Patti's Blog - Advocate for Elders, People with Disabilities and Their Families

Low Obamacare Premiums to Soften Blow for Those Losing Medicaid

Ganny Belloni
March 16, 2023, 5:44 PM

CMS will take active role during Medicaid eligibility checks

All states required to take 14 months to complete checks

One-third of the millions of individuals expected to lose Medicaid coverage as eligibility checks resume this spring will qualify for Affordable Care Act coverage with low or no premiums, a top Medicaid official said.

The Department of Health and Human Services believes the majority of those whose Medicaid eligibility will be redetermined will remain eligible, and the government is actively collaborating with states to make sure beneficiaries don’t lose coverage because of administrative issues, Daniel Tsai, director of the federal Center for Medicaid and CHIP Services, said Thursday in an interview with reporters

see full article at :

https://news.bloomberglaw.com/health-law-and-business/low-obamacare-premiums-to-soften-blow-for-those-losing-medicaid

#AffordableCareAct #DepartmentofHealthandHumanServices #CenterforMedicaidandCHIPServices #DanielTsai #Medicaid #CMS

Medicaid Eligibility: Using Estate Planning Techniques

Excerpt from: Strafford Pub (click for more information)

 

Tuesday, June 18, 2013
1:00pm-2:30pm EDT, 10:00am-11:30am PDT

Early Registration Discount Deadline, Friday, May 24, 2013

Elder law practitioners must integrate estate planning with long-term care planning and may need to contemplate a client's eligibility for Medicaid long-term care coverage. Understanding the tools available to assist clients in achieving Medicaid eligibility, while ensuring assets are protected, is critical.

Strategies to consider for income planning, gifting and asset protection include annuities and various trusts such as special needs trusts and credit shelter trusts.

Counsel must understand transfer of asset rules, exceptions to the rules, the application of the five-year look back, and how to maximize coverage. Counsel must also recognize pitfalls and potential penalties for transferring and gifting assets.

Listen as our authoritative panel of elder law attorneys outlines how to use estate planning tools to best ensure that clients meet the Medicaid eligibility requirements.

 

Patti is speaking at this event.

Medicaid Spend Down

Excerpt from: caring.com (click for full article)

 

The cost of nursing home care is extraordinarily expensive, and Medicaid won't help pay if you have more than $2,500 in "countable" assets. Sometimes people decide to "spend down" their excess assets to qualify for Medicaid benefits. But this can be risky. If the Medicaid agency thinks you're bending the rules, you risk losing eligibility for five years. And current crackdowns by Medicaid are much more common than in years past.

Estate Planning In A Second Marriage

Excerpt from: Huffington Post (click for full article)

 

Love may be lovelier -- but it is also a whole lot more complicated the second time around.

Record numbers of us will, one day, be in a second marriage. The pool of eligible second marriage candidates is vast as a result of both the high divorce rate and increased longevity.

But before saying "I do" (again), there are a few legal issues that merit consideration.

How should the new spouse be provided for in the estate plan? The competing interests here are typically one's adult children and the new spouse. There is an expectation that assets accumulated in the first marriage will, in some measure, inure to the benefit of the children of that marriage. On the other hand, the new spouse may not have sufficient assets to provide for retirement needs in the event that he or she is widowed.

Historically, the compromise solution was to provide that the estate be held 'in trust' for the lifetime benefit of the surviving spouse. During widowhood, the surviving spouse received income from trust assets. Some trusts also provided for distributions of principal, in the discretion of the trustee. Then, upon the survivor's subsequent death, the trust terminated and all remaining assets reverted to the adult children of the first to die.

Capacity for Lifetime and Estate Planning

Excerpt from: Penn State Law Review (click for full article)

 

Clients consulting with elder and estate planning attorneys for estate planning documents will likely receive a “package” of five documents: a will, a trust (revocable or irrevocable), a health care power, a durable power of attorney, and a living will. Although capacity standards have varied for each of the items in the “package,” an informal survey of American College of Trust and Estate Counsel (ACTEC) members reveals that practitioners do not pay attention to these distinctions when they create the “package.” Practitioners are either unwilling to accept the engagement for lack of competence or willing to overlook the capacity distinctions when accepting the engagement. This article thus advocates for a uniform test for capacity when an attorney considers preparing the “package” for a client.

Unresolved Emotional Conflicts Drive Post-Death Disputes

Excerpt from: JDSupra (click for full article)

 

No family is perfect.  And while all litigation is emotional, our experience is that almost all trust and estate litigation is driven by underlying emotional disputes among family members.  And death, like divorce, can open the floodgates of those disputes.  Long simmering sibling rivalries come to a boil.  Suppressed anger towards step-parents or step-children bursts forth.  Children who felt minimized by their parents assert themselves.

