Category Archives: MassHealth

Your Guide to Medicaid in Massachusetts

 

Before you sacrifice your own money, or your inheritance, to pay for your parents’ nursing home care, ask yourself the following question:

What are my parents’ assets, and what can I do with them?

According to Massachussets law, a person can only use Medicaid if he or she has less than $2,000 in “countable assets.” Certain kinds of assets, however, are exempt from this rule, including irrevocable trusts, long-term care insurance, and some annuities. If your parents have more than $2,000, ask a Massachusetts estate planning lawyer for advice on how to make these assets exempt.

What about my parents’ home?

Owning real estate makes paying for a nurisng home tricky under Massachusetts law. If your parents own a house, and one of them has to live in a nursing home, the house is exempt as long as your other parent continues to live there. You can also get an exemption if one of their children lives there and has a disability. Otherwise, your parents will have to sell it and spend the money on nursing home care before they can use Medicaid.

What are my responsibilities as a child?

Under Massachusetts law, children are required to support their elderly parents. If your parents use Medicaid to pay for nursing home care, the state may ask you to reimburse a portion of these costs. You can get out of this requirement, however, if you lack sufficient means or can prove that your parents didn’t support you in your youth. Ask a Massachusetts elder law attorney if you qualify for these exemptions.

Meta Title: Your Guide to Massachussets Elder Law and Medicaid

Meta Description: Before you put your parents in a nursing home, talk to your Massachusetts nursing home attorney about these three questions.

How a Massachusetts Elder Law Attorney can help you with Healthcare

Learn more about Massachusetts Elder Law and Health Care.In addition to helping with estate planning, financial issues and housing options, a Massachusetts elder attorney can help you make informed healthcare choices for your future. Your attorney can make sure that you have access to affordable healthcare and that you know how the latest healthcare legislation will affect your current and future plans.

Thanks to changes in healthcare on both state and federal levels, the field of medicine is constantly changing, making it difficult for the average person to keep up with the latest policies. These policies affect private health insurance programs, Medicaid, Medicare and veterans’ benefits, making it essential that you have a trusted person who can give you the correct information that you need to know. While the future of the healthcare system is uncertain, like potential spending cuts in government programs that many seniors rely upon, it’s important to have someone on your side to guide you through the maze of regulations.

Although you can’t predict the future, your Massachusetts estate planning attorney can help you make plans for the future so that your wishes are met every step of the way. They can help you decide on potential options such as whether you’d prefer in-home care by private caregivers or if living in a residential facility is better for your needs.

Your elder lawyer can also help you make important decisions related to your healthcare, and draw up the proper documents such as a power of attorney and advance directives, to ensure that you’re well taken care of. Making these decisions now allows your loved ones to focus on spending quality time with you, and without heavy burdens weighing on their minds.

For assistance with your estate planning, or to find out how a Massachusetts elder attorney can help you, contact us today!

Ten Reasons to Consult an Estate Planning Attorney

Helping your elderly parents face the financial and health-related challenges that come with growing older can put quite a strain on your other responsibilities. Enlisting the help of the right professionals leaves you with more time to spend with your family. Since there are complex state and federal regulations regarding wills and other paperwork necessary for settling an estate, it is best to consult an experienced estate planning attorney. There are ten specific benefits to working with an elder lawyer.

1. Ensure the last will and testament of your parent or relative is legally binding and properly designated.

2. Designate a power of attorney contract to ensure the right person is responsible for making medical and financial decisions if the person becomes incapacitated.

3. Create a living will. Living wills help your elderly relatives make their wishes clear and save you a lot of stress when the time comes for difficult decisions.

4. Avoid mistakes. A practicing estate planning lawyer can craft a strong will that covers all the bases, while most packages designed to help you do it yourself lack coverage of crucial areas.

5. Handle any business or investment transfers smoothly and without delays.

6. Address complex situations where blended or extended families are involved. Planning the estate is much more complicated if your elderly relatives have had more than one marriage.

7. Minimize the taxes heirs will need to pay by choosing the right type of trust.

8. Update and change any existing wills and estate paperwork. Changing laws and family structures make old agreements insufficient very quickly.

