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BY ROBERT J. LONGSTREET, ATTORNEY AT LAW презентация
Содержание
- 1. BY ROBERT J. LONGSTREET, ATTORNEY AT LAW
- 2. MEDICAID VS. MEDICARE MEDICAID IS A LARGE
- 3. MEDICAID In Michigan, Medicaid implemented by county
- 4. MEDICAID DOES PAY FOR LONG TERM NURSING
- 5. WHY DO WE CARE ABOUT MEDICAID ELIBILITY?
- 6. MEDICAID QUALIFICATION REQUIREMENTS Must be 65 years
- 7. AND IF YOU QUALIFY… The nursing home
- 8. THIS SOUNDS HORRIBLE!!!!
- 9. SOME GOOD NEWS NOT ALL ASSETS ARE
- 10. HOMESTEAD EXEMPTION
- 11. OF ANY VALUE ONE AUTOMOBILE
- 12. PERSONAL PROPERTY CLOTHING JEWELRY HOME APPLIANCES FURNITURE
- 13. PRE-PAID FUNERAL CONTRACTS MUST BE IRREVOCABLE FOR
- 14. EVERYTHING ELSE IS A “COUNTABLE ASSET”
- 15. VALUING COUNTABLE ASSETS Joint Assets Joint
- 16. Valuing Countable Assets Retirement Funds and Annuities
- 17. EXTRA EXEMPTION FOR “COMMUNITY” SPOUSE OF REMAINING
- 18. EXAMPLE: Mr. Brown is entering a long
- 19. IF MR. BROWN APPLIED FOR MEDICAID: MR.
- 20. WHAT ABOUT INCOME? MR. BROWN GETS TO
- 21. WHAT ABOUT THE REMAINING $80,000 THE BROWNS OWN?
- 22. WHAT ABOUT THE REMAINING $80,000 THE BROWNS
- 23. MEDICAID PENALIZES GIFTS ON MEDICAID APPLICATION, ASKED
- 24. IF MR. BROWN GIFTS REMAINING $80,000 TO
- 25. SO WHAT IS LEFT FOR CLIENTS TO
- 26. FOR A SINGLE CLIENT “HALF-A-LOAF” METHOD GIFT
- 27. FOR MARRIED CLIENT TAKE ADVANTAGE OF FULL
- 28. AS A REVIEW… REMEMBER MR. AND MRS. BROWN?
- 29. EXAMPLE: Mr. Brown is entering a long
- 30. Mr. Brown is Medicaid Eligible MR. BROWN
- 31. MRS. BROWN HOUSE, CAR, PRE-PAID FUNERAL AND
- 32. POST PLANNING IS KEY FOR MRS. BROWN…
- 33. Estate Recovery Only applies to: Persons on
- 34. Estate Recovery Normally talking about the house,
- 35. Estate Recovery Every state is different. 2007
- 36. What We Do Avoid probate by using
- 37. Two Powerhouse Methods You Can Do NOW
- 38. IF YOU HAVE A NURSING HOME ISSUE….
MEDICAID VS. MEDICARE MEDICAID IS A LARGE GOVERNMENT HEALTH INSURANCE PROGRAM DIFFERENT FROM MEDICARE IN THAT MEDICAID ELIGIBILITY REQUIRES AGED OR DISABLED + STRICT FINANCIAL ELIGIBILITY REQUIREMENTS COOPERATIVE FEDERAL & STATE
Слайд 2MEDICAID VS. MEDICARE
MEDICAID IS A LARGE GOVERNMENT HEALTH INSURANCE PROGRAM
DIFFERENT FROM
MEDICARE IN THAT MEDICAID ELIGIBILITY REQUIRES AGED OR DISABLED + STRICT FINANCIAL ELIGIBILITY REQUIREMENTS
COOPERATIVE FEDERAL & STATE PROGRAM
FEDERAL LAW PROVIDES BROAD PARAMETERS, STATE PROVIDES SPECIFIC RULES AND ADMINISTERS ELIGIBILITY
COOPERATIVE FEDERAL & STATE PROGRAM
FEDERAL LAW PROVIDES BROAD PARAMETERS, STATE PROVIDES SPECIFIC RULES AND ADMINISTERS ELIGIBILITY
Слайд 3MEDICAID
In Michigan, Medicaid implemented by county DHS (Department of Human Services)
Offices.
Many Medicaid Programs for various populations.
Medicaid Long Term Care Programs:
Nursing Home (NH) Medicaid
MI Choice Waiver
Many Medicaid Programs for various populations.
