Government Programs for Seniors

Current inflationary pressures are leading to financial insecurity for many US seniors. Besides reducing unnecessary expenses, many retirees or near-retirees should consider contacting the government to see if they qualify for assistance and reduce the anxiety many Americans feel living on a fixed income.

The National Council on Aging (NCOA) works with thousands of national and local partners to provide tools, resources, advocacy, and best practices for every aging American to have health and financial security. Checking out if you qualify for senior benefits through government programs is easy to do with NCOA’s online BenefitsCheckUp tool.

Wasted Benefits

Every year billions of available dollars in US benefits programs are not claimed because older adults (55 or more) are unsure if they are eligible and, if so, how to apply. No registration is necessary, and requests for information are minimal. Personal data entered into the website will remain confidential, and accessing the database costs nothing. If you hate filling out forms and get confused by all the questions, estate planning and elder law attorneys go through this process every day. Contact them for help. There is rarely an upfront cost for legal help, and you will be in a much better financial position once you begin receiving assistance.

The Online Benefits Check Up

If you complete the benefits check-up online, NCOA will send a confidential report to your mailing address listing the help available to you and how to apply for it. Since 2001 this NCOA program has helped millions of older adults receive help paying for medicine, food, utilities, and more. More than 2,000 benefits programs are in the check-up system, including categories such as:

  • Food and nutrition
  • Health care and medication
  • Housing and utilities
  • Income
  • In-home care and aging in place
  • Disability services
  • Skilled nursing facilities and other long-term care environments
  • Tax help
  • Legal, crisis, and general assistance
  • Veterans’ programs
  • Discounts and activities

The online BenefitsCheckUp site helps older individuals identify the federal and state assistance programs for which they can qualify. This NCOA website is newly revamped and permits error corrections and the addition of information if you feel the need to revise your answers. The resulting online individualized Eligibility Results report can be saved in a PDF format to email to yourself, your lawyer, or a trusted family member.

Providing this eligibility information to your elder law or estate planning attorney is a smart strategy. Suppose you already receive disability benefits through SSDI, SSI, or other programs. In that case, adding other government assistance programs may result in unintended and negative consequences that may render you ineligible for benefits you already receive. Your lawyer will know the strategies already in place and how additional programs may affect your current planning.

The chart above shows how many older adults struggled to manage basic expenses even before the inflationary circumstances of late 2021 – 2022 (and predicted beyond). Participation rates in government assistance programs are at a historic low, with a mere low to mid sixty percent of eligible individuals participating.

Benefit take-up rates are low due to program enrollment barriers. Many older adults lack awareness that these benefits exist, and when they do, the application process for many programs can be cumbersome and complex. Additionally, perceived stigma about receiving government assistance and other program misconceptions contribute to lower participation rates.

Ramsey Alwin, NCOA CEO and President, admits, “In today’s economy, inflation is taking a bigger and bigger bite out of people’s incomes.” He adds, “We completely redesigned BenefitsCheckUp to make it even easier … no one should have to choose between paying for medications or food.”

To worry less and age better with more resources at your disposal, explore the NCOA’s BenefitsCheckUp website and learn what is available to you. Before you use the contact information to take the next step to apply, be certain to consult with your elder law or estate planning attorney. All assistance you receive should not interfere with existing plans and help you age successfully. More than 2,000 government benefits programs are available to help you, and it can make the difference between thriving or just surviving. For assistance, please contact our Ruston, LA office by calling us at (318) 255-1760.

Helping Seniors Avoid Loneliness

Our goal is to live a long and healthy life. Senior citizens are admired for their wisdom and knowledge. However, their long life often comes with the grief of outliving their spouses, friends, and sometimes their children. If they can’t maintain and make new meaningful connections as they age, they are at risk for crippling loneliness.

Loneliness is feeling sad about a lack of human connections and interactions. While social isolation may make most people feel lonely, loneliness is not the same as being alone. Not everyone who lives alone feels lonely, and not all people who feel lonely live alone. People of any age may feel lonely, but the condition is especially common in the elderly.

Risks Factors for Loneliness among Seniors

Studies from the University of California San Francisco show that loneliness among senior citizens is pervasive and contributes to poor health and even death. The Center for Disease Control and Campaign to End Loneliness outline several risk factors for people 65 and over.

