Ralph Robbins
Certified Financial Planner
Ralph S. Robbins, CFP©, is a licensed Certified Financial Planning Practitioner and an Accredited VA Claims Agent specializing in Eldercare Financial Planning. He works everyday helping families in crisis find creative ways to fund long-term care expenses and deal with family financial issues.
Show:
Articles Question
Question
How do I know if my mother has life insurance?
There really is no way to know unless you know the name of an insurance company she may have done business with.
Question
We're paying for home health care out of pocket, are these expenses legally tax deductible?
Medical expenses, including the cost of medically necessary home health care, are deductible to the extent they exceed 7.5% of Adjusted... Medical expenses, including the cost of medically necessary home health care, are deductible to the extent they exceed 7.5% of Adjusted Gross Income. see more
Question
How can I be sure that my dad's reciprocal will is enforceable?
The way your father has set this up has one fatal flaw: At his demise your step-mother can change her will any way she desires. Sure hope... The way your father has set this up has one fatal flaw: At his demise your step-mother can change her will any way she desires. Sure hope you get along well with your step-mom and step-siblings!
The better way to do this if they have separate assets or have agreed on estate separation at his demise would be for his will to devise the portion that is to eventually go to you to a QTIP trust (Qualified Terminable Interest Property).
This arrangement will permit your step-mother to have income from the asset for her lifetime and at her demise the principal would devise to you (if the trust is so worded, in some instances principal invasion can be permitted if there are extenuating circumstances).
An attorney familiar with these matters should be consulted. It will not be expensive to establish this. see more
The better way to do this if they have separate assets or have agreed on estate separation at his demise would be for his will to devise the portion that is to eventually go to you to a QTIP trust (Qualified Terminable Interest Property).
This arrangement will permit your step-mother to have income from the asset for her lifetime and at her demise the principal would devise to you (if the trust is so worded, in some instances principal invasion can be permitted if there are extenuating circumstances).
An attorney familiar with these matters should be consulted. It will not be expensive to establish this. see more
Question
My mom has Alzheimer's and lives at home. Her bank account is dwindling down fast and what she receives from S...
You must immediately explore public benefit options. These will vary by state, county, and sometimes city. You will have to start doing... You must immediately explore public benefit options. These will vary by state, county, and sometimes city. You will have to start doing some serious homework. A good place to begin will be your county Area Agency on Aging or Aging and Disability Resource Center. Every county in the US has one. These are usually the "lead" agencies for many of the programs funded by the Older Americans Act and many other Federal as well as state specific programs.
Medicaid will most likely be an eventuality and again, state specific rules will apply. Do not wait to spend down all of your mother's money before applying. You are going to need every cent even is she receives Medicaid benefits. Explore techniques that can be used to preserve assets for her benefit while still permitting Medicaid qualification.
Was her husband a veteran? Were they married when he passed? If so, she may be eligible for a non-service connected pension called "Aid and Attendance" which may provide a benefit of up to $1,057 per month for cost of care at home or in any type of facility.
If you seek professional help shop carefully. Pricing is extremely arbitrary. see more
Medicaid will most likely be an eventuality and again, state specific rules will apply. Do not wait to spend down all of your mother's money before applying. You are going to need every cent even is she receives Medicaid benefits. Explore techniques that can be used to preserve assets for her benefit while still permitting Medicaid qualification.
Was her husband a veteran? Were they married when he passed? If so, she may be eligible for a non-service connected pension called "Aid and Attendance" which may provide a benefit of up to $1,057 per month for cost of care at home or in any type of facility.
If you seek professional help shop carefully. Pricing is extremely arbitrary. see more
Question
I have medicare A + B. Will it cover temporary care?
It depends on what you mean by "temporary care". Medicare (I am referring here to "original" Medicare. If you have a... It depends on what you mean by "temporary care". Medicare (I am referring here to "original" Medicare. If you have a Medicare Advantage Part C contract, read your contract) only covers Skilled levels of care whether in a facility or at home. This means that services required must be ordered by a physician and performed by a licensed professional. The patient must be "improving" as a result of therapies and treatment. Once the patient is "no longer improving" Medicare will no longer pay for services.
In a facility Medicare will provide benefits if:
1. The patient is hospitalized for at least 3 days.
2. Enters a Medicare approved facility...
3. for the same condition for which they were hospitalized...
4. and does so within 30 days of discharge.
Under these circumstances Medicare will pay full costs for the first 20 days. After 20 days Medicare will provide coverage for another 80 days but there is a co-payment which is usually covered by Medicare supplements. This is per benefit period, no annually.