9. Take care of disabled family members for their rest of their life. A good probate lawyer can help craft a plan that ensures that the people in your family with special needs never go without support.

10. Make the process easier. Planning an estate is stressful for both the elderly and their helpers, but an experienced professional helps.

Understanding Medicaid

Nursing home care and Medicaid in Massachusetts.The process of applying for Medicaid can be difficult to understand. The first time many people begin to even think about entering this process is when a loved one requires nursing home care or such care is imminent. Many times applying for Medicaid is reactive to situations such as these and emotions are usually running quite high. In many instances the applicant tries to complete the process as quickly as possible and doesn’t pay close enough attention to some of the details – resulting in their application being declined. Since the Medicaid field is always changing it’s important to do your due diligence when going through this process.

What is Medicaid?

Medicaid was created in 1965 as a part of the Social Security Act as a form of welfare for individuals and families with low income/resources who require long-term medical care. Often confused with Medicare, Medicaid is a joint federal-state funded program which is run by each individual state. While eligibility rules are often different from state to state, each system must adhere to federal guidelines in order to receive funding (which is usually about half of the state’s Medicaid costs).

What are the eligibility requirements for Medicaid?

Since each state operates its own Medicaid program there are often discrepancies in eligibility depending on which state the applicant lives in (the Medicaid program in Massachusetts is referred to as MassHealth).  You may be eligible to apply for Medicaid if you have limited resources and fall into any of the following categories: children requiring nursing home care (some states up to age 21), parents/guardians of eligible children (under age 18), pregnant women, people with certain disabilities, and elderly persons needing nursing home care. Each individual case is different so it is important to contact an expert on elder law services to help assess your situation. For more information about whether or not you may be eligible to apply for Medicaid click here.

For further assistance in this complicated process contact the law offices of Adam J. Tobin today!

Determining if a Loved One Requires Home Care

Caretaker aids senior citizen at home care

Caretaker aids senior citizen at home care

It’s a difficult thought, wondering if your loved one might not be able to fully take care of them selves anymore. Countless Americans go through it all the time, dealing with the decision of whether or not they should put their loved one in a home. And even senior citizens are often reluctant to admit that they need help. It’s not easy for a person who’s lived a full life and provided for themselves and their families to come to terms with their predicament for fear of losing their independence or just out of embarrassment. Even those of us who are closest to loved ones have a hard time admitting the fact because we have seen them throughout our entire lives as able bodied and fully capable. But it is a fact of life. People age and the older they get, the harder life can be.

It’s important for us to be aware of the situation and keep a look out for the early signs that a loved one needs home care. Sometimes these signs aren’t easy to spot and can “suddenly sneak” up on you if you’re not paying attention. Here is a list of warning signs that you will want watch for if you concerned that your loved one may need home care:

  • Your loved one neglects personal grooming.
  • Your loved one ignores household tasks.
  • Your loved one doesn’t eat well.
  • Your loved one has fallen or has a fear of falling.
  • Your loved one has difficulty administering medications.
  • Your loved one shows signs of inactivity or isolation.
  • Your loved one neglects mail and has overdue bills.
  • Your loved one has been scammed or a victim of fraud.
  • Your loved one caring needs have become increasingly difficult.
  • Your loved one often gets confused or disoriented.

If one or more of the described symptoms above have been noticed or experienced by your loved one, a home care solution might be the right decision.

For more information and guidance on this difficult dilemma, contact your Massachusetts elder law lawyer at the offices of Adam Tobin. We would be glad to help you with the process and answer any questions you need.

How to Avoid a Nursing Home with a Pooled Trust

While baby boomers’ parents have been retired for years or even decades, their retirement income is no longer enough to pay for the rising costs of the long-term care that could keep them out of nursing homes.

Often times, children will do whatever they need to in order to keep their parents living in their own home, but it can be challenging, especially for middle-class families who can’t afford private home care. The other problem with these middle-class families is that often they will have too much income or assets to qualify for state-run Medicaid progra

ms. For these families, they are often faced with no choice but for their parents to enter nursing home facilities.

