Florida Elder Law Blog - A blog by Elder Law Associates, South Florida's premier elder law attorneys, who handle elder law, medicaid planning, guardianships and much, much more.
Arline Kardasis, Rikk Larsen, Crystal Thorpe, and Blair Trippe
Mom Always Liked You Best: A Guide to Resolving Family Feuds, Inheritance Battles & Eldercare Crises. Elder Decisions. 2011. 123 pages.
Making decisions about elderly parents can cause conflict even in the best of families. In this book, three experienced elder mediators provide step-by-step advice and tools for managing disputes with siblings about elder care, inheritance issues and estate planning.
The authors of Mom Always Liked You Best are co-founders of Elder Decisions a mediation, training and consulting firm that specializes in helping families resolve disagreements. Drawing on the authors' experiences with getting siblings to compromise, the book discusses how to use negotiating tools to work through issues. The authors explain the importance of understanding the underlying interests behind the dispute before discussing solutions and using active listening techniques to better understand where siblings are coming from.
Though the subject matter is similar to They're Your Parents, Too! this book is more technical, offering very specific techniques for finding middle ground with siblings. Mom Always Liked You Best is another good choice for families who need help settling adult family conflicts.
Having difficulty keeping on top of your bills? Maybe a daily money manager can help. Daily money managers can assist elderly individuals with handling anything from routine bill-paying to more complicated tasks like filing medical insurance claims.
A daily money manager -- a member of a relatively new profession that now has its own professional association -- is an individual experienced in dealing with mundane financial matters that can build up if they aren't taken care of. Money managers can aid seniors with physical limitations like arthritis or who are having difficulty keeping track of their affairs. A money manager can also help adult children who are acting as caregiver for a parent and don't have the time to devote to money management.
Some of the many tasks daily money managers can perform include:
- paying bills
- preparing checks
- making bank deposits and reconciling bank accounts
- dispensing cash
- organizing tax documents
- keeping track of medical insurance claims
- reviewing and sorting mail
- negotiating with creditors
- tracking investments
In general, you do need to pay for this service. Daily money managers can cost between $30 to $100 an hour. However, you may be able to get a free consultation to determine if money management is right for you. And in some states, the AARP offers daily money management services to low-income elderly individuals. Click here to find out more about the AARP's program.
To find a money manager near you, contact the American Association of Daily Money Managers (AADMM). Before selecting a money manager be sure to ask for references and thoroughly check the references out. Also, make sure the money manager is bonded. The AADMM has a list of questions to ask potential money managers before hiring one.
House Budget Committee Chairman Paul Ryan (R-WI) has proposed a budget that would radically reshape both the Medicare and Medicaid programs and shift more costs to seniors and people with disabilities. The plan may well become the Republican Party's de facto platform in 2012.
The proposed budget, aimed at shrinking the nation's deficit as well as the size of government, slashes $1.43 trillion from Medicare and Medicaid over the next 10 years, in part by bringing the curtain down on the popular Medicare program as we know it and by ending Medicaid's guarantee of nursing home benefits for low-income seniors.
Here are the broad outlines of the proposed changes to Medicare and Medicaid and their impact on seniors. For more details from Kaiser Health News, click here.
Medicare: Starting in 2022, people who turn 65 or who qualify for Medicare because of a disability would not enroll in the current Medicare program but instead would receive a "premium support payment" (what many call a "voucher") to help them purchase private health insurance. Also beginning in 2022, the age of eligibility for Medicare would increase by two months a year until it reaches 67 in 2033. Because the plan also repeals the new health reform law's coverage provisions, many 65- and 66-year-olds would be uninsured.
Under the Ryan plan, future seniors would pay far more for health coverage than do today's beneficiaries, according to an analysis by the nonpartisan Congressional Budget Office (CBO). For example, by 2030 a typical 65-year-old would pay 68 percent of the total cost of her coverage, compared to the 25 percent she would pay under current law, the CBO calculates. In 2022, the typical 65-year-old Medicare beneficiary would be spending $12,500 a year out of pocket in today's dollars.
This new Medicare scheme would apply to anyone who is age 54 or younger at the end of 2011.
Medicaid: The House Republican proposal would turn Medicaid funding to states into a "block grant," something proposed by George W. Bush in 2003 and by Newt Gingrich in 1995. Rather than the current system, under which the federal government matches every dollar that states spend on Medicaid, under the House Republican plan starting in 2013 states would receive a fixed amount every year, which would only increase with population growth and the overall cost of living. The result, according to the CBO's analysis, is that by 2022 federal funding for Medicaid would fall 35 percent below what the federal government now is projected to provide states, and the shortfall would be 49 percent by 2030.
