Mar
01
2018
0

Items Generally Exempted for Medi-Cal Qualification

If you apply for Medi-Cal, the following list includes items that are generally exempted for qualification.

  • Your home is exempted if it is your principal residence. When applying for Medi-Cal, you will confirm on the application that you intend to return home after your stay in a skilled nursing facility. Medi-Cal requires a “subjective intent in writing to return home” to establish the home as an exempt asset. We have our clients execute an “intent to return home” form when we prepare their asset protection estate plans.
  • IRAs, 401k’s and other “qualified accounts” are exempt. The applicant however must be taking RMD’s or some amount of principal and interest on a periodic basis.
  • Not more than $2,000 in cash in the applicant’s name, which could include savings and checking accounts.
  • One care is exempt. If a couple owns two cars, we request an exemption for the more expensive car.
  • Term life insurance is exempt, but whole life insurance cannot have more than $1500 cash value.
  • Burial plots are exempt, and prepaid irrevocable burial plans are exempt.
  • Qualified or work related annuities are generally exempt. Other annuities may be exempt according to the Medi-Cal regulations.
  • Household furnishings are exempt.

This list is not exhaustive, and this information is not to be taken as legal advice. You are encouraged to see your elder law and probate 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, probate avoidance, wills, trusts, powers of attorney and probates. 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.

Michael J. Young

Walnut Creek Elder Law

Elder Law, Asset Protection,

Medi-Cal and Probate Attorney

1931 San Miguel Dr. Ste., 220

Walnut Creek, CA 94596

925-256-0298

Jan
30
2017
0

Do not Listen To Your Neighbors Regarding Medi-Cal Eligibility

Do not listen to your neighbors regarding Medi-Cal eligibility! Over the last number of days, we have been told by several individuals who are interested in our services, that their understanding is that they would never qualify for Medi-Cal based upon “advice” they received from their neighbors. In each case, the advice was wrong.

One person told me that she was told that her husband would not qualify for Medi-Cal because his IRAs were too high. I told her that her husband can have any amount of IRAs and still qualify for Medi-Cal. In fact, I told her that she, as the well spouse, can also have any amount of IRAs, and her husband could still qualify for Medi-Cal.  In addition, I told her that both her and her husband’s IRAs cannot be collected against by the State for Medi-Cal recoupment.

In another case, an individual told me that she was informed that she could not qualify for Medi-Cal because she owned her own home. This information is also incorrect. All she has to do is express a subjective intent in writing that she intends to return home, even if she is in a nursing home. We prepare that documentation for our clients as part of their estate plan. This intent to return home is also confirmed on the Medi-Cal application. In addition, I told her that as of January 1, 2017, her home cannot be collected against by the State for Medi-Cal recoupment, if her home is in her revocable living trust at the time of her death.

In another case, a person told me that he understood that he could not qualify for Medi-Cal because his and his wife’s income was too high. This advice is also erroneous because of the Medi-Cal rules regarding Share of Cost. The state pays qualified nursing homes $8,189 a month for a Medi-Cal recipient, minus a share of cost from the recipient. The $8,189 is usually much lower than a nursing home would be if you were to private pay. The recipient’s income goes to a share of cost to the nursing home, up to $8,189, minus a few small deductions from the recipient’s income. If the recipient is married, the well spouse can keep all of her income, without penalty. If the well spouse makes under $2,981 per month, the ill spouse’s income is allocated to the well spouse’s income to bring her up to $2,981 per month. As a result, many of our clients end up paying a very small share of cost, and sometimes nothing, to the nursing home.

The moral of the story is, do not listen to your neighbors regarding Medi-Cal eligibility.

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 the older client and their families get their “Ducks in a Row” in order help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension benefit.

Dec
21
2016
0

Medi-Cal Recovery Will Be Limited to Probate Estates after January 1, 2017

We have recently blogged about the new legislation Governor Brown signed, effective January 1, 2017, which changes the rules regarding recovery by the state for payments it has made to nursing homes for Medi-Cal recipients. Under the old law, the only way we could avoid recovery was to ensure that there was nothing in the Medi-Cal recipient’s name at the date of his death. Under the new law, for Medi-Cal recipients who die after January 1, 2017, recovery will be limited to those estates that are subject to probate under California Probate Law. Assets transferred from a revocable living trust of the Medi-Cal recipient will not be subject to recovery under California Law, because assets in a revocable living trust are not be subject to probate.

For example, if Mary the Medi-Cal recipient leaves her home to her son in her will, the home will be subject to a probate. If the state paid $30,000 to a nursing home for Mary, the state will be able to recover the $30,000 from the probate of the home. If the home was in Mary’s revocable living trust at the time of her death, the state will not be able to recover against the home, because the home will transfer from the trust to Mary’s son, and will not be probated.

The new rules, effective for Medi-Cal recipients who die after January 1, 2017, also exempt certain assets from state recovery. For example, property transferred prior to death, that are no longer in the beneficiary’s name, are not subject to recovery. However, any transfers must be made within the Medi-Cal regulations in order to avoid periods of ineligibility when applying for Medi-Cal. Also, the state cannot recover against your life insurance policy as long as you name one or more beneficiaries under your policy. If you do not name a beneficiary, or if the beneficiary you have named dies before you do, there will be a probate to determine who the beneficiary is. The state will be able to recover against the probate.

