Questions and Answers Surrounding Elder Care Law

Transcription

1 Questions and Answers Surrounding Elder Care Law Heather Durham Nadler, Esq. Certified Elder Law Attorney Heather Durham Nadler, P.C Century Parkway, Suite 100 Atlanta, Georgia (678)

2 What is Elder Law? Practice area that is defined by the client served seniors Holistic practice Estate Planning Planning for Incapacity Planning for Long-Term Care

3 Estate Planning at a Glance Advance Directive for Health Care Durable Financial Power of Attorney Last Will and Testaments Trusts Titling of assets Beneficiary designations

4 Planning for Incapacity Advance Directive for Health Care Durable Medical Power of Attorney Living Will Durable Financial Power of Attorney Last Will and Testament Special Needs Trust for Disabled Beneficiaries

5 What happens without Powers of Attorney? Guardianship Conservatorship

6 What is Long Term Care? In-home care Independent Living Community Assisted Living Personal Care Home Nursing Home Continuing Care Retirement Community

7 Options for Financing Long Term Care Pay privately Long Term Care Insurance Limited Medicare benefits Veteran s benefits Medicaid

8 Private Pay Rates in Georgia 24 hour/day in-home skilled care can easily exceed $100,000 per year Average cost of assisted living is $35,000 per year Average nursing home cost in Georgia is $60,000 per year more in Metro Atlanta

9 What does Medicare pay? Medicare is designed to cover acute illness not chronic illness Limited home care benefit - skilled care Limited nursing home benefit only if move to nursing home follows a 3-day hospital stay Days 1-20 in the NH are covered Days potentially covered with a co-pay

10 Basic Eligibility for VA Aid & Attendance Benefits 90 days of active service one of which was in wartime Other than dishonorable discharge Limited income (after deducting unreimbursed medical expenses) and assets (<$80,000) Permanent and total disability at the time of application (over 65 presumed disabled) Disability caused without willful misconduct of claimant

11 VA Aid and Attendance (cont.) Available to a veteran or widow(er) who is blind OR living in a nursing home OR unable perform activities of daily living Amounts Veteran with no dependents - $1,644/mo Veteran with one dependent - $1,949/mo Widow(er) with no dependents - $1,056/mo

12 Nursing Home Medicaid Provides payment for nursing home level care for the aged, blind or disabled population who meet the financial eligibility criteria

13 Income Eligibility Requirements The income of the individual seeking nursing home Medicaid eligibility must be less than $2,022 per month (2009 figure) Income of the spouse of the individual in the nursing home is not relevant in determining eligibility If income exceeds the $2,022 income cap, the individual must establish a Qualified Income Miller Trust

14 Nursing Home Payments Member is required to pay all income toward the cost of his care at the nursing home Exceptions: $50/month personal needs allowance Cost of health insurance premiums Spousal diversion Incurred medical expenses Remaining income is paid to the nursing home

15 Resource Allowances A Member may have $2,000 in countable resources The community spouse may have an additional $104,400 in countable resources

16 Countable Resources Bank accounts Investment accounts Stocks Bonds CDs Cash value of certain life insurance policies Annuities Retirement accounts Real estate other than a homeplace

17 Exempt Resources Homeplace with up to $500,000 in equity One car Household goods Burial Resource Allowance of up to $10,000 Certain retirement accounts Certain annuities

18 Transfer of Assets Deficit Reduction Act of 2005 Look-back period expanded from 3 years to 5 years Penalty period for making a transfer begins when the individual is otherwise eligible for Medicaid (ie, in the nursing home and assets have been reduced to allowable levels)

19 Exempt Transfers The following transfers are not subject to a transfer of asset penalty Transfers to a spouse Transfers to a special needs trust for a disabled child Transfer of homeplace to a caregiver child (as defined by Medicaid), a sibling with an equity interest in the home, a disabled child or a child under 21

20 Estate Recovery Effective May 3, 2006 The Department of Community Health (DCH) is entitled to place a lien against all property that is owned by a Member at the time of his death Property passing by joint tenancy, beneficiary designation or life estate is subject to Estate Recovery

21 Estate Recovery (cont.) An estate recovery lien cannot be enforced so long as there is a spouse, child under 21 or disabled child of the member living A lien can be placed at such time as a Member is deemed permanently institutionalized (as defined by Medicaid) but such a lien cannot be enforced if there is a spouse, child under 21, disabled child, caregiver child or sibling with an equity interest living in the home Any transfers made by a Member within the look-back period are voidable and may be set aside

22 Questions and Answers Surrounding Elder Care Law Heather Durham Nadler, Esq. Certified Elder Law Attorney Heather Durham Nadler, P.C Century Parkway, Suite 100 Atlanta, Georgia (678)