These risk factors include:

  • Being an immigrant who lost touch with loved ones from their home country
  • Feeling marginalized by the wider community
  • Living alone
  • Being physically limited by illness or disability
  • Lacking the financial means to do activities or visit others
  • Grieving the loss of a loved one
  • Not having meaningful outlets for their talents
  • Being a full-time caregiver
  • Struggling with incontinence
  • Lacking the ability to drive or take public transportation
  • Having a communication barrier from language, loss of hearing, or inability to talk
  • Feeling depressed or anxious and lacking the motivation to join activities

Overcoming Loneliness with Meaningful Social Engagement

The first step to overcoming loneliness is acknowledging it and a need to change some habits. If you are the one experiencing loneliness, think about small ways you can start connecting again. Even the smallest positive change might put you on the right path for reaching out more and more. If a spouse or loved one is feeling lonely, you might invite them to join you in some of these activities to get the ball rolling. Look for opportunities to talk, laugh, cry, and share in the following ways:

  • Join a club, class, or religious institution to get to know people with similar values and interests—if you can’t drive, look into ridesharing, public transportation, and online groups
  • Invite one or two friends over to share a meal, watch a movie, or play cards
  • Try an exercise class geared toward senior citizens
  • Call or visit a family member or friend
  • Volunteer your time and talents at a school, animal shelter, or place of worship
  • Get a job that you enjoy to interact more with others

Remember that everyone needs physical contact too. Don’t be shy about asking for a hug. Consider getting a cat or dog to satisfy that need.

You might also need to consider changing your living arrangements to make interactions easier. Even the most loving family members will not be able to visit as often as you would like if you live far away. Some seniors love residential programs with communal dining, planned outings, and frequent activities. Others prefer living with a family member or in a senior citizen community where everyone has their own homes. With a little research and keeping an open mind, you might find that changing your home is the best thing you can do to meet new friends and stay engaged. For assistance, please contact our Ruston, LA office by calling us at (318) 255-1760.

Nursing Home Questions to Protect Loved Ones

A nursing home advocate plays a vital role in ensuring the well-being of your loved one. Residents in nursing homes and other long-term care facilities are disproportionately affected by the flu, pneumonia, COVID 19, and other contagious diseases. According to the American Family Physician Journal, a flu outbreak in a nursing home often affects 20 percent or more of the residents.

If you have a loved one in a nursing home or other long-term care facility, AARP has identified some specific questions to ask about the facility to help ensure the safety of your family member.

Inquire About Vaccinations:

  • What proportion of staff and residents are up to date on regular vaccinations? Compare these vaccination rates at any Medicare-certified nursing home to the state and national averages.
  • How is the facility educating staff and residents regarding the vaccine’s safety and effectiveness?
  • What type of access to vaccines do residents have?

Ask if Anyone at the Facility Has Tested Positive for any Infectious Disease Recently:

  • Include staff, residents, visitors, vendors, maintenance workers, and anyone with access to the facility.
  • How many people, if any, have tested positive?
  • What is the facility testing protocol for symptomatic individuals?

Understand the Steps is the Facility Taking to Prevent Outbreaks of Disease:

  • What are the screening protocols for staff and other people entering the facility?
  • How are positive cases being handled after identification? Do staff quarantine at home? Do residents move into isolation units?
  • What are the protocols for sanitizing the facility, and how often are they implemented?
  • Are there social distancing measures in place? What are the precautions for residents with roommates?

Find out if the Nursing Home Helps Residents Stay in Contact with their Families and Other Loved Ones:

  • What are the infection control measures for visitors?
  • Does nursing home staff help residents call their loved ones via phone or video?
  • Will the facility set up a regular schedule for residents to speak with family and loved ones?

Determine if the Facility Regularly Communicates Important Information to Residents and Their Loved Ones:

  • If there is an outbreak of an infectious disease within the facility, how long will it take to notify residents and their families or representatives?
  • How is the information shared?

Know if the Nursing Home is Fully Staffed with Doctors, Nurses, Aides, and Other Workers:

  • In the event of staffing shortages, what are the backup plans to ensure the needs of nursing home residents are met? The plan should include bathing, feeding, physical therapy, medication management, and social engagement.

Ask About the Maintenance of Healthy-Living Programs:

  • Are communal activities adapted for social distancing in exercising, entertainment, and socialization?
  • Are any services suspended, and if so, which ones?

If you have a spouse, parent, sibling, or other loved one living in a nursing home, they depend on you to advocate for their protection and wellbeing. Asking the right questions helps ensure that their nursing home facility or long-term care services prioritize their health.

For assistance, please contact our Ruston, LA office by calling us at (318) 255-1760.

Work After Retirement: Making a Decision

You may find that commonly the business owner or service provider at a podiatrist or shoe repair business is over the age of 55. You are witnessing what the statistics show. Older workers dominate some professions. In addition, more Americans are working more years across industrial sectors. The Bureau of Labor Statistics reports that the percentage of Americans working after age 65 has been increasing for decades.

Reasons Seniors Work Longer

As people live longer and often healthier lives than in previous eras, it makes sense that people are staying in the workforce longer. Senior Living says that many people work for as long as possible because it keeps them active, feeling purposeful, and engaged in the community. Others work for financial reasons. Perhaps they don’t receive Social Security benefits, or the benefits are insufficient to cover their needs. Many people work to stay enrolled in a group healthcare plan. And still, other older Americans realize late in life that they want a different career that fulfills them in a way their previous job did not. They may even go back to school or get new training.

