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.


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
10
2013
0

2013 CA Medi-Cal Quick Reference Guide

The State of California has changed some of the Medi-Cal qualification figures and requirements for 2013. A brief listing of these changes and requirements is set forth below:

2013 CA Medi-Cal Quick Reference Guide

Community Spouse Resource Allowance

$115,920

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

$2,898

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

Average Private Pay Rate (Divestment Penalty Divisor)

$7,549

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.

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 families through the 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 families get their “Ducks in a Row” in order help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension benefit. This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney regarding any planning.

May
31
2013
0

Baby Boomer Alert!

You should get your “Ducks In A Row” now. Many of us Baby Boomers, born between 1946 and 1964, have helped to take care of our elderly parents. Both of my parents are gone now, but my siblings and I helped our parents through their “Elder Care Journey,” which I talk about in my workshops. We helped our parents, the best that we could, with issues concerning their illnesses, memory issues, trips to and from the hospital and trips to and from nursing homes. We helped to get in-home-care for them, and helped to get them into assisted living facilities and a board and care home. Finally, both parents passed away while on hospice.

 I remember my brother Charles saying to me early on regarding helping our parents, that “This isn’t getting any easier.” And I remember thinking to myself that it won’t be that much longer, in the scheme of things, before my wife and I, who are both Baby Boomers, could need care. We want to make things as easy as possible for our children to help care for us.

 The first thing Baby Boomers should do is check their estate planning documents, including their revocable living trust and financial durable powers of attorney, to be sure that the proper asset protection and government benefits language is in the documents. The boiler plate language in the majority of estate planning documents will not help in these areas if you lose mental capacity. If the language is not there, and you lose mental capacity, your family may have to resort to going to court to reform your documents, which can be costly.

 With proper long term care planning, which starts with your estate planning documents, Medi-Cal could be accessed to pay for nursing home stays if you use up your Medi-Care days. And, there techniques you can use to protect the home from a Medi-Cal lien, which can be specified in your estate planning documents. In addition, the VA Aid and Attendance Pension Benefit is there to help older war time veterans, and this benefit can be used to help pay for in home care and assisted living facility costs. Proper language in your estate planning documents will make it much easier for your children to follow through with your care and to access these benefits, especially if you lose your mental capacity. 

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

 This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney regarding any planning.

Mar
25
2013
0

Can The State Take My Home If I Die After Having Been On Medi-Cal?

One of the most frequently asked questions I receive as an elder law attorney in Walnut Creek, CA is, “Can the State of California take my home if I die after having been on Medi-Cal?”

 The state will not actually take your home. But your home, if it is in your estate when you die, can be subject to a claim by the state after your death for the amounts the state has paid for your care. This claim will be paid when your property is sold from your estate. The state can only recover for the amounts they have actually paid for your care. Presently the amount they can recover is $7,092 per month, minus the share of cost that you have contributed to a nursing home. This amount of course would be less than what you would have paid as a private pay patient in a nursing home.

 In order to establish your home as an exempt asset when you apply for Medi-Cal, you must confirm your intent to return home if you have entered a nursing home. There is a question on the Medi-Cal application which allows you to establish this intent.

 The state will not pursue a claim for reimbursement against a surviving spouse of a Medi-Cal recipient as long as she is still living in the property. When she dies, the state will pursue the claim against any assets she received from her spouse, including the home, if he was a Medi-Cal recipient. In addition, the state cannot pursue a claim against the home if the Medi-Cal recipient is survived by a minor, blind or disabled child.

 There are techniques allowed by the state for protection of the home from a claim after death. For instance, we can “transmute” or transfer the ill spouse’s interest in the home to the well spouse during his life, and reserve a life estate to the well spouse. We can also transfer the home from a single Medi-Cal recipient to his children, for instance, and reserve a life estate to the Medi-Cal applicant. Transfers such as these must be done correctly and pursuant to the regulations in order to avoid a state claim, and in order to avoid capital gains issues. Please be aware that there is no protection for the home if it is in the revocable living trust of the Medi-Cal recipient when he passes away. Asset protection planning must be accomplished while the Medi-Cal recipient has good mental capacity. Otherwise, we may have to go to court to correct the problem. Do not rely on the idea that your financial durable power of attorney and revocable living trust will allow you to make these transfers during mental incapacity. The estate planning documents require specialized language in order to do this, and most plans do not have the requisite language.

 Keep in mind that the state cannot make a claim against assets that are not in your estate when you die. You will need the help of your elder law attorney aka your asset protection attorney in order create a long term care and asset protection plan for you. 

 Written Michael J. Young, elder law attorney, Medi-Cal attorney, senior law attorney and probate attorney in Walnut Creek, CA and former in-house counsel for title insurance companies. Mr. Young is a Medi-Cal attorney and is VA Certified. He is a member of NAELA www.WalnutCreekElderLaw.com LawYoung1@Gmail.com 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Mr. Young advises clients regarding Probates, Probates with Real Estate, Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is an Elder Law Attorney and Probate Attorney with offices in Walnut Creek, CA. Walnut Creek Elder Law Attorney, Walnut Creek Probate Attorney. Senior Law Attorney

Mar
11
2013
0

Can Mom Go On Hospice at Home?

