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Case Study: Life Care Planning

Joseph and Marie had been happily married for 52 years, raised a family, and were enjoying their retirement years when health issues began to surface. Marie was the first to exhibit health concerns and was diagnosed with dementia, leaving her unable to effectively communicate with Joseph and her three children. Shortly thereafter, Joseph began showing signs of mild cognitive impairment along with age-related physical limitations that made taking care of Marie and himself difficult.

Fortunately, Joseph and Marie had met with Scott Bloom Law a few years prior to experiencing these health issues and had a plan in place for when their decision-making capabilities had waned. While this didn’t make any of these end-of-life realities easier to confront, they were comforted by the fact that their children would be taken care of and that they were not adding to the stress the family was dealing with. With the help of Scott Bloom Law, the family was able to take the necessary steps to ensure that their parents’ best interests were always the most important consideration. With Scott Bloom’s legal counsel:

  • They had given their oldest child power of attorney a few years prior, ensuring that when needed their family would be prepared and that their wishes for end-of-life care would be met.
  • While it was challenging, the children were able to convince their father that the best next step was to find a long-term care facility where they could receive round-the-clock care. As with most families, convincing their elder loved ones to leave their home was a difficult and heart-wrenching process. When their funds for paying for long-term care were exhausted, they were able to utilize Medicaid.
  • In addition, a trust was created for the benefit of their children, mimicking their testamentary intent as shown in their Last Will and Testament. Often with multiple children involved, it can, unfortunately, become a contentious process with differing ideas and motivations in play. At Scott Bloom Law, we work with families to help mediate disputes and keep the focus on the well-being of everyone involved.

Too often, families look to a ‘specialist’ who does not have the all-encompassing understanding of the myriad of issues that are faced by the elderly and their loved ones.  This case demonstrates the importance of utilizing an elder law attorney. At Scott Bloom Law, we have the experience and breadth of knowledge necessary to understand and advise on all aspects of eldercare issues. With compassion, honesty, and attention to detail, the team at Scott Bloom Law will be there every step of the way for you and your family, providing a plan and offering guidance through the elder law legal process. Schedule a call with us today to discuss your situation and how we can help.

Benefits of Hiring an Elder Law Attorney for Medicaid Planning

When an elderly loved one experiences a life-changing health episode, options for long-term care will be undoubtedly pricey. Applying for Medicaid benefits is most families’ first move when told by a doctor that their loved one will require long-term, full-time care. Unfortunately, too many people have not adequately prepared for these decisions and the experience can be overwhelming and stressful for all involved. Seeking counsel from an experienced, knowledgeable elder law attorney can save families money and provide peace of mind that their loved ones’ needs and wishes are being met. Below, after a brief summary of what Medicaid entails, are some of the benefits of hiring an elder law attorney for Medicaid planning. 

What is Medicaid

Medicaid is a federal assistance program that is administered by the states. It is designed to help those who are financially eligible pay for the cost of long-term care and allows access to other medical and healthcare benefits. Because Medicaid is a needs-based program, there are strict financial requirements in order for someone to be eligible for Medicaid assistance.

Benefits of Retaining an Elder Law Attorney

  • Avoidance of conflicts of interest – Conflicts of interest can arise when a nursing home refers the family of a resident to a Medicaid specialist for assistance with the preparation of Medicaid documentation. Often this Medicaid specilaist has loyalties to both the facility that provided the referral and the client applying for benefits. When the facility and person preparing the documentation both want the Medicaid application to be successful, there is no conflict. However, it often benefits nursing homes when residents pay privately for as long as possible before going on Medicaid, and this can provide an incentive on the part of Medicaid specialists to ensure that Medicaid applications are delayed or denied. An elder law attorney hired to assist with Medicaid planning, however, only has a duty to his or her client, thereby eliminating conflict of interest concerns. 
  • Experience and knowledge – Elder law attorneys, with their years of experience, have the knowledge necessary to successfully and compassionately advise their clients on how to achieve their legal goals, regardless of what they may be. And in the elder law arena, these goals are often related to Medicaid. 
  • The availability of malpractice insurance – When an attorney or other professional makes an inadvertent error, malpractice insurance typically covers the loss. However, other advisers in the Medicaid arena often lack such coverage. Therefore, while mistakes by experienced elder law attorneys are rare, clients can rest easy with the assurance that unlikely errors will be covered. 
  • Peace of mind – Finally, consultation with an experienced elder law attorney will provide you with the peace of mind that you have all your bases covered in regards to Medicaid planning. An experienced attorney will take legal issues into consideration during the process that other Medicaid advisers may miss, ensuring that you receive all of the benefits you are entitled to. 