How Seniors Contribute to the Labor Market

Workplaces benefit from diverse perspectives. Years of experience give older workers a depth of knowledge and understanding that may help them spot potential challenges and see solutions that younger people might miss. As their motivations for working may not be to climb the corporate ladder as much as younger workers, they may be able to call out problems without fear of those actions hurting their advancement. They often have fewer family responsibilities. They might be able to relocate and accept positions with more travel or less monetary compensation than those who are balancing raising a family with their career. Finally, they help fill pipeline gaps in certain professions, like teaching, caregiving, and medicine.

Government Response to Hiring Practices with Ageism

Unfortunately, some employers have biases against older workers. They may think that older workers lack energy, can’t keep up with workplace technological advances, or take too many sick days. Also, positions requiring extensive and expensive training, like flying a newer model jet, can make hiring older people who may retire in a few years a poor return on investment. Of course, all of these challenges could be true of individuals in any age category, but ageism is still a major hurdle to employment for many older Americans.

To combat workplace ageism, the Age Discrimination Workforce Act of 1967 prohibits employers from discriminating based on age. The bill’s aim is still relevant and helpful, but some details and support systems are outdated. There is bipartisan support to update it, but as of July 2022, the bill has not passed the senate.

Additionally, the head of the National Council on Aging wants the Department of Labor (DOL) to establish an “Older Workers Bureau.” The bureau would operate within the labor department to “look holistically at older worker issues across the federal government” and “identify and coordinate existing federal resources, identify and work to eliminate barriers to working longer, and disseminate promising employment and training practices.” Ramsey Alwin, president and CEO of the National Council on Aging (NCOA), discusses the new bureau and the need for federal resources to promote public-private partnerships.

Making the Decision that Works for You

Many people choose to retire based on age and experience milestones for Social Security benefits, pensions, 401k withdrawals, and Medicare eligibility. Each of these has implications for your lifestyle and estate planning. An estate planning attorney or elder law attorney helps older Americans figure out how to plan to meet their needs and desires in a confidential and caring atmosphere. If you or a loved one would like to discuss when, if ever, is the right time to retire, please give us a call.

For assistance, please contact our Ruston, LA office by calling us at (318) 255-1760.

SSI and SSDI Claims Rejection

Before spending time and effort on federal Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) applications, you should review some of the major disqualifiers. Eligible individuals can benefit from both programs though they have distinct differences. The major difference is SSI eligibility qualification relies on age, disability, and limited resources and income, while SSDI eligibility determination relies on disability and work credits. In most states, SSI recipients automatically qualify for Medicaid health care coverage, which could result in additional supplementary benefits through your state’s Medicaid program. However, both programs have some common reasons that can disqualify your claim.

Typically most people think about the reasons they should receive benefits without ever considering why they may be denied. Some of the reasons are beyond your control, while other reasons are missteps you can avoid that result in denial. Things to consider include:

Your Income Earnings are Too High

In the case of SSI, the disability benefit for low-income individuals, you cannot exceed the substantial gainful activity (SGA) threshold. However, it is permissible to earn more money after your approval. Still, there is a limit of about $1,600 a month on all earned and unearned income for SSI. This dollar amount applies to both application for and collection of benefits. Any time your monthly income exceeds $85, your SSI payment will receive a reduction based on a complex formula. Anything over $1650 per month, and you will no longer qualify.

When you apply for SSDI (the benefits program for workers who paid into the Social Security tax base over multiple years), your claim may be denied if you work above the threshold considered substantial gainful activity. Going over this amount means you earn too much money to be considered disabled. It is permissible to earn a small amount during your application and collecting of SSDI but not over the SGA limit. This limit (for non-blind individuals) was $1310 per month in 2021, and the figure is adjusted annually. It is worth noting income from investments does not count toward the SGA; only work income determines your ability to work.

Your Disability is Not Considered Severe or Won’t Last Long Enough

Qualification for both SSI and SSDI benefits means the Social Security Administration (SSA) must believe your impairment is severe enough to continue for at least 12 months or result in your death. Blind SSI applicants are the only exception to the duration requirement.

Many claims based on bone fractures resulting from acute trauma from accidents are commonly denied since the disability is unlikely to last 12 months. Nearly all bone fractures heal in under a year. If your bone fractures are severe enough and have not healed after six months, you may resubmit your claim as the SSA will likely believe your impairment will last a year. Each case receives an individual evaluation.

If your medical condition is not trauma-related, it must still cause severe limitations of disability to qualify for SSI or SSDI. Most denied claims are due to the applicant’s impairment not being severe enough. You can learn about the disability determination for benefit claims here.

