Don’t Forget Long-Term Care Costs When Planning Your Estate

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When discussing estate planning with clients or potential clients, the meeting usually begins with questions about who will receive property, who will make medical and/or financial decisions upon incapacity, and how to minimize taxes  and the costs of estate administration.  Most individuals tend to shy away from discussing how to pay for long-term care or nursing home expenses as it is not easy to talk about the unpleasant thought of needing nursing home care.  No one wants to go into a nursing home. I believe many families are sincere when they say they will not let mom or dad go into a nursing facility or they will care for them at home.  Sometimes, however, it is just not safe for someone to remain at home and skilled nursing care is the only option.

Long-term care expenses can cost six figures annually in some states, and generally speaking are not covered by Medicare or your private health insurance policy. Although there are several strategies to protect your assets in the event you require long-term medical care, we will focus on two of the more common financial and legal strategies for this article.

Long-Term Care Insurance

Long-term care insurance policies should be considered as an option to pay for long-term care in the event care is needed.  There are different options for coverage, so discussing your needs with a qualified insurance representative and elder law attorney is very important to ensure you are protected.

Irrevocable Trust

Asset protection using an irrevocable trust is another option to protecting your assets from estate recovery should you need long-term care. Because of the 5-year look-back period rules involving trusts, this type of planning must be done at least five years before the need for long-term care and the filing of a Medicaid/MassHealth application. A consultation with a qualified estate planning and elder law attorney is highly recommended if considering an irrevocable trust strategy.

As discussed above, we discussed only two strategies for purposes of this article. Each family’s situation should be discussed on a case-by-case basis to determine what strategies are appropriate.  Many different factors such as health, family dynamic, assets/income, and whether we are working with a spousal couple or single/surviving spouse are a few examples of the factors we must evaluate to determine what options our families have.  Please call our office to schedule a consultation to discuss what’s best for your family.

Filed Under: Irrevocable Trusts, Long Term Care Insurance, Long Term Care Planning, Medicaid Planning

Elder Law: The Importance of Planning

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A recent Boston Globe article reveals as many as 60% of Massachusetts nursing homes are finding ways to skirt a 2012 dementia care law intended to prevent deceptive practices. The law requires that facilities advertising dementia care must meet specific criteria including dementia-specific training for staff, specialized activities, and security measures to prevent wandering.

This story is just one of many that illustrate how important it is to do your homework and advocate for your loved one through estate planning and long term care planning. Our firm assists clients with all of their elder law concerns. Areas within elder law include:

  • Nursing Home Issues – Sadly, as our population ages, we see increased cases of abuse, neglect, and exploitation in nursing homes. An elder law attorney can help secure return of assets in a case of financial exploitation or recover damages for injuries resulting from neglect or abuse.
  • Medical Directives – Should you become incapacitated and unable to communicate your wishes, it’s imperative that you have medical directives in place. In Massachusetts, you will need a living will and health care proxy. An attorney can help you through this delicate process.

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Filed Under: Elder Law, Estate Planning, Long Term Care Planning, Medicaid Planning

Estate Planning Considerations for Singles and Massachusetts Law

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Single persons without heirs have unique considerations when planning for the future. Unlike most married couples with spouses and/or children, they need to involve friends or other relatives in their financial, medical emergency and end of life arrangements.

Documents used to convey what should take place if a single person becomes incapacitated can include a durable power of attorney, springing power of attorney, a health care proxy advance care directive and an authorization under HIPAA. Employing one or more of these documents will authorize your agent to make medical and financial decisions on your behalf in the event you are not able.

The springing power of attorney only comes into effect upon an event such incapacitation or disability. In contrast, a durable power of attorney applies when it is signed.

Despite being childless, a single person may have dependents such as parents or siblings. Perhaps, there are valued charities and friends he or she wishes to endow. Setting up a revocable living trust or making a will is the way to make sure that his or her wishes take precedence.

If there is no Will, trust, or beneficiary designations in place, the estate of a single person may become subject to Massachusetts probate process and is disbursed under Massachusetts law.

For those without family, choosing the right person to carry out your wishes might be difficult.  In this case, working with an estate planner is beneficial.

Filed Under: Estate Planning, Health Care Proxy, Long Term Care Planning, Wills

Options For Long Term Care Planning

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Planning options for long-term care will generally fall into two areas depending on the client’s current need for long-term care.  If there is no immediate need for skilled nursing care or other significant medical issue, the discussion may focus on long term asset protection, or advanced planning.  This usually requires at an asset protection plan in place at least 5 years in advance of a long-term care need.  There are numerous planning options to protect assets if you have time to plan, and multiple factors will affect your decisions.  Some of the factors that will impact your plan will be your income, assets, medical needs, long-term care insurance, age and financial situation of beneficiaries, and whether there are family members with special needs.  This list is not exhaustive, but gives you a sense of the type of information that will be needed to develop a comprehensive plan appropriate for your situation.

Another area of planning, crisis planning, involves an immediate need for skilled nursing care.  Planning options at this time are limited, however there are still options to attempt to protect assets, especially for a married couple.  In addition, a Medicaid application will need to be filed if seeking Medicaid benefits to cover the costs of the Nursing Home.  This process is complicated and the application is lengthy, therefore guidance with this process is strongly recommended.

Filed Under: Long Term Care Planning