Jan
12
2015
0

2015 CA Medi-Cal Quick Reference Guide

The State of California has changed some of the Medi-Cal qualification figures and requirements for 2015. A brief listing of these changes and requirements is set forth below:

Community Spouse Resource Allowance (CSRA)

$119,220

This is the amount that the community, or (at home) well spouse can retain in liquid assets. This amount does not include exempt assets, such as the home and qualified accounts, such as IRA’s.

Minimum Monthly Maintenance Needs Allowance (MMMNA)

$2,981

This is the minimum amount of income the well spouse can keep.

Average Private Pay Rate – Divestment Penalty Divisor – (APPR)

$7,628

This is the amount the State pays to nursing homes on the Medi-Cal program, minus a share of cost by the applicant. This figure is also used to calculate penalty periods of ineligibility for Medi-Cal.

Applicant Resource Allowance

$2,000

The applicant can keep this amount in cash, checking, etc.

Monthly Personal Needs Allowance

$35

The amount of income the ill person is allowed to keep.


Jan
02
2015
0

Treatment of The Home With Reverse Mortgages By Medi-Cal

Under the Medi-Cal regulations, it is fairly easy for us to establish the home as an “exempt asset” for qualification for Medi-Cal. The usual way is to confirm “an intent to return home” by the Medi-Cal applicant. The next task is to protect the home from a Medi-Cal lien if you pass away after having been on Medi-Cal. If you die after having been on Medi-Cal, and you are still on title to the home, Medi-Cal can put a lien on your home to recover the payments they have made to the nursing home. If you are not on title to the home when you die, Medi-Cal cannot pursue recoupment against your home. After we confirm the home as an “exempt asset”, we can transfer the home to another person without penalty under the Medi-Cal regulations. You can always transfer the home to your spouse without penalty. The goal is to keep the home as a legacy in your estate without it going to the state.

If you have a reverse mortgage on your home, it may become difficult for you to transfer title of the home to another person without triggering the due on transfer clause under the mortgage. This means that the loan could be due and payable upon the transfer. Also, if you go into a nursing home for an extended period of time, the reverse mortgage can become due and payable, and the home could be sold under the terms of the reverse mortgage. Any proceeds from the sale that you realize may make you ineligible for Medi-Cal benefits.

A reverse mortgage on your home is sometimes a good option for the older person. However, please keep in mind that it may not be such a good option if you could go into a nursing home in the foreseeable future. You should seek the advice of your elder law attorney for a full discussion of protecting the home, before committing to a reverse mortgage.

For additional information, you can contact your elder law attorney Michael J. Young. This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney. At the law offices of Michael J. Young, 1931 San Miguel Dr., Ste. 220, Walnut Creek, CA http://www.WalnutCreekElderLaw.com, 925-256-0298,lawyoung1@gmail.com, we practice elder law and we help Baby Boomers, Seniors and families through their Elder Care Journey. We help families with Sustainable Estate Planning TM, long term care planning, asset protection plans, special needs trusts, comprehensive estate planning, wills, trusts and powers of attorney. We also help Baby Boomers and families get their “Ducks in a Row” in order to help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension Benefit.

Dec
31
2014
0

Mom Is Showing Some Dementia – Can we still create a long term care plan for her?

In my workshops, we talk about the Elder Care Journey. Along this journey, which I show on a chart, is an area called “Declining Senior With Memory or Mobility Issues.”  I reference this step along the Elder Care Journey as a DANGER ZONE. We know that mobility issues and falling oftentimes is the beginning of a downward slope for our older loved ones. A person with mobility issues but who still has good mental capacity can of course enter into a long term care estate plan. She can agree in the plan that if she loses capacity, her loved ones can proceed with asset preservation, possible gifting, transfer of her home for asset protection, and getting her ducks in a row for qualification for Medi-Cal, etc.

If she has lost mental capacity by the time she sees her elder law attorney, she will not be able to enter into such a plan. If there is a formal diagnosis for instance of advanced dementia, we of course will not be able to proceed. In that case, if she has the plain vanilla type of estate plan, which is more suitable for a younger person, the plan will most likely not have the powers to allow her fiduciary to complete gift transfers or to transfer the home to her spouse or her children for asset protection. In that event, we may need to go to court to obtain an order to reform her existing estate planning documents.

If Mom has some dementia, such as short term memory loss, she may still have sufficient mental capacity to enter into a long term care plan. We can usually tell through our interview and conversation with her if she understands what the plan is about. If we are not certain, we can ask her medical doctor whether he would be willing to confirm in a letter that she has sufficient mental capacity to create the estate plan.

The sooner the older client sees the elder law attorney, the better. It is never too late to do long term care planning, but it is much more expensive if we need to go to court to complete the planning.