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 the older client and their families get their “Ducks in a Row” in order help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension benefit.

Nov
28
2016
0

‘Tis the Season for Stress’ – Special Challenges

Once again the Holiday Season is upon us. ’Tis the season’ for mixed blessings. Along with the joys of the season come the stressors. This year you wonder how you will manage to get everything done. Your “to-do” list, as always, seems never ending with shopping, baking and decorating. This year, however, you know at the top of your priority list is providing the best possible care for your elderly loved one who suffers from increased dementia.

This time of year can likewise create stress for your loved one whose anxiety levels seem to mirror your own. Unlike yourself, however, the dementia affects your loved one’s ability to express himself or herself clearly. Simple changes in routine can cause unexpected anxiety which increases with the inability to verbalize what they are feeling.

In addition to the stress on both caregiver and care recipient, out of town guests add a whole new dynamic. Family members may feel shocked by your loved one’s mental and physical changes. This shock can produce feelings of guilt or anger that may be directed at you. Your loved one may also exhibit additional uneasiness — possibly viewing family members as strangers.

So the question remains, “How do you make it through the holidays and maintain some semblance of peace?” And, equally important, “How do you help your elderly loved one do the same?”

First of all, you may want to do some pre-planning. Waiting until the last minute often leaves a person feeling rushed and harried. To avoid this unnecessary stress, create a list of priorities.

If you plan to take your loved one with you holiday shopping, hit stores early in the day and on weekdays. Most malls and department stores are far less crowded at these times. Also, take along a picture of the person you are shopping for. This provides a reminder to your loved one and an opportunity for their input on the gift. Encourage your loved one to take part in wrapping the gifts when at home. (Be mindful, however, of their frustration levels.)

If you are doing any of the holiday cooking, establish the menu ahead of time. Plan to buy as many of the ingredients as possible a week or two in advance. Also, prepare whatever will keep in the refrigerator or freezer ahead of time so there is less to do on the actual day of your gathering. Most importantly, don’t be afraid to ask others to bring along a dish. Most guests would be happy to help.

Prepare your visiting family members for potential changes in your loved one’s status. Imagine how drastic changes and declines would seem if you had not been present to witness them. Sharing can help them prepare family and friends for the emotions they may feel when confronted with these changes.

Ultimately, you cannot eliminate stress from every environment. For this reason it is essential that you eat well, exercise and get plenty of sleep. With your own stress level in check, you can focus on monitoring the stress levels of your loved one.

If the stress gets overwhelming, consider getting help with your caregiving tasks. Home health care agencies can provide help a few hours a day or a few hours a week. Adult Day Care gives your loved one a safe environment in which to interact with others. If your holiday plans include an over-night visit or extended stay, check into Respite Care.

Nov
09
2016
0

2017 Medi-Cal Recovery Against Surviving Spouse

Governor Brown has signed new legislation, effective January 1, 2017, which changes the rules regarding recovery by the state for payments it has made to nursing homes for Medi-Cal recipients.  Under the present law, the state can recover against the surviving spouse or domestic partner of a Medi-Cal recipient, from whatever was in the Medi-Cal recipient’s estate that was left to the surviving spouse or partner by distribution or survival, as from joint tenancy or community property, or property left under a will to the surviving spouse. After January 1, 2017, if the Medi-Cal recipient is survived by a spouse or registered domestic partner, a claim is forever barred against that person. If the surviving spouse however receives Medi-Cal benefits, then his or her estate can be subject to an estate claim after his or her death.

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 the older client and their families get their “Ducks in a Row” in order help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension benefit.

Sep
28
2016
0

Consider A Joint Checking Account With Your Parents

Many older people insist on handling their own financial affairs without assistance, for as long as as possible. This is admirable, but what if something bad happens to the older person, like a medical event which lands the older person in the hospital, and ready access to cash is needed? And, what if the older person begins to lose capacity and starts to make bad decisions with their money?

For access to immediate cash, a child or other loved one should be a joint owner on a checking account with the older person. If the older person is hospitalized and indisposed for a period of time, the child will be able to take care of finances, and pay bills for their parent. If the older person starts to make bad financial decisions, or is the subject of fraud, the child could shut the account down.

The bank and financial accounts, except for IRAs, should be transferred to the revocable living trust of the older person, with a child or other person named as successor trustee. These transfers to the revocable living trust are completed through the bank or financial institution, and these trust assets are reflected on the schedules of assets attached to the revocable living trust. The trust is set up so that if the older person loses capacity, a doctor’s note is obtained, and the child can act as the new trustee to control the assets for the benefit of the parent.

But what if the parent refuses to cooperate and do any of these things? You should try to maintain a dialogue of communication with the parent, and try to stay informed about what is happening with his daily life. If the parent becomes unusually defensive when asked about his finances, this should be a red flag. At this point, a geriatric social worker may be able to help you communicate with your parent. If the estate plan and finances aren’t properly set up, and the parent loses mental capacity, a court conservatorship may be required for you to be able to gain control of the accounts. The earlier the estate plan and joint checking account is set up, the easier it will be for all concerned.

