Medicaid Planning

Wednesday, November 30, 2011

How You Can Work With A Houston Elder Law Attorney to Shield Your Assets From Nursing Home Costs

Many Houston seniors are making strides toward estate planning by working with their elder law attorneys to set up what they believe are the appropriate wills and trusts.  The goals with this type of planning are most commonly to:

• avoid probate,
•  make decisions regarding trust administration,
• and—most importantly—to protect your assets for your heirs. 

Unfortunately, this final criteria isn’t always met in traditional wills and trusts.

The problem stems from long-term care.  When you set up your initial estate planning documents, such as a revocable living trust, you probably fully intend to outline your wishes for how your estate will be dispersed upon your death.  Unfortunately, this document does not protect your assets from creditors, lawsuits or the incredible costs associated with nursing home care.

In order to pay for that care, your entire estate can be at risk.  Your assets will be used to pay for your medical and other needs, potentially leaving little or nothing to be administered in your trust.  This means that even if you have a legal document directing how your assets should be distributed, it will be referring to assets that were already sold off to cover expenses.  As nursing home costs continue to rise, we see more and more of this in Houston.

To avoid this situation, it’s often necessary to work with an attorney who focuses on elder and long-term care planning, in addition to traditional estate planning.  If it appears your estate is at risk of being wiped out due to unexpected illness, incapacity or long-term care costs, your attorney can work with you to create the right kind of trust that will adequately shield your assets during your lifetime, and after death.

To learn more about how seniors around the country are engaging in long-term care planning to shield their assets from the skyrocketing costs of nursing home care, consider discussing this option with your Houston elder care or estate planning lawyer.

Monday, July 18, 2011

Houston Wills and Trusts Lawyer Offers Ways to Approach “Tough Conversations” With Mom or Dad

When meeting with a wills and trusts lawyer in Houston for the first time, many adult children realize that they have no idea where their parents stand in terms of having the right plans in place to protect their assets and wishes if something happens to them.

Do their parents have a will or trust and, if so, where are these and other important documents located? Should assisted living or nursing home care become necessary, what plans are in place to cover the costs? Will mom or dad even have enough money after these costs to carry them through retirement?

These are some very important questions that need to be asked, and an experienced Houston wills and trusts lawyer can steer you in the right direction. That being said, no matter how good your relationship is with mom or dad, the subject can be a difficult one to approach.

Perhaps the best place to start is timing. Holidays such as Christmas, Hanukkah and Thanksgiving are known to be stressful times, so avoid these occasions. Current events often present the perfect opening, as there is always some Hollywood legend or financial mogul who dies leaving a fortune for the heirs to squabble over.

Or, the personal experience of a friend or relative can be worked into a dialogue. “So-and-So’s mother was admitted to the hospital recently and no one knew where to find her important papers.” For the adult child who is doing estate planning of their own, it would only be natural to want to discuss their parents’ plans with them during this time.

For some families, several conversations over a longer period of time might be a better approach. No one wants to feel like they are being told what to do, and money matters are often emotionally charged conversations to begin with. 

Remember, advance preparations are in the best interests of the parents, sothattheir wishes can be carried out upon death.  Be sure to communicate this from the start to avoid your parents shutting down or getting defensive about the questions you are asking.

Finally, don’t forget to include the topic of long-term care in your conversations with mom or dad.   While no one likes to think about the possibility of becoming disabled or incapacitated by something like a stroke or Alzheimer’s disease, it does happen and it’s something that must be planned well in advance for.  If you start early enough, an Houston wills and trust lawyer can help you put the right plans in place to ensure mom or dad’s wishes during incapacity are honored and that they won’t be forced to sell or give away all of their assets in order to qualify for state or federal assistance.

Are you now ready to help your parents put a rock-solid plan in place that ensures their end-of-life wishes are honored to the fullest?  Then be sure to call our Houston wills and trusts lawyers for assistance.  With the mention of this article, you may qualify for a Lifetime Legacy Planning Session ($750 value), at no-charge.  Simply call (281) 218-0880 to find out more. 

Friday, June 10, 2011

Advice on Medicare and Medicaid from a Wills and Trusts Lawyer in Houston

Wills and trusts lawyers in Houston frequently get inquiries about arrangements for long-term care. Life expectancy continues to rise, due in part to more effective treatments for diseases previously thought to be terminal.

