Archive for the ‘Medicaid’ Category

How to Discuss Estate Planning Without Unnecessary Drama

Friday, September 11th, 2020

Littman Krooks Retirement PlanningFamilies can usually agree on the importance of creating a New York estate plan. However, as crucial as having a comprehensive estate plan is, recent studies show that only a small percentage of couples – most of them older – have current estate planning documents in place. When those who do not have an estate plan are asked why that is the case, the most common response is that they are avoiding having a difficult conversation with their loved ones. For parents, this concern is primarily centered around not wanting to cause problems between siblings.

The first step toward drama-free estate planning is understanding what causes drama between siblings in the first place. Of course, parents cannot necessarily resolve existing sibling rivalries or long-standing disagreements between siblings, which can make the process more challenging. In addition, the estate planning process itself can cause other types of issues to arise. For example, siblings who may not communicate that often may be skeptical of the others’ motives; they may disagree on who should pay for final arrangements, or how assets should be divided. Parents can take specific steps to make the estate planning process easier and reduce the chance of starting arguments between their children.

Create a Financial Overview

littman krooks elder lawWhile a comprehensive estate plan provides a detailed explanation of where a couple wants their assets to end up after they pass on, it does little to explain to children what those assets are and where they are located. A financial overview solves this problem by providing a list of all family assets and their location. For example, parents may have bank or investment accounts that at least one child is unaware of. If a child believes assets are only made known to certain siblings, it can start to build resentment, which may grow over time. By sharing a financial overview with all children, parents can reduce the perception of favoritism.

A proper financial overview should include the following information:

  • A list of all assets, liabilities and insurance policies, as well as how they are titled and any named beneficiaries.
  • Contact information for all financial, legal and insurance professionals.
  • Usernames and passwords for all financial and insurance websites.
  • A legacy letter outlining the non-financial assets, such as family heirlooms, that parents want to pass on to their children.

By creating a financial overview, parents can not only make the estate administration process easier for the executor but can also reduce the chances of starting family conflict. However, ongoing and open communication will also be essential.

Schedule a Family Meeting

After parents create an estate plan and a financial overview, the next step is to schedule a family meeting. Both parents, as well as all children who will be inheriting assets, should attend the meeting. While ideally, family members would meet in person, if children live across the country or a family is concerned about maintaining social distance, a family meeting could be held virtually.

Topics to cover at the family meeting include:

  • Discussing the basics of the estate plan;
  • Ensuring at least one person knows the location of the estate planning documents;
  • Explaining who will be the executor of the estate, as well as any other necessary parties, such as trustees;
  • Discussing the importance of transparency and openness during the estate administration process;
  • Outlining the parents’ plan for important non-financial items, such as family heirlooms; and
  • Discussing the importance of keeping things fair and using the process to bring the family together.

For many parents, the process of discussing their estate plans with their children is a topic to be avoided. However, these are crucial conversations that must take place to increase the likelihood of a smooth and drama-free estate administration process.

Speak With a New York Estate Planning Lawyer for Immediate Assistance

Creating an estate plan to address your family’s unique needs is crucial to securing your legacy and ensuring that future generations are cared for. At the New York estate planning law firm, Littman Krooks, LLP, we have over 30 years of experience helping families effectively plan for their financial future. We pride ourselves in providing an exceptional level of service to individuals of varying net worth, helping our clients ensure that future generations are well taken care of and reducing the tax burdens on their estates. To learn more about how our dedicated team of attorneys can assist your family with its unique needs, call 914-684-1200 to schedule a no-obligation consultation today.

 

Three Tips for Caregiving From Afar

Tuesday, June 30th, 2020

When distance comes between you and an aging parent or another loved one who needs extra help, it can be especially tough to become their caregiver. A caregiver who lives an hour or more away from their parent or loved one is considered a long-distance caregiver. Although this arrangement presents many difficulties, it can also be effective and beneficial for everyone involved with a few special considerations.