At Scott Bloom Law, we are a team of advocates who care, always fighting for what’s best for our clients and their families. With knowledge, experience, and compassion, we strive to find solutions that make the aging process as emotionally and financially easy as possible. Visit us at scottbloomlaw.com or call 215-364-1111, to talk to find out more.

WHAT IS MEDICAID PLANNING?

WHAT IS MEDICAID PLANNING?

  • Medicaid planning is structuring your finances and assets to optimize your ability to pay for coverage of the future costs of long-term care, such as in-home or nursing care.
  • Medicaid planning is similar to tax planning; we all want to look at our financial situation to minimize tax liability throughout our lives and to our estates after we die. Medicaid planning is the same–it’s possible to minimize our out-of-pocket care costs through Medicaid eligibility.
  • Financial strategies, supported by the laws of the state in which you live, may be utilized so that one spouse may retain assets while the other spouse can be supported by Medicaid for their long term care costs. Many of these laws are in place so that a healthy spouse isn’t punished financially while the care needs for the ill spouse can be supported via Medicaid.

WHY DO I NEED A MEDICAID PLAN?

  • We all know that any form of long-term or nursing care is very expensive. As we age, particularly when one spouse requires long-term care and the other can live independently, the concerns about financial security for both are considerable.
  • Medicaid planning can provide Medicaid eligibility for one spouse while preserving assets for the healthy spouse.
  • Ideally, your Estate Planning will be put in place long before any question of Medicaid eligibility arises–while you are still living independently and healthy.
    • Medicaid planning can be done once the need arises, but the process requires time, expertise and patience.
    • The sooner you establish your plan, the more options you will have available.

HOW CAN I DETERMINE MY MEDICAID ELIGIBILITY?

  • How your finances compare to the federal and state guidelines determines Medicaid eligibility. Your current health situation figures in as well. It’s a complicated analysis that a professional such as an elder care attorney should undertake with you.
  • Items such as income, real estate, savings accounts, brokerage account balances, and insurance policies are among the items that can determine your eligibility. Again, it depends on the state in which you live.
    • Eligibility may differ slightly for married and single people.
  • A professional’s assessment should be done before you fill out any forms to apply for Medicaid.

WHAT WILL MY MEDICAID PLAN INCLUDE?

  • Everyone’s financial situation is unique, and every state has different guidelines, so there are no hard or fast rules about what your plan will involve.
  • Here are some examples of Medicaid plan components:
    • The simplest form of Medicaid planning is having an experienced professional assist you with filling out the application forms. If your eligibility is straight-forward, this is the right path for you.
    • A more complicated plan for a married couple can include:
      • Establishing irrevocable trusts. This removes certain assets from your eligibility calculation.
      • A transfer deed for your primary home. When the well spouse plans to continue to live at home, your state may allow a deed transfer into the well spouse’s name. This will protect the home from liquidation to cover costs of care.
      • Establishing an annuity. An annuity can help you “spend down” assets per the Community Spouse Resource Allowance (CSRA) for your state. You purchase an annuity with existing assets; the annuity provides a source of steady income for the healthy spouse, while setting up Medicaid eligibility for the ailing spouse.