At home, Medicare will pay for intermittent skilled services paid at 100%. The care must be physician ordered. When receiving skilled services at home, a professional such as an respiratory, occupational, or physical therapist, etc. will come to the home, perform a service, and then leave. While receiving Medicare home services SOME home health services may be provided; for instance an aide may be sent once or twice a week to assist the patient with bathing. Once skilled services end, so do any home health aide services.
Under no circumstances does Medicare pay for ongoing custodial or personal care services at home or in a facility. see more
In a facility Medicare will provide benefits if:
1. The patient is hospitalized for at least 3 days.
2. Enters a Medicare approved facility...
3. for the same condition for which they were hospitalized...
4. and does so within 30 days of discharge.
Under these circumstances Medicare will pay full costs for the first 20 days. After 20 days Medicare will provide coverage for another 80 days but there is a co-payment which is usually covered by Medicare supplements. This is per benefit period, no annually.
At home, Medicare will pay for intermittent skilled services paid at 100%. The care must be physician ordered. When receiving skilled services at home, a professional such as an respiratory, occupational, or physical therapist, etc. will come to the home, perform a service, and then leave. While receiving Medicare home services SOME home health services may be provided; for instance an aide may be sent once or twice a week to assist the patient with bathing. Once skilled services end, so do any home health aide services.
Under no circumstances does Medicare pay for ongoing custodial or personal care services at home or in a facility. see more
Question
My brother and sister-in-law keep mom's mail, check book, medical and social security cards, but I get no help...
If mother is still competent the decision as to who handles her affairs is hers. If she agrees, you can have a new power of attorney... If mother is still competent the decision as to who handles her affairs is hers. If she agrees, you can have a new power of attorney drawn. Make sure there is a clause or a separate document revoking the old power. Don't forget the Health Care Surrogate as well! see more
Question
Are there guidelines for making a caregiver agreement?
Whether the amount you are paid is fair or not is ultimately between you and your family however, if you believe there is a possibility... Whether the amount you are paid is fair or not is ultimately between you and your family however, if you believe there is a possibility that either of your parents will require Medicaid in the future it is important that your caregiver agreement and its terms be Medicaid compliant.
Rules with respect to Personal Care or Service Contracts or Agreements vary state by state. In Florida, which is a bit more liberal than other states, you must make sure the pay you are receiving is "reasonable" in light of what other professionals would charge for similar services. The amount of time spent per week must be reasonable and a contemporaneous care log indicating when and what type of services are performed must be maintained.
Additionally, the term of the contract cannot be greater than the care receiver's life expectancy as dictated by SS life expectancy tables.
Lastly, many states permit the transfer of lump sums to the caregiver in prospective satisfaction of the contract. If this is done, some states will require money to be returned to the estate of the care receiver in the event they pre-decease the term of the contract.
Whatever you do, make sure you document your transactions thoroughly.
By the way, is your father a veteran? He may be eligible to receive a non-service connected pension of up to $1,950 per month (for the couple) to help pay you for their care. see more
Rules with respect to Personal Care or Service Contracts or Agreements vary state by state. In Florida, which is a bit more liberal than other states, you must make sure the pay you are receiving is "reasonable" in light of what other professionals would charge for similar services. The amount of time spent per week must be reasonable and a contemporaneous care log indicating when and what type of services are performed must be maintained.
Additionally, the term of the contract cannot be greater than the care receiver's life expectancy as dictated by SS life expectancy tables.
Lastly, many states permit the transfer of lump sums to the caregiver in prospective satisfaction of the contract. If this is done, some states will require money to be returned to the estate of the care receiver in the event they pre-decease the term of the contract.
Whatever you do, make sure you document your transactions thoroughly.
By the way, is your father a veteran? He may be eligible to receive a non-service connected pension of up to $1,950 per month (for the couple) to help pay you for their care. see more
Question
Shoud we take annuity payments for Mom's healthcare needs from the interest on her annuity or the principle?
Sorry to say the answer is "it depends". One issue is taxation. If the contract was issued prior to August 14, 1982 there may be... Sorry to say the answer is "it depends".
One issue is taxation. If the contract was issued prior to August 14, 1982 there may be an advantage to taking principal first as "FIFO" (First In - First Out) taxation of gain applied. What this means is that for such contracts the owner is permitted to withdraw tax-free principal first as opposed to "LIFO" (Last In - First Out) taxation which requires withdrawal of taxable gain first. This allows the owner to determine when it is best to pay taxes on the gain.
It may not be readily apparent that the policy is that old. Over the years, many annuity owners have exercised what is known as a “1035 exchange” which is a tax-free exchange of one policy for another. Policies exchanged this way will still qualify for the old tax rules.