This is great news, but with a larger elderly population, new dilemmas arise, including uncertainties related to assisted and rehab care facilities. Two of the most frequently asked questions are, “How do I pay for short-term and long-term care?” and “What is the difference between Medicare and Medicaid and what can each offer me?”

Medicare and Medicaid both pay for certain aspects of rehabilitation after a hospital stay, but there are specific requirements that must be met. A knowledgeable wills and trusts lawyer can give you the exact stipulations and explain the difference between Medicare and Medicaid provisions.

In general terms, Medicare provides coverage to people over the age of 65, and is similar to regular health insurance. Since Medicare is a federal program, benefits and requirements are universal for all states. An individual must have been hospitalized for at least 3 days and 3 nights before transferring to a nursing or rehabilitative facility, and the move must be made within 30 days of the hospital stay. In a sense, Medicare pays for an acute occurrence and the rehabilitation from it.  Since Medicare coverage is not intended for custodial care or long-term care, the patient must demonstrate a need for skilled care, in-home or in a care facility, and show that progress is being made toward recovery. If qualified, Medicare will cover a total of 100 days, the first 20 days paid in full and the next 80 days with a co-pay of $124 per day.

On the other hand, Medicaid is a state-run entity intended for those in financial need with different rules and qualifiers which vary from state to state.  Just as wills and trusts in Houston are subject to the specifics of state law, so must certain criteria be met to be eligible for benefits.  In nearly all states, the patient would need to spend down his/her assets to around two-thousand dollars, although some states exempt certain assets-- such as your house and car--up to a predetermined value. Any subsequent income the patient gets, including social security, goes first to paying for long-term care.

Unlike Medicare, Medicaid does offer custodial care, but not all facilities are Medicaid approved. Due to the small percentage of nursing homes which offer Medicaid approved housing, and possible waiting lists, it is best to explore all options with the hospital social worker prior to the patient being discharged. Anecdotally, Medicaid approved nursing homes are crowded, so it would be wise to check out a number of facilities in person ahead of time.

Wills and trusts lawyers in Houston will be the first to tell you that investigating and understanding your options, and implementing preparations before a crisis occurs is the prudent course of action to take.        

We work with families every day to explore such options and also help families implement the best asset protection strategies to preserve the things they’ve worked so hard for without jeopardizing the ability to qualify for Medicaid.  If you would like to know these options, we invite you to give our office a call at (281) 218-0880 and ask about our Lifetime Legacy Planning Sessions.

Wednesday, March 09, 2011

Houston Elder Lawyer Discusses Caring For The Elderly--While Taking Care of Kids

By: Kim Hegwood, Houston Elder Lawyer

Depending on your perspective, this can feel like a double-whammy.

Certainly, as with children, it is always a better idea to focus on the benefits of more time with your parents, etc ... but yes, I have seen many times how this can put a major drain on a family.

From what I have observed of adults thrust into the role of caring for their parents, the biggest struggle often comes from trying to keep their dual responsibilities segregated.  They try to ensure that the needs of the aging parent don't impact what's going on in their children's lives. 

As an example, the adult children feel like they have to choose between making sure that Mom takes a walk for exercise and attending a child's piano recital.  No matter what the adult parent chooses, he or she often feels like a failure at everything.

What you need to realize is that this process is not something that you can keep separated in your life.  You will do your family a great service by viewing it as an experience to be shared with everyone in the family, and maybe even with some members of the outside community.

If you find yourself in this situation here are 3 practical tips I can offer as a Houston elder lawyer:

1) Get the Actual Facts. You may have avoided talking with your parents about finances in the past.  Whether you were taught that those things are private or "it just never came up," now is not the time for surprises.  You need to know how your parents are doing financially and whether they have made any provisions in case they become ill or suffer a long-term disability.

2) Ensure the Estate is Set Up Right.  At this stage of your parent's life it is important to make sure that your parent's legal house is in order.  My client's parents enjoy a healthy discount on their estate planning.  But, no matter where you get it done, your parents absolutely need to have a financial power of attorney, advance health care directive (a health care power of attorney plus a living will), and a simple will.  It may not be the best estate plan for your parents.  It might not be proper Medicaid planning.  However, it is the bare minimum you will need to help care for your parents.

3) Insure Against the Future. Now is the time to examine long-term-care insurance or assess whether savings will cover an extended nursing home stay, assisted-living facility costs or extended home-care services.  You may be tempted to begin to liquidate your holdings or stop saving for your own benefit to help pay for the cost of your parent's care.  Big mistake. 

