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Illinois’ interprets prepaying your funeral as requiring a contract for goods and services. In October 2013, we participated in discussions with Mason Budelier of the Office of Inspector General regarding Illinois Medicaid rules. During those discussions Mason mentioned that it is their view that when prepaying for a funeral you must have a contract for specific goods and services or they will not consider it to be an exempt asset, but rather a transfer for less than fair market value. The consensus among most practitioners participating in the discussions was that interpretation is wrong. In fact, shortly before the meeting the State had actually tried several cases in court arguing their point. Those cases are still under review and a decision has not be rendered. We believe the prudent approach until we receive a judicial determination on the matter is to comply with their position. For most of our clients, it is simply not worth the time and stress of fighting with the State of on the issue.
Many people are not aware that our services at Jones Elder Law include Special Needs Planning.
I recently worked with a family who was planning for their daughter “Amy” who has a disability. I asked them about their plans for Amy when they were no longer with us. The couple felt confident that her sister would have no problem stepping into their shoes as caregiver upon their passing. I asked if they had discussed this with their daughter, to which the answer was “not yet.” I encouraged them to have this conversation now and suggested they bring her in so we could all discuss the planning for Amy. When the family came back, much to their surprise their daughter explained she did not feel she was capable of caring for Amy once they are gone. While her parents were disappointed and saddened with this answer, in the end it was better to get this out on the table now as it allowed the family, as a whole, to develop a plan so Amy’s quality of life did not change upon the passing of her parents.
Special needs planning combines legal, personal, and financial planning techniques that enhance the quality of life of a person with a disability to allow that person to reach their full potential. Estate planning for a child with a disability presents a unique challenge. You must address the same issues as every parent – establishing trusts, naming guardians, and dealing with tax issues – but you face additional concerns as well. You may be asking yourself:
* If I leave my assets to my child, will my child be ineligible for government benefits he or she may be receiving?
* How can I leave financial assets to care for my child?
* Who will look after my child’s personal needs, make medical decisions, and look for opportunities that can help my child lead as complete and fulfilling a life as possible?
* Where will my child live for the rest of his or her life when I’m no longer there?
A special needs plan can provide a framework for proper medical care and management of assets, as well as protection of assets from creditors and predators. Estate planning for a loved one with special needs is one of the most rewarding services we can offer at Jones Elder Law. An advanced plan provides comfort to families that their loved one is protected. It addresses and resolves some of the biggest concerns that people have when protecting a loved one with special needs. If you have a family member with special needs, we can provide you an overview of the information needed to prepare a plan and suggestions on the proper way to implement the plan.
If you, or a loved one, enter the hospital and are a Medicare recipient, it is very important that you have a clear understanding of whether you have been formally admitted as a patient or whether you are being held for observation. Observation status is essentially, out-patient status. And as such, observation status can create large bills for you, especially if you need rehabilitative services after the hospital stay.
Out-patient services are billed under Medicare Part B (requiring you to pay 20% of the cost with no cap), they are not covered under Medicare Part A which covers hospital charges above the $1,184 deductible.
Observation patients will have to pay out of pocket for medications they received during their stay.
And potentially the most costly risk of observation status comes with rehabilitative care. Medicare pays for the first 20 days of rehabilitative care at a skilled nursing facility, however the patient must have spent three consecutive nights at a hospital as an inpatient to qualify for this coverage. So, you can see the importance of understanding your status in a hospital, just because you are physically located in the hospital does not mean that you have been admitted as an inpatient. It also does not mean that Medicare will be there to cover the bills, and it may mean that you have spent time in a skilled nursing facility receiving rehab that will be billed directly to you at the end of the month. If you find yourself in this situation, you can appeal both your hospital bill and nursing home bills, by following the instructions on your Medicare Summary Notice.
Be an advocate for yourself and your loved ones, arm yourself with knowledge and information.
With the new year the Veteran’s Administration has announced a cost of living increase to the Veteran’s Service Pension, Aid & Attendance Benefit. The rate for a single veteran is now $1,758, for a married veteran is $2,085 and for a widow of a veteran is now $1,130. For more information on whether you may qualify for a Service Pension, contact our office or your local Veterans Services Officer (”VSO”).
Visiting the doctor with the person you provide care for can be a very important aspect of your role as caregiver. Many times a doctor’s visit can be a stressful and confusing event for a senior. Having another person there to provide support and ask the difficult questions, may provide an opportunity to improve the entire process and the benefits received.
Before the appointment: Prepare! Pay attention to symptoms and any changes in eating habits, weight gain or loss, and even temperament. Prepare a list of questions that need to be discussed with the doctor, and prioritize the questions to make sure you don’t run out of time. Schedule the appointment for the best time of day for the senior.