Here’s a simple example of an annuity – based solution for a married couple:

James (80) and Julia (77) live in New Jersey. James has recently been diagnosed with Dementia. He will need to move to a memory care residence since his care needs will soon go beyond what Julia can handle. His memory care residence will cost $8,000/month.

The couple’s Medicaid-countable assets total $250,000.

Julia’s goal is to get James eligible for Medicaid and move him into the memory care facility she has chosen–while providing income for herself and preserving their assets. Julia makes an appointment with Scott Bloom, an eldercare attorney, to put together her Medicaid plan. She brings all of their financial information with her to the appointment.

For starters, Scott states that James’ and Julia’s community assets must be “spent down” to $123,600, under New Jersey law for the Community Spouse Resource Allowance (CSRA) threshold. Right now, James and Julia are currently over New Jersey’s CSRA by $126,400 ($250,000 minus $123,600).

Scott recommends Julia set up a Medicaid–compliant annuity which will be funded by their CSRA “excess” of $126,400. The annuity is set up for 5 years, which will give Julia a monthly income of approximately $2,100, on top of her existing $1,500/month pension income–for a total of $3,700.

Without this Annuity strategy in place, James memory care would have consumed James’ and Julia’s CRSA “excess” in a little over 15 months. With the Annuity, Julia receives the entire annuity income benefit from the CRSA “excess.”

There are other components in James’ and Julia’s Medicaid plan, like the calculation how much of James’s income will go toward his Medicaid co-pay. This scenario is a bit lengthy for a blog post–see your eldercare attorney to dig into the details of this aspect of your plan.

• The Medicaid system is subject to yearly changes in federal and state rules, so it’s best to retain a professional who is up to date on the law–someone who can counsel you throughout the application process and can alert you of pending changes to the Medicaid system–especially when it’s time to apply for your annual eligibility.

HOW DO I PREPARE FOR A MEDICAID PLANNING DISCUSSION?

You’ll need to gather all of the information on your financial situation, including:

  • Most recent tax return–federal and state.
  • Annual income statements–pension, social security, annuities, etc.
  • Bank account statements
  • Brokerage statements
  • Real estate holding (s) description/deeds, mortgage balances
  • Insurance policies

To get started with your Medicaid Plan, talk to the professionals at the Scott D. Bloom Law office.

To schedule your free consultation,
email us, or call 1-215-364-1111
or 1-855-992-6337 (Toll Free)

Life Care Planning – Tend to Personal Matters in the Comfort of Your Own Home

Life Care Planning should be handled by an elder law attorney. Their clients should be primarily senior citizens and they should specializes in eldercare matters across the board.

When it’s time to start making decisions about our care, our finances and our wishes, it is very important to find someone we trust. An elder law attorney can help guide your way through your journey of life care planning. Many lawyers touch on elder care issues but the majority of these attorneys’ clients may not be seniors.

Life Care Planning can be talked about at your home!

Sitting down and talking about life care planning can often be very overwhelming. What would you say if a qualified Elder Law attorney would make a house call to talk about your personal matters in the comfort of your own home? Would that make you more comfortable?

The Law Office of Scott D. Bloom understands that seniors and their families are dealing with many emotional issues. Moreover, most people wait until they need to make these decisions in the short term. Most of the time, this happens due to a crisis as opposed to a family planning ahead for the future.

Let Scott Bloom make your life care planning easier by calling today to schedule a free consultation in the comfort of your own home. All of your questions will be answered and the start of your planning can get underway.

We want to be the elder law attorney and firm for the rest of your life and walk with you every step of the way. From our home to yours, The Law Office of Scott D. Bloom is here to help in whatever legal and supportive way possible.

CLIENT Testimonial

Dear Scott - Thank you for a job well done. I've settled the estate with my siblings. I also remitted my executor's fee to the children of my deceased sister. Thanks again for all you do!
- Estate of Fay B., Cranbury, New Jersey

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