The Social Security Administration Can’t Reach You

Both the SSA and Disability Determination Services (DDS) agencies need to be able to communicate with you regarding your application. If they cannot reach you, schedule examinations, appointments, or communicate about critical matters, you will likely be denied benefits. Every day claimants are denied because the SSA cannot locate them. If you opt to name a representative (such as a disability lawyer) to handle your application, you may not have to contact the SSA. However, you most certainly must maintain contact with your disability attorney.

Your Refusal to Cooperate

The SSA requires medical information about your impairment, and if you refuse to release these records, your claim of disability will likely be denied. If you provide medical records, but the SSA deems them incomplete, or you lack a regular doctor for treatment, they will schedule a consultative examination (CE) with an SSA doctor. Refusal to accept this exam(s) and requesting a determination of eligibility be based on existing medical records may be cause for denial due to inadequate medical data or failure to comply with a CE. Your attorney also helps you gather the correct medical information according to the requirements.

Your Failure to Follow Prescribed Therapy

If you receive medical treatment, failure to adhere to the doctor’s prescribed therapy when you are able to may cause a denial of disability benefits. Some acceptable medical excuses include:

  • The severity of your mental illness precludes your ability to comply with the prescribed therapy.
  • You elicit intense fears regarding surgery, making the procedure inappropriate. Your treating doctor will confirm the severity of your fears to the consulting DDS doctor.
  • You are physically unable to follow the prescribed therapy without assistance due to paralysis, cataracts, or other physical limitation.

Some acceptable non-medical excuses include:

  • You lack the money to pay for the treatment.
  • You have religious beliefs that prohibit receiving the proposed medical therapy.
  • Your doctor prescribes a treatment with which a second opinion doctor disagrees.
  • The proposed therapy will not result in the restoration of your ability to do substantial gainful activity.

Your attorney can review the details of your situation to see if any exclusions apply and collect the necessary documentation.

Your Disability is a Result of a Drug Addiction or Alcoholism (DAA)

If a contributing factor to your disability is DAA, the SSA will deny your claim for benefits. The DDS medical consultant will determine whether you would still be disabled if you ceased using drugs or alcohol. You can read more about DAA determining factors here.

You have a Criminal Conviction

Certain conditions relating to criminal conviction or imprisonment will prevent approval of SSDI.

  • You are in prison after your felony conviction without a court-approved rehabilitation program likely to result in employment upon release. That release expectation is within a reasonable amount of time.
  • You received an injury while committing a felony and are convicted of the crime. The resulting impairment, or worsening of an existing one, suffered during a felony crime is ineligible to use as a basis for disability benefits.
  • You became injured while in prison. The resulting impairment, or worsening of an existing one, suffered while incarcerated can’t be used to get benefits. However, you can likely receive benefits after your prison release.

If these conditions apply to your situation, it is still worth the effort to apply for SSDI benefits. Although you will not receive cash benefits, you may still be granted a benefit-free disability period that freezes your earnings record, preventing the decrease of eventual disability, retirement, or dependents benefits. Talk to a disability attorney if your claim is complicated by these circumstances.

The above conditions do not prevent your receiving SSI disability benefits, although you will be unable to collect them while incarcerated.

You Commit Fraud

Always apply for disability benefits honestly. If you receive them by dishonest means, the SSA may terminate your benefits and choose to prosecute you for fraud. Benefits obtained through fraudulent methods by your representative or someone working for the SSA also may cause the termination of your benefits.

These common reasons stop you from legally obtaining SSI and SSDI benefits. Before you become too involved in applying, be certain you meet the minimum standards for approval. A disability lawyer can help you sort out any issues, avoid missteps, and properly present your case for disability approval.

For assistance, please contact our Ruston, LA office by calling us at (318) 255-1760.

Achieving Advanced Directives Requires Critical Conversations

It is among the most difficult challenges we will ever have to confront in life to consider our own death. Yet it is very important to think carefully about the medical treatment we would want for that challenging time. Medical technology can now keep us alive long after we have ceased to enjoy meaningful quality of life.

A series of legal rulings around thirty years ago established the rights of patients to decide when life support should be stopped. The fear of being kept alive indefinitely by artificial means led many to create legal documents known as advance directives.  An advance directive expresses our wishes about the kind of medical treatment we would prefer. It is called “advance,” meaning ahead of time; and “directive,” meaning our directions for whether we want medical providers to keep us alive at all costs, or whether we would prefer to pass naturally when life becomes no longer meaningful. It is wise to think about this, and to create such a document, well before we are facing the end.

After thirty years, concerns have now shifted to assess whether advance directives really do serve the purpose for which they are intended. Do advance directives really ensure that we receive the treatment we would like?

