Impact of Stimulus Check on Medicaid Eligibility

Impact of Stimulus Check on Medicaid Eligibility

Impact of Stimulus Check on Medicaid Eligibility

If you recently received a stimulus check from the Federal Government as a result of the CARES Act, we are writing to let you know that the stimulus check does not count as income and is an exempt asset for a period of twelve months after it is received.

If you are currently receiving Medicaid coverage (a “Recipient”) and received a stimulus check from the Federal Government as a result of the CARES Act, you may be concerned with maintaining your eligibility. Medicaid’s asset rule requires the bank account of a Recipient to remain below $2,000 as of the first moment of the first date of each month to maintain eligibility. In addition to the asset rule, Recipients must also report all changes in monthly income to FSSA.

How will FSSA treat the stimulus checks that thousands of Recipients are receiving in their bank accounts or mailboxes?

The stimulus check is an exempt asset for a period of twelve months after it is received and will not immediately disrupt eligibility. The receipt of a stimulus check is considered a federal refund under FSSA’s Policy Manual and therefore will not immediately count as an available asset.

In addition, Medicaid’s income rule considers the individual’s monthly income in the calculation of the monthly liability amount payable to a nursing facility. The one-time stimulus payment is not considered income and will not result in a change to your monthly liability amount.

What does this mean for you?

While it remains critical that the balance in a Recipient’s bank account NEVER exceed $2,000 on the first day of any given month, the stimulus check deposited is not included in this balance. While you can now essentially keep up to $3,200 ($2,000 asset limit + $1,200 stimulus check) in your account without penalty, we strongly recommend maintaining accounts at a balance of approximately $1,500.00 to avoid any unforeseen errors.

If you have any questions about the information provided or obtaining Medicaid eligibility for yourself or a loved one, please contact our office for assistance.

 

New Smartphone App for Health Care Decision-makers

The American Bar Association has launched a new app to help keep key health care decision-making information close at hand. Mind Your Loved Ones is available in all app stores and allows the user to keep copies of health care documents, such as powers of attorney, health care consents, living wills, and POST (physician’s order on the scope of treatment) forms on their smartphones, along with lists of medications, doctors and insurance information. Because there is no limit to the number of profiles in the app, you can keep this important information for your spouse, children, parents, and any loved one you are caring for. Documents stored in the app can easily be shared via email, text, or fax. For more information on the Mind Your Loved Ones App visit the ABA website. 

Kahlyn N. Barcevic, Estate Planning & Elder Law Attorney, Tuesley Hall Konopa, LLP

Author: Kahlyn N. Barcevic is an estate planning, estate administration, and elder law associate at Tuesley Hall Konopa, LLP. Kahlyn helps clients with wills, trusts, special needs trusts, guardianships, powers of attorney, and long-term care planning including Medicaid planning.

You can contact Kahlyn by calling 574.232.3538 or by email kbarcevic@thklaw.com.

Disclaimer: The THK Legal Blog is for informational purposes only and should not be relied upon as legal advice. In no case does the published material constitute an exhaustive legal study, and applicability to a particular situation depends upon an investigation of specific facts. You should consult an attorney for advice regarding your individual situation.
Estate Planning & Elder Law Issues in Trying Times

Estate Planning & Elder Law Issues in Trying Times

Dear Clients and Friends,

Recent events have many people thinking about their estate planning documents and whether they and their family members are adequately covered. Despite the lockdown, the attorneys of Tuesley Hall Konopa stand ready to answer your questions or help you get a plan in place or revise the plan you have via video or teleconference.

Estate Planning

In a crisis situation, your estate planning points of focus should be as follows:

  • First, do I have the necessary documents in place to ensure my wishes are carried out in the event that I cannot communicate with my health care providers?
  • Second, if I am unable to make financial decisions or handle routine bill-paying tasks, is there someone authorized to take over and do they have the information that they need?
  • Third, for those who are caregivers for a family member or other loved one, is there a plan in place to ensure continuity of care for those individuals?
  • Finally, are my final wishes and my plan for the management and distribution of my estate clear and properly documented?

If you already have documents in place, now is the time for a quick read through to make sure they still meet your needs. If you can’t locate your copies, don’t worry. If we prepared them, we have them on file and can get copies to you. Make sure that you have communicated your plan with the appropriate people so that everyone knows what their roles and responsibilities are.