At the appointment: Be Supportive & Helpful! Discuss your role in the appointment with the senior in advance. Find out if the senior would like to visit with the doctor alone initially. Ask the doctor to clarify if confusion exists. Make sure the senior gets their questions answered, and concerns addressed, by the doctor. Take notes during the visit.
After the appointment: Implement. Discuss the visit with the senior to ensure they felt the visit went well. Review your notes from the visit. If there are any changes in prescriptions, be sure to monitor for any side effects. Follow up on any test results that may be outstanding. If a follow up visit is needed schedule it and add it to your calendars
If you have not named your spouse or significant other your agent to make your financial and health related decisions when you are incapacitated, they cannot do so. The only option in this instance is a guardianship or conservatorship. This is a court process that takes time and money. In fact, far more money than simply getting your planning taken care of ahead of time. Every person over the age of 18 should have powers of attorney in place.
There are many steps out-of-state or long distance family members can do to help out with the caregiving responsibilities. What normally begins as a few social calls a week or month, can become a long-lasting and ever-expanding role. That social call is a way to casually check on the status of things, how is everyone feeling, did the prescriptions get refilled, are the household bills being managed as they always have. A conversation regarding whether the Halloween decorations are up, can be very insightful to whether your loved one is aware that a new month is upon us. Keep in mind, many times our loved ones do not want their children to worry, so they may fib a little on the answers. So that long-distance caregiver will want to be observant and creative during the conversations.
Other ways a long-distance caregiver might stay involved is by providing emotional support to the primary caregiver. Many times the primary caregiver can feel overlooked or taken advantage of. Offering appreciation and positive feedback to the primary caregiver can go a long way during this journey. They can also assist with the hiring of a professional caregiver to come in once a week, possibly to give their mother or sister a day off. Or, making travel arrangements to come in town for a week here or there to allow the primary caregiver a vacation. Respite care is very important to ensure the primary caregiver is taking care of themselves as well as their loved ones. Respite care can be for an afternoon each week or for several days at a time. Remember every family is different, you have to find the best fit for you and your family, but there are always tasks a long-distance caregiver can manage to stay involved.
It is very common for someone to ask us “what is the most important legal document to have.” Obviously you do not want to discount the importance of any legal document, as they all serve a purpose. Depending on your respective client’s need, each legal document serves a separate purpose and can be of great importance at the right time and place.
However, with that being said, if pressed for an answer my personal opinion is that the single most important document for family to have in place is the power of attorney for property. The reason is quite simple, through a power of attorney for property containing all the important provisions, you can effectively manage any other need or situation that may arise for the family. A properly drafted power of attorney for property is simply instrumental in protecting the familiy’s assets.
Routinely, families come into our office and tell us they have a Power of Attorney for Property already in place. When that document turns out to be the Statutory Short Form we have to break the news to them that it is not effective as an asset protection tool. The Statutory Short Form on the four corners of the document does not vest the agent with sufficient authority to protect their loved ones assets.
There is a tremendous difference between the Power of Attorney we use for traditional estate planning and the power of attorney that we use for asset protection cases.
Things you need to consider in determining if the power of attorney you hold will protect your assets include (but are not limited to):
· Does the Power of Attorney allow for gifting?
· Does it allow for gifting to the acting agent under the Power of Attorney?
· Does the Power of Attorney allow for the creation of an irrevocable trust?
· Does the Power of Attorney allow for the agent to enter into a caregiver agreement with the agent acting and being compensated as the caregiver?
· Does the Power of Attorney clearly state the client’s intent to return to their home?
· Does the Power of Attorney allow for changes to pay on death, transfer on death and beneficiary designation?
All of these provisions and many more can be contained in a Power of Attorney for Property designed to protect the client’s assets.
One constant consideration is when and how should such broad powers be included and enacted. The Power of Attorney that a 30 year old client needs is not the same as that of a client in their 50s, 60s or 70s. A clear conversation about the power they are granting others is required before such documents should ever be executed. Many times the appropriate answer lies in when certain powers within the Power of Attorney become active. For example, maybe the traditional powers become active immediately but more advanced asset protection powers do not become active until a doctor determines the client unable to handle their affairs or some subsequent document being signed by the client activating the powers.
An IRA is one of the few assets that will be taxed when your heirs receive it. An IRA has income in respect of a decedent status. Planning for the transfer of your IRAs is a critical part of protecting your assets. Ensuring your heirs ability to stretch an IRA can save $300,000 over time
Tune in today to hear Stephen on The Bystander’s Kid with Jill Boomer on WJBM 1480 AM. Stephen will be discussing planning for the Second Half of Life and upcoming educational workshops held throughout the community by Jones Elder Law.