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VA Aid & Attendance--How Can I Correctly Choose Help?
One can consult with various people. The choice can mean the difference between success and failure. What you need to know to protect yourself!
 
A Survival Guide for Those Left Behind: The Price of a Loved Ones Dying...
What do you do when you find your spouse expired on the floor?
 
Estate Planning: The Price of Organization...
This report will guide you through the questions surrounding getting your estate planning in order.
 

Books Dealing with Estate
Planning, Trusts and Probate Law

Thoughts shared here do NOT constitute legal advice.

In Depth Elder Law Articles

We’re going to take a bit of a break from writing these frequent blogs.  You can keep up with the latest in our more in depth Elder Law Articles.  Thanks.

Posted in Elder Law |

DON’T GO BROKE IN A NURSING HOME!

We are holding workshops Jan 21 and Jan 23 at Shadowridge Country Club.  You can afford the best care without going broke!

Do You Know the VA’s & Medi-Cal’s Hidden Secrets for Obtaining Benefits?  

This workshop focuses on the two government benefit programs that can help in this area and their best kept secrets.  These programs can keep you from going broke.  The Veterans Administration Aid & Attendance Benefit (technically known as the Non Service Connected Disability Pension) and the California Medi-Cal program.    For more information.

Posted in Elder Law, Medi-Cal Benefits, Veteran's Benefits | Tagged , , , , , , |

Does Being Married Avoid Probate?

You may have heard that owning property jointly will avoid probate.  Probate is the court process of overseeing the distribution of your assets after your death.  It can be expensive and time-consuming compared to trust administration or beneficiary designation.  As a result, many people wish to avoid the process by naming their spouse or, in some cases, children, as joint owners of their assets.  However, such strategies have limitations that should be addressed with a knowledgeable attorney.

Common methods to avoid probate:  Community property often avoids probate.  But owning property as community property with your spouse  will not avoid probate if your spouse gifts his or her community interest in property to someone else.  (Community property law allows each spouse a fully vested right in his own 50% share of the asset; you might think of it as two individually owned halves rather than a jointly owned whole.  Joint tenancy also avoids probate.  But joint tenancy will not provide the same tax benefits as community property ownership, such as a full step-up in basis on the first spouse’s death.  Planning through a trust may accomplish all your goals by not only avoiding probate but defining each spouse’s post-death distributions, providing for the surviving spouse, and preserving more assets for beneficiaries.

Other ways to avoid probate:  If the surviving spouse is the beneficiary, he or she may qualify for an abbreviated probate process, known as a Spousal Property Petition.  This process is often faster and less expensive than a full, formal probate.  Alternatively, when property is owned in trust, the surviving spouse may simply notify the relevant institutions of the death of the spouse and assume his or her position as sole trustee, according to the provisions of the trust.  Although it is still important to consult an attorney following the first spouse’s death in order to determine whether any steps must be taken, including notifying beneficiaries of a trust that has become irrevocable and changing asset titles, the requirements are typically less than with a probate.

The biggest differences between using joint ownership as an estate planning strategy and completing a formal estate plan, however, occur before either spouse dies and after both spouses have died.  Estate planning can prevent conservatorship during life by providing for a smooth transition of financial and medical decisions if necessary.  Through a QMap Trust  or QVap Trust, you can optimize assets between the spouses if one spouse becomes ill and requires Medi-Cal or VA Aid & Attendance Non Service Connected Disability benefits.  Planning ahead can avoid driving the well spouse into poverty in order to meet stringent qualification requirements. As a result, the surviving spouse will retain more assets and, ultimately, more may be available to beneficiaries.

Additionally, joint ownership may defer probate until the surviving spouse’s death.  However, if the surviving spouse does not engage in estate planning or name a new joint owner, then probate will be necessary.  Continuing to name joint owners can create inequities among your beneficiaries or lead to bizarre results!  It is wise to consult with an attorney about your goals and the best way to achieve them before assuming that joint ownership will resolve your concerns!

Estate Planning: The Price of Organization, Rewards, Gifts, and Wondrous Tax Things… FREE REPORT: This complimentary report, focused on Estate Planning, is comprised of many of Mr. Miller’s articles from his long running column for the largest regional newspaper in San Diego County. This report will guide you through the questions surrounding getting your estate planning in order.