Medicaid Long Term Care Programs:
Nursing Home (NH) Medicaid
MI Choice Waiver
Слайд 4MEDICAID DOES PAY FOR LONG TERM NURSING HOME STAYS FOR SENIORS
WHO QUALIFY
BUT MEDICAID IS ‘MEANS TESTED’, MEANING THE STATE WILL LOOK AT ASSETS AND INCOME
(FOUR TESTS TO PASS… WE’LL DISCUSS IN A FEW MINUTES)
BUT MEDICAID IS ‘MEANS TESTED’, MEANING THE STATE WILL LOOK AT ASSETS AND INCOME
(FOUR TESTS TO PASS… WE’LL DISCUSS IN A FEW MINUTES)
Слайд 5WHY DO WE CARE ABOUT MEDICAID ELIBILITY?
0ver 6,000 people turn 65
every day, and 40% of these people will spend time in a nursing home.
The average cost in 2014 for 1 month in a nursing home in the State of Michigan?
$7,867.00
The average cost in 2014 for 1 month in a nursing home in the State of Michigan?
$7,867.00
Слайд 6MEDICAID QUALIFICATION REQUIREMENTS
Must be 65 years or older or disabled, blind
or receiving SSI
Must be a resident of the State of Michigan
Income must be below the monthly private pay cost of the nursing home ($7,867)
An applicant cannot own more than $2,000 of countable assets (individually or with spouse)
Must be a resident of the State of Michigan
Income must be below the monthly private pay cost of the nursing home ($7,867)
An applicant cannot own more than $2,000 of countable assets (individually or with spouse)
Слайд 7AND IF YOU QUALIFY…
The nursing home patient is allowed to keep
$60.00 per month for ‘personals’
The remainder of the patient’s income goes to the nursing home
MEDICAID will pay the remainder of the nursing home bill
The remainder of the patient’s income goes to the nursing home
MEDICAID will pay the remainder of the nursing home bill
Слайд 9SOME GOOD NEWS
NOT ALL ASSETS ARE “COUNTABLE”
THESE ARE ASSETS A PERSON
CAN OWN AND STILL RECEIVE MEDICAID BENEFITS
HOMESTEAD
ONE AUTOMOBILE
PERSONAL PROPERTY
PREPAID FUNERAL CONTRACTS
HOMESTEAD
ONE AUTOMOBILE
PERSONAL PROPERTY
PREPAID FUNERAL CONTRACTS
Слайд 10
HOMESTEAD EXEMPTION
HOMESTEAD INCLUDES HOME AND ANY CONTIGUOUS LAND
CAN BE SEPARATED BY
ROAD OR RIVER, BUT NOT BY ANOTHER’S LAND
NEED NOT BE IN MICHIGAN
FOR A SINGLE PERSON: LESS THAN $536,000 IN EQUITY VALUE
NO VALUE CAP IF OCCUPIED BY SPOUSE, DISABLED CHILD, OR CHILD UNDER 21.
NEED NOT BE IN MICHIGAN
FOR A SINGLE PERSON: LESS THAN $536,000 IN EQUITY VALUE
NO VALUE CAP IF OCCUPIED BY SPOUSE, DISABLED CHILD, OR CHILD UNDER 21.
Слайд 13PRE-PAID FUNERAL
CONTRACTS
MUST BE IRREVOCABLE
FOR HUSBAND AND WIFE
CAN INCLUDE BURIAL PLOTS
FOR ENTIRE
FAMILY
Слайд 14EVERYTHING ELSE IS A “COUNTABLE ASSET”
CHECKING ACCOUNTS
SAVINGS ACCOUNTS
CERTIFICATE OF DEPOSITS
OTHER REAL
ESTATE (BESIDES HOMESTEAD)
STOCKS, BONDS, ETC.
STOCKS, BONDS, ETC.
Слайд 15VALUING COUNTABLE ASSETS
Joint Assets
Joint with Spouse = All counts
Joint
with Non-Spouse
For Bank Accounts = All counts unless demonstrate contribution
Real Estate, Stocks and Mutual Funds = valued in proportion to ownership
For Bank Accounts = All counts unless demonstrate contribution
Real Estate, Stocks and Mutual Funds = valued in proportion to ownership
Слайд 16Valuing Countable Assets
Retirement Funds and Annuities
If the owner can make a
withdraw, the value is the amount that can be withdrawn, reduced by any withdrawal penalty (but not reduced for taxes owing).
Annuity in pay status or pension that pay monthly benefit (with no right of withdrawal) in treated as income.
Annuity in pay status or pension that pay monthly benefit (with no right of withdrawal) in treated as income.
