Michigan Estate Planning Blog

Will Your Spouse Inherit Your IRA?

IRAs are powerful accounts uniquely suited for retirement. No surprise, then, that there are some unique rules that go into effect when an IRA is bequeathed and inherited. Whoever the inheritor of an IRA is they will have some important choices to make fairly soon. If a spouse is inheriting, they have extra leeway that’s worth putting to good use. The sorts of things an IRA inheriting spouse ought to think about don’t make the headlines quite as often. However, DailyFinance offered a helpful guide a short time ago in an article titled “When A Spouse Inherits An IRA.” You see, a spouse has more age-based decisions than a younger inheritor like an adult child. A spouse also has different choices. For instance, a spousal IRA heir can either retitle the account into an inherited IRA or roll it into their own IRA. What to do depends a great deal on the age of the spouse that has passed and the age of the surviving spouse. After all, age determines when and if you can take distributions, and likewise affects the amount in distributions to take. To roll the IRA into your own means to simply add the balances and treat it like a normal IRA from thereon out, taking distributions based on your own life expectancy when you hit age 70½. On the other hand, if it is kept as an inherited account, you might have to immediately start taking distributions (based upon the RMD of the deceased) if the account had already begun distributions. Indeed, just the difference between one account and two accounts is worthy of consideration. The original article offers a few examples on the math that comes into play, and there are a few numbers to play with. In the end, you might say the decisions should come down on a few basics. First, the balance between income and savings. This is both a question of how much money do you need and how soon, especially for retirements and medical costs. Also, factor in taxes because traditional IRA distributions are taxable. Second, depending upon the age and needs of the inheriting spouse, you might consider where the IRA is eventually going. Will you need the money in your lifetime or will you also leave it behind? How ought you to structure that?

Reference: DailyFinance (April 22, 2014) “When A Spouse Inherits An IRA”

For more information, see www.jerryreiflawyer.com

A Plan In Eight Steps

Your estate plan is, to put it briefly, the sum total of your plans for your loved ones, your end-of-life, your assets, and your charitable hopes, and all of it put to paper. Naturally, a properly planned and executed estate plan will have a few key elements and a number of important documents. So how many pieces is that? It should depend upon your own estate and estate plan of course. Regardless, it’s also helpful to break down a basic estate plan and build a basic list. There are a great number of little estate planning lists out there, and a dozen ways to list the documents you might need. That noted, MSN Money provided a helpful guide not too long ago with a helpful list of eight titled “Estate-Planning Documents You Need Right Now.” The eight? 1. Last will and testament 2. Revocable living trust 3. Beneficiary designations 4. Durable power of attorney 5. Health care power of attorney and living will 6. Provision for digital assets 7. Letter of intent 8. List of important documents Now you might not need all of these elements. In the context of your plans, one or another may be all the more important and so all the more robust. However, these are the basics to consider as you get started. The original article has more to say concerning each tool and some further resources besides. Do you have unique goals, unique assets, or a unique family? It’s very likely there is more to be done with these documents and a few useful tools besides. Whether your plan will be basic or advanced, it pays to ensure that your affairs are in order with the input and guidance of competent counsel.

Reference: MSN Money (April 18, 2014) “Estate-Planning Documents You Need Right Now”

For more information, see www.jerryreiflawyer.com

An Intermediary Care Service

Caring for an elderly loved one is, more often than not, ensuring that they receive the right care at the right time, and neither too much of it nor too little. This balancing act can be difficult, expensive and exhausting. Elder care options are often appreciated and one intermediary option was recently covered in an ElderLawAnswers post titled “Adult Day Care: Providing a Break for Caregivers.” While there are a number of types of actual facilities, sometimes you don’t quite want or need a facility. Perhaps you are not ready just yet or you hope to avoid them entirely. Increasingly, families are choosing to personally care for their elderly loved ones at home. The difficulty faced is the burden this places on the caregiver, and the limitations it imposes on the lifestyle of the elderly loved one. A convenient solution is adult day care, a service less diminutive than the name suggests and rather quite useful as an intermediary option to take much of the burden off of the caregiver. Adult day care programs vary widely, both in substance and in availability. As a result, it is wise to snoop around in your local area and consider your needs. The costs tend to be modest, in the grander scheme, and various health insurances or long-term care insurances will cover or defray the cost. Medicare, unfortunately, does not yet pay for this type of service.

Reference: ElderLawAnswers.com (April 11, 2014) “Adult Day Care: Providing a Break for Caregivers”

For more information, see www.jerryreiflawyer.com

Handing Down a Headache and Not a Home: Pitfalls of the Reverse Mortgage

The reverse mortgage has its benefits, especially for many retirees needing some additional cash to make ends meet in the current interest rate environment. However, as the financial community has been quick to point out, there are also some serious drawbacks to consider. The biggest drawback to bear in mind is that your heirs and loved ones may bear the brunt of the burden when it comes to those drawbacks. It is important to know how reverse mortgages work before you sign up for them. While you are at it, make you’re your heirs and other inheritors know what to expect. The issue of reverse mortgages and inheritances is not a new difficulty. Nevertheless, it does seem to be a new sour spot between borrower families and lenders. The New York Times recently reported on the situation as more and more baby boomers are finding themselves discovering that the “Pitfalls of Reverse Mortgages May Pass to Borrower’s Heirs.” Whether you are the one with a reverse mortgage (or considering taking one out) or one of those on the inheriting end, this article is worth reading. Ideally, a reverse mortgage is supposed to assist an elderly person or couple by providing a “loan” against the value of their home. The home equity serves as the security for the loan. The loan is really only expected to be dealt with at the time of their passing (or, earlier should they move). The home is likely their most valuable and yet entirely non-liquid asset, after all. Following the death of the elderly person or last surviving spouse, the lender either forecloses on the house to secure repayment of the reverse mortgage or, by law, the family/inheritors are allowed to pay off the balance or some lesser settlement amount. Apparently, more and more lenders are playing hard ball. They are hiding the pay-off options, the settlement options, and even moving straight to foreclosure proceedings within weeks of the passing of the borrower. This means that many baby-boomers finally inheriting the home either will not inherit the home at all or end up fighting against a bureaucracy. Even if it’s not intentional on the part of lenders, it’s still a very real problem for even diligent heirs to face. It’s important to know the difficulties that may be inherited, whether you are set to leave the house behind or whether you’re set to inherit it and want to keep it in the family.

Reference: The New York Times (March 26, 2014) “Pitfalls of Reverse Mortgages May Pass to Borrower’s Heirs”

For more information, see www.jerryreiflawyer.com

 

Estate Planning And The Specter Of Alzheimer’s

Alzheimer’s is no ordinary condition. What it means to the patient and to their mind is simply unique, just as it is uniquely meaningful to the family. Unfortunately, it is also a uniquely meaningful condition when it comes to estate planning and there are very important steps to take sooner rather than later. Planning for one’s estate and for one’s late-in-life plans requires more than a bit of wherewithal. This is not only an empirical fact but also a legal one. Because Alzheimer’s and dementia affect the mind means certain legal choices, whether regarding healthcare or disposition of property to one’s heirs, simply have to be down and in writing well before they are questionable. It’s a complex problem. Fortunately, there are some important tools to keep in mind early and get a plan in place. Some of the basics were helpfully pointed out in a LifeHealthPro article last month titled “4 things to know about Alzheimer’s and estate planning.” The four things? • Collect Your Documents: that is, all of the important documents should be easily at hand or easily discoverable for when they are needed, and not by the patient but by whoever cares for them. • Property Management: perhaps more appropriately, you should have a plan for assets in this life and an estate plan to direct assets thereafter. • Advanced Directives: these documents spell out important decisions and/or give that decision-making power to others through a Durable Power of Attorney, a Living Will, and Medical Directives (like a Do Not Resuscitate order). • A Living Trust: a trust can be all the more useful in organizing and disposing of property as well as allowing another to manage it, which is that much more powerful for an Alzheimer’s patient. These are just the basics. Regardless, and not without coincidence, these are important basics steps and tools when it comes to any estate plan. Planning in anticipation of Alzheimer’s is no different than the planning one ought to do anyway. But then, to the extent many of us will be affected by Alzheimer’s or dementia, it only stands to reason that we should all be diligent in our planning. Once we have one of these conditions, it could be too late to plan for anything. Be sure to get your own estate in place and work with your elderly loved ones to ensure they have the plans in place allowing for you to care for them.

Reference: LifeHealthPro (March 11, 2014) “4 things to know about Alzheimer’s and estate planning”

For more information, see www.jerryreiflawyer.com

Study Shows Higher Estimates Of Deaths From Alzheimer's

Alzheimer’s disease is a unique challenge to a family. As you plan for old age, and even while planning for the estate itself, it is essential to plan accordingly. Unfortunately, some recently released bad news regarding Alzheimer’s has brought the need for proper planning into even sharper focus. Earlier this month, Reuters reported on a recent Alzheimer’s study in an article titled “Alzheimer's deaths much more common than realized: study.” Alzheimer’s is actually a fatal disease. However, the real toll from the disease occurs first during life. More to the point, the recent study found that, “Nearly half a million elderly Americans likely died from Alzheimer's disease in 2010, a figure almost six times higher than previous estimates of annual deaths.” The original Reuters article has much to say about the study and about the nature of the disease itself. Nevertheless, beyond the data, this news should get us thinking about what it means to be living and planning for old age or an estate in an era of Alzheimer’s. This is a story about medical facts, but Alzheimer’s also brings economic and legal issues to confront. If a loved one already shows signs of the disease, then there is much to learn and understand. Do not ignore the matter. Get help now, not later. Contact a qualified elder law attorney to help you with the legal issues and coordinate the professional resources you will need.

