupational therapist.
- Discuss LTCI
- Refer to OMR tool Practice pointer: don’t assume, as in past, that just because client in nh, will qualify for Medicaid LTC benefits in nh
- Illustration of “legal ability to make resource available” and a resource not subject to “a legal impediment which precludes applicant from making resource available. Gship or conservatorship--evidence inability to make resource available. Asset unavailable to to refusal of joint tenant to sell, and hence partition suit (ask JK + law school case)
- BEFORE GOING TO NEXT SLIDE—DISCUSS INCOME SINGLE PERSON MARRIED