The other issue is qualification for public benefits. If the annuity owner applies for Medicaid the cash surrender value of the annuity will be considered an available asset and must be "spent down" before benefit eligibility. If the policy is "annuitized" the asset is converted to an income stream and the asset "disappears".
The resulting income from the annuitization will be countable for Medicaid eligibility purposes and in the event the added income from the annuity puts the applicant over the income cap of $2,022 per month that situation is easily cured via the use of an "Irrevocable Qualified Income Trust".
In my opinion, annuitization only makes sense when the Medicaid beneficiary is in a Home and Community Based Waiver program and receiving care at home or in an assisted living facility as the excess annuity income can be used for cost of care. If the beneficiary is in a nursing home the annuity payments are essentially “wasted” as countable income and other planning techniques should be considered (unless there is a community spouse).
Caveat: If you want to annuitize the contract for Medicaid benefit eligibility be certain the policy is then a "Medicaid Qualified Annuity". Most companies do not have the terms in their contracts Medicaid requires and it may be necessary to surrender (cash in) the policy and then purchase the appropriate immediate annuity. You will need a professional to identify the correct policy. see more
One issue is taxation. If the contract was issued prior to August 14, 1982 there may be an advantage to taking principal first as "FIFO" (First In - First Out) taxation of gain applied. What this means is that for such contracts the owner is permitted to withdraw tax-free principal first as opposed to "LIFO" (Last In - First Out) taxation which requires withdrawal of taxable gain first. This allows the owner to determine when it is best to pay taxes on the gain.
It may not be readily apparent that the policy is that old. Over the years, many annuity owners have exercised what is known as a “1035 exchange” which is a tax-free exchange of one policy for another. Policies exchanged this way will still qualify for the old tax rules.
The other issue is qualification for public benefits. If the annuity owner applies for Medicaid the cash surrender value of the annuity will be considered an available asset and must be "spent down" before benefit eligibility. If the policy is "annuitized" the asset is converted to an income stream and the asset "disappears".
The resulting income from the annuitization will be countable for Medicaid eligibility purposes and in the event the added income from the annuity puts the applicant over the income cap of $2,022 per month that situation is easily cured via the use of an "Irrevocable Qualified Income Trust".
In my opinion, annuitization only makes sense when the Medicaid beneficiary is in a Home and Community Based Waiver program and receiving care at home or in an assisted living facility as the excess annuity income can be used for cost of care. If the beneficiary is in a nursing home the annuity payments are essentially “wasted” as countable income and other planning techniques should be considered (unless there is a community spouse).
Caveat: If you want to annuitize the contract for Medicaid benefit eligibility be certain the policy is then a "Medicaid Qualified Annuity". Most companies do not have the terms in their contracts Medicaid requires and it may be necessary to surrender (cash in) the policy and then purchase the appropriate immediate annuity. You will need a professional to identify the correct policy. see more
Question
Will Medicare pay for respite care for patients with Alzheimer's living at home?
That will depend on the state in which you live. Some still only provide benefits for nursing home care however more and more now have... That will depend on the state in which you live. Some still only provide benefits for nursing home care however more and more now have what are known as Medicaid "Waiver" programs (called Waiver programs because the Federal government "waives" the previous regs only permitting Fed dollars to be used for nursing home care).
These programs typically provide "Home and Community Based Services" (HCBS) and sometimes you will find the programs identified with that moniker. HCBS programs may provide benefits for services at home or for care in an assisted living facility. To add confusion to the matter some states have state funded only Medicaid programs for the elderly as well.
Perhaps the easiest way to gain information about your state is to go here: http://www.medicare.gov/contacts/ and select "Do you want to search for information on a topic?". Click "Find Contacts..." and on the next page select your state and the box "Other Health Insurance Programs".
Click "Find Contacts" again and you will be directed to a list of agencies and programs. The State Medical Assistance Office will almost always be at the bottom of the page with a direct link to the agency's website.
I, for example, just did a search for Connecticut using the procedure above and when I clicked "Elders" on the State's website I was directed to there, right near the top of the page, was an Alzheimer's respite program (hope you live in CT; the website states the program is open to new beneficiaries!).
Each county in the US also has the agency I cited in my first reply. see more
These programs typically provide "Home and Community Based Services" (HCBS) and sometimes you will find the programs identified with that moniker. HCBS programs may provide benefits for services at home or for care in an assisted living facility. To add confusion to the matter some states have state funded only Medicaid programs for the elderly as well.