Слайд 17EXTRA EXEMPTION
FOR “COMMUNITY” SPOUSE
OF REMAINING ASSETS, SPOUSE IS ENTITLED TO KEEP:
½
THE COUNTABLE ASSETS
UP TO A MAXIMUM OF $117,240
**UNLESS A HIGHER AMOUNT IS ESTABLISHED BY THE COURT**
UP TO A MAXIMUM OF $117,240
**UNLESS A HIGHER AMOUNT IS ESTABLISHED BY THE COURT**
Слайд 18EXAMPLE: Mr. Brown is entering a long term care facility. Mr.
and Mrs. Brown own the following assets:
HOME ($180,000)
ONE CAR
PERSONAL PROPERTY
PRE-PAID FUNERAL
$100,000 cd (Mr. Brown)
$20,000 savings (Mrs. Brown)
$35,000 CDs (joint)
$7,000 checking (joint)
Слайд 19IF MR. BROWN APPLIED FOR MEDICAID:
MR. BROWN COULD KEEP $2,000
MRS. BROWN
(THE COMMUNITY SPOUSE) COULD KEEP:
THE HOUSE
THE CAR
THE PREPAID FUNERAL
PERSONAL PROPERTY
$80,000 IN CASH
THE HOUSE
THE CAR
THE PREPAID FUNERAL
PERSONAL PROPERTY
$80,000 IN CASH
Слайд 20WHAT ABOUT INCOME?
MR. BROWN GETS TO KEEP $60.00 PER MONTH
IF
MR. BROWN WERE SINGLE, THE REMAINDER OF HIS INCOME WOULD GO TO THE NURSING HOME BILL
MRS. BROWN GETS TO KEEP ALL OF HER INCOME
PLUS, ENOUGH OF MR. BROWN’S INCOME TO PAY HER MONTHLY BILLS (APPOX. $1,500 - $2,500 PER MONTH)
Слайд 22WHAT ABOUT THE REMAINING $80,000 THE BROWNS OWN?
THEY COULD SPEND IT
ON THE NURSING HOME (APPROX. 1 YEAR)
OR THEY MIGHT BE TEMPTED TO GIFT THE MONEY TO RELATIVES…..
OR THEY MIGHT BE TEMPTED TO GIFT THE MONEY TO RELATIVES…..
Слайд 23MEDICAID PENALIZES GIFTS
ON MEDICAID APPLICATION, ASKED IF MEDICAID APPLICANT HAS GIVEN
AWAY ASSETS IN LAST 60 MONTHS
FOR TRANSFERS BEFORE FEBRUARY 8, 2006, ONLY ASKED ABOUT LAST 36 MONTHS
IF YES, APPLICANT PENALIZED FOR AMOUNT OF TIME GIFTED MONEY COULD HAVE PAID FOR NURSING HOME STAY
GIFT AMOUNT / $7,867 = Penalty Time
FOR TRANSFERS BEFORE FEBRUARY 8, 2006, ONLY ASKED ABOUT LAST 36 MONTHS
IF YES, APPLICANT PENALIZED FOR AMOUNT OF TIME GIFTED MONEY COULD HAVE PAID FOR NURSING HOME STAY
GIFT AMOUNT / $7,867 = Penalty Time
Слайд 24IF MR. BROWN GIFTS REMAINING $80,000 TO CHILD
AND MR. BROWN APPLIES
FOR MEDICAID WITHIN 60 MONTHS OF GIFT
$80,000 / $7,867 = 10.2 MONTH PENALTY
RESULT: MR. BROWN WILL NEED TO GET THE MONEY BACK TO PAY FOR NURSING HOME STAY!
$80,000 / $7,867 = 10.2 MONTH PENALTY
RESULT: MR. BROWN WILL NEED TO GET THE MONEY BACK TO PAY FOR NURSING HOME STAY!
Слайд 25SO WHAT IS LEFT FOR CLIENTS TO DO?
FOR A SINGLE CLIENT
CONVERSION:
Transfer countable assets to an exempt asset.
EX: Purchase a pre-paid funeral.
TRANSFER TO DISABLED CHILD:
A transfer to a *disabled individual* is not a “divestment.” **interestingly, MI does not distinguish between child and individual**
EX: Purchase a pre-paid funeral.
TRANSFER TO DISABLED CHILD:
A transfer to a *disabled individual* is not a “divestment.” **interestingly, MI does not distinguish between child and individual**
Слайд 26FOR A SINGLE CLIENT
“HALF-A-LOAF” METHOD
GIFT APPROXIMATELY 60% OF ASSETS
REMAINING 40% USED
TO COVER THE PENALTY PERIOD
EX: MR. X HAS $100,000 IN COUNTABLE ASSETS. WE HELP HIM GIFT $60,000 AND USE $40,000 TO COVER THE 8.5 MONTH PENALTY PERIOD.
EX: MR. X HAS $100,000 IN COUNTABLE ASSETS. WE HELP HIM GIFT $60,000 AND USE $40,000 TO COVER THE 8.5 MONTH PENALTY PERIOD.