For additional information, you can contact your elder law attorney Michael J. Young. This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney. At the law offices of Michael J. Young, 1931 San Miguel Dr., Ste. 220, Walnut Creek, CA http://www.WalnutCreekElderLaw.com, 925-256-0298,lawyoung1@gmail.com, we practice elder law and we help Baby Boomers, Seniors and families through their Elder Care Journey. We help families with Sustainable Estate Planning, long term care planning, asset protection plans, special needs trusts, comprehensive estate planning, wills, trusts and powers of attorney. We also help Baby Boomers and families get their “Ducks in a Row” in order to help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension Benefit.

Oct
06
2014
0

Little Known Law May Help Seniors Pay for Long Term Care

On August 17, 2006, the President signed into law The Pension Protection Act of 2006. This law, which came into effect in 2010, can be very helpful to Baby Boomers and older clients who are looking for ways to private pay for long term care without coming up with additional funds.

Many of our clients own annuity contracts, and this law allows them to add long term care riders for an additional premium. The Pension Protection Act allows the cash value of annuity contracts to be used to pay the premiums for these long term care riders. The payment of premiums in this manner also has a tax benefit in that it will reduce the cost basis of the annuity contract.

The act also allows for the purchase of an annuity contract with a long term care rider by using cash in another annuity. By utilizing a Section 1035 tax-free transfer, you can purchase the new contract with a long term care rider without paying capital gains on the cash transfer.

Another option under the act for some clients, is to use the accumulated cash value in an annuity to purchase long-term care insurance through a § 1035 exchange. Other premium sources for long-term insurance can be by way of a § 1035 exchange. You can also utilize after tax money, such as savings or money market accounts or CD’s to purchase long term care insurance or life insurance with long term care riders.

For additional information, you can contact your elder law attorney Michael J. Young. This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney. At the law offices of Michael J. Young, 1931 San Miguel Dr., Ste. 220, Walnut Creek, CA http://www.WalnutCreekElderLaw.com, 925-256-0298,lawyoung1@gmail.com, we practice elder law and we help Baby Boomers, Seniors and families through their Elder Care Journey. We help families with long term care planning, asset protection plans, special needs trusts, comprehensive estate planning, wills, trusts and powers of attorney. We also help Baby Boomers and families get their “Ducks in a Row” in order to help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension Benefit.

Sep
29
2014
0

An Interesting Insurance Based Strategy To Help Private Pay For Long Term Care

Our clients are concerned about how they will private pay for their long term care. Most long term care takes place first in our homes and then in assisted living facilities. We have Medi-Cal in California, but it only pays for a stay in a skilled nursing facility, if we qualify. As a result, our clients are always asking, “How can we private pay for our long term are if we do not go into a nursing home?”

This strategy may be appropriate for individuals who do not want to pay premiums to purchase long term care insurance policies. People have become reluctant to purchase long term care insurance because of the cost, and because of the fact that if you do not use it, your investment by way of premiums paid is lost. In addition, long term care insurance companies have been known to raise the premiums of its insureds over time.

Many of our clients take the position that they will “self-insure”, using their savings for their care. For these individuals, one effective planning approach may be to leverage some of their savings that they would use for their care in the future to provide a larger pool of money. This money can be utilized to pay for care in the home, assisted living facility or nursing home. If the money is not needed, it would then pass to their children or heirs.

To employ this strategy, money is transferred from its current location (bank account, older fixed annuity past the penalty period, etc.) into a specially designed life insurance policy with riders that allow accelerated payment of a large portion of the death benefit to the policy owner upon a qualified health event, to help pay for the costs of long term care.

Depending on the age and health status, the lump sum premium paid into this type of life insurance policy may provide a death benefit of double or more that amount. However, if the insured qualifies to begin using the long term care benefits, the insured may receive as much as five times the amount of the original premium. Any monies not used for convalescent care would still pass to the heirs upon the death of the insured.

When your elder law attorney prepares your long term care estate plan, ask him to explore this possibility with you.

For additional information, you can contact your elder law attorney Michael J. Young. This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney. At the law offices of Michael J. Young, 1931 San Miguel Dr., Ste. 220, Walnut Creek, CA http://www.WalnutCreekElderLaw.com, 925-256-0298, lawyoung1@gmail.com, we practice elder law and we help Baby Boomers, Seniors and families through their Elder Care Journey. We help families with long term care planning, asset protection plans, special needs trusts, comprehensive estate planning, wills, trusts and powers of attorney. We also help Baby Boomers and families get their “Ducks in a Row” in order to help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension Benefit.