The short answer is “yes but.”

Yes because it is just as important now to create a legal document by which to appoint a person to help communicate our wishes. The “but” part comes in with the issues raised below.

The answer to these issues is the same as it has always been: to establish a close relationship with one or two people – called “agents” or “proxies” – whom patients appoint to step in when patients can no longer make health-care decisions for themselves. Patients must talk with their agents so the agents will know, in as much depth as possible, where the patient stands on end-of-life questions.

Over the years, we have learned that advance directives might not work as well as they could. Here are concerns that have emerged:

➢        It is unrealistic to micro-manage health care in advance. There are so many variables that depend on the particular situation. Treating a complicated illness has been likened to a jigsaw puzzle, where each puzzle piece could fit multiple other pieces; the right fit for each piece must be arrived-at, often by a team of various specialists who sort through the pieces and collaborate in assembling the picture. Under those circumstances, it can be difficult, if not impossible, to interpret a legal document that was intended to guide detailed medical treatment for as-yet-unknown conditions.

➢        The “check-the-boxes” approach taken by many “fill-in-the-blank” forms is too crude to be helpful in any but the most general of ways. Without additional detail, these documents don’t adequately address the nuances that almost always arise.

➢        Change is constant and humans are adaptable. It is one thing to imagine, when in good health, that life would not be worth living if, say, one became permanently bedridden. But when the patient is actually in that situation, new meaning in life could emerge. Choices made years in the past might look a lot different in the moment of truth.

➢        The prognosis can change with time. As reported in Kaiser Health News,

if a senior contracted COVID-19 early in the pandemic, and her advance directive stated that she did not want to be placed on a ventilator, doctors tended to assume that the virus was universally fatal to such seniors. Some never got the care that could have saved their lives.

➢        The documents must be readily available, both at patients’ homes and in agents’ hands too. They must not be hidden away and forgotten-about, so no one can locate them when they are needed.

The best alternative is to create an effective, current, and available legal document backed up by serious talk between the patient and the agent or proxy. A document that meets legal requirements is essential, but beyond that: conversation in advance is the crucial additional element.

That conversation should occur first between the patient and their agent or proxy, in which they discuss quality of life issues and what matters most to the patient. The talk should avoid excessive detail for hypothetical situations that may never arise. Rather, the aim should be to provide the agents or proxies with enough information to be able to respond flexibly to unforeseen circumstances.

These conversations can be challenging. Helpful resources to assist can be found at The Conversation Project (https://theconversationproject.org) or the Centers for Disease Control and Prevention (https://www.cdc.gov/aging/pdf/acp-resources-public.pdf).

Then, if the time comes when the patient is unable to speak or make decisions, the agent will be best equipped to convey the patient’s wishes to medical providers. Knowing those wishes in advance, the agent can focus on ensuring that providers furnish as much information as possible to make the hard decisions on the facts as they presently exist.

What if you are alone and without a person whom you trust to be your agent? First, study the guidance resources provided in this article. Then call us to create a legally effective advance directive document that spells out your wishes. And the final step would be to schedule an appointment with your doctor to discuss your wishes. Give him or her a copy of your document.

Again, all must make sure that doctors and agents have copies ready for use. And everyone should also carry a wallet card to inform health-care providers whom to call in case of an emergency. Print one here,

https://www.aha.org/system/files/2018-01/piiw-walletcard.pdf

provided by the American Hospital Association.

There are no assurances in this life, except that it will end for us all. The hope is that we will have delegated people whom we trust to step in when we need them – and that we will have talked with them about the kind of care we want to prepare for a passing that is as peaceful and merciful as it can be.

Contact our Ruston, LA office by calling us at (318) 255-1760 we are happy to help.

 

A Nursing Home can be Covered by Medicaid

Remember Medicaid planning doesn’t simply mean meeting strict income and asset limits to qualify for long-term care insurance. You will also need to demonstrate you need the level of care typically provided in a nursing home setting. These health eligibility rules are valid if you apply for nursing home coverage or a Medicaid waiver program for coverage in your home. Each state has a level of care requirement and its own criteria to determine if you meet the mandated level of care. It can get complicated because eligibility criteria are not always clear.

Determining the level of care necessity usually includes:

  • The need for two or more activities of daily living constitutes bathing, toileting, dressing, eating, and mobility.
  • You require frequent medical care, like IVs or other injections, medications, or other medical treatment.
  • You exhibit behavioral problems such as aggressiveness or wandering away from home.
  • Alzheimer’s disease or another form of dementia impairs your cognitive ability; making decisions on your own is problematic, or you cannot correctly process information.

The state evaluates the assessment of a Medicaid applicant and, in many cases, will require a doctor’s diagnosis. The assessment generally requires the applicant to answer a series of questions about their abilities to perform activities of daily living and any behavioral issues or cognitive problems. There are further questions regarding the applicant’s family and their ability to provide support.