Reference: Reuters (March 5, 2014) “Alzheimer's deaths much more common than realized: study”

For more information, see www.jerryreiflawyer.com

 

No Inheritance Or Compensation For Services? Lesson Learned

Even if you do not live in Massachusetts, if you are caring for an elderly loved one and may or may not be an heir apparent, there is something to be learned from a recent case in the Bay State, Cheney v. Flood (84 Mass. App. Ct. 1134, Feb. 7, 2014). There is a difference between care given out of responsibility and that given out of expectation of payment. Similarly, there is a difference between payments for services and an inheritance. ElderLawAnswers considered the Cheney case in an article titled “Don't Just Hope for an Inheritance; Get It in Writing.” In the case in question, Suzanne M. Cheney and her family offered many services to her stepfather, Anthony R. Turco. They provided these services without an actual agreement for payment. Well, Anthony passed away and Suzanne was left out of any inheritance. Suzanne was, as a result, not happy. She took the estate to court, arguing that she was due reasonable compensation for her care independent of any inheritance. The court disagreed, finding that there was no evidence she offered her care with expectation of compensation. In reality, there truly is a difference between an inheritance and compensation for services rendered. It is easy to think the worst, but in these cases oftentimes is a very legitimate conversation to be had about the needs and expectations of the caregiver as much as the needs of the elderly loved one. If you care for an elderly loved one, there are some very real ways to structure the relationship that might serve to benefit everyone. These conversations (and written agreements) are much better worked out by family in advance than by a court later on.

Reference: ElderLawAnswers (March 17, 2014) “Don't Just Hope for an Inheritance; Get It in Writing”

For more information, see www.jerryreiflawyer.com

Planning for Late-In-Life Care

Planning for the health and proper care of an aging parent is no easy undertaking. That is a given. As a parent moves toward healthcare and assisted living there are myriad questions and issues to consider. These run the gamut from financial to medical and, yes, the emotional. By way of a primer, consider reading (and sharing) a recent Forbes article titled “The Basics: Assisted Living For Your Parent.” Some of the most important issues in planning for late- or end-of-life care include understanding the various kinds of facilities and treatments available. There is, for example, a decided difference between nursing home care and an assisted living situation. Even within assisted living communities there are many different kinds of facilities, from the large to the small and the homey to the clinical. In the end, you must know what to look for and what is appropriate for the elderly loved one in need of care. The key, if possible, is to include your loved in the evaluation process. Ensure that they are included in the discussions and options. Otherwise, expect resistance to change because the transition to care away from home is by nature very disruptive on many levels. Once you know the kind of care needed and your loved one is on board, then comes the question of how to pay for it and how to understand Medicaid, Medicare, and the programs that can help fill the gaps. Needless to say, this can be a complex process. Be sure to read and share the original article to help you and your loved one make a transition that is right for their circumstances.

Reference: Forbes (March 13, 2014) “The Basics: Assisted Living For Your Parent”

For more information, see www.jerryreiflawyer.com

Dementia and Family Finances: the Glass Half Empty and the Need for Planning Early

Dementia is an unfortunate and pernicious affliction. Unfortunately, it is one that will afflict the majority of households at some point. Because it is so real a possibility to face, it is one better faced sooner rather than later. Proper planning can reduce the inevitable stress on all concerned. The issue of dementia in planning was recently addressed by MarketWatch in article titled “Stunning study on dementia, couples and money.” The results of the study mentioned are multifaceted. However, there is one obvious data point upon which the article rotates - the vast majority of households turn over financial control to the unimpaired spouse once the original leader of family finances shows signs of dementia. Unfortunately, dementia doesn’t work that way; it’s far too subtle. This means that many households may have waited too long, and then the unimpaired spouse is left to learn all of the finances and pick up any broken pieces from a spouse who may be unable to fully account for it all. That is a glass half empty, unfortunately. So how do you fight against so subtle an affliction and a tide of impairment affecting (as far as we can tell) fully 22% of Americans over the age of 71? You plan early and spouses plan together. In fact, there is much to do and it is all about starting early. The original article, as it happens, also offers a helpful bit of wisdom with five practical tips. Are you an adult child working to assist your aging parents? Then some of these tips are critical to share with your parents sooner rather than later.

Reference: MarketWatch (June 2, 2014) “Stunning study on dementia, couples and money”

Dementia and Family Finances: the Glass Half Empty and the Need for Planning Early

Dementia is an unfortunate and pernicious affliction. Unfortunately, it is one that will afflict the majority of households at some point. Because it is so real a possibility to face, it is one better faced sooner rather than later. Proper planning can reduce the inevitable stress on all concerned. The issue of dementia in planning was recently addressed by MarketWatch in article titled “Stunning study on dementia, couples and money.” The results of the study mentioned are multifaceted. However, there is one obvious data point upon which the article rotates - the vast majority of households turn over financial control to the unimpaired spouse once the original leader of family finances shows signs of dementia. Unfortunately, dementia doesn’t work that way; it’s far too subtle. This means that many households may have waited too long, and then the unimpaired spouse is left to learn all of the finances and pick up any broken pieces from a spouse who may be unable to fully account for it all. That is a glass half empty, unfortunately. So how do you fight against so subtle an affliction and a tide of impairment affecting (as far as we can tell) fully 22% of Americans over the age of 71? You plan early and spouses plan together. In fact, there is much to do and it is all about starting early. The original article, as it happens, also offers a helpful bit of wisdom with five practical tips. Are you an adult child working to assist your aging parents? Then some of these tips are critical to share with your parents sooner rather than later.

Reference: MarketWatch (June 2, 2014) “Stunning study on dementia, couples and money”

To Marry Or Not To Marry, But To Plan Accordingly Either Way Saginaw, MI

It has been said that marriage is a young persons’ game, but love isn’t. These days, more and more Americans are meeting new loves or (finally) their true loves later in life. These later-in-life marriages can be tricky. On the other hand, even if you leave marriage to the young and idealistic, there is some planning that really has to be in place. The sociology of later-in-life marriage is fascinating, both in thinking about the recent jump in numbers and the more recent decrease. Either with or without tying the knot it is also a practical issue with legal ramifications, and for those later-in-life loves not destined for marriage there is some practical advice to be gleaned in a recent article on the subject in The New York Times titled “Welcoming Love at an Older Age, but Not Necessarily Marriage.” The article has the voice of several experts and more than a few horror stories to share. You see, marriage is an emotional union, but it is also an economic and legal one. This may come far more naturally to 20-somethings than boomers. It seems the older you get the more you have and the more you have to think about. If you are to marry, then the separate pasts, lives, and families have to account for it all and mesh together, which is a tricky enterprise when everything from college financial aid for children/grandchildren to Medicare or Medicaid benefits may instantly be affected. To not marry doesn’t necessarily make all of those issues go away, but it might add new ones. For example, how will you legally care for one another and how will you own assets like the home. And of course, there is always the possibility of a split – even this late in life – and the question then of how protected your assets comes to the forefront. Do take a look at the original article, especially if marriage is not the end-goal, and be sure to structure this new stage in life so that it might also be a happy one.

Reference: The New York Times (April 25, 2014) “Welcoming Love at an Older Age, but Not Necessarily Marriage”

For more information, see www.jerryreiflawyer.com

 

Legal Mistakes, Cut-Corners, And The Inheritance Of Litigation

Sometimes even a good estate plan can run into dire straits when the universe throws you a curveball. On the other hand, more often than not, when an estate plan fails and litigation follows it is because the estate plan was not a good plan at all. Legal mistakes and cut-corners are liabilities not worth keeping on the books, as a growing body of case law goes to show. Do not let a legal mistake haunt your estate, your assets or your family after you are gone. When it comes to estate planning, the liability of legal mistakes and cut-corners has a special kind of edge to it since it is so often the family or your partners who end up feeling the burden or even winding up in litigation. What do these cases look like and what terrible mistakes have been made? Forbes recently compiled a quick list of recent litigation and legal cautionary tales worth perusing in an article titled “Legal Mistakes That Haunt After Death: Three Cases.” Consider the following: • Selzer v. Dunn, or, ‘why you should always ensure that an entire plan is in writing and in place before you rely upon it.’ This was the case of two business partners who took out life insurance policies on one another ostensibly to fund a buy-sell agreement, but no buy-sell agreement was ever drafted. The family of the deceased was stuck with the shares to the company rather than the life insurance money intended to buy them out. • Aldrich v. Basile, or, ‘why DIY will writing and fill-in forms can get you into hot water.’ Here is the case where a do-it-yourself will writing kit could not properly account for state law, leading part of the family to argue the intent of a codicil to change the will was clear while the other half of the family argued it was unenforceable. • PHL Variable Insurance Company v. Bank of Utah, or, ‘why lying on legal documents is just a bad idea and maybe outright fraud.’ Here, the deceased had lied extensively on his life insurance application (inflating his value to at least ten times what could truthfully be underwritten) and naturally the discovery of this fact led the insurer to cancel the payout altogether by reason of fraud. Sometimes it is obvious what can go wrong, and sometimes it just takes a practiced mind to understand the issues that can arise. Regardless, never is a simple (or grand) legal mistake a worthy gift to your inheritors. If it is important enough to plan, then it is important enough and even necessary to plan well.