Jun
09
2014
0

How To Convert Your Life Insurance Policy To Help Pay For The Cost of Senior Care

Some of our clients have asked whether they should let their life insurance premiums lapse, as part of budgeting for the cost of care for their loved one. Many of our clients have been making premium payments on their life insurance policies for a long period of time.

My answer is to first find out whether their life insurance policy has a value that can be converted to a long term care benefit. As part of the process, we present a copy of the policy to a Life Care Funding Company along with a simple application. The company underwriters will determine whether they will make a cash offer to you for the purchase of the policy. If they make such an offer and you accept it, the cash is then placed into a benefit account that is professionally administered by the company.

 Payments from the benefit account are then made monthly to the care providers for the benefit of the individual receiving care. Payments can be made for instance to assisted living communities, nursing homes, retirement communities and home health care providers.  

Once the life insurance policy is converted to a long term care benefit, you will no longer make premium payments to keep the life insurance policy in effect.

For additional information, you can contact elder law attorney Michael J. Young. This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney. At the Law Offices of Michael J. Young, at 1931 San Miguel Dr., Ste. 220, Walnut Creek, CA www.WalnutCreekElderLaw, 925-256-0298, lawyoung1@gmail.com we practice Elder Law and we help Baby Boomers, Seniors and families through their Elder Care Journey. We help families with long-term care planning, asset-protection plans, special needs trusts, comprehensive estate planning, wills, trusts and powers of attorney. We also help Baby Boomers and families get their “Ducks in a Row” in order help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension benefit.

May
20
2014
0

Hiring Home Health Aides:

As part of the Elder Care Journey as we call it, many of our clients will eventually need in-home-care. Our clients want to stay at home but will need help with various activities of daily living, such as eating, bathing, dressing, ambulating and toileting. In fact, our estate planning documents usually confirm an intent to remain home for care for our clients, and an intent to return home after a stay in a skilled nursing facility. The issue then becomes whether you should hire the in-home-care aide through a home care agency or should you hire the aide directly.

Please keep in mind that the aide who will be helping your Mother for instance, will be coming into your Mother’s home, and will be left alone in the home with her for long periods of time. You should avoid risks regarding the aide as best as you can. Health Care Agencies pre-qualify their aides, and do background checks before hiring. Their aides are also bonded. Most of our clients and their families maintain a better comfort level and peace of mind when they hire an aide through a health care agency.

With regard to proof of spending issues for qualification for Medi-Cal and the VA Aid & Attendance Pension Benefit, the fact that you are using an agency creates a much smoother application process. The agreement you have with the agency and proof of payment to them is usually sufficient proof for Medi-Cal and VA. When cash payments are made to an individual, who may also be undocumented, it is much more difficult to obtain these benefits.

Another issue to be concerned with is the IRS and who does the tax reporting and wage withholding for wages paid to the aide. If you are hiring an aide through an agency, you do not face these additional issues. I am not sure that the IRS would become involved, but you have enough to worry about, dealing with the issues of being older and needing care, without worrying about the IRS.

This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney. At the Law Offices of Michael J. Young, at 1931 San Miguel Dr., Ste. 220, Walnut Creek, CA www.WalnutCreekElderLaw, 925-256-0298, lawyoung1@gmail.com we practice Elder Law and we help Baby Boomers, Seniors and families through their Elder Care Journey. We help families with long-term care planning, asset-protection plans, special needs trusts, comprehensive estate planning, wills, trusts and powers of attorney. We also help Baby Boomers and families get their “Ducks in a Row” in order help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension benefit.

Apr
28
2014
0

Special Needs Trust & Inheritance & Workshop 5-8-2014

Special Needs Trusts and Inheritance:

Q: Our father just passed away and left $400,000 in his revocable living trust to myself and my brother. My brother is on SSI and will lose his benefit when he receives the inheritance. What should we do?

 A. There is a remedy for this problem when someone dies, and their revocable living trust does not have a special needs trust provision for a special needs beneficiary. Under the law, the revocable living trust became irrevocable when your father died. As a result, it is too late for you to amend the trust to include a Special Needs Trust for your brother.

 However, the California Probate Code does allow the Court to amend the trust to include a special needs trust upon a petition to the Court from the special needs beneficiary. The special needs beneficiary files a petition with the court requesting that the trust be modified to include a special needs trust for himself for his part of the inheritance. Your brother, who will be the petitioner, will tell the court in the petition that had your father gone to an elder law attorney who would have advised your father about the addition to his revocable living trust of a special needs trust for your brother, that your father would have requested that addition.

The courts have been willing to grant these petitions. After the court signs its order for the modification of your father’s trust, the inheritance for your brother will flow into his new Special Needs Trust and he will not lose his public benefits. Your Walnut Creek Elder Law Attorney can advise you and help you in the preparation of a petition for the modification of a revocable living trust after the maker of the trust dies.