Understanding Medical Services Covered by Medicare

Medicare still covers the medical services you may need beyond nursing care along with institutional Medicaid. If you need to see a specialist or go to a doctor’s office, Medicare pays first, and Medicaid will cover your remaining costs like copayments, coinsurances, and deductibles. When applying for institutional Medicaid, consider the following:

  • The program considers you and your spouse together when counting assets and income. Typically, you can set aside a certain amount of assets and income to protect your spouse’s standard of living. This spousal amount does not count when applying for Medicaid.
  • You will still be able to keep a small amount of income for your allowance even though you qualify. The amount varies by state, and your local Medicaid office can provide more information. The remainder of your income will pay the nursing home.
  • There is a look-back period of up to five years for institutional Medicaid in most states. When determining your eligibility, your state will count any assets you have transferred in the past five years. If Medicaid determines any transfers violate the Medicaid eligibility rules, you may be penalized. Medicaid may opt to pay only a portion of your nursing home stay or none at all.
  • Owning your own home affects Medicaid eligibility and coverage. An elder law attorney can characterize your specific circumstances and how the equity in your home may count as an asset. When long-term care is no longer necessary, or you are deceased, these assets may repay Medicaid for your care coverage.

Nursing home level of care, also known as nursing facility level of care (NFLOC), Is not an easily definable term as there is no formal federal definition. Each state has the task of defining the term, and rules are not always consistent from one state to the other. Generally, there are four areas of concern, though not every state considers all four; physical functional ability, medical needs/health issues, cognitive impairment, and behavioral problems.

For those families with a loved one who requires more care than they can provide at home but do not require a high enough level of care to qualify for nursing home admittance, there is an in-between care type typically provided in assisted living. However, Medicaid coverage of this type of assisted living is very limited in numbers.

Nursing homes are experiencing very limited capacity, and waitlists can be years. Medicaid is adapting to provide this coverage type in-home to those applicants who may meet NFLOC Medicaid eligibility requirements but not pose a danger to themselves or others in a home environment. Perhaps using this as a springboard as a potential nursing home residence is waitlisted for full-time care.

Before applying to become eligible for Medicaid nursing home coverage, there is much to consider. Applications that are insufficient or incorrectly filed can create delays, and with limited space available, it can be several years on a waiting list before admittance can take place.

The need is more significant than ever before for long-term care in a nursing home. Meeting your state’s eligibility requirements can be a long and complex series of providing documents, answering questionnaires, having assessments and reviews, and filling out and filing forms. The scope of the project can be overwhelming. To get to your best outcome, don’t wait. Contact our Ruston, LA office today at (318) 255-1760. Proactive planning with an elder law attorney will help you understand and address all criteria you need to act on to succeed.

 

Choosing a Long-Term Care Option for 2022

It’s more crucial than ever to take stock of your life and your healthcare planning at the start of a new year. Americans continue responding to the ever-present threat of COVID-19 in its many iterations, and we are identifying that which is most important in our lives to preserve our health and financial future best.

For many, the mere mention of long-term care health insurance congers up images of twilight years seemingly far removed from our daily lives. However, the reality is that you may find yourself in need of long-term care due to a sudden disease or illness or as the result of an accident. The US Department of Health and Human Services statistics currently show that about seventy percent of individuals over the age of 65 will require some long-term care during their lives. Genworth’s latest statistics show that a full thirty-seven percent of these long-term care recipients are, in fact, under sixty-five years of age.

Regardless of your age or cause, when long-term care becomes a requirement, it is important to know and plan for your options regarding funding the care you need, where and how you prefer to receive it. Your planning today can make a huge difference in your financial solvency and those caregivers (mostly family) who participate in the financial burden of your care.

Naturally, the best scenario is having prepared for the future by having healthy balances saved in your retirement programs and health savings accounts. If the funding is available to cover long-term care costs for yourself or a loved one, it is prudent to do so. Perhaps you can only make part of the funding happen, in which case you may have to ask loved ones for help. They may have the financial where with all to finish covering premium costs. Paying some out-of-pocket for an aging parent early on means less of a toll emotionally, physically, and financially, should a family member have to assume becoming a full-time caregiver.

The IRS considers long-term care insurance as a medical expense. As long as the policy is qualified, it is deductible. IRS rules state the policy must have been issued on or before January 1, 1997, and adhere to certain requirements. Policies purchased before this date may qualify to become grandfathered if the state’s insurance commissioner approves the selling of the policy. The IRS rules from 2021 to 2022 are little changed, most notably in age categories from sixty to seventy years old the IRS reduced the deduction by ten dollars.