Perhaps the easiest way to gain information about your state is to go here: http://www.medicare.gov/contacts/ and select "Do you want to search for information on a topic?". Click "Find Contacts..." and on the next page select your state and the box "Other Health Insurance Programs".
Click "Find Contacts" again and you will be directed to a list of agencies and programs. The State Medical Assistance Office will almost always be at the bottom of the page with a direct link to the agency's website.
I, for example, just did a search for Connecticut using the procedure above and when I clicked "Elders" on the State's website I was directed to there, right near the top of the page, was an Alzheimer's respite program (hope you live in CT; the website states the program is open to new beneficiaries!).
Each county in the US also has the agency I cited in my first reply. see more
Question
Do you feel that you have just given up on your parents? That there's nothing much you can provide as funds al...
Maggie...great example of drawing boundaries. Thank you so much for sharing your experience and being so frank.
Question
I think my mom has dementia...we have a doctors appointment today...will he diagnose her with dementia? And do...
A frightening prospect to be sure and obviously you will want to concentrate on what mom will need from a medical perspective first and... A frightening prospect to be sure and obviously you will want to concentrate on what mom will need from a medical perspective first and foremost.
I want to encourage you, however, to think about the financals as soon as is practicable. Many wait and wait before dealing with the fact that the financial resources may not be there to provide for their loved one. The best planning is that which is done as soon as the need for long-term care becomes a possibility.
My father has had Alz for over six years and is still home with my mother and a full time aide. There have been occaisions where mom has felt it was time for assisted living but so far, so good. Much depends on the behaviours of your loved one and what can be managed at home.
All care, whether provided at home or in a facility is expensive. Interestingly, though, it is not in often that facility care is actually less expensive in the end. Moreover, there are greater benefit sets available for assisted living than home care. see more
I want to encourage you, however, to think about the financals as soon as is practicable. Many wait and wait before dealing with the fact that the financial resources may not be there to provide for their loved one. The best planning is that which is done as soon as the need for long-term care becomes a possibility.
My father has had Alz for over six years and is still home with my mother and a full time aide. There have been occaisions where mom has felt it was time for assisted living but so far, so good. Much depends on the behaviours of your loved one and what can be managed at home.
All care, whether provided at home or in a facility is expensive. Interestingly, though, it is not in often that facility care is actually less expensive in the end. Moreover, there are greater benefit sets available for assisted living than home care. see more
Question
Both of my parents live in their own home in Florida and we would like to transfer them to Wisconsin to be clo...
Just to amplify and clarify some of what Carol and Doreen said above... 1. Make sure you understand the distinction between Medicare and... Just to amplify and clarify some of what Carol and Doreen said above...
1. Make sure you understand the distinction between Medicare and Medicaid.
2. Both Florida and Wisconsin have Medicaid Home and Community Based Waiver Programs. These programs are designed to help elders in need who might otherwise have no option but Medcaid nursing home benefits to receive care at home or in an assisted living facility. The Florida program is currently closed but typically re-opens in the fall/winter. You can find out information about the WI programs here: http://www.dhs.wisconsin.gov/ltc_cop/glossary.htm . You should call and see if the program is available to new beneficiaries.
3. The VA pension benefit Doreen mentioned above should not be confused with service related disablity compensation. If a vet is receiving compensation they may receive a higher award from pension (both cannot be received at the same time). If dad is a vet, you can find more information here: http://www.vba.va.gov/bln/21/pension/ or for a readable summary go here: http://ralphrobbins.com/Veteran%20Benefits%20Florida.htm
3. Both Medicaid and VA pension can be received simultaneously. The maximum VA Aid and Attendance pension for a couple is $1,950 per month. In Florida, the Medicaid waiver program will pay a sitpend of up to $1,300 per month per beneficiary towards the cost of care in an assisted living facility. Combined, the two benefit sets offer powerful financial help. The VA benefit will be the same nationwide. Medicaid Waiver benefits vary from state to state.
4. DO NOT SPEND DOWN ASSETS TO QUALIFY FOR MEDICAID. This is the typical advice and it is financially devastating. Whether your parents stay in FL or move to WI there are techniques that can be implemented to legally preserve your parent's assets for their own use while receving public benefits. Using these techniques can mitigate the problem of ongoing home maintenance expenses as well as cover the cost of services and supplies not covered or covered inadequately by Medicaid.
5. Community Spouse protections. Again, as Doreen mentioned, Medicaid treats the applicant and the spouse separately. The spouse applying for Medicaid cannot have more than $2,000 in assets. The spouse not receiving benefits may retain up to $109,560 (in Florida may vary in other states) in cash assets not including home, auto, personal effects or IRA's (in Florida may vary in other states). Simple planning technique: Transfer all assets above $2,000 from the applicant spouse to the community spouse and then apply for Medicaid.
