Why Work With An Elder Law Attorney

Why Work with an Elder Law Attorney?

Seniors face complex legal concerns that are often different from what they faced when they were younger. Actions taken may have unintended legal effects. As a senior or someone who’s helping make decisions for a senior, it’s important that you work with an attorney who specializes in Elder Law.

What Is Elder Law?

Elder Law encompasses many different fields of law. An Elder Law attorney specializes in how to best use their knowledge to fit the needs of seniors. Some of these fields include:

• Preservation/transfer of assets seeking to avoid spousal impoverishment when a spouse enters a nursing home

• Medicaid

• Medicare claims and appeals

• Social security and disability claims and appeals

• Supplemental and long-term health insurance issues

• Disability planning, including use of durable powers of attorney, living trusts, "living wills," for financial management and health care decisions, and other means of delegating management and decision-making to another in case of incompetency or incapacity

• Conservatorships and guardianships

• Estate planning, including planning for the management of one's estate during life and its disposition on death through the use of trusts, wills, and other planning documents

• Probate

• Administration and management of trusts and estates

• Long-term care placements in nursing home and life care communities

• Nursing home issues including questions of patients' rights and nursing home quality

• Elder abuse and fraud recovery cases

• Housing issues, including discrimination and home equity conversions

• Age discrimination in employment

• Retirement, including public and private retirement benefits, survivor benefits, and pension benefits

• Health law
• Mental health law

Most Elder Law attorneys do not specialize in every one of these areas, so when an attorney says he or she practices Elder Law, find out which of these matters he or she handles. You will want to hire the attorney who regularly handles matters in the area of concern in your particular case and who will know enough about the other fields to question whether the action being taken might be affected by laws in any of the other areas of law. For example, if you are going to rewrite your will and your spouse is ill, the estate planner needs to know enough about Medicaid to know whether it is an issue with regard to your spouse's inheritance.

NAELA Report on Senate "Fiscal Cliff" Legislation

The Senate “Fiscal Cliff” Legislation


The Senate passed a compromise bill, the American Taxpayer Relief Act of 2012, to avert the fiscal cliff at about 2 a.m. January by an overwhelming 89-8 vote. The deal was brokered by Vice President Biden and Minority Leader Mitch McConnell. The House has not voted on the bill and there are reports that the Republicans are overwhelmingly opposed to the deal (in part because it does not cut enough spending) and will need to amend the bill in order to secure the necessary votes. If the bill is amended and sent back to the Senate, it may loose support from the Democrats in the Senate and the White House.

The bill addresses many of the outstanding fiscal cliff concerns, including the
Bush era tax rates, estate and gift tax rates, Medicare reimbursement, and the sequester, among numerous other issues. In addition, federal unemployment benefits would be extended for a year without a budget offset elsewhere.

The bill will extend current tax rates for individuals earning less than $400,000 and couples earning less than $450,000. Tax rates will revert to the Clinton-era rate of 39.6% from 35% for those making more than $400,000.

The estate tax exemption will remain the same as 2012 at $5.12 million per person (and will be indexed for inflation). Effective January 1, 2013, the top estate tax rate will increase from 35% to 40%. These rates and exemption levels are permanently extended. Portability is also extended and the gift tax exemption will remain at $5 million as well.

The payroll tax holiday will not be extended for another year. Since 2011, the payroll tax rate, which funds Social Security, was 4.2%. The payroll tax rate will now revert to the pre-2010 level of 6.2%.

The bill addressed sequestration and delayed the automatic spending cuts by two months until March 1, 2013. The cost of continuing current spending levels will be paid equally through tax revenue increases and later spending cuts (half of those $12 billion in cuts will come from defense and half of those cuts from nondefense spending). The bill reduces the total amount of the sequester by $24 billion over nine years.

There is a one year “doc fix” included in the bill. This “doc fix” prevents the scheduled 27% reimbursement cuts to Medicare physicians. The “doc fix” will not be paid through cuts to the Affordable Care Act or to beneficiaries.

Also included in the bill, and of particular interest to NAELA members, are the repeal of the CLASS Act and the establishment of a Commission on Long-Term Care. It is reported that President Obama agreed to repeal the CLASS program in exchange for Republicans agreeing to raise the tax rates on the wealthiest Americans.