If you do not have a plan in place, or if you have been sitting on draft documents that you just haven’t signed, we can help. While we are currently limiting in-office appointments to document signing meetings, we are continuing to hold meetings with new estate planning and elder law clients via video or teleconference.

Elder Law

As if the current pandemic wasn’t complicating life enough, effective March 1, our region began implementing a new case processing system for Medicaid applications. This is leading to increased delays in the Medicaid application process and more incorrect denials of eligibility. If you receive a denial notice that you believe is incorrect or are experiencing difficulties in the Medicaid application process, contact our office to see if we can assist with your situation.

Most, if not all, nursing home and assisted living facilities are currently on lockdown, either severely restricting visitors or banning them altogether. How can you be sure your loved one is getting the care they need and maintain contact with them? One option is to have an iPhone or an iPad delivered to the facility. You can have it pre-set up with FaceTime and if the facility has Wi-Fi, you can get the connection set up from the facility parking lot. Another option is the use of private home health aides. While some facilities are not allowing family members to visit, they may be allowing outside health care workers into the facility, and hiring someone to go in and check on your loved one periodically (and possibly help facilitate communication with the outside world) can help with your peace of mind.

Contact our estate planning and elder law team with your questions at 574.232.3538. We are open 8 a.m. to 5 p.m. Monday through Friday, and all our attorneys are available to assist you via phone and virtual meetings.

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Author: Jennifer L. VanderVeen is a certified elder law attorney (CELA) at Tuesley Hall Konopa, LLP where she counsels clients on long term care planning, Medicare, Medicaid, veterans benefits applications, guardianships, special needs trusts, and complex estate planning issues. Jennifer frequently speaks to community groups on caregiver responsibilities and caregiver burnout.

Disclaimer: The THK Legal Blog is for informational purposes only and should not be relied upon as legal advice. In no case does the published material constitute an exhaustive legal study, and applicability to a particular situation depends upon an investigation of specific facts. You should consult an attorney for advice regarding your individual situation.
Supported Decisionmaking

Supported Decisionmaking

Supported Decisionmaking – a new alternative to guardianship

Effective July 1, 2019, Indiana now has the option for supported decisionmaking agreements to be used in lieu of guardianship proceedings for individuals who may need assistance in making certain types of decisions, but do not necessarily require a full guardianship to be established. It allows people with disabilities to maintain some level of a self-directed, independent life.

While, on its face, this seems like a huge step forward in disability rights, there are some lingering issues that will need to be hammered out before these agreements can really begin to make a difference in people’s lives.

Indiana is one of only a handful of states to have legislation authorizing these types of agreements. However, unlike in a number of other states, Indiana has no statutory form. Just as with the power of attorney documents, each supported decisionmaking agreement can be unique. Although this allows customization to make the document suit the situation, it can lead to difficulties in getting the document recognized and accepted. Schools, medical providers, and financial organizations may not see the agreement as a legally binding document.

In addition, these agreements are not a substitute for powers of attorney in the event of an individual’s complete incapacity. Rather, supported decisionmaking agreements are a tool in our toolbox that we can use to help facilitate a more independent lifestyle. Just as with any adult, power of attorney documents for health care and finances should also be executed to provide a decisionmaking chain of command in the event the individual is incapable of making a decision for him or herself.

The framework found at the link below can help start the conversation about supported decisionmaking and guide the creation of the document.

Charting the LifeCourse – Tool for Exploring Decision Making Supports

In addition, other states, such as Maine, Texas, and Delaware have statutory forms that can be used for reference in discussing the agreement. We recommend consulting with an attorney who has experience in special needs planning prior to signing one of these agreements to ensure that it meets all of your needs. If you would like us to review the special needs situation for your loved ones, please call 574.232.3538 to schedule an appointment.

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Author: Jennifer L. VanderVeen is a certified elder law attorney (CELA) at Tuesley Hall Konopa, LLP where she counsels clients on long term care planning, Medicare, Medicaid, veterans benefits applications, guardianships, special needs trusts, and complex estate planning issues. Jennifer frequently speaks to community groups on caregiver responsibilities and caregiver burnout.