Posted in Elder Law, Estate Planning, Medi-Cal Benefits, Veteran's Benefits | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

The VA and Vietnam – Very Vital!

It’s that time of year again: Veterans Day!  Veterans Day is a day of celebrating those who honorably served our country at home and abroad.  On Monday, the annual Veterans Day parade will be held in downtown San Diego, specifically highlighting Vietnam veterans and commemorating 50 years since the war.  Vietnam veterans have had particular difficulties due to the nature of the conflict and it’s important to recognize the unique benefits available.

For wartime veterans who are over age 65 and need help with daily tasks, VA Aid & Attendance Non-Service Connected Disability Pension benefits can be invaluable for helping to cover the cost of needed care.  The benefit will potentially pay more than $24,000 per year toward service to help you.  Additionally, veterans who are under age 65, but who are totally and permanently disabled may also take advantage of the benefit.  In order to qualify, veterans must meet certain income requirements and should plan their estates so that they may maintain eligibility long-term.  Certain major actions, such as selling a home, may disqualify veterans for the benefit.  Proper planning, such as the creation of a QVap Trust, can avoid disqualification.  Although there is not currently a lookback period for V.A. benefits, it’s important to plan early!

Additionally, veterans may take advantage of a number of other benefits provided by the VA.  Planning ahead for long-term care and burial is essential to ensuring that your wishes are carried out.  In particular, burial in National Cemeteries such as Arlington must be arranged after death.  If it is your wish to utilize these spaces, you should make your family aware of those wishes before the need arises.  Otherwise, it is possible that your family will make other arrangements in the rush following your death.
Furthermore, surviving spouses of veterans may take advantage of many benefits, including survivor benefits and Aid & Attendance.  These frequently overlooked advantages can provide significant help to a spouse who requires assistance with daily living even if the spouse never served in the military.  We recognize that military spouses also make their share of sacrifices for the benefit of the country!

Although it was a long time coming, the VA has recognized exposure to Agent Orange as detrimental to Vietnam veterans.  The VA presumes that certain disabilities and diseases, such as Parkinson’s disease, Hodgkin’s disease, and many cancers, were caused by Agent Orange if the veteran can show that he or she was exposed to the poisonous herbicide.  For Vietnam veterans in particular, disability compensation may be paid to those exposed to Agent Orange.  Also, children of Vietnam veterans may receive certain benefits if they suffer from birth defects attributed to Agent Orange, such as spina bifida.  Veterans of the Korean War also qualify for benefits related to Agent Orange exposure.

If you are considering planning for or applying for VA benefits, make sure you see an accredited advisor.  Do not consult anyone who has not been accredited by the VA!  I hope everyone has a happy and safe Veterans Day weekend!

Posted in Elder Law, Veteran's Benefits | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

Punishing the VA…

The benefits available from the VA help many veterans through difficult periods of their life.  The benefits may help veterans obtain a college education, transition to the civilian workforce, compensate for a disabling injury, or pay for home care during old age.  However, the nature of most benefits is that they are time-sensitive; the veteran in need of the benefit cannot wait indefinitely to receive it without diminishing the effect.  Over the course of the last several years, the VA has been faced with an increasing backlog of disability claims due to outdated systems and application processes, among other problems.

The continuing and growing backlog has persisted due to a number of factors.  Most recently, the government shutdown ceased most VA functions, including claims processing.  The mandatory overtime VA workers were facing prior to the shutdown in order to finally make headway on the backlog ceased.  Additionally, veterans benefits were in jeopardy of going unpaid on November 1 due to the shutdown because the VA expected to run out of funds to pay the benefits!  Ironically, the U.S. House of Representatives recently passed a bill that, among other things, reduces bonuses for VA employees as a result of the poor progress on the backlog.  What’s more?  They passed it unanimously!  The new bill, if passed by the Senate and signed by the president would decrease available funds for VA bonuses by 14% even though the most recent backlog increase was caused by Congress.