6. If you decide to work with an advisor, make sure that person is expert in both Medicaid and Veteran benefit eligiblity. They are two separate and distinct programs with different eligiblity and qualification requirements. You do not want to disqualify yourself from one while attempting to qualify for another. In my experience there are many elder law attorneys who are not knowledgeable about VA benefits.
It is a shame that your decision may have to based on finances rather than what would truly be in your parents best interest...hopefully that will not be the case. see more
1. Make sure you understand the distinction between Medicare and Medicaid.
2. Both Florida and Wisconsin have Medicaid Home and Community Based Waiver Programs. These programs are designed to help elders in need who might otherwise have no option but Medcaid nursing home benefits to receive care at home or in an assisted living facility. The Florida program is currently closed but typically re-opens in the fall/winter. You can find out information about the WI programs here: http://www.dhs.wisconsin.gov/ltc_cop/glossary.htm . You should call and see if the program is available to new beneficiaries.
3. The VA pension benefit Doreen mentioned above should not be confused with service related disablity compensation. If a vet is receiving compensation they may receive a higher award from pension (both cannot be received at the same time). If dad is a vet, you can find more information here: http://www.vba.va.gov/bln/21/pension/ or for a readable summary go here: http://ralphrobbins.com/Veteran%20Benefits%20Florida.htm
3. Both Medicaid and VA pension can be received simultaneously. The maximum VA Aid and Attendance pension for a couple is $1,950 per month. In Florida, the Medicaid waiver program will pay a sitpend of up to $1,300 per month per beneficiary towards the cost of care in an assisted living facility. Combined, the two benefit sets offer powerful financial help. The VA benefit will be the same nationwide. Medicaid Waiver benefits vary from state to state.
4. DO NOT SPEND DOWN ASSETS TO QUALIFY FOR MEDICAID. This is the typical advice and it is financially devastating. Whether your parents stay in FL or move to WI there are techniques that can be implemented to legally preserve your parent's assets for their own use while receving public benefits. Using these techniques can mitigate the problem of ongoing home maintenance expenses as well as cover the cost of services and supplies not covered or covered inadequately by Medicaid.
5. Community Spouse protections. Again, as Doreen mentioned, Medicaid treats the applicant and the spouse separately. The spouse applying for Medicaid cannot have more than $2,000 in assets. The spouse not receiving benefits may retain up to $109,560 (in Florida may vary in other states) in cash assets not including home, auto, personal effects or IRA's (in Florida may vary in other states). Simple planning technique: Transfer all assets above $2,000 from the applicant spouse to the community spouse and then apply for Medicaid.
6. If you decide to work with an advisor, make sure that person is expert in both Medicaid and Veteran benefit eligiblity. They are two separate and distinct programs with different eligiblity and qualification requirements. You do not want to disqualify yourself from one while attempting to qualify for another. In my experience there are many elder law attorneys who are not knowledgeable about VA benefits.
It is a shame that your decision may have to based on finances rather than what would truly be in your parents best interest...hopefully that will not be the case. see more
Question
I am in the military and my Dad is in a nursing home which my mom has POA over him. How do I get him to come l...
A POA does not give the attorney-in-fact the ability to determine where the principal will live. It only provides for authority over... A POA does not give the attorney-in-fact the ability to determine where the principal will live. It only provides for authority over financial and contractual matters.
If it is a health related situation, one might have better luck with a Health Care Surrogate provisions (aka Medical Power of Attorney) but there again the creator of the document must be deemed unable to make decisions for him/herself and I'm guessing that the first party mentioned as surrogate will also be the spouse.
If you feel your father is danger or not being well taken care of you can always petition the courts for guardianship or conservatorship. This will be an expensive and bloody process if the spouse contests.
Before you persue any of this think very carefully. If dad is in a nursing home he obviously requires intensive care. Are you really prepared to deal with this? Can you afford it? What will be the consequences for you family. There is a lot to consider when taking care of an chronically ill or incapacitated person at home. see more
If it is a health related situation, one might have better luck with a Health Care Surrogate provisions (aka Medical Power of Attorney) but there again the creator of the document must be deemed unable to make decisions for him/herself and I'm guessing that the first party mentioned as surrogate will also be the spouse.
If you feel your father is danger or not being well taken care of you can always petition the courts for guardianship or conservatorship. This will be an expensive and bloody process if the spouse contests.