New rules enacted to stop the spread of COVID-19 have made some local caregivers into, effectively, long-distance caregivers too. Social distancing and quarantine efforts kept some caregivers away for safety’s sake and shut nursing homes, hospitals and other care facilities down to outside visitors. In these cases, tips for long-distance caregivers might be useful too.

Stay Informed

Staying organized and informed is really important when you are not there in person. This cuts down on unnecessary stress and confusion and makes talking to multiple medical professionals or other caregivers easier. Keep a list of all of your loved one’s medical conditions, medications, doctors, appointments and anything else that is relevant to their care. Be sure to update this list often and to research anything with which you are unfamiliar. Take detailed notes during appointments and phone calls with other care providers.

You will need to prepare a few legal documents in order for medical staff to share information about your loved one with you. A HIPPAA Authorization form provides written consent for this. You may also want to have a medical power of attorney document prepared so you would be able to make decisions for your loved one in the event that they are unable to do so for themselves.

Collaborate With Others

Especially when there are multiple people involved in caregiving, complicated medical needs and other family members who are concerned about how your loved one is doing, sharing information and communicating often is key. Make copies of your lists and notes about your loved one’s health for other family members and caregivers or start a shared online document that can be edited as needed. Becoming the sole recorder and keeper of this information creates unnecessary stress and even resentment so, if possible, share the effort.

It is important to stay in touch with your loved one’s doctors and other professionals. Conference calls or meetings involving members of the care team, caregivers and family members streamlines the information sharing process.

Connect With Your Loved One

Being a long-distance caregiver usually means that visits cannot occur as often as you would like. Planning can keep visits productive and enjoyable, so you and your loved one can make the best of your time together.

Whether physical distance or new social distancing guidelines are keeping you apart, technology creates new ways to keep in touch and have fun with your loved one. Getting them a phone or tablet — and providing the lessons on how to use it — give a direct line of communication. You can use it to video chat, text, play games together and send pictures, all of which can keep feelings of loneliness away.

The New York estate planning law firm of Littman Krooks, LLP combines extensive legal knowledge and experience with individual attention suited to each clients’ needs. For over 30 years, Littman Krooks attorneys have brought astute, honest counsel and strong, thorough representation to every client they have served. Reach Littman Krooks at https://www.littmankrooks.com/.

 

Is Your Estate Plan Up To Date?

Friday, March 22nd, 2019

By: Amy C. O’Hara, Esq., Littman Krooks LLP

In order to ensure your existing estate plan meets your objectives, it is imperative that it be reviewed at least every 3-5 years and updated when needed.  Here are some issues that might necessitate updating your estate plan:

  • You want to avoid probate;
  • You or a beneficiary become disabled or have a long-term illness;
  • Death of a beneficiary;
  • Marriage, divorce or remarriage;
  • Birth or adoption of a child;
  • Death or change of executor, trustee, and/or guardian;
  • A change in the distribution of your estate;
  • A significant increase or decrease in your net worth;
  • Retirement;
  • Expecting to change state of domicile; and
  • Finally, any time you feel uneasy about any of your documents, making changes and/or speaking with your estate planning lawyer to make you feel comfortable with them.

Never make any changes on your current estate planning documents.  Mark-outs, interlineations and other informal changes are of no effect and will not be honored during an illness or after your death.  It is important to meet with an experienced estate planning lawyer to ensure you estate plan is updated properly to protect you and your loved ones.

 

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How to find resources for seniors in New York City

Monday, February 5th, 2018

New York City’s senior population is growing quickly. There are now more than 1.4 million New Yorkers over the age of 60, and that number is expected to rise to more than 1.8 million by 2030. At that time, there will be more older adults than school children in New York City, and seniors will account for one out of every five residents. There is a vast array of community resources available to help seniors with their daily needs, but they can be difficult to locate. New York City’s Department of Aging has an online tool that can help.

