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Special Needs and Elder Planning

If you are an adult child, you may find yourself sandwiched beween either/and elderly, declining parents and off-spring who may have special needs.  Careful and deliberative Estate Planning can assist with funding, providing necessary services and ultimately transferring assets for the benefit of persons who might not have the congative ability to manage those assets.

Special Needs Trusts and funding concerns apply to children born with special needs, victims of accidents who are suffering with TBI  including Veterans and the growing elderly population. According to the 2000 US census, there are close to 50 million people with disabilities, which is approximately 17 percent of the total population in the United States. It is estimated that, of the 50 million who have identified themselves as having a disability, 28 percent are 65 years and over. 

Planning for your older years: 

 If you are concerned about planning for a time when you might not be able to make decisions on your own, an estate planning attorney can explain the various options available to you in the event you become incapacitated.  If you are concerned about needing access to government funded long-term care such as Medicare or Medicaid, an attorney can help you to plan now so that your family may inherit your assets instead of losing everything to the government to pay for your care.

ELDER LAW and Estate Planning FAQS:
  • If I need long-term care, what are my options? Long-term care can be delivered at home, in assisted living or in a nursing home, depending on the level of care needed. There are also continuing care retirement communities (CCRCs) which provide a continuum of care. At a CCRC, you are able to enter the community when you need a lower level of care and then move to a different part of the community as your care needs change. Many CCRCs require a significant advance deposit prior to admission. An elder law attorney can review the admissions agreement for you to protect your and your family’s interests.

  • Does Medicare cover the cost of long-term care? No. Medicare covers short-term (30 days) rehabilitation but does not cover care at home or in a nursing home. Medicare will cover acute illnesses such as heart surgery or strokes, but not chronic illnesses such as Alzheimer’s disease or Parkinson’s disease. If you meet strict requirements, you may receive up to 100 days of Medicare coverage for skilled nursing care in a nursing home; however, there are significant co-payments that will be due. 

  • What is long-term care insurance? Long-term care insurance is designed to cover the cost of long-term care if you need it in the future. In order to purchase a long-term care insurance policy you must go through the underwriting process of the insurance company. Depending on the type of policy your purchase, you will be required to pay premiums for the rest of your life or for a certain period of years. In exchange for the payment of premiums, the insurance company will cover you, up to the policy limits, for the cost of your long-term care, if necessary. In light of the fact that Medicare does not cover long-term care, long-term care insurance should be considered as part of your overall estate planning.

  • How much does long-term care cost? Long-term care is expensive, whether delivered at home, in assisted living or nursing home. Costs vary by geographic region. In some of the major metropolitan areas of the United States, costs can exceed $200,000 per year. These catastrophic costs can bankrupt most middle class families if they don’t plan in advance. An attorney can explain the various options available and help guide you through the long-term care maize so that your family does not go broke paying for long-term care.

  • How do I pay for long term care? Basically, there are four ways to pay for long-term care:

  1. Private pay, which can cost more than $200,000 per year in some areas,

  2. Medicare, which only covers short-term rehabilitation for skilled nursing care and does not cover custodial,

  3. longterm care, long-term care insurance, which must be purchased while you are healthy, and

  4. Medicaid, which is the only government program that pays for long-term care.

  • How can I qualify for Medicaid?  Medicaid was intended to be for people who are destitute. In fact, to qualify by the 2018 guidelines, you must have less than $2465 in personal assets, excluding the value of your home.  Most people are disqualified simply because of the amount they are eligible to receive in social security benefits. This presents middle class folks who have a loved one with a chronic illness with a tough choice: impoverish yourself and your family, or engage in Medicaid planning.  

  • What is a 'clawback'? The  government has imposed stringent rules penalizing transfers of your assets prior to entering a nursing home. You may be disqualified from receiving Medicaid if you have made asset transfers during the five-year look back period prior to applying for Medicaid. An attorney can explain the Medicaid lookback and penalty period rules to you so that inappropriate, disqualifying transfers are not made

  • When should I engage in elder law planning? The sooner, the better. We never know when illness or incapacity resulting from an accident will strike. While many of us think of nursing home residents as people who are elderly, a significant number of people who need long-term care are middle age or younger. Thus, it is never too early to plan.

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