Most of our clients make it well known in their long term care plans, that if they become ill, they wish to be taken care of at home for as long as possible. My parents made a pact with each other that if either of them had to go to “rehab”  as my mother called it, which is a skilled nursing facility, that they wanted to return home and be taken care of at home. My mother died at home under hospice care. Your elder law attorney can make these desires known in your elder care estate planning documents. In fact, at the Law Offices of Michael J. Young in Walnut Creek CA, we have our clients sign a separate “Intent To Return Home Document,” which states that if they have to go to a nursing home, it is always their intent to return to their home.

Most of our clients also make it known in their long term care planning documents that if they have a terminal illness, and they would only survivie by being hooked up to machines, that they would rather instead, be allowed to die with dignity, and not be hooked up to machines.

Many people do not know that hospice care can take place at home, and that hospice care professionals can come to your home. Hospice is also often paid for by Medicare or private insurance. To qualify for hospice, a physician must confirm that in their opinion, their patient is likely to die within a six month period. This is generally all that is required. I remember how relieved my siblings and I were when my mother was on hospice at home, and various nurses, social workers, doctors, priests and other aides came into my parents home to attend to my mother. All of us benefitted from this process. 

The hospice process allowed my mother, my dad, myself and my siblings to  to appreciate our last days together with my mother, outside of the traditional, more hectic hospital atmosphere.  

For more information about hospice, long term care planning, asset protection, Medi-Cal qualification and the VA Aid & Attendance Pension Benefit, please feel free to contact Michael J. Young at The Law Offices of Michael J. Young in Walnut Creek, CA. www.youngelderlaw.com www.walnutcreekelderlaw.com

Written Michael J. Young, elder law attorney, Medi-Cal attorney, senior law attorney and probate attorney in Walnut Creek, CA and former in-house counsel for title insurance companies. Mr. Young is a Medi-Cal attorney and is VA Certified.  www.WalnutCreekElderLaw.com LawYoung1@Gmail.com 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Mr. Young advises clients regarding Probates, Probates with Real Estate, Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is an Elder Law Attorney and Probate Attorney with offices in Walnut Creek, CA. Walnut Creek Elder Law Attorney, Walnut Creek Probate Attorney. Senior Law Attorney

Apr
19
2012
0

The Importance of an “Elder Law” Durable Power of Attorney

     Does your Financial Durable Power of Attorney (financial DPA) contain asset protection and government benefits qualification language? It probably does not, unless it was prepared by an elder law attorney. If you lose mental capacity, your spouse or children may be prevented from gifting your assets to themselves, in order to help you qualify for Medi-Cal or for the VA Aid & Attendance Pension benefit.

If your financial DPA contains any gifting language at all, it is probably limited to the annual gift tax exclusion amount, which is $13,000 per person this year. This language is usually of little help for Medi-Cal qualification. In addition, the language will probably not allow for gifting to the ”attorney in fact”, who is the person acting for you.  Specialized language is required under the law in order to allow for any gifting to the person acting as the “attorney in fact.” This specialized language usually does not appear in a “regular” financial durable power of attorney.

For instance, the home can easily be established as an exempt asset for Medi-Cal qualification. If the home is in the name of the Medi-Cal applicant who has lost mental capacity, and we want to transfer the home to a child and reserve a life estate to the applicant in order to avoid a Medi-Cal lien, most financial durable powers of attorney will not allow for this. Most financial durable powers of attorney will allow a transfer only upon receipt of consideration from a sale for fair market value of the real property.

To give another example, the Medi-Cal applicant, under the regulations, is allowed to own a life insurance policy, with a pay on death figure in any amount. However, in order to qualify for Medi-Cal, the applicant’s life insurance policy cannot have more than $1500 cash value. If there is a $5,000 cash value, for instance, the Medi-Cal applicant cannot qualify. The remedy is to liquidate the cash from the policy and then gift it out. What do you do however if the Medi-Cal applicant has lost capacity? We need to then look at the powers in the financial durable power of attorney. However, although most financial DPAs may allow for a liquidation of the cash value, they will not allow you to gift the cash out. The Medi-Cal applicant can only retain $2,000 in non qualified accounts, and if the cash from the policy cannot be gifted, it would have to be spent before qualification for Medi-Cal can be obtained.

The financial DPA in an elder law context, is also coordinated with the revocable living trust of the applicant. There should be specialized asset protection language in the trust, which refers to the financial DPA. This specialized language will allow the attorney in fact to “stand in the shoes” of the maker of the trust, for all purposes, including for Medi-Cal qualification. This technique is allowed by law, and provides the greatest amount of flexibility for the family who is helping the older person who has lost capacity, when we are applying for Medi-Cal.