Littman Krooks elder law attorneysThe Department of Aging’s Find Help tool is designed to help seniors and their family members easily find the resources they need in their area. You can search by zip code or borough, and search for the type of services you are looking for, which may include abuse prevention, caregiver resources, case management, health promotion services, home care, home delivered meals, legal services, naturally occurring retirement communities, senior centers, social adult day care and day services, transportation and geriatric mental health.

Searching by location and type of services gives you a list of providers, and by clicking on an individual result, you will be given detailed information about the service provider, including the address, phone number, hours of operation and services offered.

 

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Advocates Say Proposed Cuts to Medicaid Will Harm Seniors and People with Disabilities

Tuesday, July 11th, 2017

Health care legislation currently being considered by Congress includes steep cuts to the Medicaid program, which advocates for seniors and people with disabilities say will cause tremendous harm.

The U.S. House of Representatives passed its version of the legislation, the American Health Care Act, on May 4, 2017. The U.S. Senate is now considering its amended version, which is called the Better Care Reconciliation Act (BCRA). The bill is a move by Republican lawmakers to repeal major parts of the Affordable Care Act, passed under President Obama.

The nonpartisan Congressional Budget Office said that under the BCRA, the number of uninsured people would increase by 15 million next year, and by 22 million by 2026.

Critics have numerous objections to the bill, but advocates for seniors and people with disabilities have focused on the harm they say will be caused by cuts to Medicaid, the joint federal and state program that insures nearly one in five Americans.

The Affordable Care Act expanded eligibility for Medicaid, though states could opt out. The BCRA would phase out that expansion by 2024, and would make further cuts as well, by permanently restructuring the program. Medicaid is a partnership between the federal government and the states, and the new legislation would cap the amount contributed by the federal budget, leaving states to make up the difference or cut benefits.

Medicaid is the nation’s largest government health care program, covering more people than Medicare. Medicaid covers 64 percent of all nursing home residents, 60 percent of all children with disabilities, 30 percent of all adults with disabilities, 76 percent of poor children and 49 percent of all births.

Some nursing home residents could be forced out by the cuts. Under federal law, state Medicaid programs must cover nursing home care, but the Center for Medicare Advocacy predicted that under the budgetary pressures that would be imposed under the BCRA, states would have to limit how much they pay, or restrict eligibility. The AARP said that under the new legislation, older adults could also be charged up to five times more for health insurance than younger people. Under the Affordable Care Act, rates are capped at three times more.

People with disabilities say that cuts to Medicaid would be devastating, likely resulting in reduced access to home and community-based services that allow many to live independently rather than in institutions.

The BCRA is opposed by the Arc, the AARP, the American Hospital Association, the American Medical Association and the American Cancer Society’s action network.

Concerned citizens can contact their representatives in Congress by calling the U.S. Capitol switchboard at 202-224-3121.

 

Learn more about elder lawestate planning and special needs planning at https://www.elderlawnewyork.com and  www.littmankrooks.com. Have questions about this article? Contact us.


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Westchester to Receive $3.3 Million Grant for In-Home Senior Services

Tuesday, September 27th, 2016

Governor Andrew M. Cuomo recently announced that the Westchester County Department of Senior Programs and Services will receive a $3.3 million grant for in-home services for seniors.

Gov. Cuomo said that the funding would help older New Yorkers continue to live in their homes with dignity and would improve their quality of life.

New York State’s county-based Area Agencies on Aging will receive a total of $50 million through the Expanded In-Home Services for the Elderly Program to help seniors remain in their homes and communities. The program is intended to maximize independence, providing the assistance that seniors need in order maintain a high quality of life in their communities. This may prevent the need for more expensive care, the cost of which is often borne by Medicaid.

The services are designed to help lower income seniors who may have functional impairments and need help with activities of daily living. The in-home services program provides non-medical supports such as assistance with cooking, shopping and getting bills paid.Littman Krooks Elder Law

State Senator Sue Serino, chain of the Senate Standing Committee on Aging, said that both seniors and the community at large benefit when people are able to age in place. When seniors maintain their independence costly nursing home placement is prevented. The program is expected to benefit nearly 70,000 New York seniors.

To be eligible, seniors must not be eligible for similar services such as Medicaid, must be 60 years of age or older and must be able to reside safely in the community. It is not necessary to show that there is a medical need for the services.

 

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Medicaid Asset Transfers: What Are The Rules?

Tuesday, June 21st, 2016

For many families, paying for a loved one’s extended stay in a nursing home would be difficult without the help of Medicaid. However, in order to qualify for the program, a person’s income and assets must fall within certain limits.

Federal rules state that to qualify for Medicaid nursing home coverage, a person must have no more than $2,000 in “countable” assets. However, New York State has more generous rules, so for New York residents in 2016 the limit is $14,850 for a single person. If a married person needs nursing home care, there are protections for a spouse who remains outside. In this situation, the community spouse has a maximum threshold of &74,820 to $119,220 ($14,850 for the institutionalized person and $119,220 for that person’s spouse). Certain types of resources are exempt, such as up to $828,000 of equity in a home and one motor vehicle.

Littman Krooks Elder LawIf you have countable resources above the limits, you may be told that you need to “spend down” your assets, paying for nursing home care yourself, until you reach the resource limits, at which point Medicaid begins covering the cost. This is what happens in many cases. In other cases, a family may anticipate the need for long-term care and wish to transfer assets to the next generation ahead of time, in order to preserve the family’s resources while still qualifying for Medicaid. This is an excellent strategy, as long as the Medicaid rules are followed.

Medicaid has a five-year “look-back” period for transfers of assets. A person applying for Medicaid must disclose all financial transactions for the previous five years. During this time, any transfers of assets for less than fair market value may prevent the person from being eligible for Medicaid. (However, in New York State, the asset transfer rules do not apply for recipients of Medicaid for home care services.) In addition, invalid transfers may result in a costly penalty period during which ineligibility may continue even after assets are spent down.

To avoid ineligibility and penalties, it is important to plan ahead. Transfers made more than five years in advance are not affected by the rules. There are also important exceptions to the asset transfer rules as well as legal strategies including certain trusts that can help preserve assets while ensuring eligibility. As you can see, Medicaid planning is very complex and it is essential to have help from a qualified elder law attorney.

 

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Seniors & Mental Health: Is it Mental Illness or Aging?

Sunday, May 22nd, 2016

Seniors are more at risk for mental illness than the general population. According to the Centers for Disease Control and Prevention (CDC), about 20 percent of people age 55 and older experience some kind of mental health concern. Not only are more seniors affected by mental illness, nearly one in three affected older adults does not receive treatment. By learning more about this often-misunderstood problem and watching for warning signs, we may be able to help elders in need get treatment.

Littman Krooks Elder LawMost people are aware that seniors are more at risk for Alzheimer’s disease and other cognitive impairment. About 11 percent of seniors have Alzheimer’s disease, but it is crucial to understand that cognitive decline is not a normal part of aging. Therefore, changes such as increased forgetfulness, confusion or disorientation should be taken seriously. With a prompt diagnosis, seniors can benefit from treatment earlier, and any necessary changes to their living environment can be made in order to keep them safe.

Seniors are also at risk for depression and mood disorders. According to the CDC, in a 2006 survey, 10.5 percent of people age 65 and older said they had received a diagnosis of depression at some time in their lives, and 5 percent had current depression. Another 7.6 percent received a diagnosis of an anxiety disorder at some time in their lives. Anxiety disorders can include a variety of problems, such as phobias, post-traumatic stress disorder and obsessive-compulsive disorder, including hoarding syndrome. Many seniors fail to seek treatment, in part because some people mistakenly believe that depression is a condition natural to aging.

Mental health concerns can have consequences beyond the symptoms of the condition itself. Untreated mental illness can lead to social isolation, take away from seniors’ independence, and cause physical problems and additional medical concerns. That is why it is important for seniors to take preventive measures, and for their loved ones to be aware of warning signs.

Studies have shown that preventive measures can alleviate mental health problems. The risk of depression and anxiety can be lowered as a result of better physical health. Simple exercise three times a week can be even more effective than prescription medication. Research also indicates that keeping the mind active, through social activities, games and puzzles, and communication with friends and family, can decrease the risk of mental health disorders.

Loved ones and caregivers should watch for changes that may indicate mental health concerns for seniors.

Warning signs include:

  • social withdrawal,
  • a depressed mood that lasts longer than two weeks,
  • memory loss,
  • confusion,
  • feelings of worthlessness or guilt,
  • unexplained physical changes, such as in dress, weight or hygiene.

If any of these symptoms appear, discuss them with the family doctor. Treatment such as counseling or psychiatric care can help seniors get on the right track to healthy aging.

 

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Learn the Facts About Medicare, Medicaid and Long-term Care

Tuesday, July 14th, 2015

More than 40 million seniors rely on Medicare for their everyday health insurance needs, and many mistakenly assume that Medicare will also cover long-term care if it is needed. In fact, there are specific limitations to Medicare coverage for long-term care, and such care is often covered instead by Medicaid, which has eligibility requirements. Therefore, it is important to understand how these two public benefit programs affect long-term care expenses.

Littman Krooks Elder Law

Medicare pays for health care for people age 65 years and older or with certain disabilities. Under certain conditions, Medicare will pay for short-term stays in skilled nursing facilities, hospice care, or home health care. Generally, Medicare focuses on medically necessary care such as doctor’s visits and hospital stays, rather than personal care services associated with long-term care.

Until recently, there was an unevenly enforced “improvement standard,” by which Medicare beneficiaries were denied coverage if their condition was no longer improving. However, the settlement of Jimmo v. Sebelius, a 2013 lawsuit, clarified that no such “improvement standard” can be enforced, and people with chronic conditions can continue to be eligible for Medicare to pay for their medical treatment.

Nevertheless, Medicare generally does not provide for room, board and custodial care such as that offered in a skilled nursing facility. Therefore, people needing such care usually use personal resources, long-term care insurance, and Medicaid. Medicaid has income and asset eligibility requirements, and many seniors will have to spend down some assets to qualify. The financial requirements for Medicaid can be complicated, and the advice of an experienced elder law attorney can be invaluable in planning for long-term care.

 

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Age-Related Financial and Planning Milestones that People Will Encounter in their Sixties

Friday, March 28th, 2014

As one nears retirement age, a number of important financial planning milestones begin to approach. It can be difficult to keep them all straight. Here is a timeline of what happens when:

  • At age 59 1/2, people can begin to make withdrawals from 401(k)s, traditional IRAs and similar retirement savings accounts, without an additional tax penalty of 10 percent. (Withdrawals are still taxed as income in any case.) Of course, just because one can begin to make withdrawals at this age does not mean one necessarily should.
  • At age 60, if one’s spouse has died, then one can begin to collect a Social Security survivor benefit. This is also true if an ex-spouse has died, if the marriage lasted at least 10 years and the survivor did not remarry.
  • Upon reaching age 62, people can take the option of early Social Security retirement benefits. Keep in mind that starting one’s benefits early results in lower payments, and it is usually better to wait a few years to receive a larger benefit. If one is eligible for a pension, these benefits also often kick in at this age.
  • At age 65, one becomes eligible for Medicare. There is a seven-month window around one’s 65th birthday to sign up for Medicare benefits and avoid a surcharge.
  •  Age 66, for most baby boomers, is full retirement age for the purposes of Social Security retirement benefits. Additionally, at this age, someone who chose early benefits can now suspend benefits in order to build up delayed retirement credits.
  •  Upon reaching age 70, there is no further advantage to delaying taking Social Security retirement benefits. People who wait until this age to begin receiving benefits maximize their monthly payments.
  • At age 70 1/2, required minimum distributions begin for 401(k)s and IRAs. A certain amount must be withdrawn from these accounts each year, based on the total value of all such accounts.

By paying close attention to these milestones, one can complete a more precise budget, an important part of retirement planning.

 

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