Before you persue any of this think very carefully. If dad is in a nursing home he obviously requires intensive care. Are you really prepared to deal with this? Can you afford it? What will be the consequences for you family. There is a lot to consider when taking care of an chronically ill or incapacitated person at home. see more
Question
My mother is selling her home and will recieve approximately $40,000. She is 70-years-old. Can she protect thi...
Living Trusts...aka Revocable Living Trusts can be an effective tool however I find that when it comes to eldercare planning later in life... Living Trusts...aka Revocable Living Trusts can be an effective tool however I find that when it comes to eldercare planning later in life they may cause more headaches than help.
A revocable trust (as opposed to an irrevocable trust) is a flexible instrument. Because it is revocable, i.e., the terms of the trust can be changed by the grantor, it is treated, from a public benefit eligibility standpoint, the same as any other personal asset.
The concept is that since it is revocable, the grantor has full power to control trust assets including paying for their own care. Since the trust is treated as a personal asset there is no "five year look back" or resulting penalty when an individual transfers assets to a revocable trust they have created (self settled).
If the trust were irrevocable the grantor would be giving up all control of the assets in the trust and the trust provisions cannot be changed. In this instance the five year look back would apply; the idea being that one creating and funding such a trust may be doing so to shed assets to qualify for public benefits.
Why then, do people create living trusts? There are several main reasons:
1. To avoid probate. Assets titled in a revocable trust will be devised by the terms of the trust; not by will. Probate time and cost are therefore avoided.
2. Incapacity. The trust permits the grantor to be their own trustee. In the event they are unable to do so due to incapacity, such trusts usually have provisions for successor trustees to step in and administer the trust thus avoiding potential guardianship proceedings.
3. Succession. Trust terms can provide testamentary (death) provisons that restrict when and how beneficiaries can receive funds; particularly helpful where grandchildren or spendthrift children are beneficiaries.
This being said, there are other ways to accomplish the same thing that may be less cumbersome.
1. Naming beneficiaries. Many assets permit beneficiaries to be named. You can name beneficiaries to bank accounts, IRA's, brokerage accounts, annuities, and life insurance policies. When a beneficiary is named to an asset, that asset will devise directly to the beneficiary and therefore avoid probate.
2. Power of Attorney. Whether "springing" (effective when the principal becomes incompetent) or "durable" (effective at signing and "durable" through incompetency), a power of attorney gives the attorney-in-fact the ability to have authority over assets and transactions enumerated in the document. This is just as effective as being a "successor trustee" but less cumbersome.
It is amazing but I would say easily 95% of those I counsel who have revocable living trusts have not titled all appropriate assets in the name of the trust thereby nullifying all the planning they have done! Keep it simple if your situation is simple.
By the way, just a small correction to information above...As I mentioned, only assets titled in the name of the trust are subject to the terms of the trust. When establishing a trust I also have drafted what is known as a "pour-over will". This will is designed to catch and then devise those assets that are not titled in the trust such as personal effects, etc. or those assets that should have been so titled but weren't as described above.
The trust and the will are separate and distinct. The executor of a will has no authority over trust assests unless they are also a successor trustee. see more
A revocable trust (as opposed to an irrevocable trust) is a flexible instrument. Because it is revocable, i.e., the terms of the trust can be changed by the grantor, it is treated, from a public benefit eligibility standpoint, the same as any other personal asset.
The concept is that since it is revocable, the grantor has full power to control trust assets including paying for their own care. Since the trust is treated as a personal asset there is no "five year look back" or resulting penalty when an individual transfers assets to a revocable trust they have created (self settled).
If the trust were irrevocable the grantor would be giving up all control of the assets in the trust and the trust provisions cannot be changed. In this instance the five year look back would apply; the idea being that one creating and funding such a trust may be doing so to shed assets to qualify for public benefits.
Why then, do people create living trusts? There are several main reasons:
1. To avoid probate. Assets titled in a revocable trust will be devised by the terms of the trust; not by will. Probate time and cost are therefore avoided.
2. Incapacity. The trust permits the grantor to be their own trustee. In the event they are unable to do so due to incapacity, such trusts usually have provisions for successor trustees to step in and administer the trust thus avoiding potential guardianship proceedings.
3. Succession. Trust terms can provide testamentary (death) provisons that restrict when and how beneficiaries can receive funds; particularly helpful where grandchildren or spendthrift children are beneficiaries.
This being said, there are other ways to accomplish the same thing that may be less cumbersome.
1. Naming beneficiaries. Many assets permit beneficiaries to be named. You can name beneficiaries to bank accounts, IRA's, brokerage accounts, annuities, and life insurance policies. When a beneficiary is named to an asset, that asset will devise directly to the beneficiary and therefore avoid probate.