Note these tax deductions are, for the most part, not available in hybrid policies. These policies combine life insurance and annuity policies with a long-term care benefit. Hybrid policies are becoming particularly popular because if long-term care is not a requirement, the individual’s heirs may receive a death benefit. Your medical expenses need not exceed a certain percentage of your income to be tax-deductible. As long as you earn a profit, you may take the amount of your long-term care insurance as a deductible.

Public programs are becoming more heavily leveraged for lower-income individuals to plan for long-term care services. There is nothing wrong with taking advantage of these programs; however, most Americans do not understand the differences between Medicare and Medicaid, what and who they fund, and for how long. The answers are complex as there are physical and financial thresholds to qualify for benefits, and these may vary from state to state. Here is a general overview of qualifications and limitations in coverage and choices of care facilities.

Sometimes referred to as Medicaid crisis planning, an elder law attorney can guide you through the process of sheltering some of your assets. Medicaid is a federal/state program helping low-income seniors with limited income and assets afford healthcare and long-term care. Many seniors believe their only option to qualify for the program is to “spend down” their assets. While this is true in some cases, proactive Medicaid planning can protect a substantial portion of your assets if done correctly.

The program’s eligibility rules are complicated, as is the application process, so it is best to navigate the process with a specialized Medicaid planning elder law attorney well before you need to tap the benefits. Always seek professional legal advice when creating your long-term care strategy using Medicaid. Applications are rarely successful as a do-it-yourself project, and mistakes can have devastating long-term consequences on a family and their finances.

Options for long-term care exist; however, finding the best solution for your financial circumstances is complex. As 2022 is before us, it behooves us all to look to the future of our healthcare and prioritize proactive planning, ensuring there will be a plan in place when we encounter the likelihood of a long-term care requirement. If you have questions or would like to discuss your personal situation, please contact our Ruston, LA office by calling us at (318) 255-1760.

 

Add to Your Estate Plan with Life Insurance

Grieving loved ones should not need to inherit assets only to find they are not accessible for cash expenditures they will be responsible for after you pass away. Most retirees’ assets are in homeownership and retirement accounts, requiring a sale to get cash. Life insurance can provide the liquidity needed when managing and distributing your estate assets. Your policies can address final expenses, estate taxes, business ownership, estate equalization, probate, and special purposes depending on your circumstances and the number of assets at hand.

Final Expenses

The average funeral cost in the US is nearly $8000 and somewhat less with cremation. The price becomes even greater when adding a burial plot, vault, or headstone. Even without a funeral service, cremation ranges between $1,000 and $10,000, depending on location, with the average around $4,000.

Some debts of the decedent will become part of the estate’s responsibility. These debts can reduce the remaining assets for your heirs, requiring a cash payout. Creditors may present the estate with outstanding bills and even litigate for payment.

State and federal final income taxes are a requirement. The government will seek payment of any back taxes in addition to those taxes owed in the year in which you die. Life insurance death benefits can help address these final expenses, helping meet the estate’s obligations.

Estate Taxes

The size of the estate affects the state and federal inheritance taxes that may be due. How much and at what rate is a shifting target of late. As thresholds change, so too should efficient tax planning for your legacy. Beneficiaries receive life insurance death benefits tax-free. With the right guidance, these proceeds can be used to offset inheritance taxes and avoid selling estate assets to cover tax obligations.

Business Ownership

If you own a business or are a co-owner, your passing may present substantial challenges for continuing the business, affecting family or business partners. Many start-ups and partnerships establish plans to address these eventualities, often in a buy-sell agreement. This contract outlines how a departing partner or founder’s business shares will be reassigned to other stakeholders or sold. Life insurance is often the financial product employed to fund such an agreement.

Estate Equalization

In the case of multiple heirs, assets often do not divide up easily or equally. For example, a vacation home worth $600,000 may be local and desirable to one heir, while the other two heirs live far away and have no interest in the property. To compensate those heirs who do not want to co-own the property, the heir wishing to retain the property must cash them out $200,000 each. This situation can quickly create a family rift.

As part of an estate plan, life insurance can fill the gap and equalize inheritance among heirs. In this case, one heir would get the property outright, while the other two would receive death benefit proceeds to compensate for their portion of the property value.

Probate Avoidance

Probate court oversees the settlement and distribution of a decedent’s assets. It can be a lengthy, involved, and expensive process even when a general estate plan and will are in place. Life insurance proceeds bypass probate when going to the named beneficiary.

Unlike a public probate process, the payment remains private and tax-free to the beneficiary. Be aware that life insurance death benefits may still be subject to estate tax if the insured had “incidents of ownership” when they died.

Special Purposes: Child Support, Divorce, and More

A life insurance policy earmarked for special purposes can address divorce obligations like child or spousal support. Death benefit proceeds may go to the continuation of support of a loved one like a minor child with special needs or an elderly family member.