This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney. At the Law Offices of Michael J. Young, at 1931 San Miguel Dr., Ste. 220, Walnut Creek, CA www.WalnutCreekElderLaw, 925-256-0298, lawyoung1@gmail.com we practice Elder Law and we help Baby Boomers, Seniors and families through their Elder Care Journey. We help families with long-term care planning, asset-protection plans, special needs trusts, comprehensive estate planning, wills, trusts and powers of attorney. We also help Baby Boomers and families get their “Ducks in a Row” in order help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension benefit.

Apr
17
2014
0

Special Needs Trusts For Children

A number of our clients have “special needs” children who are presently receiving public benefits such as Supplemental Security Income and Medi-Cal. Other clients have “special needs” children who may need public benefits later in life. These public benefit programs have asset limits. Many times the children who are receiving public benefits become settled in their lifestyles regarding their living arrangements and working requirements. They usually do not want to lose these benefits and have their lifestyles disrupted by receiving an inheritance when their parents or grand parents pass away.

The parents and grandparents want to preserve the family wealth for all of their children and grandchildren, and do not want to disinherit a child. There is a remedy for this problem, and that is the creation of a supplemental special needs trust. This trust is written into the revocable living trust of the parents or grandparents as part of their estate plan. The share of the inheritance for the special needs child will go into the supplemental special needs trust upon the passing of the parents or grand parents for the benefit of the special needs child.

The overall goal of the supplemental special needs trust is to provide for the needs of the special needs child that are not being met by government benefits. The life of the special needs child can be enhanced by providing for better care, supplemental medical needs, supplemental therapies, recreational opportunities and other living enhancements. The wealth of the family can thereby be preserved, and when the special needs child passes away, his or her share of the inheritance can go to his children or to other family members.

The language in the supplemental special needs trust must be very specific in order for the child to keep the public benefits and yet benefit from the trust. First, the child must not be the trustee, and may not have legal access to the funds in the trust. Another person must be named as trustee. The terms of the trust direct that any distributions from the trust must be in compliance with the Supplemental Security Income, Medi-Cal or other government benefits regulations, so that benefits are not disrupted. The trust must also be drafted in such a way as to avoid any recoupment by Medi-Cal after the special needs child passes away. Your Walnut Creek Elder Law Attorney can advise you and help you in the preparation of a supplemental special needs trust.

This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney. At the Law Offices of Michael J. Young, at 1931 San Miguel Dr., Ste. 220, Walnut Creek, CA www.WalnutCreekElderLaw, 925-256-0298, lawyoung1@gmail.com we practice Elder Law and we help Baby Boomers, Seniors and families through their Elder Care Journey. We help families with long-term care planning, asset-protection plans, comprehensive estate planning, wills, trusts and powers of attorney. We also help Baby Boomers and families get their “Ducks in a Row” in order help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension benefit.

Mar
11
2014
0

No Look Back Period for VA Aid & Attendance

There will NOT be a look-back gifting penalty period for the VA Aid & Attendance Pension Benefit. On February 27, 2014, Senate Bill 1982, known as The Veterans Pension Protection Act, did not get the required votes to pass. One of the purposes of this bill, which also contained other provisions, was to help curtail some of the backlog at the VA for processing this benefit.

 Unlike Medi-Cal, VA does not have a look-back gifting penalty period for qualification for the Aid & Attendance Pension Benefit. As a result, you can theoretically gift all of your assets away today, and be eligible for this VA benefit tomorrow with no gifting penalty. California however has a 30 month look back penalty period for gifting for eligibility for Medi-Cal. Medi-Cal pays for nursing home costs, minus a share of cost contribution by the recipient.

 A problem has been that the 30 month look back penalty rules for Medi-Cal have often been ignored when large gifts have been made for qualification for Aid & Attendance. The result has been that if you make a big gift today in order to receive this VA benefit, you may have created a long period of ineligibility for Medi-Cal, by not following the Medi-Cal gifting regulations. Your elder law attorney will advise that any gifting made for qualification for the VA Aid & Attendance Pension benefit should coincide with the Medi-Cal gifting rules.

 If Senate Bill 1982 had passed, any gifts made within the last three years would be reported, and a penalty for eligibility would attach.

This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney. At the Law Offices of Michael J. Young, at 1931 San Miguel Dr., Ste. 220, Walnut Creek, CA www.WalnutCreekElderLaw, 925-256-0298, lawyoung1@gmail.com we practice Elder Law and we help Baby Boomers, Seniors and families through their Elder Care Journey. We help families with long-term care planning, asset-protection plans, comprehensive estate planning, wills, trusts and powers of attorney. We also help Baby Boomers and families get their “Ducks in a Row” in order help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension benefit.

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