Reference: Forbes (May 13, 2014) “Legal Mistakes That Haunt After Death: Three Cases”

Educate Your Heirs On Reverse Mortgages

Even when heirs inherit a home outright and with no strings attached there are many issues to consider. Family homes are unique assets. However, as assets go, family homes can be as difficult as they are meaningful. But what about when there are strings that come with inheriting the family home? What if there is still a mortgage or, increasingly common, a reverse mortgage? Notably, when a reverse mortgage is in play there are a few more things an heir needs to know. Kiplinger recently examined this topic in an article titled “What Heirs Need to Know About Reverse Mortgages.” The key issues are timing and payoff. At the passing of the last borrower named in the reverse mortgage, that mortgage has to be paid off. Why? Because that is what a reverse mortgage does. A regular mortgage offers money for the borrower to buy the home while a reverse mortgage offers money for the equity a borrower already has locked up into their home. To keep the house you inherit, then, you have to pay off the lender. Consequently, to earn anything from the sale there must be more equity in the home than debt incurred by the reverse mortgage. But what if the reverse mortgage balance is greater than the value of the home? Fortunately, reverse mortgages can never force an estate into debt greater than the value of the home itself or allow the lender to collect against the estate beyond the home (they are “nonrecourse” loans). In short: there is a very definite need to quickly determine what is to be done with the home and if it is financially feasible. Whether as an heir or a planner, a reverse mortgage is an important financial product to understand and to plan accordingly. When it comes to settling the estate, handling creditors is a serious responsibility and a reverse mortgage is a serious undertaking. If a reverse mortgage becomes part of the financial plan late-in-life, it also carries with it significant estate consequences that must be navigated very carefully.

Reference: Kiplinger (March 2014) “What Heirs Need to Know About Reverse Mortgages”

For more information, see www.jerryreiflawyer.com

To Marry Or Not To Marry, But To Plan Accordingly Either Way Mid Michigan

It has been said that marriage is a young persons’ game, but love isn’t. These days, more and more Americans are meeting new loves or (finally) their true loves later in life. These later-in-life marriages can be tricky. On the other hand, even if you leave marriage to the young and idealistic, there is some planning that really has to be in place. The sociology of later-in-life marriage is fascinating, both in thinking about the recent jump in numbers and the more recent decrease. Either with or without tying the knot it is also a practical issue with legal ramifications, and for those later-in-life loves not destined for marriage there is some practical advice to be gleaned in a recent article on the subject in The New York Times titled “Welcoming Love at an Older Age, but Not Necessarily Marriage.” The article has the voice of several experts and more than a few horror stories to share. You see, marriage is an emotional union, but it is also an economic and legal one. This may come far more naturally to 20-somethings than boomers. It seems the older you get the more you have and the more you have to think about. If you are to marry, then the separate pasts, lives, and families have to account for it all and mesh together, which is a tricky enterprise when everything from college financial aid for children/grandchildren to Medicare or Medicaid benefits may instantly be affected. To not marry doesn’t necessarily make all of those issues go away, but it might add new ones. For example, how will you legally care for one another and how will you own assets like the home. And of course, there is always the possibility of a split – even this late in life – and the question then of how protected your assets comes to the forefront. Do take a look at the original article, especially if marriage is not the end-goal, and be sure to structure this new stage in life so that it might also be a happy one.

Reference: The New York Times (April 25, 2014) “Welcoming Love at an Older Age, but Not Necessarily Marriage”

For more information, see www.jerryreiflawyer.com

A Medicaid Primer 101

What is your Medicaid IQ? Most Americans have heard of Medicaid, since it has been part of the national political debate for some time. A political discussion is one thing, but what does Medicaid mean to your elderly loved ones? If you have elderly parents, it is high time to learn about Medicaid and how it works. Fortunately, a recent Forbes article is a good place to start. The article is aptly titled “Medicaid And Your Parents: The Basics.” Essentially, Medicaid is a program run jointly by the federal government and each respective state government. Think of it as government insurance for, among other things, late-in-life medical care like home care or nursing home care when the one needing care has too limited financial resources. Medicaid is “means-tested.” Consequently, having too great an income or too much in assets will disqualify a Medicaid applicant and create a legal hurdle to receiving benefits. In addition, having “assets” is not the same as having the money to pay for care. For those with assets exceeding the Medicaid limits, “giving” assets away will only disqualify them from Medicaid assistance if the transfers violate the “look back” period designed to keep them from gaming the system. Of course, an elderly individual might have had innocent intentions when they made a disqualifying gift a few years ago and the need for Medicaid was unforeseen. Regardless, such transfers are a red flag when it comes to Medicaid qualification. Each state is subtly different in its approach, but these are very real rules and they require careful thought and timing. Otherwise, it is easy to run afoul of the rules now and be disqualified from care later. You owe it to your elderly loved ones to start planning for a worst case scenario without delay.

Reference: Forbes (February 11, 2014) “Medicaid And Your Parents: The Basics”

For more information, see www.jerryreiflawyer.com

Estate Planning With A Life Estate

Do you want to avoid probate when it comes to the transfer of your assets at death, especially when it comes to your home? Perhaps you would prefer that home to pass directly into the hands of your adult heirs. If yes, then consider using a “life estate” approach. If the concept of a life estate is new to you, then a recent article in The Wall Street Journal ought to be on your reading list. As the article titled “An Easy Way for Heirs to Inherit Your Home” explains, a life estate for real estate operates like a “payable-on-death account” for a bank account. Here is how a life estate works. First, you draw up a deed to your house naming your heirs as beneficiaries. Second, you live in the house for the rest of your life. Third and lastly, after you pass, your named heirs need only to present your death certificate to assume title to the family home. This can save time and money often associated with probate. Simple? A life estate may be too simple, depending on the circumstances. As with most things legal, things can get complicated quickly. For example, you will not be free to sell your home during your lifetime without beneficiary consent and there are tax issues to consider. Depending upon the home and your objectives, there may be better ways to transfer the family home. Regardless, a life estate is a proven transfer tool just right for the right circumstances.

Reference: The Wall Street Journal (February 9, 2014) “An Easy Way for Heirs to Inherit Your Home”

For more information, see www.jerryreiflawyer.com

When Children Are Responsible For The Nursing Home Bill

Filial support is not just a moral virtue. In many parts of the country and branches of the legal system filial support is a legal imperative. Filial support laws exist in 29 states as well as Puerto Rico, and have quietly existed on the books for some time. Now, however, these laws are a very real and present concern for the adult children of elderly loved ones. Fortunately, Forbes has provided a crash course regarding filial laws and their potential challenges in an article titled “Who Will Pay For Mom's Or Dad's Nursing Home Bill? Filial Support Laws And Long-Term Care.” Essentially, filial support is the legally-imposed financial responsibility whereby children are responsible for their aging parents. The origins of filial support are found in some pretty old laws and lines of legal reasoning. History aside, consider filial support the flip-side of the legally-imposed financial responsibility parents owe to young children. Nevertheless, in a modern context with the massive escalation of healthcare costs, some see a dangerous pattern emerging. This is most dramatically evident when it comes to the costs of long-term care. So are you at risk? These are state laws. However, you might be liable if an elderly loved one resides in one of these states and you do not. Does this have your attention? Be sure to read the original article and, perhaps, do a little online research yourself. If nothing else, find out which states have filial support laws. Better yet, consult with an experienced elder law attorney.

Reference: Forbes (February 3, 2014) “Who Will Pay For Mom's Or Dad's Nursing Home Bill? Filial Support Laws And Long-Term Care”

For more information, see www.jerryreiflawyer.com

Estate Planning And The Specter Of Alzheimer’s Saginaw, MI

Alzheimer’s is no ordinary condition. What it means to the patient and to their mind is simply unique, just as it is uniquely meaningful to the family. Unfortunately, it is also a uniquely meaningful condition when it comes to estate planning and there are very important steps to take sooner rather than later. Planning for one’s estate and for one’s late-in-life plans requires more than a bit of wherewithal. This is not only an empirical fact but also a legal one. Because Alzheimer’s and dementia affect the mind means certain legal choices, whether regarding healthcare or disposition of property to one’s heirs, simply have to be down and in writing well before they are questionable. It’s a complex problem. Fortunately, there are some important tools to keep in mind early and get a plan in place. Some of the basics were helpfully pointed out in a LifeHealthPro article last month titled “4 things to know about Alzheimer’s and estate planning.” The four things? • Collect Your Documents: that is, all of the important documents should be easily at hand or easily discoverable for when they are needed, and not by the patient but by whoever cares for them. • Property Management: perhaps more appropriately, you should have a plan for assets in this life and an estate plan to direct assets thereafter. • Advanced Directives: these documents spell out important decisions and/or give that decision-making power to others through a Durable Power of Attorney, a Living Will, and Medical Directives (like a Do Not Resuscitate order). • A Living Trust: a trust can be all the more useful in organizing and disposing of property as well as allowing another to manage it, which is that much more powerful for an Alzheimer’s patient. These are just the basics. Regardless, and not without coincidence, these are important basics steps and tools when it comes to any estate plan. Planning in anticipation of Alzheimer’s is no different than the planning one ought to do anyway. But then, to the extent many of us will be affected by Alzheimer’s or dementia, it only stands to reason that we should all be diligent in our planning. Once we have one of these conditions, it could be too late to plan for anything. Be sure to get your own estate in place and work with your elderly loved ones to ensure they have the plans in place allowing for you to care for them.