Слайд 27FOR MARRIED CLIENT
TAKE ADVANTAGE OF FULL COMMUNITY SPOUSE ALLOWANCE (1/2 OF
COUNTABLE ASSETS)
WE THEN DRAFT AN “IRREVOCABLE ANNUITY TRUST” TO HOLD REMAINING ASSETS FOR SPOUSE
TRUST PAYS OUT REMAINING FUNDS TO SPOUSE BASED ON LIFE EXPECTANCY
WE THEN DRAFT AN “IRREVOCABLE ANNUITY TRUST” TO HOLD REMAINING ASSETS FOR SPOUSE
TRUST PAYS OUT REMAINING FUNDS TO SPOUSE BASED ON LIFE EXPECTANCY
Слайд 29EXAMPLE: Mr. Brown is entering a long term care facility. Mr.
and Mrs. Brown own the following assets:
HOME ($180,000)
ONE CAR
PERSONAL PROPERTY
PRE-PAID FUNERAL
$100,000 cd (Mr. Brown)
$20,000 savings (Mrs. Brown)
$35,000 CDs (Jointly)
$7,000 checking (Jointly)
Слайд 30Mr. Brown is Medicaid Eligible
MR. BROWN
GETS TO KEEP $2,000
$60 PER
MONTH OF HIS INCOME FOR MISCELLANEOUS
Слайд 31MRS. BROWN
HOUSE, CAR, PRE-PAID FUNERAL AND PERSONAL PROPERTY
COMMUNITY SPOUSE ALLOWANCE (1/2
COUNTABLE ASSETS) $80,000***
REMAINING $80,000 IN IRREVOCABLE TRUST PAID TO HER ANNUITY STYLE
ALL OF HER INCOME, PLUS ENOUGH OF MR. BROWN’S INCOME TO PAY MONTHLY BILLS
REMAINING $80,000 IN IRREVOCABLE TRUST PAID TO HER ANNUITY STYLE
ALL OF HER INCOME, PLUS ENOUGH OF MR. BROWN’S INCOME TO PAY MONTHLY BILLS
Слайд 32POST PLANNING IS KEY FOR MRS. BROWN…
HER ESTATE PLAN NEEDS TO
SUPPORT MR. BROWN’S CONTINUED MEDICAID ELIGIBILITY
Community Spouse Trust
Testamentary Trust
Community Spouse Trust
Testamentary Trust
Слайд 33Estate Recovery
Only applies to:
Persons on Medicaid in Nursing Homes or receiving
care through long term care programs including:
MI Choice Waiver Services
Home Help
Home Health
PACE
Over the age of 55
MI Choice Waiver Services
Home Help
Home Health
PACE
Over the age of 55
Слайд 34Estate Recovery
Normally talking about the house, as that is typically the
only asset of significant value owned by a Medicaid beneficiary
Слайд 35Estate Recovery
Every state is different.
2007 Michigan law provides favorable exceptions:
Only applies
to “probate assets”
Exclude 50% of average value of home in the county.
Spouse or disabled child residing in home delays implementation.
Caregiver relative residing in home delays implementation.
Exclude 50% of average value of home in the county.
Spouse or disabled child residing in home delays implementation.
Caregiver relative residing in home delays implementation.
Слайд 36What We Do
Avoid probate by using ladybird deeds and other non-probate
arrangements.
Transfer homes to disabled or caregiver children where possible.
Where no estate, provide minimal information and return questionnaire with death certificate and cover letter.
Where there is an estate, complete questionnaire with nominal information (sign it? not required).
Disallow the claim when filed.
Transfer homes to disabled or caregiver children where possible.
Where no estate, provide minimal information and return questionnaire with death certificate and cover letter.
Where there is an estate, complete questionnaire with nominal information (sign it? not required).
Disallow the claim when filed.
Слайд 37Two Powerhouse Methods
You Can Do NOW
Power of Attorney with Extraordinary Powers
Authority
to make gifts
Authority to create trusts
Community Spouse Estate Planning
Nursing home spouse should not be beneficiary
Create testamentary trust to care for NH spouse
Authority to create trusts
Community Spouse Estate Planning
Nursing home spouse should not be beneficiary
Create testamentary trust to care for NH spouse
Слайд 38IF YOU HAVE A NURSING HOME ISSUE….
ROBERT J. LONGSTREET
GEE & LONGSTREET,
LLP
269-945-3495
607 N. BROADWAY
HASTINGS
rlongstreet@geelongstreetlaw.com
www.longstreetlegalservices.com
269-945-3495
607 N. BROADWAY
HASTINGS
rlongstreet@geelongstreetlaw.com
www.longstreetlegalservices.com
LongstreetElderLaw.com
(269) 945-3495