Remember that there aren't nearly the same kind of government programs or lending scenarios that will help you pay for your kids, or their college or fund your retirement -- as there are to help support aging parents.  It is vital that you continue to save for your retirement.

Thursday, June 17, 2010

Houston, TX Elder Lawyer Offers 9 Critical Considerations In Searching for an Assisted Living Facility

From the Desk of Kim Hegwood, Houston, TX Elder Lawyer

As a Houston, TX Elder lawyer, I help seniors and their families make smart decisions regarding their end-of-life wishes and long-term care on regular basis.

And because of my experience in this area, I understand that the options facing seniors and their loved ones can be VERY expensive and overwhelming at times.  

Not to mention, there is never a good time to talk to a senior about moving into an assisted living facility, nor is mom or dad ever happy about relinquishing their last bit of independence into the hands of a nursing home.

Yet that is why it is extremely important for seniors (and their kids) to do their due diligenceand proactively plan ahead to ensure they can qualify (or even afford) a facility that best meets their ongoing medical and long-term care needs.

Of course in the 21^st century there are many options as far as retirement communities are concerned.  These options include independent retirement communities, assisted independent communities, at-home assisted living, at-home nursing care, live-in nursing homes, and the list just continues.

All these options may feel overwhelming at first, but there are a number of tips and tools that your family can rely on in their quest to weed out the good long-term care facilities from the bad.

In fact, US News and World Report recently published an article listing nine key things to consider when searching for an assisted living facility.  The tips they gave were extremely valuable, and for that reason I have summarized them here below:

1. Reflect on the values of you or your loved one. Figure out what is important in your life and make sure that it is going to be incorporated in your living arrangements.
2. Consider your future needs. Are you or your loved one going to require more assistance later on? What about when your mobility changes? Do you have any kind of progressive illness? The answers to these questions will help you find a place that is just right for your current and future needs.
3. Make sure that the facility is licensed. You need to make sure that it is up to par with your state’s assisted living regulations. Go to eldercare.gov and search by zip code.
4. Assess the financial stability of the facility. Let’s face it – in these times of financial straits, it is a real possibility that the facility that you are looking into has expanded beyond its capabilities. If it is not financially stable, it is probably not the place for you.
5. Get referrals.  Talk to other people that are looking for retirement options. Contact your agency on aging.  Find out where everyone else is going.
6. Ask if there is a waiting list. More than likely, for the good places, there will be. This is another reason to start early – don’t wait until you need a place to go. Plan ahead.
7. Visit a few times. That means one scheduled tour and then a couple pop-in visits.  Take note of what is the facility is like when you show up unannounced. Try to make one of your surprise visits at night, too, to see what it is like when the day staff leaves.
8. Talk with current residents. This is pretty self-explanatory: who will know the facility better and be more willing to tell the truth than the residents?
9. Get a copy of the contract and review it with a lawyer. I know this sounds tedious but this will help you avoid being thrown a curve ball later on when you decide to move in. If there are parts of the contract you are not sure about, you can talk to the facility and see what you can work out.

As you can see, these 9 key considerations provide a great starting point for families seeking nursing home or assisted living care in Texas.   Yet finding a facility is only half the battle as you will also need to consider the costs and mounting expenses that accompany any long-term stay.

Contrary to popular belief, seniors do NOT have to forfeit their assets and everything they have worked so hard for to qualify for Medicaid.  Instead, a Houston, TX elder lawyer can help you implement a number of tools designed to proactively shield your assets (or your parent’s assets) without jeopardizing eligibility for federal assistance down the road. 

Yet these tools all depend on the senior’s personal situation,  how soon they will need nursing home or assisted living care and their own actions over the past few years (especially if they have ‘gifted’ their assets away improperly or without the help of an attorney!).

But if you are currently at theplace of planning for long-term care, I encourage you to call a Houston, TX Elder Lawyer before any binding decisions are made.  Here at Hegwood & Associates, PC, we have made the process easier than ever by offering seniors (or children of seniors) a FREE Lifetime Legacy Planning Session (normally $750) with the mention of this article.

Together in this session we will review your current situation (or plan if you have one), your assets and your end-of-life wishes to determine whether or not you and your family are truly protected should something unexpectedly happen.  I will also teach you how to maximize your assets and inheritance without sacrificing the ability to qualify for Medicaid in the future. 

Simply call (281) 218-0880 and mention this article to redeem your free session.  These appointments are limited to 10 sessions per month so call today!