Reference: LifeHealthPro (March 11, 2014) “4 things to know about Alzheimer’s and estate planning”

For more information, see www.jerryreiflawyer.com

 

Knowing Better Than The Professionals: New Medicare Rules And Knowing Your Rights

Sometimes big legal changes happen. Nevertheless, sometime you still have to point out these changes to the powers that be. Sometimes you must do so over and over for the real changes to manifest. As you may know, Medicare has recently undergone a big change affecting long-term care and the availability of skilled nursing or therapy. Namely, thousands are now eligible for Medicare benefits, but you might just have to point that out to care providers. The slow transition to full adoption of the rules and new standards of care, as well as the continuing plight of those left in a lurch, is discussed in a recent Reuters article titled “New Medicare coverage of long-term care off to a rocky start.” As pointed out there, you or a loved one may be eligible for benefits, but may need to fight to receive the benefits. Formerly, Medicare would only pay for skilled nursing or physical therapy sessions if there were signs of improvement. The trouble is that skilled nursing and therapy are not always about improvement but about maintenance, or even slowing a natural decline to keep a patient in a positive state. The rules were challenged and the case of Jimmo v. Sebelius brought about relaxed rules, allowing such services for far broader classes of patients. Medicare communicates these kinds of changes directly to healthcare providers and not to beneficiaries. However, it seems many beneficiaries are having to figure it out for themselves and push institutions to adopt the changes. As a Medicare beneficiary, it may be important to know what the new rules mean and how to advocate for your care or the care of a loved one. The original article offers some important resources like the Center for Medicare Advocacy, as well as the Medicare Rights Center. Each of these resources has some helpful guides and much more information on this and other relevant issues.

Reference: Reuters (April 29, 2014) “New Medicare coverage of long-term care off to a rocky start”

Long-Term Care Lapse Logistics

Do your elderly loved ones have a long-term care insurance policy or something similar? If yes, then they likely are relying on it to cover the potentially catastrophic financial risk that is long-term care. If yes, then what happens if they forget to pay the premiums? Do I have your attention now? If yes, then you will want to read a recent horror story in The New York Times - The New Old Age Blog titled “The Policy Lapsed, but No One Knew.” Generally speaking, any form of “insurance” exists to help minimize various financial risk exposures to the insured. In essence, you pay a premium you can afford (and the insurance company will accept) to cover a risk you cannot afford. Once insured, you really only need to think about the much easier task of remaining insured, which usually means making timely premium payments. Unfortunately for some families, remaining insured can sometimes present a few challenges uniquely associated with old age itself. What happens when the loved one begins to develop dementia and simply stops making the premium payments on the policy? Dementia is rather subtle before it becomes fairly dramatic. Accordingly, you may need to implement some financial safety precautions. The terrible lesson coming out of the original article is how the caregiver/son was diligent, but a mistake by his father at the bank snowballed into missed payments and a lapsed policy. The worst part of the horror story is that the cancellation notice from the insurer was never received - and the family was unaware of the policy lapse until they went to claim its benefits. Ultimately, the burden of proof was not on the insurer regarding whether the premium notice had been sent and received. Will there be a legislative reaction to stories like these? It seems this case will not go anywhere soon, but there may be more like it across the country.

Reference: The New York Times – The New Old Age (January 31, 2014) “The Policy Lapsed, but No One Knew”

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Medicare Rehab Requirements Relaxed?

Whenever the rules for receiving Medicare benefits change it has a real impact on real beneficiaries and patients. Sometimes legal changes occur literally overnight, while at other times the changes are more subtle. After a landmark lawsuit a year ago, there may be some tangible effects to the system – for the better. This is especially the case when an elderly loved one requires skilled nursing or physical therapy. The landmark case was Jimmo v. Sebelius. Recently, Forbes explored the legal evolution Jimmo sparked in an article titled “When Medicare Will Pay for Skilled Nursing or Physical Therapy.” The salient change concerns one of the guiding principles of Medicare, or at least what has been the common wisdom for years. This principle is the so-called “improvement standard.” The idea was that Medicare would pay for skilled nursing care or physical therapy only when the patient’s health had the potential to improve. Accordingly, the payments would cease when there was no more improvement to be had. Problem: skilled nursing and physical therapy are not necessarily just for curing a problem, but for managing it, especially among the elderly. Jimmo, however, provides that payment for these services will be made if they are “reasonable and necessary to prevent or slow further deterioration” and that benefits “cannot be denied based on the absence of potential for improvement or restoration.” Real changes have been slow as providers test the waters, and all the other rules regarding skilled care are in place. Nonetheless, an apparent misunderstanding has been put to rest and an entire class of real beneficiaries and patients can now be assured of receiving benefits. Those previously denied benefits may even have the option of having their coverage re-reviewed.

Reference: Forbes (January 31, 2014) “When Medicare Will Pay for Skilled Nursing or Physical Therapy”

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When Your Pacemaker Outlives You

Do you or a loved one live with a pacemaker or implanted defibrillator? How do you plan for end-of-life matters when one of these miraculous medical devices can keep you going and going and going long after your other essential bodily functions are otherwise shutting down? This scenario is all too common and is presenting challenges in geriatric medicine and palliative care. Recently, The New Old Age Blog took a look at this perplexing issue in an article titled “A Decision Deferred: Turning Off the Pacemaker.” Compounding the problem is the fact that standard medical directives are designed with feeding tubes and breathing support in mind. Rarely do such legal instruments address the question of a pacemaker, implanted defibrillator or other surgically implanted electronic heart monitor. These devices may extend life, and maybe not for the better, but without the directive who is empowered to direct when or even whether they should be turned off? Simply put: no one. So how many patients with these devices have built their wishes (whether on or off) into their plans and medical directives? In one survey of 150 elderly and dying Mayo clinic patients, more than half had a medical directive (and only that -- a bad statistic in itself). However, only one medical directive addressed the issue of the patient’s defibrillator.

Reference: The New York Times – The New Old Age Blog (January 29, 2014) “A Decision Deferred: Turning Off the Pacemaker”

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Will Your IRA Affect Your Medicaid Eligibility?

For many of us and the older loved ones for whom we may care, receiving needed medical care in old age will mean ensuring an easy transition into Medicaid. The problem, however, is that there are some strict financial rules governing eligibility to receive Medicaid benefits. Consequently, it is often all-too-easy to run afoul of them. Here is an important question to ask: “Can an IRA Affect Medicaid Eligibility?” ElderLawAnswers posed and answered this question, noting that the greatest asset many of us will own throughout our lives and well into old age will be our IRA or other retirement account. That said, just because you have the account doesn’t mean it can or will pay for the needed care. No, in the end you might need Medicaid. However, the mere existence of the IRA may cause you some trouble getting into the program. So, can an IRA affect Medicaid eligibility? The short answer is that “it depends.” It depends upon whether or not the IRA is in “payout status” (i.e., are taking minimum required distributions?). This might actually work differently than you’d expect. If your IRA is in payout status, then you might be in the clear. Medicaid allows you to have some income for personal use, after all. As a result, the payout from an IRA might be so small as to not cross the Medicaid income threshold and larger amounts will simply go to the nursing home until reduced to the small personal expense amount. If your IRA is not in payout status, however, then the IRA is non-exempt and can be held against you, potentially to full value. What to do with the IRA depends upon state law and the possibility of transfer versus cashing-out. Either option may not be pretty or productive. With proper planning beforehand you can help ensure that your assets won’t accidentally trigger a problem. IRAs can be tricky. Much of what you should do will depend upon your needs and your assets, with more than a little hanging on state law. Interpreting the relevant laws can mean a world of difference, so seek competent Elder Law counsel in structuring a plan.

Reference: ElderLawAnswers (March 28, 2014) “Can an IRA Affect Medicaid Eligibility?”

For more information, seee www.jerryreiflawyer.com

When Home Is Where The Healthcare Is, How Good Is The Care?

Receiving medical care in old age or securing it for a loved one is a difficult and often expensive choice to navigate. There are many options, paths and plans, to be sure. In the end, however, the choice can easily come down to finding that care at home or in a facility. How does the quality of care compare? Specifically, how good is the care at home? The answer seems to range from “we don’t know” to an unhelpful “it depends.” With so many people receiving care at home, either by default or by design, it is an important option to understand. A recent article in Forbes, titled “We All Want To Live At Home In Old Age, But Know Nothing About the Quality of Care We'll Get There,” to a look under the hood on this subject. The problem is a knowledge-vacuum. There are many levels of oversight for skilled nursing homes or other care facilities. On the other hand, there are few levels for care received in the home. In-home care may be delivered by a loved one, but it may also be delivered by a paid aide through Medicare home-based long-term services or some other program. There has been large expansion in the kinds of services available, but most of us have a hard time figuring out the quality of care available. Be sure to consult an experienced elder law attorney who is “plugged into” the network of care providers.