In addition to the cuts to bonuses, however, the bill contains a number of additional provisions.  The bill allows the VA to appoint fiduciaries to individuals who are incapable of making their own financial decisions.  Veterans will be able to pre-designate their fiduciary , as is the case for a regular Financial Power of Attorney.  However, the VA may override your choice and notify you of the reason.  If you have named a Financial POA, that person is allowed priority for appointment by the VA, along with relatives and conservators. This person may receive your VA benefits on your behalf.

The House bill further requires that benefit denials be sent with an appeals claim form.  By sending the forms, it is more likely that those who wish to appeal an adverse decision will know the appeal is possible and avoid missing any deadlines that apply.  Finally, the bill would recognize the service of reserve military members as honorary veterans, without changing their benefit status.

If you have not reviewed your plan for VA benefits, including your QVap Trust, in the last few years, it may be time to verify that your goals will continue to be met, even as the law changes.  It is particularly important to verify that you have chosen an appropriate trustee, executor, financial POA, and VA fiduciary.  Further, to the extent that your various fiduciaries differ from each other, it is important to regularly reevaluate the relationships among your various choices!

VA Aid & Attendance–How Can I Correctly Choose Help for my Application Process?  FREE REPORT:  This complimentary report focuses on the various kinds of people one can consult when applying for the Veterans Aid & Attendance benefit. Who one chooses can mean the difference between success and failure. Remember, if you are denied, you may not be able to reapply for up to a year or longer. Download our complimentary report for a behind the scenes look at the different types of people you can consult and the dirty underbelly of the Veterans Aid & Attendance industry.

Posted in Elder Law, Veteran's Benefits | Tagged , , , , , , , , , , , , , , , , , , , |

Give Me All the Benefits!

Planning for benefits eligibility in old age makes good financial sense.  Many people fear outliving their retirement accounts even without major expenses depleting their accounts.  Unforeseen health expenses can deplete an estate rapidly, particularly if you need help with basic, daily tasks through regular home care or skilled nursing.  When it comes to planning for benefits, however, you must know how to qualify and how to use each program.  Medicaid (Medi-Cal in California) and VA Aid & Attendance Non-Service Connected Disability Pension are not mutually exclusive benefits; if you have one, you can still have the other under certain circumstances.
Aid & Attendance is available to low income wartime veterans and their spouses who are at least 65 or are totally and permanently disabled.  In order to qualify, certain income requirements must be met.  Similarly, Medi-Cal is available to seniors who are over age 65.  However for Medi-Cal eligibility the senior must meet certain asset requirements.  Although the limits appear low, there are exempt assets and income deductions that may be used to fall beneath the thresholds.  Taking stock of your expected retirement income and assets at the outset is helpful for planning to receive either benefit.

Aid & Attendance benefits are most helpful for veterans who need assistance with daily tasks, in-home care or assisted living.  The benefit supplements the cost of care so that the assistance does not bankrupt the veteran.  If you meet the qualifications for Aid & Attendance benefits, it is worth it to take them!  They are not treated as a loan; instead the payments are a gift from a grateful nation for your service.  If you do not qualify for Aid & Attendance benefits, then Medi-Cal may be used to pay for skilled nursing facilities.  However, Medi-Cal payments are treated as a loan and are potentially recoverable against your estate.

In cases where your health declines to the point where skilled nursing is required, it is possible to transition from Aid & Attendance benefits to Medi-Cal to cover the higher cost of a skilled nursing facility.  In these cases, the Aid & Attendance benefit does not stop entirely, but is significantly decreased once Medi-Cal coverage is obtained.  However, the decrease is not automatic when a spouse is also alive, meaning that a married couple may be able to receive both Medi-Cal benefits and Aid & Attendance payments.  Further, the Aid & Attendance benefit payments often do not count toward income for Medi-Cal purposes!  It is important to have assistance when preparing your application for Aid & Attendance benefits to ensure that your Medi-Cal eligibility is preserved; you do not want to make an error that comes back to bite later!

Considering and planning for the possibility that you will need public benefits is an important part of ensuring your financial security.  In some cases, you may need to shift assets around in order to meet the strict limitations of either program.  Using a QVap Trust or a QMap Trust, may be the ticket to qualifying while maintaining some flexibility with your assets and preserving your estate for your heirs.  By planning ahead, you can also avoid issues with the look-back period for Medi-Cal!

