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.


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.

Jan
20
2014
0

7 Practical Considerations To Take Into Account When Choosing an Assisted Living Facility

Here are 7 Practical Considerations to take into account when you are choosing an assisted living facility, either for yourself or a loved one. We have developed this list  after having first hand experience with assisted living facilities that my father lived in, and after having interacted with our clients regarding these issues over many years.

  1. Is the facility well regarded in the community? Has it been recommended to you by someone who has had a loved one or friend there?
  2. Would the friends and family members of the resident be able to visit at any time, or are there restrictions in this regard?
  3. Is the facility in close proximity to the hospital and medical offices that the resident may need to visit?
  4. How were you treated by the staff and the administrator when you visited the facility? Did you feel welcome and were you comfortable with the experience?
  5. Were all of your questions answered satisfactorily when you visited the facility? Were you left in doubt or were you confused about any of their answers?
  6. Did you feel that you or your loved one would fit into the community for an extended period of time?
  7. Could you imaging yourself or your loved one living there?

* 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 and 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 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.

Nov
04
2013
0

Peace of Mind Now For Baby Boomers and Seniors Facing Retirement

A big issue now facing Baby Boomers and seniors is, surviving in retirement. We should have our “Ducks In A Row” now regarding health and financial issues, and there are many things we can do.

 Most of our clients do not have long term care insurance to pay for a stay in a nursing home. If they do, the policy would probably not pay the full cost. Fortunately however, California has Medi-Cal, which will pay for a stay in a nursing home provided that you qualify. You can now set up a long term care plan through your elder law attorney, as part of your estate plan, to provide for asset protection and qualification for Medi-Cal. For veterans, the plan will also help for qualification for the VA Aid & Attendance Pension Benefit to help pay for in home care and assisted living facilities. Your plan will also confirm your overall desires regarding how your assets will be spent for your care at home and otherwise. If you lose capacity, your loved ones will have the authority to follow through with your plan.

 The home is often our clients’ largest asset. You can take steps now through your estate planning documents to assure that your home will pass to your loved ones as a legacy, without a Medi-Cal lien, so that the state will not be able to recoup the nursing home payments it has made for you.

 Many Baby Boomers’ do not have sufficient savings to live on through retirement. The stock market has hurt many portfolios in the past. Fortunately however, Social Security is still in existence. Some analysts say that the program can pay for benefits for the next 25 years for the general populace. There also seems to be a consensus of opinion, that any changes in the law should not affect Baby Boomers, and that the fund will be available for them. Although you can begin taking benefits at age 62, this could be a 25% reduction of what you would receive if you waited until you are 66. If you wait until age 70, this could raise your benefit by 8%, so wait longer if possible.

 For additional peace of mind, you can change your life style just a little bit, and try to keep more of what your earn. I recommend reading The Millionaire Next Door by Thomas J. Stanley in this regard. Stanley gives examples of how changing your lifestyle somewhat, and giving up certain luxuries, will allow you to put more money into your retirement accounts on an ongoing basis.

 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 and 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 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.

Aug
19
2013
0

Finding Support For Alzheimer’s Patients:

If you are taking care of a loved one who has been diagnosed with Alzheimer’s disease, you are probably overwhelmed. You of course will need help. At the Law Offices of Michael J. Young in Walnut Creek, CA, www.WalnutCreekelderLaw.com, we suggest that our families begin by taking small steps.

One of the first steps I would take is to start to become educated about the disease by checking out the Alzheimer’s Association website www.alz.org.  By reading the material on this website, you will become informed about what Alzheimer’s is, how the brain works, and what to expect regarding symptoms and preferred treatments.

The site will also show you where the local Alzheimer’s Association offices are. Through these offices, you can sign up for support groups and learning centers. One thing that you will become aware of is that you are not alone! Through the Alzheimer’s Association website, you can check out early-stage support groups, and become involved in them. You will gain peace of mind through this wonderful organization.

You of course can also obtain individual support through the clergy, home health agencies and private counseling.

The next step you should take is to make sure you have your “Ducks in a Row” from a legal perspective. Did you know that you can incorporate asset protection and government benefits planning into your estate planning documents, that will be effective even if there is a diagnosis of dementia? Your loved one may have to go to a nursing home at some point, which is extremely expensive if you have used up your Medicare days and have to pay privately. Fortunately, California still has the Medi-Cal system to pay for nursing home costs. However, the program is asset and income based, and you will need to get your ducks in a row ahead of time for qualification to obtain this benefit. Couples and individuals are many times surprised to learn that their loved one can qualify for this wonderful benefit, even though they would appear to have too much in the way of assets. If your loved one has lost mental capacity at the time we start to work on qualification for Medi-Cal, the qualification process can become more difficult.  

You can also arrange a time for a free 15 minute telephone consultation to discuss these issues with elder law attorney, Michael J. Young, by going to https://www.timetrade.com/book/PTXVP

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 and 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 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.

Jul
19
2013
0

Baby Boomers Predict The Future!

Baby Boomers Predict The Future!

Wouldn’t it be nice to be able to predict the future for us Baby Boomers, and start planning for it! But we do know certain things about our future …

  •  On average, 10,000 people are turning age 65 every day.
  • It is predicted that at least 70% of people over age 65 will need long-term care services.
  • Currently, the median cost of long-term care for one year in the United States is $83,950.00.
  • In 30 years, when the last of the Boomers reach age 65, the price of long-term care is expected to be at an all time high of $190,000 per year.
  • Currently, the average amount of time a person needs long term care is 2.7 years.