States would make up for this dramatic loss in funding by restricting eligibility for Medicaid (including nursing home coverage), reducing covered services, and cutting already-low payment rates to health care providers. The result would be more uninsured or underinsured citizens, as well as doctors, hospitals, and nursing homes refusing to take Medicaid patients. It would be easier for states to make these changes than under current law because the Ryan plan would give states additional flexibility in designing their Medicaid programs.
"The House Republican budget proposal should be accompanied by a 'Grandma Beware!' sign," said Ron Pollack, executive director of Families USA, in a statement. "The proposal will inevitably result in seniors losing the nursing home and other long-term care they need at a time when they are most frail."
For the April 11, 2011, New York Times article "Republican Medicare Plan Could Shape 2012 Races,"
click here.
Labels: florida elder law, Florida Elder Law Attorney, Florida Estate Planning, Florida Medicaid Planning
Because the home is the largest asset a couple can keep while still qualifying for Medicaid, it is also usually the main target of estate recovery.
Sidney and Rachel's Story:
Sidney and Rachel had lived in their home since it was new. They built it just after Sidney got a promotion to regional sales manager for a shoe distributor. Through the years, the house was remodeled twice and expanded to add a loft bedroom. Even when their children were grown with families of their own, they all remained close, with frequent family gatherings for holidays and birthdays.
Sidney and Rachel had paid off the mortgage and two second mortgages before Sidney retired. So in addition to being the center of family life, the house had also become the couple's biggest asset.
Rachel always hoped the house would remain in the family when she and Sidney were gone. She often talked about leaving it to their oldest son, Mark, who promised that he and his wife would continue the tradition of hosting the family for holidays and birthday dinners. However, as Sidney's Alzheimer's disease progressed, Rachel worried that Sidney would need to move into a nursing home. With the high cost of long-term care, Rachel knew their savings wouldn't last long. Sidney would eventually need to qualify for Medicaid to pay the bills.
Her biggest question was, "Will I lose my home?"
A Common Question Indeed
For a great many people who need Medicaid benefits for long term care, the home makes up most of their life savings. Often, it's all a couple has to pass on to their children.
You may not know that the home is an exempt asset according to Medicaid. It continues to be exempt as long as the community spouse lives there. However, after both the ill spouse and the healthy spouse pass away, the property may no longer be protected.
What Is Estate Recovery?
According to the Omnibus Budget Reconciliation Act of 1993 (OBRA-93), the state has the right to take back whatever it paid for the care of a Medicaid applicant. And because you have to be "broke" to qualify for Medicaid, usually the only property of substantial value that a person on Medicaid is likely to own when they die is their own home. When OBRA-93 was passed, each state established an Estate Recovery Unit (ERU) to go out and find what assets they can take back from those that received Medicaid benefits!
Because the home is the largest asset a couple can keep (while still qualifying for Medicaid), in most states it is also the main target of estate recovery.
After both the community spouse and the ill spouse die, the state's estate recovery unit has the authority to take just about any property that the Medicaid recipient had their name on. In most cases, that means going back to the house.
For example, if Sidney dies before Rachel after living in a nursing home for two years and Medicaid has paid the nursing home $3,000 per month, the state will have paid $72,000 for Sidney's care ($3,000 per month times 24 months). If the family home where Rachel lives is worth $100,000, the state would have a claim for the first $72,000 that comes from the sale of the house.
So, the house is protected while Rachel is alive. However, when she passes, the state may force the sale of the house. Whatever's left over after Medicaid is paid back ($100,000 minus the $72,000 taken out to repay Medicaid) would go to their children.
A Married Couple Strategy For Protecting The Family Home From Recovery
According to federal law, a married Medicaid applicant is allowed to transfer the home to his or her spouse - without any penalty. Once the transfer is made (meaning the ill spouse no longer has any interest in the house), the community spouse may be able to make some changes to that asset. In some states the community spouse can even give the house away!
That sort of gift, of course, would create a period of Medicaid ineligibility if the community spouse needs nursing home care within the five-year look-back period.
The family home remains one of the most difficult assets to protect because of timing, but there are proven strategies that make it possible to protect the home from Medicaid Recovery.
The Society of Medicaid Planners offers a free download of their report “Medicaid Secrets Revealed by Dan Stemen. The report offers information on qualifying for Nursing Home Medicaid without losing the family home to recovery or spending down your life savings.
Labels: florida elder law, Florida Elder Law Attorney, Florida Estate Planning, Florida Medicaid Planning