VA Aid & Attendance–How Can I Correctly Choose Help for my Application Process?  FREE REPORT:  This complimentary report focuses on the various kinds of people one can consult when applying for the Veterans Aid & Attendance benefit. Who one chooses can mean the difference between success and failure. Remember, if you are denied, you may not be able to reapply for up to a year or longer. Download our complimentary report for a behind the scenes look at the different types of people you can consult and the dirty underbelly of the Veterans Aid & Attendance industry.

Posted in Elder Law, Medi-Cal Benefits, Veteran's Benefits | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

Things That Go Bump in the Night…

In honor of the recent Halloween holiday, I thought I’d talk about the scariest part of it: the tricks.  Elderly individuals, even with estate plans, are frequently the victim of financial abuse by caretakers, children, and living facilities.  Even independent trustees andattorneys have been known to take advantage of their clients’ estates for all manner of personal gain.  Protecting yourself against the possibility of financial abuse while maintaining complete control over your finances and estate plan can be very difficult.

Financial abuse often comes from the person closest to the elder.  Sometimes it is a family member who undermines others by convincing the elderly person that other family members are trying to take advantage of them or that the other family members have already stolen assets.  In cases where even minor dementia is present, the elder is often confused about their total assets or where items seem to have gone.  This presents an opportunity for the conniving family member or caretaker to place blame on someone else.  The elderly person may then change their distribution plan in their trust to disinherit one person in favor of the offending caretaker or family member.  Other fiduciaries may be more brazen; those with access to financial accounts may treat themselves to the assets or charge unreasonably high fees for their services.

Unfortunately, for those who wish to protect themselves, there is a fine line between deciding to reward someone for their help during a time of need and being manipulated into changing an estate plan!  In the effort to maintain financial autonomy for as long as possible, trusts are often drawn with relatively loose provisions that do not account for the decline into incapacity.  However, there are some measures you can take in your estate plan that may help.

First, when a determination of your capacity is necessary, you may appoint specific individuals to help make the determination.  You might specify your primary care physician so that a one-time exam from an arbitrary physician is not sufficient to determine your level of capacity.  Instead, your main physician who knows you is charged with deciding.  You may also appoint a family member or panel of family members who are familiar with your daily routines to determine changes in your awareness and behavior.
Another option may be to appoint co-trustees or a financial power of attorney and trustee who differ from one another.  Although there are a number of potentially unnecessary complications that arise with too many hands in the pot, there is added safety when your fiduciaries must clear actions through each other or act unanimously.

Perhaps most importantly, you should ensure that caregivers, assisted living or nursing facilities, and professional fiduciaries have been checked out.  Before choosing a provider or appointing a professional, get references, qualifications, and information about their procedures, ethical understanding, and processes.  Additionally, find out whether there is a system for responding to and addressing complaints.

You work your entire life to build your estate and have it distributed according to your wishes.  By being vigilant early on, you may prevent the squandering of your estate by unscrupulous family members, aides, and advisors!

Estate Planning: The Price of Organization, Rewards, Gifts, and Wondrous Tax Things… FREE REPORT: This complimentary report, focused on Estate Planning, is comprised of many of Mr. Miller’s articles from his long running column for the largest regional newspaper in San Diego County. This report will guide you through the questions surrounding getting your estate planning in order.

Posted in Elder Law, Estate Planning | Tagged , , , , , , , , , , , |

I Hate the Hospital!

It seems that most people do not like going to the hospital.  It is even more difficult to force someone else to go to the hospital when they need it.  For one thing, going to the hospital frequently means that you are pretty ill or have suffered a pretty serious injury.  For another, it is possible to leave the hospital more sick than when you went in!  Indeed, a new Frontline documentary, called “Hunting the Nightmare Bacteria” airs this week and tracks the spread of drug-resistant bacteria in hospitals.  Furthermore, the hospital is one of the most expensive methods of obtaining treatment; your wallet is probably none too fond of the place either.  Obamacare aims to take direct aim at this issue through its expansion of Medicaid (Medi-Cal in California) and insurance coverage in an attempt to lower overall healthcare costs.  Planning for your medical care and long-term care in advance may help you avoid the need to crisis-based hospitalizations.