Reference: Forbes (March 19, 2014) “We All Want To Live At Home In Old Age, But Know Nothing About the Quality of Care We'll Get There”

For more information, see www.jerryreiflawyer.com

A Plea To Put It Down On Paper

It can be hard to appreciate the kind of frustration a family can go through when someone’s affairs are not in order and the time comes. On the other hand, if you have been there and done that, or have seen it second hand, then you know what I mean. There are simply a lot of plans that need to be made, because there are a lot of things that can go wrong. For an impassioned voice on the matter and some advice you should heed, be sure to read a recent commentary published in The Washington Post titled “Put your estate plan on paper before it’s too late.” The author recounts her own experience with her mother, who wasn’t even suffering from old age. Her mother was moved to critical condition after an accident. Unfortunately, the author was left on the other side of a legal wall caused by the lack of a financial durable power of attorney and healthcare directive that might have allowed her to come to aid. Worse still, the mother had actively put-off or refused committing her wishes to paper, and that’s why there was no legal recourse. If you or a loved one have not committed your financial durable power of attorney and healthcare directive wishes to paper, then here’s one more story to remind you why they are so important. We plan because there is a reason for certain privacy, healthcare and even probate. It is our own personal responsibility. If nothing else, we plan because when the time comes there are more important things to think about, like the comfort of an ailing loved one or the memory of a recently passed one. The original article spells out the basics and brings the need to complete your own plan clearly into focus.

Reference: The Washington Post (March 20, 2014) “Put your estate plan on paper before it’s too late”

For more information, see www.jerryreiflawyer.com

Will Your IRA Affect Your Medicaid Eligibility?

For many of us and the older loved ones for whom we may care, receiving needed medical care in old age will mean ensuring an easy transition into Medicaid. The problem, however, is that there are some strict financial rules governing eligibility to receive Medicaid benefits. Consequently, it is often all-too-easy to run afoul of them. Here is an important question to ask: “Can an IRA Affect Medicaid Eligibility?” ElderLawAnswers posed and answered this question, noting that the greatest asset many of us will own throughout our lives and well into old age will be our IRA or other retirement account. That said, just because you have the account doesn’t mean it can or will pay for the needed care. No, in the end you might need Medicaid. However, the mere existence of the IRA may cause you some trouble getting into the program. So, can an IRA affect Medicaid eligibility? The short answer is that “it depends.” It depends upon whether or not the IRA is in “payout status” (i.e., are taking minimum required distributions?). This might actually work differently than you’d expect. If your IRA is in payout status, then you might be in the clear. Medicaid allows you to have some income for personal use, after all. As a result, the payout from an IRA might be so small as to not cross the Medicaid income threshold and larger amounts will simply go to the nursing home until reduced to the small personal expense amount. If your IRA is not in payout status, however, then the IRA is non-exempt and can be held against you, potentially to full value. What to do with the IRA depends upon state law and the possibility of transfer versus cashing-out. Either option may not be pretty or productive. With proper planning beforehand you can help ensure that your assets won’t accidentally trigger a problem. IRAs can be tricky. Much of what you should do will depend upon your needs and your assets, with more than a little hanging on state law. Interpreting the relevant laws can mean a world of difference, so seek competent Elder Law counsel in structuring a plan.

Reference: ElderLawAnswers (March 28, 2014) “Can an IRA Affect Medicaid Eligibility?”

For m ore information, see www.jerryreiflawyer.com

When Home Is Where The Healthcare Is, How Good Is The Care?

Receiving medical care in old age or securing it for a loved one is a difficult and often expensive choice to navigate. There are many options, paths and plans, to be sure. In the end, however, the choice can easily come down to finding that care at home or in a facility. How does the quality of care compare? Specifically, how good is the care at home? The answer seems to range from “we don’t know” to an unhelpful “it depends.” With so many people receiving care at home, either by default or by design, it is an important option to understand. A recent article in Forbes, titled “We All Want To Live At Home In Old Age, But Know Nothing About the Quality of Care We'll Get There,” to a look under the hood on this subject. The problem is a knowledge-vacuum. There are many levels of oversight for skilled nursing homes or other care facilities. On the other hand, there are few levels for care received in the home. In-home care may be delivered by a loved one, but it may also be delivered by a paid aide through Medicare home-based long-term services or some other program. There has been large expansion in the kinds of services available, but most of us have a hard time figuring out the quality of care available. Be sure to consult an experienced elder law attorney who is “plugged into” the network of care providers.

Reference: Forbes (March 19, 2014) “We All Want To Live At Home In Old Age, But Know Nothing About the Quality of Care We'll Get There”

For more information, see www.jerryreiflawyer.com

A Plea To Put It Down On Paper

It can be hard to appreciate the kind of frustration a family can go through when someone’s affairs are not in order and the time comes. On the other hand, if you have been there and done that, or have seen it second hand, then you know what I mean. There are simply a lot of plans that need to be made, because there are a lot of things that can go wrong. For an impassioned voice on the matter and some advice you should heed, be sure to read a recent commentary published in The Washington Post titled “Put your estate plan on paper before it’s too late.” The author recounts her own experience with her mother, who wasn’t even suffering from old age. Her mother was moved to critical condition after an accident. Unfortunately, the author was left on the other side of a legal wall caused by the lack of a financial durable power of attorney and healthcare directive that might have allowed her to come to aid. Worse still, the mother had actively put-off or refused committing her wishes to paper, and that’s why there was no legal recourse. If you or a loved one have not committed your financial durable power of attorney and healthcare directive wishes to paper, then here’s one more story to remind you why they are so important. We plan because there is a reason for certain privacy, healthcare and even probate. It is our own personal responsibility. If nothing else, we plan because when the time comes there are more important things to think about, like the comfort of an ailing loved one or the memory of a recently passed one. The original article spells out the basics and brings the need to complete your own plan clearly into focus.

Reference: The Washington Post (March 20, 2014) “Put your estate plan on paper before it’s too late”

For more information, see www.jerryreiflawyer.com

Crucial Conversations: The End-of-Life Plan Talk Saginaw, MI

There are certain discussions that are just too important not to have. Unfortunately, these are also often the most difficult conversations to think about. As many planners will know well, talking with your adult children about your end-of-life wishes may be the hardest conversation of all. Back when the kids were kids, it seemed like the “birds and the bees” talk was tricky. However, according to a recent article in The Washington Post, the “aging talk” is far more difficult to grasp. Why is that? Be sure to read (and share) this article titled “Having ‘the other talk’ with your kids — not storks, but aging.” More to the point: what do you have to say? End-of-life planning these days has so much to do with medical and financial planning. You and your loved ones have to understand what health crises may arise, how to handle them or even how to receive the needed care. In fact, nearly 70 percent of people over the age of 65 will need long-term care services late in life. This is itself a financially uncomfortable prospect to think about, let alone discuss. So what is there to think and talk about? The original article has a helpful list of the bare essentials. At this point in life – more than ever – all of your planning is related. How does your end-of-life plan relate to your overall plan for your life, your family, and for your estate?

Reference: The Washington Post (March 29, 2014) “Having ‘the other talk’ with your kids — not storks, but aging”

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The Hidden Powers of Family Heirlooms Mid Michigan

Objects of inheritance seem to be imbued with a special power. This is oftentimes the case, whether the family is aware of it yet or not. As one sitting down to put your intentions to paper, or even as the inheritor, it is a power worth pondering. There are always the goals and intentions of the planning parent, of course. Nevertheless, more often than not, it is the family that sees the peculiar power of an heirloom. Maybe it is something well-loved and fought over, or the heirloom may simply provide the tinder to which a disgruntled heir may choose to set match and light a fire. Recently, Forbes considered this common source of family discord in an article titled “When It's Time To Part With Family Heirlooms, And Why I Gave Away Grandpa Oscar's Violin.” You cannot make all of the mistakes in life yourself, so it is best to learn from the trials (and errors) of others. Be sure to read the original article as it is really far from a tale of fighting, divvying up, or even maximizing sale returns. No, this article provides fresh insights into the kinds of special moments an inherited object can bring to a family well after the loved one has past. Each family member had a piece of the story behind this particular violin chronicled in the original article, and, therefore, they all walked away learning a bit more about Uncle Oscar.

Reference: Forbes (March 31, 2014) “When It's Time To Part With Family Heirlooms, And Why I Gave Away Grandpa Oscar's Violin”

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Six Tax-Saving Tips For Retirement

Proper planning is all about thoughtful planning for the now, for the later, and for the “after I’m gone” stages of life. So be diligent about your everyday finances, and plan for your final estate since you never know “when.” While you are at it, also consider your retirement and end-of-life finances. To keep things on an even keel it pays to consider taxes in structuring your late-in-life finances, and even more so to limit those taxes. There are a lot of variables in play when it comes to budgeting for retirement, to include ever lengthening life-spans and ever increasing medical bills. No one said it would be easy. One variable you will not want to ignore is taxes and how they will affect you. For some advice on how to make the finances last, and how to preserve wealth both for yourself and your heirs, be sure to read a recent article in Morningstar titled “6 Ways to Curb Taxes in Retirement.” The six ways? Roughly: Tip 1: Diversify Your Assets by Tax Treatment Tip 2: Consider a Roth Conversion--Even in Retirement Tip 3: Get Savvy With RMDs Tip 4: Mind State Taxes, Too Tip 5: Bundle and Time Your Deductions Tip 6: Avoid the 'Tax Torpedo' [i.e. Social Security tax payments] After you have read the original article, consider your own finances, or those of your elderly loved ones. Retirement is an important stage in life and one requiring careful financial planning so you do not outlive your money. Taxes are a major threat to your retirement financial security. How do your end-of-life finances coordinate with your plans for your estate? That is the next question, of course.