You can contact Jennifer by calling 574.232.3538 or by email jvanderveen@thklaw.com.

Disclaimer: The THK Legal Blog is for informational purposes only and should not be relied upon as legal advice. In no case does the published material constitute an exhaustive legal study, and applicability to a particular situation depends upon an investigation of specific facts. You should consult an attorney for advice regarding your individual situation.
Making Caregiving Easier with Technology

Making Caregiving Easier with Technology

Frequently, the burden of caring for a family member falls on one individual because it’s just simpler for one person to coordinate caregiving, so nothing is missed or miscommunicated. However, with modern technology, that burden can be shared without the risk of information being lost.

Carezone.com helps families coordinate care for aging or disabled loved ones and share information between family members or other caregivers. Its app and website have a calendar, to-do list and journaling tools to allow everyone in the caregiving team to know when appointments are, what changes have been made to the care plan, and what tasks need to be completed, along with the person assigned to do them. This is a great tool for sharing the workload of caregiving along with keeping everyone informed so that no one is out of the loop.

Using this website, in conjunction with powers of attorney and caregiving agreements can go a long way to helping avoid unnecessary conflict and misunderstandings at a difficult time.

For more information on powers of attorney, caregiving agreements, or other questions on caring for an aging or disabled loved one, contact the estate planning attorneys at Tuesley Hall Konopa, LLP.

Call 574.232.3538 to make an appointment with our Certified Elder Law Attorney to discuss your caregiving questions.

Author: Jennifer L. VanderVeen is a certified elder law attorney (CELA) at Tuesley Hall Konopa, LLP where she counsels clients on long term care planning, Medicare, Medicaid, veterans benefits applications, guardianships, special needs trusts, and complex estate planning issues. Jennifer frequently speaks to community groups on caregiver responsibilities and caregiver burnout.

You can contact Jennifer by calling 574.232.3538 or by email jvanderveen@thklaw.com.

Disclaimer: The THK Legal Blog is for informational purposes only and should not be relied upon as legal advice. In no case does the published material constitute an exhaustive legal study, and applicability to a particular situation depends upon an investigation of specific facts. You should consult an attorney for advice regarding your individual situation.
Veterans Administration Imposes New Rules

Veterans Administration Imposes New Rules

Effective October 18, 2018, the VA is imposing new rules and regulations on the popular Aid and Attendance program. These rules are designed to clarify the previously ambiguous asset limit rules and impose a more certain and predictable penalty period for gifting.

First, the rules impose a clear asset limit of $123,600 to establish eligibility for the aid and attendance program. The VA defines “assets” as the fair market value of countable resources less any mortgages or liens plus the applicant’s annual household income. Unreimbursed medical expenses in excess of 5%  the maximum annual pension rate will still be deducted from annual income.

In deciding what expenses will qualify as medical expenses to be deducted, the VA will now require a statement from a physician or qualified medical professional that home care is required for those payments to be deducted. Payments to assisted living or other facilities that include meals and lodging will be included as long as health or custodial care is also included in the payment.

The rules also clarify the treatment of a residence, stating that a primary residence will be an excluded asset, even if the applicant is not residing there. However, the definition of primary residence is limited to a lot size of two acres. Any land above two acres will be counted as an asset. The rules also exclude the proceeds from the sale of a primary residence if they are used to purchase another residence in the same calendar year.

Finally, the VA will impose a penalty period on any gifts made within thirty-six months of an application for VA benefits. This penalty will apply to any gifts made after October 18, 2018. The number of penalty months is calculated by dividing the amount gifted by the maximum annual pension rate. The applicant will not be eligible to receive benefits during the penalty period. There is a maximum penalty of five years.

While the lookback period on gifts is an unwelcome change, the certainty that the new rules provide to applicants may make an application for VA benefits a more viable option for some.

Contact Jennifer at 574.232.3538 or email jvanderveen@thklaw.com for an appointment if you need help planning for the future using your VA benefits.

Author: Jennifer L. VanderVeen is a certified elder law attorney (CELA) at Tuesley Hall Konopa, LLP where she counsels clients on long term care planning, Medicare, Medicaid, veterans benefits applications, guardianships, special needs trusts, and complex estate planning issues. Jennifer frequently speaks to community groups on caregiver responsibilities and caregiver burnout.