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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Dec
17
2015
0

Beware of Arbitration Clauses

The New York Times has examined, in a series of articles, the problems with mandatory arbitration agreements in consumer contracts. The articles examine “… how clauses buried in tens of thousands of contracts have deprived Americans of one of their most fundamental constitutional rights: their day in court.”

The NY Times series discusses how consumers are often, unknowingly, forced to have their disputes heard by business-friendly arbitrators, without the benefit of courts or judges. As a result, the claim resolution may end with business biased results, without accountability through the justice system.

Unfortunately, nursing homes usually have arbitration clauses in their admission agreements. When the resident signs an agreement upon admission that has an arbitration provision, the resident agrees to give up their constitutional right to have a dispute decided in court, with a judge and jury. This arbitrator’s decision is final, binding, and with no right to appeal.  Arbitration is expensive, with the arbitrator receiving between $400 and $1,000 an hour for his time. Also, studies have shown that arbitrators have a pro-business bias, and that consumers receive less money from arbitration awards, than through the court process.

It is illegal under California law to force a prospective nursing home resident to sign an arbitration agreement as a condition of admission. Also, the state requires that the arbitration agreement be separate and apart from the admission agreement. So, the best way to preserve your right to the judicial system is to not sign the arbitration agreement. Our financial powers of attorney do not give powers to the attorney in fact to sign an agreement for binding arbitration.

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
02
2015
0

What assets can you keep when qualifying for Medi-Cal?

What assets can you keep when qualifying for Medi-Cal?

Your Home: Your home is generally exempt, or not counted, in determining eligibility for Medi-Cal. The Medi-Cal applicant, or their representative, must express an intent to return home. This is confirmed on the Medi-Cal application. It is also confirmed when you execute your estate planning documents with your elder law attorney. The home is also exempt if a spouse, minor, blind or disabled child lives in the home. You will most likely want to transfer your interest in the home to your spouse or child in order to avoid a recovery by the state against your home after you die. You will need the help of your elder law attorney regarding an transfers concerning the home.

Personal Property: Your household goods and personal effects are totally exempt for determining eligibility for Medi-Cal.

Cars: Medi-Cal will give you an exemption for one car.

Jewelry: When one spouse is in a nursing home, all jewelry is exempt. For a single person, wedding and engagement rings and heirloom jewelry are exempt.

Whole Life Insurance: You cannot have more than $1500 cash value in your policy. If there is more than $1500 cash value, it must be reduced.

Term Life Insurance: Term life insurance is totally excluded.

Burial Plots: Burial plots are totally excluded:

Prepaid Irrevocable Final Expense Trusts: You can put any amount into an irrevocable final expense trust for your funeral and final expenses. These trusts are used for general estate planning, but are also helpful for planning for Medi-Cal eligibility. You can “spend down” a portion of your assets by transferring them to a final expense trust in order to create eligibility for Medi-Cal. You can ask your elder law attorney about this trust, and there is generally no fee for its creation and implementation.

IRAs and work-related annuities: If the IRA is in the applicant’s name, the IRA is exempt if the applicant is receiving periodic payments of interest and principal. If the IRA is in the well spouse’s name, it is totally exempt.

Community Spouse Resource Allowance: The spouse at home, called the community spouse, can have up to $119,220 in liquid assets, plus the home, IRAs and other exempt assets listed above.

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.

Dec
01
2014
0

More On Alternative Long Term Care Insurance Options for Baby Boomers

In our last post we discussed how many of our Baby Boomer clients have looked into buying long term care insurance, but have decided against the purchase because of various reasons. Some feel that the cost is too high, or they don’t like the idea that if you don’t use it, you lose most of it. Also, some of our clients have been denied coverage because of their age, health issues, or both. Fortunately, there are alternatives to consider for our older clients.

Many of our clients have several hundred thousand dollars in various investments, including savings accounts, mutual funds, annuities and IRAs, in addition to their home. This would appear to be a nice nest egg, but would be depleted quickly if they were in need of 24/7 care. For a single person, the cost of care could conservatively be $90,000 or more per year and twice that for a couple.

One option is to purchase a type of annuity which provides payments for long term care. The initial premium payment for the annuity could create 2 to 3 times the amount of the premium in long term care payments. For example, if you re-position $50,000 into the annuity, then $100,000 to $150,000 could be available for long term care expenses. The underwriting for this type of product is much simpler than applying for long term care insurance, but the age and health of the client is still taken into account.

In addition, under the “Pension Protection Act”, you could withdraw the $50,000 tax free from an existing annuity to purchase an annuity with the long term care payment option. You could also fund the purchase of this new product using IRA money through an income tax free “trustee to trustee transfer.”

When you visit our office, ask us to help you explore the possibility of repositioning a portion of your assets for payment of your long term care should you need it in the future. These options should be explored as part of your long term care asset protection and estate 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 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.

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