NAELA’s public policy team is closely monitoring the creation of a Commission on Long-Term Care. The Commission will “develop a plan for the establishment, implementation, and financing of a comprehensive, coordinated, and high-quality system that ensures the availability of long-term services and supports.” The Commission will investigate the interaction between Medicare, Medicaid, and private long-term care insurance. The Commission should account for demographic changes and trends in order to improve the delivery system for long-term services and supports. The Commission will consist of 15 members with the President, Senate majority leader, Senate minority leader, Speaker of the House, and House minority leader each appointing 3 members. Members will represent the interests of consumers, older adults, family caregivers, health care workforce, private long-term care insurance, State insurance departments, and State Medicaid agencies.

Estate tax changes for couples

The clock is ticking to make strategic changes before the end of 2012.

Fidelity Viewpoints
– 01/13/2012

Couples with estate planning needs only have a one-year window of opportunity to make changes or adjustments to their estate plans before federal estate tax exemption levels change and tax hikes set in on January 1, 2013.

For 2012, the current law provides a generous $5,120,000 per person federal estate tax exemption and taxes estates over that amount at a top rate of 35%. This compares with a $1 million per person federal estate tax exemption and a 55% effective top tax rate scheduled to go into effect on January 1, 2013.

Perhaps even more important for some married couples, the current law contains a portability provision. During 2012, if one spouse dies without using up his or her federal estate tax exemption, the unused portion may be transferred to the surviving spouse if elected by the executor of the estate of the first-to-die spouse.

To read more click here Estate Tax Changes for Couples, cont.

4-steps-for-planning-health-care-costs

4-steps-for-planning-health-care-costs
Chicago Sun-Times
By DAVID PITT AP Personal Finance Writer May 15, 2011 4:54PM

There’s a tremendous lack of knowledge when it comes to planning for health care costs in retirement.

A new survey by Sun Life Financial found that 92 percent of workers said they don’t know how much their health care will cost in retirement or vastly underestimate the amount.

Forty percent said they have “no idea” what their health care costs are likely to be in retirement. Only 8 percent were in the correct ballpark estimating costs of $200,000 or more. Another 51 percent estimated less than $200,000 would be needed.

Developing a plan should alleviate anxiety. Here are four ideas to help prepare for unexpected medical costs.

Read More . .

How is a 90% long-term care insurance rate hike OK? - Chicago Sun-Times

How is a 90% long-term care rate hike OK? - Chicago Sun-Times
TERRY SAVAGE savage@suntimes.com March 18, 2012 7:26PM

Bob Levy, age 69, and his wife, Cheryl, age 64, each bought John Hancock long term care insurance policies 10 years ago. And every year since then they have paid a combined premium of $3893.40 per year. The couple live on a fixed income and the low interest they earn on their savings. So they were shocked when Cheryl received a notice of a 90 percent increase in the annual premium for the policy. Then Bob got a similar notice. It means they would now pay $7,385.52 a year.

“Needless to say I was shocked and disappointed. . . . what a waste of money!,” says Bob. “How can that kind of increase be approved by the State of Illinois? Why hasn’t there been any media coverage? And what should we be doing?”

* * *

They did the right thing — hoping to avoid the dreaded outcome of being older, alone, and in need of everyday care that is not covered by Medicare or supplements. They knew that long-term custodial care — at home or in assisted living or in a nursing home — now costs $7,000 a month, and rising yearly.

So they purchased Long-term Care Insurance — something I have highly recommended to defray the future cost of care if it is needed.

But now, many people who purchased long-term care insurance are getting a shock. The insurance companies that wrote these important policies are sending out notices of huge rate increases. In the case of John Hancock LTC policies, the increases are as high as 90 percent annually. ... Click here for the full story.

*Terry Savage is the Chicago Sun-Times’ nationally syndicated financial columnist, and a registered investment adviser. Post personal finance questions on her blog at TerrySavage.com and blogs.suntimes.com/savage.

NH getting $26.5 million in Medicaid grants to expand community, home care | The Republic

NH getting $26.5 million in Medicaid grants to expand community, home care The Republic

Wolfeboro, Carroll County, New Hamphsire

Plan for Long‑Term Care

Long-term care includes medical and non-medical care for people who have a chronic illness or disability. Non-medical care includes non-skilled personal care assistance, such as help with everyday activities like dressing, bathing, and using the bathroom. At least 70% of people over 65 will need long-term care services at some point. Medicare and most health insurance plans, including Medigap (Medicare Supplement Insurance) policies don’t pay for this type of care, also called “custodial care.” Medicare only pays for medically-necessary skilled nursing facility care or home health care if you meet certain conditions. Long-term care can be provided at home, in the community, in assisted living, or in a nursing home. It’s important to start planning for long-term care now to maintain your independence and to make sure you get the care you may need in the future.