A Pooled Trust can keep a Senior in their Home

There is, however, a little-known way for people in certain states to receive home care through Medicaid without going broke. A federal law established in 1993 allows disabled people to put their monthly income or assets that exceed the Medicaid approved amount into a special type of pooled trust. That money can then be used to pay for basic monthly bills such as rent, cable television, or mortgage payments, while Medicaid pays for their home care.

For those who choose to create a Pooled Trust, it can make a huge difference. Each month, a person who has been deemed disabled can deposit their excess income into the trust, which must be run by a nonprofit organization. The trust will then pay the disabled person’s bills so long as the expense is for the sole benefit of the participant. Trusts can refuse payments on items that look questionable and money cannot be used for things like gifts to children or grandchildren.

It is important to note that signing up for the trust and submitting the bills each month will require a lot of paperwork, and it is entirely possible that elderly people will need to rely on a family member to help them. After a person dies, any money left in their trust will either be paid back to Medicaid or kept by the nonprofit organization that is running the trust.

The most important thing to keep in mind is that this type of trust may not be the best solution for everyone, or it may work as a strong component of a broader strategy. Consult a professional, such as an elder law attorney, to learn more about the different options available.

How to Choose a Nursing Home

Choosing a Nursing Home

Choosing a Nursing Home

A move to a nursing home or assisted living is much more precarious of a move than simply switching apartments.  Not only must one consider location, price, and value; but also reputation, level of care, and legal ramifications.

It is highly recommended that a patient’s physician be brought in on the decision in order to establish and ensure that their needs will be adequately met.  To complicate matters further, sometimes the search must be undertaken during the stress of a hospital or rehabilitation center threatening discharge.

In order to make the transition a little easier, we have compiled some general guidelines for finding the perfect nursing home or assisted living program.

1.       Location: Establish the most reasonable distance the nursing home can comfortably be for your loved one.  One of the most important aspects involved in quality of life at a nursing home is the prospects of visits from family.  Care is also often better for patients who have family members involved in their lives.  Due to this, make it easy on your loved ones (or yourself) by picking a nursing home less than an hour away from family.

2.       Take a Tour: Contact the facility’s admissions office and request an informal meeting and tour of each facility.  Make sure to look beyond flashy lobbies and look instead for examples of interactions between staff and residents.  Ask for a brochure of the facility (make sure it includes admissions policies and the resident’s bill of rights) and ask for any addendums.  Asking for an informal meeting and tour will give you a rare opportunity to experience an unrehearsed setting.

3.       Meet the Caretakers: Speak with the nursing home administrator or members of the staff about care plans for patients.  It is important to speak with the people responsible for direct care, not just the hired marketing representative showing you around.

4.       Try the Food: Try and get a feel for the food service quality.  Eating is something that can make or break a nursing home experience.

5.       Ask for References: Try and get the names of both residents and family members if possible so you can ask about both sides of the nursing home experience.

6.       Do Your Research: Contact the Executive Office of Elder Affairs and ask to speak with the ombudsman that covers the facilities you are interested in.  Also contact the state Department of Public Health (in MA, ask for the Division of Health Care Quality at http://www.mass.gov/dph/dhcq or call (617) 753-8000 and ask for the “Survey Performance Tool for Nursing Homes.”   Sometimes it is also possible to receive a copy of survey findings and complaint reports for the nursing homes you are looking into.

7.       Check Certifying Agency Reports: CareScout is an unbiased source for ratings and reviews of eldercare providers nationwide.  Another source for nursing home reports is HealthGrades.  For a fee, HealthGrades will provide you with a report that rates the nursing home and provides information on inspections and complaint investigations.  Also be sure to ask for a report that compares the nursing homes in your area if available.

To find out more about Massachusetts laws regarding nursing home patients and resident rights, contact a knowledgeable MA nursing home attorney like Adam Tobin to answer your questions.

The Financial Health of Aging

With our current economic challenges, those of us looking forward to retirement need to be well-informed about our financial needs in coming years. And not only pre-retirees, but individuals already in retirement need to be wise to the changing economic environment. The good news is there are trained professionals who keep abreast of changes in the current economy, changes in laws and changes in government programs for the elderly. Professionals in this field are equipped to handle everything from help with retirement savings accounts, investment advice, guidance on government programs, estate planning or even new funding options such as reverse mortgages. A little planning prior to retirement will allow you to maintain your current lifestyle; whereas, a lack of planning may require you to live on an extremely tight budget. For those already retired, taking time right now to deal with financial problems instead of waiting for a crisis to happen is well advised.