You can contact Jennifer by calling 574.232.3538 or by email jvanderveen@thklaw.com.

Disclaimer: The THK Legal Blog is for informational purposes only and should not be relied upon as legal advice. In no case does the published material constitute an exhaustive legal study, and applicability to a particular situation depends upon an investigation of specific facts. You should consult an attorney for advice regarding your individual situation.
Ethics of Adjusting Your Assets to Qualify for Medicaid

Ethics of Adjusting Your Assets to Qualify for Medicaid

Whenever I tell people that I’m an elder law attorney, I usually get asked one question – “How is it ethical for people to take advantage of loopholes in the rules and protect their assets while qualifying for Medicaid to pay for nursing home care costs?

Recently, I was asked this question in a rather unusual context. New York Times columnist Ron Leiber has been writing a series of columns this summer focusing on issues of Medicaid, the middle class, and long-term care. He wanted to talk to me about how I justify helping families protect assets to qualify for a program that was intended to benefit the poor. Although the resulting column, which you can read here, gives a pretty good overview of the reasons people take steps to protect assets, there are a few more that didn’t make it into the column.

People are living longer and requiring longer nursing homestays. According to the Department of Health and Human Services, the median nursing home stay in 1985 was 237 days at an average cost of care of around $80 per day. In 2004, the median nursing home stay had increased to 835 days at an average cost of $210 per day. Currently, families in our area can expect to pay anywhere from $250 to $320 per day for long-term care.  When people who are in their 80’s today were retiring, they could not have anticipated the costs of care and length of stays we are seeing today.  They could not have predicted and planned for costs in excess of $10,000 per month.

Many of my clients are couples, where one person may need nursing home level of care while the other needs to continue to support him or herself in the community. Medicaid’s rules allow a spouse to keep a maximum of $120,000 in assets and may leave a spouse at home with as little as $2000 a month of income.  If a spouse has extraordinary living expenses, that might increase to $3,000 a month of income. So, if the well spouse needs assisted living costing $4,500 per month, plus insurance and prescriptions of another $500 per month, she can afford to pay for that care for about five years.  And this assumes that there is $3,000 per month of income to transfer to her, enough assets to make her limit the maximum of $120,000 and that her costs don’t increase at a greater rate than her income.

Once a person is on Medicaid in the nursing home, they are allowed to keep a minimal amount of money each month to cover any needs not covered by Medicaid. In Indiana, this amount is $52 per month. Michigan gives a more generous allowance of $60 per month.  This must cover haircuts, clothing, and anything else “extra” that a person needs. Medicaid has limits on how often it will pay for items like hearing aids, glasses, and dentures.  If those items are lost or damaged before Medicaid will cover them, the patient will need to use his or her meager monthly allowance to pay for these items. Asset protection allows nursing home patients to have the funds available to pay for necessities and for niceties that contribute to the quality of life.

Finally, we are beginning to see a shortage of Medicaid beds in this area. While it hasn’t reached the level that other areas of the state or country have seen, waitlists for Medicaid beds in some facilities can be months long.  If you are not eligible for Medicaid when a bed becomes available, you run the risk that a bed may not be there when you run out of funds.  You may be forced to move to a different facility to find an available bed.

Medicaid asset protection is more than just preserving an inheritance for the next generation.  It can be an essential part of preserving the dignity and quality of life for your loved ones. If your family members are facing long-term care needs in the near future, call (574) 232-3538 for an appointment.

Author: Jennifer L. VanderVeen is a certified elder law attorney (CELA) at Tuesley Hall Konopa, LLP where she counsels clients on long term care planning, Medicare, Medicaid, veterans benefits applications, guardianships, special needs trusts, and complex estate planning issues. Jennifer frequently speaks to community groups on caregiver responsibilities and caregiver burnout.

You can contact Jennifer by calling 574.232.3538 or by email jvanderveen@thklaw.com.

Disclaimer: The THK Legal Blog is for informational purposes only and should not be relied upon as legal advice. In no case does the published material constitute an exhaustive legal study, and applicability to a particular situation depends upon an investigation of specific facts. You should consult an attorney for advice regarding your individual situation.