Reference: Morningstar (March 1, 2014) “6 Ways to Curb Taxes in Retirement”

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So, Have You Prepared Your Digital Estate Plan? Mid-Michigan

If you have an estate plan, chances are quite good you made specific arrangements for assets like your home, life insurance, retirement funds and perhaps even a business interest. What about your “digital assets”? Have you made proper arrangements for them? The problem of the digital estate is an entirely 21st century problem. Thankfully, more information is coming to light about the consequences of failing to make plans for digital assets. If this is a new subject matter for you, then you will want to read a recent MarketWatch article titled “Who gets your digital fortune when you die?” Basically, your digital “fortune” includes all of those digital assets that make up your digital presence. There are the social and practical ones, like e-mail accounts, Facebook accounts, and whatnot. From there your digital estate may include assets with real monetary value, like PayPal or eBay accounts, investment accounts, full bank accounts, and maybe an online-only bank account or two. While we are at it, remember the accounts that represent your ownership of digital “goods,” to include that massive Kindle library or an iTunes account. What happens to these? Without proper planning, your digital assets can easily become loose ends, losses and even liabilities. Unless you leave instructions behind, how will your heirs inherit your digital estate (let alone know it even exists)? There is no time like the present to get your digital ducks in a row.

Essential End-Of-Life (Legal Documents) Saginaw, Michigan

Not all planning is about how you leave your estate to your loved ones after you are gone. In fact, some of the most important planning concerns should include making sure your loved ones have the legal right to take care of you later in life. Consequently, there are some essential end-of-life documents you really need to have in place to make this happen. End-of-life planning has much to do with medical planning. Doctors can only do what you ask of them. But what if you cannot communicate your own wishes to them? What then? Contrary to popular belief, your loved ones cannot automatically step in and make your medical care decisions for you. The common default alternative is a formal legal procedure that is expensive, time consuming and exposes your personal circumstances and finances to the public record. If you want to spare yourself and your loved ones from this default legal scenario, be sure to read a recent Kiplinger article titled “4 Key End-of-Life Documents to Get in Order.” The four documents? 1. Durable Power of Attorney; 2. Health Care Proxy; 3. Medical Information Release; and 4. Living Will. These four legal documents need not be overly complicated, but they are important to have in place and at the ready. Whatever you do, do not put this planning on the back burner until it is too late!

Reference: Kiplinger (January 2014) “4 Key End-of-Life Documents to Get in Order”

For more information, see www.jerryreiflawyer.com

Essential End-Of-Life (Legal Documents) Mid-Michigan

Not all planning is about how you leave your estate to your loved ones after you are gone. In fact, some of the most important planning concerns should include making sure your loved ones have the legal right to take care of you later in life. Consequently, there are some essential end-of-life documents you really need to have in place to make this happen. End-of-life planning has much to do with medical planning. Doctors can only do what you ask of them. But what if you cannot communicate your own wishes to them? What then? Contrary to popular belief, your loved ones cannot automatically step in and make your medical care decisions for you. The common default alternative is a formal legal procedure that is expensive, time consuming and exposes your personal circumstances and finances to the public record. If you want to spare yourself and your loved ones from this default legal scenario, be sure to read a recent Kiplinger article titled “4 Key End-of-Life Documents to Get in Order.” The four documents? 1. Durable Power of Attorney; 2. Health Care Proxy; 3. Medical Information Release; and 4. Living Will. These four legal documents need not be overly complicated, but they are important to have in place and at the ready. Whatever you do, do not put this planning on the back burner until it is too late!

Reference: Kiplinger (January 2014) “4 Key End-of-Life Documents to Get in Order”

For more information, see www.jerryreiflawyer.com

Understanding Medicare’s “Nursing Home” Coverage Saginaw, Michigan

When is a patient not a patient? Answer: when they are not “admitted,” but just “under observation.” The distinction is critical when it comes to whether care is covered by Medicare. This is especially true when it comes to whether your elderly loved one will have nursing home coverage after discharge from the hospital. Understanding the meaning of observation status is essential. Once you do, then you will need to learn all the administrative tricks, twists and turns – and, yes, even to know how to fight it. If you are only starting to look into the world of Medicare and this most precarious transition from hospital to nursing home, then you will want to read a recent New Old Age Blog article titled “Fighting ‘Observation’ Status.” In a rush? Here is what you need to know: to qualify for Medicare nursing home coverage after a stay in a hospital, the patient has to have stayed as an admitted patient for three consecutive midnights, not including the day of discharge. In addition, that is “midnights” not “days,” “admitted” not “under observation,” and a number of additional technical rules the patient, the hospital, and Medicare have to get right. Anyone with an elderly love one should understand these Medicare and hospital rules, as well as their rights, in advance of hospitalization. If you are looking for further information beyond the original article, then the Center for Medicare Advocacy is a great resource with free information like their digital “self help packet.”

Reference: The New York Times – The New Old Age Blog (January 10, 2014) “Fighting ‘Observation’ Status”

For more information, see www.jerryreiflawyer.com

Mental Health And Medicare Coverage Saginaw, Michigan

If you have not heard by now, as of January 1, a whole host of Obamacare provisions went into place. While we are really just beginning to parse them out, one change for elderly and Medicare beneficiaries that went into effect has been on the books since 2008 through the Medicare Improvements for Patients and Providers Act. Medicare will now cover costs for psychological care to the same degree as physical medical costs at the 80/20 Medicare/Beneficiary split. The New York Times - The New Old Age Blog took note of this change in a recent article aptly titled “Medicare to Cover More Mental Health Costs.” It seems psychological issues are often the most directly felt difficulties in the life and wellbeing of elderly Medicare beneficiaries. With the new change, the long-held gap in coverage between the costs for physical medicine and psychological care has now been closed. Consequently, more elderly beneficiaries will be able to afford the care that is uniquely suited to their own needs and happiness. Nonetheless, a few sources of disparity between medical and psychological care for the elderly remain, as further noted in the original article. Does this recent change affect an elderly loved one? If yes, be sure to help them seek appropriate mental healthcare.

Reference: The New York Times – The New Old Age Blog (December 27, 2013) “Medicare to Cover More Mental Health Costs”

For more information, see www.jerryreiflawyer.com

Of Family Gifts And Medicaid Lookback Rules Mid-Michigan

Medicaid has some very well-intentioned rules to stop people from taking advantage of the system. Many people set out intending to “beat the system.” It is called fraud. Unfortunately, sometimes the rules intended to stop outright fraud can get in the way of everyday families who want to play by the rules. The most common problem families run into is the so-called “lookback” period. You can easily run afoul of the 20/20 hindsight of Medicaid and thereby threaten the care your elderly loved one needs. This common conundrum of the lookback period was recently updated in a Q&A and supporting guide produced by ElderLawAnswers. In fact, the common question that sparked the post is the same as the title: “Should I Return Money My Mom Gave Me So She Isn't Penalized by Medicaid?” The lookback period, as some know all-too-well, is the period that Medicaid looks back through the finances and tax records of an applicant to ensure that they did not give away their assets to pass muster with the means-testing of the program. Of course, there are plenty of legitimate scenarios in which an individual would want to give away money or assets only to need Medicaid a few years thereafter. So, what happens when the tripwire is tripped and your loved one is Medicaid ineligible due to a previous gift made during the lookback period? This may vary from situation to situation (and state to state), but there are ways of undoing the gift and becoming Medicaid eligible. However, there are some potentially strange tax consequences. Then again, the heir who received the gift can always pay for the care until the loved one is eligible for benefits again. Right? In either event, the best solution would be to not create the problem in the first place. For information on the lookback and other eligibility problems to Medicaid, consult the master post on the subject (see “Medicaid's Asset Transfer Rules”). As always this is yet another example of situations that require the expertise of competent counsel before making a financial or legal move now (the gift) that can have serious financial or legal consequences later.

Reference: ElderLawAnswers (mod. January 3, 2014) “Should I Return Money My Mom Gave Me So She Isn't Penalized by Medicaid?”

ElderLawAnswers (mod. September 13, 2013) “Medicaid's Asset Transfer Rules”

For more information, www.jerryreiflawyer.com

Understanding Medicare’s “Nursing Home” Coverage Mid-Michigan

When is a patient not a patient? Answer: when they are not “admitted,” but just “under observation.” The distinction is critical when it comes to whether care is covered by Medicare. This is especially true when it comes to whether your elderly loved one will have nursing home coverage after discharge from the hospital. Understanding the meaning of observation status is essential. Once you do, then you will need to learn all the administrative tricks, twists and turns – and, yes, even to know how to fight it. If you are only starting to look into the world of Medicare and this most precarious transition from hospital to nursing home, then you will want to read a recent New Old Age Blog article titled “Fighting ‘Observation’ Status.” In a rush? Here is what you need to know: to qualify for Medicare nursing home coverage after a stay in a hospital, the patient has to have stayed as an admitted patient for three consecutive midnights, not including the day of discharge. In addition, that is “midnights” not “days,” “admitted” not “under observation,” and a number of additional technical rules the patient, the hospital, and Medicare have to get right. Anyone with an elderly love one should understand these Medicare and hospital rules, as well as their rights, in advance of hospitalization. If you are looking for further information beyond the original article, then the Center for Medicare Advocacy is a great resource with free information like their digital “self help packet.”