A large number of retired individuals felt that they had planned well for the future only to find that rising medical costs, damage done to investment portfolios (by the current economy) and many other factors have caused them to go into debt. According to an article in “USA Today”, seniors are racking up debt like never before. Elderly individuals who are in debt live with a constant burden over their heads. Most of these people are on fixed incomes and have no way of paying off credit cards and home equity loans that continue to mount to cover household budget deficits. In order to meet ongoing payments, seniors often forego purchasing medications and skimp on food budgets. They live like hermits — never going out and pinching every penny — in order to pay their obligations.

Most of these people worked hard their entire lives and managed their debt. They never anticipated the rising costs of prescriptions, expensive medical care or depletion of savings by living too long. The good news is there is help for these individuals. Here are just a few examples of some relief options that could be available. There are many more besides these.

Reverse mortgagesAging and financial planning

A reverse mortgage is a risk-free way of tapping into home equity without creating monthly payments and without requiring the money to be paid back during a person’s lifetime. Instead of making payments the cash flow is reversed and the senior receives payments from the bank. Thus the title “reverse mortgage”. For those seniors who are less fortunate financially but own a home, a reverse mortgage can allow them to remain in the home by creating extra income.

Life settlements

A life settlement enables older individuals, businesses and other organizations to sell life insurance policies they currently own – but no longer want or need – for an amount greater than the cash surrender value. In some cases the value can be 2-3 times the cash surrender value. Even some term life insurance policies with a conversion option to permanent coverage can qualify for a life settlement.

Government Programs

Some government programs such as food stamps provide temporary financial help for food. Other programs provide subsidized housing, help with medical expenses and provide tax credits. For veterans there is free health care, inexpensive prescriptions and disability income. Area agencies on aging offer individual counseling, legal help and advice with Medicare costs. (National Care Planning Council, www.longtermcarelink.net)

For some, living on a fixed income and dealing with debt can be an overwhelming burden. There are knowledgeable professionals and debt relief strategies that can assist in easing this burden. The National Care Planning Council keeps a list of financial advisers and attorneys who specialize in this area of planning at www.longtermcarelink.net.

Want to explore these financial issues further for you or a loved one? Be sure to contact an elder lawyer, like Adam J. Tobin today!

Employer Support for Caregiving Employees

“There are only four kinds of people in this world. Those who have been caregivers, those who are caregivers, those who will be caregivers, and those who will need caregivers.” Rosalynn Carter, Former First Lady

The U.S. Department of Labor estimates that in the year 2010, 54% of workforce employees will provide eldercare for a parent or parents and that nearly two-thirds of caregivers will experience conflict between demands at home and demands from employers.

Today’s employed Baby Boomers are the caregiver generation for their parents. They are finding themselves juggling care responsibilities around their employment obligations. Sometimes employees find they have no option but to take leave from work or use sick time to meet their caregiving demands.

Employers also feel the toll it is taking on their employees. A report by the AARP describes the cost to employers:

“Companies are also seeing the emotional and physical toll that caregiving takes on their workers. In one study, 75% of employees caring for adults reported negative health consequences, including depression, stress, panic attacks, headaches, loss of energy and sleep, weight loss, and physical pain. Businesses suffer, too, by having to pay high health insurance costs and in lost productivity. That doesn’t count the promotions or assignments workers turn down that require travel or relocation away from aging relatives.”

Businesses that don’t offer benefits or address eldercare wind up paying for them. A recent study by the MetLife Market Mature Institute and the National Alliance for Caregiving states that U.S. companies pay between $17.1 billion and $33.6 billion annually, depending on the level of caregiving involved, on lost productivity. That equals $2,110 for every full-time worker who cares for an adult.