Remember that if existing estate planning documents are not updated before the older person loses capacity, we may have to resort to a court proceeding to modify the language in the documents. This process is expensive and is not always guaranteed. The best approach is to pre-planning, and to have your estate planning documents updated as early as possible by a qualified elder law attorney, who practices full time in this area of the law. 

Written Michael J. Young, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Mr. Young advises clients regarding Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is a Concord Elder Law Attorney with offices in Walnut Creek, CA.

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Oct
17
2011
0

What Is The Difference Between Elder Law and Estate Planning?

I practice Elder Law and represent the older client and their families. When clients come to see me, their concerns are not so much about what happens when they die, but more about ’What happens if they don’t die.’

Of course, they want to make sure that their assets pass to their family with a minimum of expenses and taxes. But the bigger and more complicated question is, “What happens if I don’t die?” As we know, Americans are living longer all the time. The infirmities of old age may require that we have in home care assistance, or go to an assisted living facility, board and care home or eventually a to a nursing home.  We are of course concerned about how we pay for these costs. A regular estate plan does not address these needs. An elder law attorney can prepare a long term care plan for you, and address these needs. He will also address the concern of passing assets to their family.

To put it another way, a regular estate plan insures that if you die, your assets will be passed on to your family the way you want. The operative word is “if”. A  regular estate plan will not help preserve assets so that hopefully there will be something left when you die to pass on to your family. As we know, the assets of the older client could be depleted by a nursing home stay or lengthy illness, which could leave their spouse or heirs with nothing.  

If you have sufficient assets to pay for long-term care or nursing home costs without running out of funds, then a regualr estate planning attorney may be all you need. However, if you cannot afford the cost of a lenghty nursing home stay, of around $90,000 per year or $180,000 per year for a couple, or more, then an elder law attorney would be able to help you.

For a real life example, Mary and Jim have about $300,000 in assets and a home worth around $500,000. Jim needs assistance and uses a wheelchair. Mary has been providing for his care, but recently has shown signs of forgetfulness and confusion. She has been diagnosed by her doctor as having early signs of dementia.   

An estate plan is of course important to Jim and Mary, but this won’t help them deal with the problems they are presently dealing with. They want to tackle the issue of how they will be able to afford the cost of nursing home care should either one or both of them need it. They want to establish how they will be taken care of should Mary’s dementia become more advanced. They want to find out if if they can stay in their home with assistance.

This couple needs a life plan, specific to them, to meet their needs for the future. Jim and Mary need to seek the advice of an elder law attorney.

Written Michael J. Young, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Mr. Young advises clients regarding Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is a Concord Elder Law Attorney with offices in Walnut Creek, CA.

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Sep
28
2011
0

Elder Law is Alzheimer’s Planning

According to the Alzheimer’s Association, Alzheimer’s disease affects more than 5 million people in the U.S., and is the seventh leading cause of death in the U.S. today. This disease is expensive for the families of Alzheimer’s patients. And, it is the families who absorb much of the cost of care.

There are government resources available to help pay for the cost of care. The VA Aid & Attendance Improved Pension Benefit for wartime veterans and the surviving spouses of wartime veterans can be very helpful to pay for care. For the single veteran, the pension rate can be as much as $1,644 per month or $19,736 per year. For the surviving spouse, the pension rate can be as much as $1,056 per month, or $12,681 per year. This VA benefit can help pay for the costs of in home care, assisted living facilities and board and care homes.

Another government benefit is Medi-Cal, which can pay for skilled nursing facilities for the Alzheimer’s patient.

Qualification for both of these programs, the VA Aid & Attendance Pension Benefit and Medi-Cal, are asset and income based. Planning for these benefits can be done through your elder law attorney. You should pursue your long term care planning goals, including asset protection, through your elder law attorney as early in the process as possible.

Your elder law and asset protection attorney will update the estate planning documents of the Alzheimer’s patient, provided it is not too late, to include asset government benefits planning, and asset protection language. Thereafter, planning steps are made over time for asset protection and for qualification for these programs.

Michael J. Young, who is an elder law attorney in Walnut Creek, CA, helps many clients with Alzheimer’s disease, and their families, with Alzheimer’s Planning. Elder Law is Alzheimer’s Planning.

Mr. Young is an elder law attorney who represents clients in Concord, Walnut Creek, Pleasant Hill, Brentwood, Antioch, Clayton, Danville, Alamo and surrounding areas.

This blog is for informational purposes only and is not legal advice. You should consult an elder law, asset protection and government benefits planning attorney for your particular case, and before you proceed with any planning.

Written Michael J. Young, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Mr. Young advises clients regarding Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is a Concord Elder Law Attorney with offices in Walnut Creek, CA.

Through proper planning from an elder law attorney,  disease is not too far advanced, the

Michael J. Young is an elder law attorney in Walnut Creek, CA.

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