Reference: The New York Times – The New Old Age Blog (January 10, 2014) “Fighting ‘Observation’ Status”

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Challenges When Selling The Inherited Family Home Mid-Michigan

Selling a home is never an easy process. Even if it moves on the real estate market, there is still the fact of moving itself. What about when it is not your home at all? What if it is the home of your parents, and perhaps your sole inheritance, with or without siblings? In that case selling the house can be rather difficult indeed, practically, financially, legally, and yes, emotionally. When it comes to selling an inherited home, there are some complications to ride out and with which you must deal. For guidance, consider reading are recent MarketWatch article titled “How to sell an inherited home.” Get past the practical facts of getting to the home (maybe you live states away) and moving out all of the possessions or figuring out what to do with them. Get past the emotional problems, too. How do you even go about selling it? Can the property move on the market to begin with or, alternatively, is there a better market for a rental and can you manage it? Who owns it exactly and, especially if it is in probate, when will those who will own it actually own it? Are there any liens on the property or a mortgage that may or may not be underwater? The simple truth for some families is that it may be best not to inherit the house at all and to let it go into foreclosure. Are there creditors in line to receive from the estate? If yes, then you cannot take ownership from the estate until bankruptcy proceedings have finalized. A few of these issues are drawn out in the article and worth the general advice offered. In the end, inheriting and selling the family home can be the uncomfortable intersection of estate law, tax law and real estate law. Without a plan, a family can find themselves in a mess. Without competent counsel, they may have trouble getting back up and away from the problems. If you are planning your estate, real estate -- especially your home -- is an essential component that may be overlooked to the peril of your loved ones later if not properly addressed from all angles now.

Reference: MarketWatch (January 13, 2014) “How to sell an inherited home”

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Of Family Gifts And Medicaid Lookback Rules Saginaw, Michigan

Medicaid has some very well-intentioned rules to stop people from taking advantage of the system. Many people set out intending to “beat the system.” It is called fraud. Unfortunately, sometimes the rules intended to stop outright fraud can get in the way of everyday families who want to play by the rules. The most common problem families run into is the so-called “lookback” period. You can easily run afoul of the 20/20 hindsight of Medicaid and thereby threaten the care your elderly loved one needs. This common conundrum of the lookback period was recently updated in a Q&A and supporting guide produced by ElderLawAnswers. In fact, the common question that sparked the post is the same as the title: “Should I Return Money My Mom Gave Me So She Isn't Penalized by Medicaid?” The lookback period, as some know all-too-well, is the period that Medicaid looks back through the finances and tax records of an applicant to ensure that they did not give away their assets to pass muster with the means-testing of the program. Of course, there are plenty of legitimate scenarios in which an individual would want to give away money or assets only to need Medicaid a few years thereafter. So, what happens when the tripwire is tripped and your loved one is Medicaid ineligible due to a previous gift made during the lookback period? This may vary from situation to situation (and state to state), but there are ways of undoing the gift and becoming Medicaid eligible. However, there are some potentially strange tax consequences. Then again, the heir who received the gift can always pay for the care until the loved one is eligible for benefits again. Right? In either event, the best solution would be to not create the problem in the first place. For information on the lookback and other eligibility problems to Medicaid, consult the master post on the subject (see “Medicaid's Asset Transfer Rules”). As always this is yet another example of situations that require the expertise of competent counsel before making a financial or legal move now (the gift) that can have serious financial or legal consequences later.

Reference: ElderLawAnswers (mod. January 3, 2014) “Should I Return Money My Mom Gave Me So She Isn't Penalized by Medicaid?”

ElderLawAnswers (mod. September 13, 2013) “Medicaid's Asset Transfer Rules”

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For Want Of A Beneficiary Will The IRA Be Lost? Mid-Michigan

Probate can be a difficult and long process. In fact, anything involving the court system is rarely quick and painless. Fortunately, IRAs can easily transfer to your loved ones outside of probate simply by completing a beneficiary designation form. Well what if there was no beneficiary designation form completed? How do the heirs or the executor figure this one out? The slightly messy situation of an IRA left without a beneficiary was tackled recently by Ed Slott’s blog, The Slott Report. The article, titled “There is No Beneficiary on the Retirement Account: Now What?,” is the perfect encouragement to ensure that every beneficiary form is filled out and up to date. The good news is that many accounts have a built-in default to the surviving spouse or children of the owner. Problem: What if that runs contrary to your estate plan? Alternatively, what if the account has no default? In all likelihood the account will then default to your probate estate and will be treated as any old bank account going through probate. Aside from probate itself, there are lots of rules regarding how IRAs can be inherited and used by the inheritor. They must take distributions just like you do, but when the IRA defaults to your probate estate it gets messy – and fast. The IRA can be assigned/transferred into a properly titled new account, but then again some IRA custodians simply refuse to do this, making the irreversible and catastrophically taxable choice to distribute the entire account to the estate. Simply put, an IRA not acting like an IRA within the estate plan is messy. It is easily avoidable by filling out the beneficiary form and keeping it up to date. In some situations this requires being proactive. For example, when a surviving spouse inherits an IRA but passes before naming a new designated beneficiary to the account

Reference: The Slott Report (January 9, 2014) “There is No Beneficiary on the Retirement Account: Now What?”

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Mental Health And Medicare Coverage Mid-Michigan

If you have not heard by now, as of January 1, a whole host of Obamacare provisions went into place. While we are really just beginning to parse them out, one change for elderly and Medicare beneficiaries that went into effect has been on the books since 2008 through the Medicare Improvements for Patients and Providers Act. Medicare will now cover costs for psychological care to the same degree as physical medical costs at the 80/20 Medicare/Beneficiary split. The New York Times - The New Old Age Blog took note of this change in a recent article aptly titled “Medicare to Cover More Mental Health Costs.” It seems psychological issues are often the most directly felt difficulties in the life and wellbeing of elderly Medicare beneficiaries. With the new change, the long-held gap in coverage between the costs for physical medicine and psychological care has now been closed. Consequently, more elderly beneficiaries will be able to afford the care that is uniquely suited to their own needs and happiness. Nonetheless, a few sources of disparity between medical and psychological care for the elderly remain, as further noted in the original article. Does this recent change affect an elderly loved one? If yes, be sure to help them seek appropriate mental healthcare.

Reference: The New York Times – The New Old Age Blog (December 27, 2013) “Medicare to Cover More Mental Health Costs”

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Life, Death, Medical Ethics And The Law Mid-Michigan

It seems we only engage in a national conversation when something in the news brings us to a crossroads. So it is with two recent medical cases making headlines over the often blurry lines between life, death, medical ethics and the law. How does one (or one’s family) navigate it all when confronting issues like brain death and life support? CNN recently considered these two cases in the headlines and the surrounding issues in an article titled “When 'life support' is really 'death support'.” These two cases share at least two things in common: a patient pronounced “brain dead” and the wishes of their families thwarted by the law. In one case, the family of a young girl seeks to keep her on life support as they hold out for a miracle. Her family refuses to accept brain death as true death. In the other case, the husband of a pregnant woman seeks to remove life support, petitioning a court to allow his wife to pass away.

Reference: CNN (December 29, 2013) “When 'life support' is really 'death support'”

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However, the hospital is forced to comply with Texas law that outright bans the option. These are difficult cases. While parents are responsible for their minor children, adults have the responsibility to make their wishes known through proper legal planning in advance. With the start of a new year, this would be an appropriate time to create, review or update your own advance medical directives. Be sure to take the crucial next step and discuss your wishes with your loved ones. In the very least, this national conversation over these two tragic medical cases should stimulate conversation and action when it comes to your own life and those of your loved ones.

Will Your E-mail Accounts Die With You? Mid-Michigan

The law is not known for moving at a terribly relevant pace, especially in the digital age. So, if you are unfamiliar with the notion of a digital estate, think about your online bank accounts, emails, social media and your entire digital presence on the web. Question: what happens to your digital life when your temporal life is ended? This is a question in need of an answer sooner rather than later. Imagine a world without you in which your heirs cannot access your digital assets. They cannot access your e-mails, either practically or legally, to get to important legal or financial information, whether about bank accounts or friends. Sadly, that is the reality in most scenarios today. The dilemma of the digital estate and the difficulties facing heirs was taken up by Forbes in a recent article titled “When Heirs Must Battle For Access To E-mail Accounts.” The conflict between the digital and the legal is very real. For example, consider the case of the Ajemian family. The Forbes article reviews four aspects of this complex, but important area of estate planning: 1. Beneficiaries for your e-mail. 2. Shared passwords. 3. Account hijackers. 4. Legal tangles. In one sense, you want your heirs to access all the digital information you and they may need when actually needed. On the other hand, do you want to give them access to every e-mail? Whatever digital information you have and whether you want to make such information available to your heirs is solely your call. The key is to think through this important area of your estate planning and to plan accordingly in this digital age.

Reference: Forbes (December 11, 2013) “When Heirs Must Battle For Access To E-mail Accounts”

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Yes, You Need To Initiate “The Talk” With Your Parents Saginaw, Michigan

Early in life, our parents start and run the money conversations from that first allowance to gearing up for those college loans, and maybe even beyond. Late in life, it is elderly parents who might need an all new money conversation about their own future and well-being. Unfortunately, to make that conversation happen, their now adult children likely will need to take the lead. Yes, it is truly a role reversal and often an important one. How do you start “the talk” and get it right? For a bit of guidance on the subject, you might turn to a recent Daily Finance article titled “Role Reversal: How to Have 'the Money Talk' with Your Aging Parents.” You see, late-in-life medical care may require the family to pull together and even offer direct care to their elderly loved ones. In the process, there may be some difficult financial hurdles to clear. In a very real way, it is not only the responsibility for the elderly parent to have planned along the way, but it is in everyone’s interest to figure out the financial hurdles sooner rather than later. Not planning has a funny way of becoming planning by default. This can lead to some painful consequences. So, what do you need to talk about and how do you even start the conversation? Take a look at the original article for some issues to parse out, and a few cautionary tales, too. One of the critical topics is that of long-term care. Given that it is a statistical reality, will the elderly parents outlive their resources due to long-term care? What can be done now to fund that obligation? Is long-term care insurance an option, especially if the children chip in to pay the premiums? There is no time like the present to plan for tomorrow. As for starting the conversation: this is always a difficult point, if only because it can be entirely different for different people. That noted, we are heading into a new year and this may be the perfect time to make “the talk” the first New Year’s resolution you make – and keep.