 As my grandson would say, “OMG!”

As a senior estate planning attorney, and a Baby Boomer, we need to ask ourselves what we can do to plan for our long term care. GE Long Term Care Insurance conducted a study and found that nursing home costs are rising at a rate of 5% every year, outpacing inflation. With the rapidly growing elderly population this is the simple law of supply and demand.

 So, what can we do to prepare for the second half of life? If you or your spouse are age 65 and one of you goes into a nursing home, do you have a spare $513,000 lying around to pay for your or your spouse’s care.

 We still have Medi-Cal in California, which pays for the cost of a skilled nursing facility. The VA Aid & Attendance Pension benefit is still available to help pay for in home care and assisted living facility costs.

But you need to “get your ducks in a row” ahead of time to plan for qualification for these benefits. For starters, Baby Boomers are now taking advantage of modern asset protection and government benefits planning qualification techniques, which are incorporated into their estate planning documents. Also, one of our main goals is to preserve our homes for our children, without a lien for payback to Medi-Cal. With the modern language in your estate planning documents, if you become incapacitated, your spouse or loved one can follow through with qualification and asset protection techniques under the Medi-Cal and VA regulations.  

This information is not to be taken as legal advice, and you are encouraged to see your senior estate planning attorney before attempting any of these techniques. 

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 and 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 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.

Jul
01
2013
0

VA Aid & Attendance 2013 Pension Benefit Amounts

The 2013 Maximum Aid & Attendance Pension Benefit Rates are set forth below. This is a wonderful benefit for older wartime veterans, which can help pay for the cost of in-home care, assisted living facilities and board and care. The benefit is “non service connected”, which means that qualification is not dependent upon a wartime injury.

The veteran must typically have served ninety days of active duty, one day of which was during an offical wartime period. The veteran cannot have had a dishonorable discharge. The veteran’s physician must declare the veteran as in need of assistance from another individual and in need of a “Protective Environment”, which may include services offered by a care facility or company.

You should discuss with your elder law attorney how to make the A&A Pension Benefit part of your long term care planning.

BENEFIT AMOUNTS:

Single Veteran         $1,732.00 Per Month or $20,795.00 Per Year

Married Veteran      $2,054.00 Per Month of $24,652.00 Per Year

Surviving Spouse $1,113.00 Per Month or $32,114.00 Per Year

Veteran Married to Veteran (Both A & A) $2,676.00 Per Month or $32,114.00 Per Year.

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
04
2013
0

Protect Your Home From a Medi-Cal Lien With a Reserved Life Estate

Medi-Cal can pay for your stay in a skilled nursing facility if you qualify. Under the state’s regulations, your home can be confirmed as an exempt asset in the Medi-Cal application. This means that you can keep your home, if you are otherwise qualified, and still receive Medi-Cal. This is true whether you are single or married. The concept is that you should not have to lose your home in order to receive this public benefit.

 The problem is that the state will want to recoup the payments it has made to the nursing home for your benefit, when you die. If your home is in your estate when you die, the state will put a lien on your home for the amount it has paid to the nursing home on your behalf. If the state has paid out $150,000 for you, they will put a lien on your home for that amount. When you die and your estate is settled, the state will be satisfied first for their lien of $150,000, and your beneficiaries will receive what is left. The state will not pursue a lien against a surviving spouse who still owns the home, but when she dies, the state’s lien will attach to the home and the state will recoup their payments at that time. 

There is a legal technique which is permitted under the regulations, which will allow you to protect your home against a Medi-Cal lien. It is called a “reserved life estate,” and your elder law attorney or senior law attorney can advise you in this regard. If the Medi-Cal applicant owns a home, we can transfer her interest in the home to her spouse, or to her children, for instance. A life estate in the home is reserved on the deed in favor of the Medi-Cal applicant. This means that the applicant owns the home for the rest of her life, and that her spouse or children own the remainder interest. The applicant is entitled to rents, issues and profits derived from the real estate. These interests are confirmed on the county record. When the Medi-Cal applicant dies, the home is not in her estate because her life interest disappears at the time of her death by operation of law, and her spouse or her children then receive the full interest in the property. Elder law planning and asset protection planning can be further pursued for the surviving spouse with your elder law attorney, to likewise protect her interest in the home.

Although under real estate law the home is not in the Medi-Cal applicant’s estate when she dies, so that a Medi-Cal lien cannot attach to the home, another benefit in using this technique is that under the IRS regulations, the reserved life estate interest should be recognized as keeping enough interest in her home in her estate, so that there should be a “step-up in basis” for capital gains purposes at the time of her death.  

If you have lost mental capacity at the time we would like to make a transfer of your interest in your home and reserve a life estate in your favor, we will need to look at the language and powers in your revocable living trust and financial durable power of attorney. If the powers are not there, and they usually are not, you may have to pursue a court petition through an elder law attorney who is familiar with this area of the law, in order to reform your documents to allow for this transfer. Most revocable living trusts and financial durable powers of attorney do not contain this favorable language. As a result people who are “baby boomer” age or older should consider getting their “Ducks In A Row” and have their elder law attorney or senior law attorney create an elder care plan for them, which will include estate planning documents with this favorable, asset protection language. An elder law attorney who is familiar with Medi-Cal qualification can certainly help you in this regard. Michael J. Young is an elder law attorney who practices in Walnut Creek, CA.

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. He is 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

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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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