Most people who are in the hospital for any length of time are fairly seriously ill.  Additionally, sick people with contagious diseases are constantly rotating through the doors.  Visiting the hospital for primary care, particularly through the emergency room, causes a lot of potentially unnecessary expense and stress. Visiting the emergency room can result in long waits for short visits with physicians who are not familiar with your medical history.  Additionally, repeat visits are often necessary due to symptom management rather than comprehensive treatment, and exposure to additional bugs. Alternatively, regular physician visits can help you catch and treat issues early.  Effective early treatment and health advice may improve your chances of remaining at home during your old age.

Unfortunately, regular physician visits and screenings have also historically been expensive.  With the advent of Obamacare, many basic services will be free, including diabetes, cholesterol, and blood pressure screening.  This will be true for all Marketplace plans, regardless of their deductible or copayment requirements.  Additionally, many common vaccines will be free of charge, including an annual flu shot.  Women receive a number of additional healthcare services for free, including breast cancer genetic testing, a la Angelina Jolie, and osteoporosis screening for women over 60.  For individuals who are not receiving Medicare and Medi-Cal benefits and are purchasing insurance on the Covered California health exchange, every available plan will offer these services.

However, even with improved insurance options, it is important to plan for long-term care in case it becomes necessary.  By planning ahead for Medi-Cal coverage, you may be able to seamlessly transition from private insurance to Medicare and Medicaid once you require the additional coverage.  In order to plan ahead for Medi-Cal benefits, it is helpful to create a QMap Trust.  Through the use of this special kind of trust, you may preserve the tax benefits of home ownership, increase flexibility for your family, and preserve assets for your heirs.  Unlike other forms of insurance, Medi-Cal is considered a loan so preventing Medi-Cal reimbursement claims may be an important aspect of planning ahead for coverage!

Estate Planning: The Price of Organization, Rewards, Gifts, and Wondrous Tax Things… FREE REPORT: This complimentary report, focused on Estate Planning, is comprised of many of Mr. Miller’s articles from his long running column for the largest regional newspaper in San Diego County. This report will guide you through the questions surrounding getting your estate planning in order.

Posted in Elder Law, Estate Planning, Medi-Cal Benefits | Tagged , , , , , , , , , , , , , , , , , , , , , |

Can I Sell Mom’s House?

This deceptively simple question is most often phrased as a sentence: “I am going to sell the house.”  Unfortunately, if the property does not belong to you, it is not enough to simply hire an agent and list the property, even when you have the authority to do so.  Furthermore, it may be a mistake!
Assuming that your parent is alive, you must first ensure that you have the proper authority to sell the home.  Determining whether you have that power requires carefully reviewing your powers as trustee or Financial Power of Attorney, as applicable.  Additionally, it is important to find the last recorded deed in order to determine how title to the property is held.  If the necessary authority has not been granted, then a court conservatorship proceeding may be necessary and court authorization to sell the real estate should be requested.

Once you have determined that the authority exists, you must consider the financial realities of your parent’s situation and whether selling the home is wise.  If your parent receives Medi-Cal benefits (Medicaid elsewhere), the home is exempt for the purpose of counting assets to qualify.  However, once the home is sold, the proceeds from the sale will likely disqualify your parent from continuing Medi-Cal benefits.  Similarly, if your parent receives VA Aid & Attendance Non-Service Connected Disability Pension benefits. the income from the sale may lead to the benefits being yanked. Often, the desire to sell the home comes at a time when the parent’s physical state requires additional attention in a nursing facility and the extra liquidity would be useful.  However, simply selling the home may provide liquidity, but only at the expense of needed benefits!

If your parent has engaged in some pre-planning, particularly through the use of a QMap Trust or QVap Trust, the decision may be simpler.  These special trusts allow flexibility for the successor trustee specifically to avoid the predicament selling a home can cause.  Through careful drafting, a QMap Trust or QVap Trust avoids eligibility problems that arise while preserving certain tax advantages that go with home ownership.  Without proper advance planning, it may be necessary to explore other available options in order to protect and preserve eligibility for benefits.