2. Power of Attorney. Whether "springing" (effective when the principal becomes incompetent) or "durable" (effective at signing and "durable" through incompetency), a power of attorney gives the attorney-in-fact the ability to have authority over assets and transactions enumerated in the document. This is just as effective as being a "successor trustee" but less cumbersome.
It is amazing but I would say easily 95% of those I counsel who have revocable living trusts have not titled all appropriate assets in the name of the trust thereby nullifying all the planning they have done! Keep it simple if your situation is simple.
By the way, just a small correction to information above...As I mentioned, only assets titled in the name of the trust are subject to the terms of the trust. When establishing a trust I also have drafted what is known as a "pour-over will". This will is designed to catch and then devise those assets that are not titled in the trust such as personal effects, etc. or those assets that should have been so titled but weren't as described above.
The trust and the will are separate and distinct. The executor of a will has no authority over trust assests unless they are also a successor trustee. see more
Question
Can a senior qualify for Medicaid if they receive Medicare?
Nothing like having more information.... It is true that mom's income is too high for Medicaid. If you are applying for long-term care... Nothing like having more information....
It is true that mom's income is too high for Medicaid. If you are applying for long-term care benefits the income threshold is $2,022 per month. The asset threshold is $2,000 (not including house, care, and other non-countable items).
There is, however, a method, codified in Federal Law, to deal with excess income. Mom must establish an "Irrevocable Qualified Income Trust" aka "QIT".
This is the second time in as many days a participant on this site has said that their loved one had income that was too high to qualify for benefits but were NOT told about the QIT remedy. Very, very, surprising and unfortunate.
By the way, if assets are also too high there are remedies for this as well. Don't spend all of her money without investigating alternatives. see more
It is true that mom's income is too high for Medicaid. If you are applying for long-term care benefits the income threshold is $2,022 per month. The asset threshold is $2,000 (not including house, care, and other non-countable items).
There is, however, a method, codified in Federal Law, to deal with excess income. Mom must establish an "Irrevocable Qualified Income Trust" aka "QIT".
This is the second time in as many days a participant on this site has said that their loved one had income that was too high to qualify for benefits but were NOT told about the QIT remedy. Very, very, surprising and unfortunate.
By the way, if assets are also too high there are remedies for this as well. Don't spend all of her money without investigating alternatives. see more
Question
What kind of financial help can I get from the VA as my wife's caregiver. I am a Korean War Vet?
Here is the deal on VA and long-term care... 1. There are two types of VA benefits available for non-career military; compensation and... Here is the deal on VA and long-term care...
1. There are two types of VA benefits available for non-career military; compensation and pension. Compensation is what most are familiar with...a veteran is injured or disabled as a result of service and they receive a "rating" and a compensation check every month. Pension is a non-service connected benefit in that the veteran's disability does not have to be service related. A veteran cannot receive compensation and pension at the same time.
2. There are three levels to VA pension benefits - basic, homebound, aid and attendance. All are needs based. Basic pension can be received without medical evidence. Homebound and Aid and Attendance do.
3. The pension (monthly maximum for vet = $1,650, for couple = $1,950, for surviving spouse = $1,056) is paid directly to the veteran. Claim can be made for virtually any service including care provided by a relative except a spouse), home health aids, geriatric care management, assisted living facilities or nursing homes.
4. To qualify the vet must have served at least 90 continuous days one day of which must have been during a TIME of combat (the vet does not have to have served IN combat). The vet must have received at least a general discharge. To be eligible for the survivor benefit, the spouse must have been married to the vet at the time of the vet's demise (no divorce).
5. You will need help to successfully apply for the benefit. You can try a local Veteran Service Office (search for National Association of Veteran Service Officers to find same near you). Keep in mind that Service Officers will not make recommendations with respect to financial planning if the claimant is "over-resourced". Also keep in mind that if the application is not done properly the first time it may take up to 9-12 months to receive an award. Although you can apply on-line for veteran benefits, you cannot do so for survivor benefits.
6. Benefits will be retroactive to the month AFTER application.
7. If you use a private consultant pay a fee. Do not use one of the profilgate "we help vets for free" firms that are actually financial service firms, typically insurance brokers, looking to sell high commission annuities. My experience has been that most of these firms are woefully inexperienced in coordinating VA benefits with other public benefit programs and as a result future access to Medicaid may be seriously compromised.