Mainly these types of direct purpose policies are part of an established trust. Assets like life insurance policies are held in the trust on behalf of a beneficiary and under the supervision of a trustee to meet obligations providing long-range monetary support in a substantially funded trust.

Your estate planning attorney can identify which trust type will suit your needs. Personal circumstances and goals help define which trust will work best regarding probate, taxes, and more.

Life insurance death benefits can solve many liquidity problems that arise in the dissolution of an estate. These proceeds are typically not subject to income taxes and have uses as wide and varied as the circumstances and goals of the individual creating their estate plan. We can advise how to use life insurance properly to serve your beneficiaries. Please contact our Ruston, LA office by calling us at (318) 255-1760.

April: Parkinson’s Awareness Month

In the month of April each year, the global Parkinson’s community engages to support awareness of Parkinson’s disease (PD), a disease whose cause remains largely unknown although treatment options exist. The goal of raising awareness can help make lives better for people with Parkinson’s disease, generate ideas to improve care, educate, and fundraise to help advance research toward finding a cure.

Effectively, Parkinson’s is a disease where nerve cells that normally deliver the neurotransmitter dopamine to other cells experience a reduction in numbers. The more cell death spreads to larger areas of the brain, the greater the body is affected. Symptoms of Parkinson’s typically develop slowly throughout the years, with symptom progressions varying from person to person because of the diversity of the disease. The neurodegenerative disorder can manifest itself through tremors, bradykinesia (slowness of movement), limb rigidity, and gait and balance problems. Dopamine reduction can also produce nonmotor symptoms, often preceding a PD diagnosis. These symptoms can include REM sleep behavioral disorder, automatic dysfunction, depressions, visual impairment, attention deficit, reduced sense of smell, and difficulties planning and acting on ordinary tasks. Parkinson’s disease is not in itself fatal; however, disease complications can be serious.

The PD Foundation website has offerings by state. Local impact, education, and support are hallmarks of the foundation’s work. Individuals can plug in their zip code on the website Parkinson’s Foundation in your area for their closest PD chapter to become involved. Whether your interest is in exercise classes, therapy services, research trials, or caregiving support, visiting a local PD website in any state can point you in the direction you need.

California’s large and diverse population makes it an ideal state to study and expand our understanding of Parkinson’s disease. The state’s Department of Health has a chronic disease surveillance and research branch (CDSRB) that collects data to measure PD’s incidence and prevalence. This research brings awareness to the disease through the California Parkinson’s Disease Registry. Statistics about how the disease is distributed among different population groups and whether the disease patterns are changing over time may lead to insights about PD about which we know surprisingly little.

In 2021, about one million people live with Parkinson’s disease, with approximately 600,000 receiving a PD diagnosis each year, with men 1.5 times more likely to have Parkinson’s than women. Estimates are that direct and indirect costs of Parkinson’s, including treatment, lost income, and social security payments account for nearly 52 billion in US expenditure annually. Just the medication averages about 2,500 dollars per year, and the cost of therapeutic surgery can be upwards of 100,000 dollars per individual.

The terms incidence (new cases arising in a population over a given time) and prevalence (a measure of all individuals affected by the disease at a particular time) are often cited when discussing who suffers from Parkinson’s disease. Does prevalence vary by study, population group, and geography? Statistics generated by studying larger and more diverse populations can address these questions. Considering the last major prevalence study was in 1978, Parkinson’s disease studies are long overdue.

The statistics matter as the Parkinson’s Foundation continues to attract state and federal government and the pharmaceutical industry to address the urgent, growing need to understand and hopefully prevent PD. As a nation, we need to understand better who develops Parkinson’s and why. Much of the research focuses on ways to identify PD biomarkers, leading to earlier diagnosis and tailored treatments to slow down the disease process. While all current therapies can slow the process and improve symptoms, they do not slow or halt the disease progression. Idiopathic Parkinson’s disease progression tends to be variable and slow, making research all the more difficult, particularly when comorbidities are present.

On social media platforms and other online forums such as Facebook, Twitter, YouTube, Instagram, Reddit, Linkedin, WhatsApp, and more, #KnowMorePD for this April’s Parkinson’s Awareness theme helps to promote the foundation’s campaign cross-platform. The goal is to have conversations among loved ones, family, friends, neighbors, care teams, and the community will lead to more education, action, funding, and understanding of Parkinson’s disease.

If you or a loved one has been diagnosed with Parkinsons’ disease, there are a number of ways we can help. For example, we can create a comprehensive legal plan to make sure you or your loved one has the proper documents in place to cover care decisions, financial decisions, and what to do in the event of a disability. We welcome the opportunity to speak with you in a confidential setting to determine how we might help. Please contact our Ruston, LA office at (318) 255-1760 to schedule an appointment.