Eldercare cost businesses:

* $6.6 billion to replace employees (9% left work either to take early retirement or quit)
* Nearly $7 billion in workday interruptions (coming in late, leaving early, taking time off during the day, or spending work time on eldercare matters)
* $4.3 billion in absenteeism” AARP

Typically, human resource departments work with employees on many issues that may affect their work productivity.  There are programs for drug and alcohol abuse, domestic violence, illness, absenteeism and child care; but, help with eldercare issues is not normally provided.

The AARP report follows several companies who are providing help with eldercare issues and what they are doing for their employees.

* “Freddie Mac has a free eldercare consultant and access to subsidized aides for a relative up to 20 days.
* Verizon Wireless offers seminars on eldercare issues and allows full-time workers 80 hours a year in back-up care, 40 hours for part-time, and $4/hour for in-home help.
* At the Atlanta law firm Alston & Bird LLP, workers can donate vacation time to colleagues who have used up theirs to care for family members. “ AARPadam-tobin

A growing number of companies nationwide are directing their HR departments to provide resources, education and group help for caregiving issues by:

* Providing materials from community resources such as phone numbers to their local Senior Centers or Area Agencies on Aging.
* Making available brochures and booklets on specific programs and services by eldercare experts
* Providing speakers to educate employees on caregiving options
* Allowing options to use paid sick leave, employee job sharing and flexible hours
* Allowing employee caregivers to use business computers for caregiving research
* Contracting with companies who provide eldercare services to help employees

Eldercare service providers are also reaching out to help employee caregivers by providing informational presentations at the work place during lunch time or other times set up by employers. One such presentation provided information on reverse mortgages. Jason, who had been trying to help his parents pay for home care, learned at a work site presentation that a reverse mortgage was one way to cover caregiver expenses.

The HR Department of a local business in Utah, invited the Salt Lake Eldercare Planning Council to present a “Brown bag, Lunch and Learn” during their employees’ lunch hour. In 30 minutes time, those who attended learned how the services of a Care Manger, Home Care Provider, Elder Attorney, Medicaid Planner and Financial Consultant can help with caregiving decisions. Problems were discussed, questions answered and employees left armed with information and the names of professional people they knew could help them.

“This was the most productive lunch I have ever attended”, related Mary, one of the attendees.

“I had been very hesitant to contact an attorney to discuss my parents’ estate, because of the cost involved.  The attorney at our ‘lunch and learn’ answered my few basic questions which will allow me to prepare what I need before I meet with him to finalize my parents’ estate planning.”

Besides workplace help for employers and employees dealing with caregiving, the internet is also a great research tool.  The National Care Planning Council website at www.longtermcarelink.net is a comprehensive resource for eldercare, senior care and long term care planning.  It contains hundreds of articles on all aspects of eldercare.  Professional providers list their services on the NCPC website.  Each of their listings provides unique information on specific eldercare services and how to obtain help.

Employers, employees and eldercare service providers working together can make parent or senior caregiving a workable solution for all.

Did Grandma Need an Elder Care Lawyer?

There is a popular tune played this time of year called “Grandma Got Run Over by A Reindeer” which relates that Grandma — after drinking too much eggnog — went out into the winter cold to get her medication and was run over by a reindeer.  The question is, “Who was supposed to be watching Grandma?”

Though this little tune is just for fun, it may very well raise alarms to many caregivers of the elderly.  Caregivers know that even at a holiday party they cannot let down their diligent watch over their elderly loved one.  As far-fetched as it may sound, with all the people and noise, an elderly family member with dementia or Alzheimer’s may be enjoying the family gathering and then suddenly become confused and walk to the door and leave.

For family caregivers the added stress of the holidays with decorating, shopping, parties and keeping up with all the family traditions is an overwhelming quest.  Feelings of isolation, depression and sadness come with this added stress.  There are millions of Americans who are caring for elderly frail loved ones and most of these caregivers will go through some of these emotions, especially this time of year.

There are some things you can do as a caregiver to help you and those you care for enjoy the holiday season…read the entire article by going to  http://www.planforcare.org

If you are a caregiver for an elderly person in need of elder law services in Massachusetts including: Medicaid (MassHealth) assistance, nursing home planning, probate administration, or estate planning please contact expert MA elder lawyer Adam Tobin.