Reference: Daily Finance (December 5, 2013) “Role Reversal: How to Have 'the Money Talk' with Your Aging Parents”

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Yes, You Need To Initiate “The Talk” With Your Parents Saginaw, Michigan

Early in life, our parents start and run the money conversations from that first allowance to gearing up for those college loans, and maybe even beyond. Late in life, it is elderly parents who might need an all new money conversation about their own future and well-being. Unfortunately, to make that conversation happen, their now adult children likely will need to take the lead. Yes, it is truly a role reversal and often an important one. How do you start “the talk” and get it right? For a bit of guidance on the subject, you might turn to a recent Daily Finance article titled “Role Reversal: How to Have 'the Money Talk' with Your Aging Parents.” You see, late-in-life medical care may require the family to pull together and even offer direct care to their elderly loved ones. In the process, there may be some difficult financial hurdles to clear. In a very real way, it is not only the responsibility for the elderly parent to have planned along the way, but it is in everyone’s interest to figure out the financial hurdles sooner rather than later. Not planning has a funny way of becoming planning by default. This can lead to some painful consequences. So, what do you need to talk about and how do you even start the conversation? Take a look at the original article for some issues to parse out, and a few cautionary tales, too. One of the critical topics is that of long-term care. Given that it is a statistical reality, will the elderly parents outlive their resources due to long-term care? What can be done now to fund that obligation? Is long-term care insurance an option, especially if the children chip in to pay the premiums? There is no time like the present to plan for tomorrow. As for starting the conversation: this is always a difficult point, if only because it can be entirely different for different people. That noted, we are heading into a new year and this may be the perfect time to make “the talk” the first New Year’s resolution you make – and keep.

Reference: Daily Finance (December 5, 2013) “Role Reversal: How to Have 'the Money Talk' with Your Aging Parents”

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The Search for a Long-Term Care Solution Saginaw, Michigan

Yes, You Need To Initiate “The Talk” With Your Parents Mid-Michigan

Early in life, our parents start and run the money conversations from that first allowance to gearing up for those college loans, and maybe even beyond. Late in life, it is elderly parents who might need an all new money conversation about their own future and well-being. Unfortunately, to make that conversation happen, their now adult children likely will need to take the lead. Yes, it is truly a role reversal and often an important one. How do you start “the talk” and get it right? For a bit of guidance on the subject, you might turn to a recent Daily Finance article titled “Role Reversal: How to Have 'the Money Talk' with Your Aging Parents.” You see, late-in-life medical care may require the family to pull together and even offer direct care to their elderly loved ones. In the process, there may be some difficult financial hurdles to clear. In a very real way, it is not only the responsibility for the elderly parent to have planned along the way, but it is in everyone’s interest to figure out the financial hurdles sooner rather than later. Not planning has a funny way of becoming planning by default. This can lead to some painful consequences. So, what do you need to talk about and how do you even start the conversation? Take a look at the original article for some issues to parse out, and a few cautionary tales, too. One of the critical topics is that of long-term care. Given that it is a statistical reality, will the elderly parents outlive their resources due to long-term care? What can be done now to fund that obligation? Is long-term care insurance an option, especially if the children chip in to pay the premiums? There is no time like the present to plan for tomorrow. As for starting the conversation: this is always a difficult point, if only because it can be entirely different for different people. That noted, we are heading into a new year and this may be the perfect time to make “the talk” the first New Year’s resolution you make – and keep.

Reference: Daily Finance (December 5, 2013) “Role Reversal: How to Have 'the Money Talk' with Your Aging Parents”

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Yes, You Need To Initiate "The Talk" With Your Parents in Virginia

Interpreting The Uninterpretable Saginaw, MI

Advanced medical directives are a tough subject. Why? Because they mean making some tough choices. For elderly loved ones in nursing homes, however, there is a very powerful tool found in a little known directive known as the “do not hospitalize” directive. Unfortunately, it also happens to be underused and misunderstood, as pointed out in recent article in The New Old Age Blog titled simply “A Misunderstood Directive.” Advanced directives, as you may well know, are your medical choices reduced to black and white. They are intended to speak for you when you cannot. “Do not hospitalize” does not mean you do not want to receive care. In fact, you can even spell out the circumstances when you really want to go the hospital! Going to the hospital, however, is not always the best (or only) alternative across a spectrum of treatment scenarios. Hospitalization itself can be an intensely disorienting process, especially for patients with advanced dementia. Little surprise, then, that more than half of all elderly patients with dementia who are transferred from the nursing home to a hospital and back will pass away within the following 18 months. Accordingly, hospitalization can be an unfortunate step in the care continuum. In fact, hospitalization is oftentimes unnecessary. For example, most nursing home patients are sent to the hospital for respiratory infections, which is both avoidable and treatable in a nursing home setting without much trouble. On the other hand, the “do not hospitalize” directive can still provide that a broken bone or the replacement of a medical device can still trigger a hospital visit if you so stipulate. While advanced directives do some important work, according to some the “do not hospitalize” directive can help assure more peaceful late-in-life care.

Reference: The New York Times – The New Old Age Blog (November 20, 2013) “A Misunderstood Directive”

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Caregiving Challenges Of Blended Families Mid-Michigan

There are a lot of “blended families” in the United States. Whether following a divorce or the death of a spouse, this fact of life can raise serious caregiving issues later in life. For example, if you are caring for your elderly husband now, what kind of assistance can you expect from his adult children (and their spouses). Perhaps not much. As reported in a recent New York Times article titled “Study Finds Wives Often Struggle With Stepchildren Over Caregiving,” a study published by the Journal of Marriage and Family, found that all is not well with older Americans who have formed blended families. There is an unfortunate breakdown occurring in families, often to the detriment of the elderly family member and, at least as poignantly, for the elderly spouse left to care for them without other family assistance. The breakdown falls between the spouses from late-in-life marriages – statistically, the wives – and the adult stepchildren. Late-in-life-healthcare has simply become a greater burden on elderly persons and their families. This largely is due to the increased costs of care effecting everyone, but especially those with late-in-life conditions like Alzheimer’s or dementia. At the same time, late-in-life marriage has become more and more common and that changes the dynamics of family. Sometimes these changes are positive, but other times they can be less so. When there is a rift between adult children and a step-parent, what happens when the chips are down and an elderly parent/spouse grows ill or begins to suffer from dementia? What happens when the family does not pull together, but rather pulls apart? The latter scenario is a very real possibility in many families. Accordingly, some advance planning would be advisable, so all parties involved can come up with an agreed game plan before a crisis strikes. What if it is too late and the family is in crisis mode? The best approach may be to mediate and remediate. As the original article points out, family meetings are a very important tool in some circumstances unless the family is already fractured beyond repair. For example, it can be a difficulty to get everyone to even show up and talk. There might not be a silver-bullet plan that is a one-size-fits-all, but if you engage the issues now you might be able to work through them later.

Reference: The New York Times – The New Old Age Blog (October 15, 2013) “Study Finds Wives Often Struggle With Stepchildren Over Caregiving”

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Medicaid Dilemma – Sell Or Keep Your Home? Mid- Michigan

The move to a nursing home is a big step. It is a major life transition for all family members. Your loved one will no longer be living in their own comfortable and familiar home. In addition, there is the issue regarding whether to retain or keep the home given the unpleasant knowledge that the home may ultimately pay for nursing home care either way.

This dilemma was the focus of a recent Q&A in ElderLawAnswers via the question, “Is It Better to Sell a Medicaid Recipient's Home Now or Wait Until Her Death?”

Essentially, by receiving Medicaid you make certain agreements as to costs and, in the case of nursing home care, the deal often hinges on that most valuable of all assets an elderly person is likely to own: their home. True, it is possible to liquidate and sell the house just to pay for the nursing home care. Although this often reduces or eliminates the costs for maintaining and insuring an empty house, this also means giving up Medicaid benefits until the sale proceeds have been expended for care.

On the other hand, Medicaid will remember your choice whether you sell the home and private pay until spend down or if you to continue receiving benefits in lieu of such sale. If a family member attempts to sell the house after the Medicaid recipient loved one passes, then Medicaid has a lien on the sale proceeds (limited to the amount Medicaid paid for the care of the Medicaid recipient). Either way, the home is subject to pay for nursing home care or to reimburse Medicaid for the cost of care.

The answer to the question posed to ElderLawAnswers hinges on more than a few factors. That said, in most cases Medicaid payments will be less than private pay, sometimes a great deal less. Consequently, the resulting lien may be less of a burden than selling the house outright!

Is there something else at work, however? Notably, is the family home worth keeping in the family? These are situations that require some delicacy.

Reference: ElderLawAnswers (updated October 17, 2013) “Is It Better to Sell a Medicaid Recipient's Home Now or Wait Until Her Death?”

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