If these disputes are recognized during lifetime, they can be addressed in the estate plan.  Decisions such as who to name as fiduciary or how to structure a gift to a particular family member can minimize the opportunities for those disputes to arise.

But sometimes those disputes only come to light after death, causing the estate administration to spin out of control and result in litigation.  And some beneficiaries use that litigation as their grieving process.  Ironically, those emotions also act as a roadblock to reaching a rational resolution of the legal disputes.

Slow Lawyering: Representing Seniors in Light of Cognitive Changes Accompanying Aging

Excerpt from: Penn State Law Review (click for full article)

 

As an increasing number of lawyers represent clients who are elderly, it is imperative that lawyers become more knowledgeable about the aging process and how it impacts our clients. Although it is difficult to generalize, many seniors experience numerous and diverse cognitive changes that accompany the aging process. Existing literature offers various frameworks for addressing capacity issues and techniques for assessing diminished capacity. However, current legal scholarship provides little guidance for lawyers on how to accommodate these changes when they do not rise to the level of diminished capacity or dementia, and when the changes may, in fact, result in increased wisdom and “developmental intelligence.” This article seeks to fill that void. It summarizes selected cognitive developments that impact memory, outlining various types of memory and how they evolve during the aging process. This article also discusses current literature on decision-making capacity and different decision-making models and strategies that seniors may rely upon. The article concludes with recommendations on methods for enhancing communications with aging clients, while simultaneously acknowledging and accommodating cognitive changes and enabling seniors to play a prominent role in the representational process.
* Professor of Law and Director, Elder Law Clinic, Syracuse University College of Law.

Beneficiary Designations: Simple but Not Always Effective

Excerpt from: Estate Planning (click for full article)

 

Many people use beneficiary designations, and for good reason. Some significant assets, including life insurance policies, IRAs, retirement plans and even bank accounts, allow you to name a beneficiary. When you die, these assets are designed to be paid directly to the individuals you have named as beneficiary.

But that is not always what happens. For example:

• If your beneficiary is incapacitated when you die, the court will probably have to take control of the funds. That’s because most life insurance companies and other financial institutions will not knowingly pay to an incompetent person; they may insist on court supervision.
• If you name a minor as a beneficiary, you are probably setting up a court guardianship for the child. Life insurance companies and other financial institutions will not knowingly pay these funds directly to a minor, nor will they pay to another person for the child, not even to a parent. They do not want the potential liability and will usually require proof of a court-supervised guardianship.

Trust and Estates Attorney in Savannah Answers, “How Much Do You Need to Save for Retirement?”

Excerpt from: Smith Barid, LLC (click for full article)

 

If you’re like 70% of people in the US who have a retirement plan, you still haven’t worked with a professional such as a trust and estates attorney in Savannah in order to determine how much money you really need to save.  A recent study found that only about 30% of this group has actually sat down with a professional to come up with a realistic number.  Another 34% has simply guessed at a number that they think might be reasonable.

Any good Savannah trust lawyer will tell you that this is incredibly dangerous.  There are so many factors that go into determining what will be needed.  Just a few of these include:

•         What do you want to do when you retire?
•         What assets do you have now?
•         How will inflation impact the value of the dollar?
•         What kind of retirement fund do you have?
•         How long do you have before you retire?
•         How much will you lose to taxes when you withdraw your money?

As you can see, getting to a total that will support your lifestyle during retirement is a bit more complex than simply plucking a number out of thin air.

Alzheimer's Disease and Dementia Mental Health Advance Directive

Excerpt from: Living with Dying (click for full article)

 

Last December, Compassion and Choices of Washington unveiled a new kind of advance directive for life planning while living with Alzheimer's Disease and Dementia. This document is the first of its kind focused on these specific challenges. With a similar purpose as the living will, the Alzheimer's and Dementia directive aims to have a person's intentions known when the person isn't in a place to speak for him or herself.

The Alzheimer's directive is different from the usual advance health care directive. An advance health care directive is used to specify what medical actions should be undertaken if the patient is too ill or incapacitated to make those decisions. A typical question for those completing these documents is whether or not the patient wants aggressive medical treatment—such as a feeding tube or artificial ventilation—when the patient is dying or in a persistent vegetative state.

Merton Simpson: Illiquid Estate, Will Contest Result in Lack of Cash for Burial Costs

Excerpt from: Wealth Strategies Journal 2.0 (click for full article)

 

Artist and art collector Merton Simpson's funeral took place on a Friday, but three days later his body remained above ground because the estate lacked funds to pay for a burial.  Although Simpson's estate contained significant assets, the wealth was overwhelmingly tied up in pieces of art.  The illiquid nature of these assets, combined with a controversy surrounding the will and the management of the estate, has resulted in lack of cash required to cover burial expenses.

For more, see  Patricia Cohen, "Art Worth Millions, Yet No Cash for Burial," New York Times (March 25, 2013).