To learn more about this benefit directly from the VA, visit here http://www.vba.va.gov/bln/21/pension/
By the way...qualifying for Medicaid now, if the financial situation warrants it, may free up cash for other purposes. Call your local Area Agency on Aging for additional resources. see more
1. There are two types of VA benefits available for non-career military; compensation and pension. Compensation is what most are familiar with...a veteran is injured or disabled as a result of service and they receive a "rating" and a compensation check every month. Pension is a non-service connected benefit in that the veteran's disability does not have to be service related. A veteran cannot receive compensation and pension at the same time.
2. There are three levels to VA pension benefits - basic, homebound, aid and attendance. All are needs based. Basic pension can be received without medical evidence. Homebound and Aid and Attendance do.
3. The pension (monthly maximum for vet = $1,650, for couple = $1,950, for surviving spouse = $1,056) is paid directly to the veteran. Claim can be made for virtually any service including care provided by a relative except a spouse), home health aids, geriatric care management, assisted living facilities or nursing homes.
4. To qualify the vet must have served at least 90 continuous days one day of which must have been during a TIME of combat (the vet does not have to have served IN combat). The vet must have received at least a general discharge. To be eligible for the survivor benefit, the spouse must have been married to the vet at the time of the vet's demise (no divorce).
5. You will need help to successfully apply for the benefit. You can try a local Veteran Service Office (search for National Association of Veteran Service Officers to find same near you). Keep in mind that Service Officers will not make recommendations with respect to financial planning if the claimant is "over-resourced". Also keep in mind that if the application is not done properly the first time it may take up to 9-12 months to receive an award. Although you can apply on-line for veteran benefits, you cannot do so for survivor benefits.
6. Benefits will be retroactive to the month AFTER application.
7. If you use a private consultant pay a fee. Do not use one of the profilgate "we help vets for free" firms that are actually financial service firms, typically insurance brokers, looking to sell high commission annuities. My experience has been that most of these firms are woefully inexperienced in coordinating VA benefits with other public benefit programs and as a result future access to Medicaid may be seriously compromised.
To learn more about this benefit directly from the VA, visit here http://www.vba.va.gov/bln/21/pension/
By the way...qualifying for Medicaid now, if the financial situation warrants it, may free up cash for other purposes. Call your local Area Agency on Aging for additional resources. see more
Question
Will an AARP reimbursement disqualify a terminally ill patient from receiving Medicaid?
I am presuming you are speaking of an AARP Medicare supplement policy for someone over the age of 65. If so, the answer is no,... I am presuming you are speaking of an AARP Medicare supplement policy for someone over the age of 65.
If so, the answer is no, reimbursement for Medicare approved medical servces wil not disqualify a patient from Medicaid. The reimbursement is not considered "income" which is what I suspect your concern is.
Same holds true for Hospice, by the way.
If mom's income is over see more
If so, the answer is no, reimbursement for Medicare approved medical servces wil not disqualify a patient from Medicaid. The reimbursement is not considered "income" which is what I suspect your concern is.
Same holds true for Hospice, by the way.
If mom's income is over see more
Question
Will Medicare pay for respite care for patients with Alzheimer's living at home?
Unfortunately not. Nor will Medicare pay for adult day care or any other form of custodial care. If funds are limited there are many... Unfortunately not. Nor will Medicare pay for adult day care or any other form of custodial care.
If funds are limited there are many organizations in some communites that will offer services on sliding scale.
Contact your local Area Agency on Aging or Aging and Disability Resource Center...a great resource. see more
If funds are limited there are many organizations in some communites that will offer services on sliding scale.
Contact your local Area Agency on Aging or Aging and Disability Resource Center...a great resource. see more
Question
How do I handle an unfit sibling who has guardianship of my parent?
You will have to petition the court. If you are challenging an existing guardianship be prepared for an expensive process. To have been... You will have to petition the court. If you are challenging an existing guardianship be prepared for an expensive process. To have been appointed guardian your sister would have been deemed fit by the court...a responsibility the court generally takes very seriously. The court doesn't like to be told they are wrong. You can try handling this pro se but it is unlikely you will be able to make a sufficient case on your own unless there is something glaring that the court missed or something substantive has changed since the appointment. see more
My father lives at home. He is blind, has Alzheimer's, suffers from a broke hip and smokes. How can I become h...
I would inquire as to whether or not the VA can help you with this. If not, I would search in your community for pro bono guardianship services (see if there is an guardianship association in your area).
If not, contact the family or probate section of your county court. Ask if they have a pro se section to assist you with involuntary guardianship.
I say all of this because attorney's sometimes want absolutely crazy amounts of money to handle these cases. If uncontested, it is not necessary to have an attorney for this proceeding.
Unfortunately, at this point, this is your only choice. see more