Paying for Long‑Term Care

Long-term Care Insurance—This type of private insurance policy can help pay for many types of long-term care, including both skilled and non-skilled (custodial) care. Long-term care insurance can vary widely.  Some policies may cover only nursing home care.  Others may include coverage for a range of services like adult day care, assisted living, medical equipment, and informal home care.

Note: Long-term care insurance doesn’t replace your Medicare coverage.

Your current or former employer or union may offer long-term care insurance.  Current and retired Federal employees, active and retired members of the uniformed services, and their qualified relatives can apply for coverage under the Federal Long-term Care Insurance Program.  If you have questions, visit www.opm.gov/insure/ltc, or call the Federal Long‑term Care Insurance Program at 1-800-582-3337.  TTY users should call 1‑800‑843‑3557.

Personal Resources—You can use your savings to pay for long‑term care.  Some insurance companies let you use your life insurance policy to pay for long-term care.  Ask your insurance agent how this works.

Other Private Options—Besides long-term care insurance and personal resources, you may choose to pay for long-term care through a trust or annuity.  What option is best for you depends on your age, your health status, your risk of needing long-term care, and your personal financial situation.  Visit www.longtermcare.gov for more information about your options.

Medicaid—Medicaid is a joint Federal and state program that pays for certain health services for people with limited income and resources.  If you qualify, you may be able to get help to pay for nursing home care or other health care costs. 

Home and Community-based Services Programs—If you’re already eligible for Medicaid (or, in some states, would be eligible for Medicaid coverage in a nursing home), you or your family members may be able to get help with the costs of services that help you stay in your home instead of moving to a nursing home.  Examples include homemaker services, personal care, and respite care.  For more information, contact your State Medical Assistance (Medicaid) office.  Call 1‑800‑MEDICARE (1‑800‑633‑4227), and say “Medicaid” to get the telephone number, or visit www.medicare.gov.  TTY users should call 1-877-486-2048.

Veterans’ Benefits—The Department of Veterans Affairs (VA) may provide long-term care for service-related disabilities or for certain eligible veterans.  The VA also has a Housebound and an Aid and Attendance Allowance Program that provides cash grants to eligible disabled veterans and surviving spouses instead of formally‑provided homemaker, personal care, and other services needed for help at home.  For more information, call the VA at 1-800-827-1000, or visit www.va.gov.

Programs of All-inclusive Care for the Elderly (PACE)—PACE is a Medicare and Medicaid program offered in many states that allows people who otherwise need a nursing home-level of care to remain in the community.  Coming Soon—The Community Living Assistance Services and Supports (CLASS) Program is a national, voluntary insurance program to help you pay for services and supports so you can maintain independence in your community if you become disabled.  People over 18 who are working will have the opportunity to enroll in the CLASS program starting in late 2012, through either payroll deductions or individual enrollment.  Enrollees who become disabled (at any point after a five year vesting period) and need help with basic daily living activities such as eating, using the bathroom, and getting in and out of bed will be able to get a benefit that will average no less than $50 a day to help pay for supports to stay independent.  Talk to your employer or benefits administrator for more information.

Long-Term Care Contacts

Use the following resources to get more information about long‑term care:

--Visit www.medicare.gov/LTCPlanning.  You can also visit www.medicare.gov/NHCompare or www.medicare.gov/HHCompare to compare nursing homes or home health agencies in your area.

--Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

--Visit www.longtermcare.gov to learn more about planning for long-term care.

--Call your State Insurance Department to get information about long-term care insurance. Call 1-800-MEDICARE to get the telephone number. You can also call your State Health Insurance Assistance Program

--Call the National Association of Insurance Commissioners at 1-866-470-6242 to get a copy of “A Shopper’s Guide to Long‑term Care Insurance.”

--Visit the Eldercare Locator at www.eldercare.gov to find your local Aging and Disability Resource Center (ADRC). You can also call 1‑800‑677‑1116. ADRCs offer a full range of long‑term care services and support in a single, coordinated program.

C E N T E R S F O R  M E D I C A R E & M E D I C A I D  S E R V I C E S

http://www.medicare.gov

Medicare & You  2011

http://www.medicare.gov/Library/PDFNavigation/PDFInterim.asp?Language=English&Type=Pub&PubID=10050