If your parent is not currently receiving Medi-Cal benefits or Aid & Attendance, it may be useful to determine why not.  Because the home is an exempt asset, it could be best to keep the home in its current form and determine what other assets are available to pay for care and living expenses.  There is a tendency for many trustees to want a lot of liquidity in order to ensure that as bills come due, there is always money to pay them.  However, it may be advantageous to strategically decrease the amount of cash and other non-exempt assets on hand while preserving the home.

Eligibility for Medi-Cal and for Aid & Attendance benefits can be very complex and should not be considered a do-it-yourself endeavor.  An attorney who is experienced in these matters and VA accredited should be consulted before you take major steps, like selling a home!

VA Aid & Attendance–How Can I Correctly Choose Help for my Application Process?  FREE REPORT:  This complimentary report focuses on the various kinds of people one can consult when applying for the Veterans Aid & Attendance benefit. Who one chooses can mean the difference between success and failure. Remember, if you are denied, you may not be able to reapply for up to a year or longer. Download our complimentary report for a behind the scenes look at the different types of people you can consult and the dirty underbelly of the Veterans Aid & Attendance industry.

Posted in Elder Law, Medi-Cal Benefits, Veteran's Benefits | Tagged , , , , , , , , , , , , , , , , , , , , , , , |

Does Care More Care More?

California pioneers industries and paves the way for modern marvels.  From biomedical research and drone design and manufacture here in San Diego, to the film industry from our neighbors to the north and computer and internet technology in Silicon Valley, this state creates products and business models that set an example for the rest of the nation.

The California-based company CareMore has similarly inspired an entire line of healthcare facilities that strive to lower healthcare costs and improve care, particularly for Medicare patients.  Although the company began in the 1990s providing Medicare Advantage plans to patients and unique care strategies, such as low-cost pedicures for diabetics, its practices are being modeled by various other clinics.  Similarly, The Heritage Provider Network, another California-based healthcare company, offers dance classes and healthy cooking classes to its patients.  The innovative methods of healthcare are forming the basis for “accountable care organizations”, which aim to treat people rather than their ailments in order to streamline healthcare and decrease costs.

For its part, Obamacare attempts to push the needle toward actual health care, rather than illness care by promoting innovative ways of looking at health.  It is well known that Americans receive worse care per dollar spent than most other developed nations; bringing the cost and quality of care more in line is a national priority.  Unfortunately, the typical healthcare model in America promotes reactionary healthcare, emergency treatment, and expensive recoveries.  Hospitals and physicians are able to charge more and, in turn, make more, when patients return or have an urgent need for care.  Obamacare attempts to incentivize healthy habits while disincentivizing unhealthy habits, for both patients and professionals.  Of course, the success of preventive care relies on your participation in planning for your own health.  Preventing illness and disease throughout your life is beneficial.  However, planning for more substantive care in your old age is also important.  Through the use of a QMap trust, you can plan for Medi-Cal (Medicaid elsewhere) coverage, particularly in case you require long-term care.  By planning in advance, you may also prevent running into problems with the look back period or fund recovery.

Increasingly, California is looking to ways to lower health care costs through preventive treatment and through expanding the roles of non-physician healthcare professionals.  California has expanded the role of health professionals who did not attend medical school, including midwives, nurse practitioners, and pharmacists, by allowing them to perform various medical tasks according to their skills.  These tasks include cholesterol screening, other forms of primary care and, notably, certain early term abortions.  By increasing the availability of these forms of healthcare, the overall costs should be reduced and doctors may be able to do more of the tasks for which they are trained.

As more individuals enter the healthcare market through expanded Medicaid and healthcare exchanges (Covered California), it is important to develop creative care methods for individuals that will prevent a physician shortage whereby physicians turn away patients with lower-paying plans, such as Medi-Cal and improve overall results.  Perhaps affordable care is only the beginning.

Estate Planning: The Price of Organization, Rewards, Gifts, and Wondrous Tax Things… FREE REPORT: This complimentary report, focused on Estate Planning, is comprised of many of Mr. Miller’s articles from his long running column for the largest regional newspaper in San Diego County. This report will guide you through the questions surrounding getting your estate planning in order.

Posted in Elder Law, Medi-Cal Benefits, Senior Resources | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , |