Category Archives: Medicaid

Pay for your funeral now?

 

By Attorney Elizabeth Durnell

 

As an Ohio Medicaid Attorney, I have discovered that the one thing that every one of my clients should have is a burial contract.

 

If done properly, the burial contract will be exempt from a nursing home spend down.

 

Some people hesitate to pre-pay because they have had a bad experience with one funeral home and the quality of their services.  Others have seen that funeral homes go out of business and then the family is stuck paying a second time for the same burial.  

 

In addition to the spend down exemption, another benefit of some burial contracts is that they can be used at any funeral home in the country, which will help to avoid these possible pitfalls.

 

If you are interested in understanding more about how a burial contract works in conjunction with Elder Law planning, please contact Cooper, Adel, and Associates for a free consultation.

Ohio Ethics Advisory Opinion on Medicaid Representation

By Attorney Nathan Simpson

Recently, the Board on the Unauthorized Practice of Law of The Supreme Court of Ohio issued an Advisory Opinion entitled “Medicaid Assistance and Planning by Non-attorneys.” In it, the Court analyzes whether Medicaid planning and application activities constitute the practice of law.  The Court concluded that non-attorneys may assist in preparing and filing Medicaid applications.  However, only Attorneys may engage in Medicaid planning activity requiring specialized legal training, skill and experience constituted the practice of law.

The Court went on to state that :

“Medicaid planning in many, if not most, instances involves estate planning according to the prevailing legal literature. Individuals in need of long-term care often use estate tools such as trusts, gifts, and asset transfers to meet Medicaid income and resource-eligibility thresholds. Such estate planning requires specialized legal training, skill, and experience because it incorporates analysis, interpretation, and the preparation of legal documents.”

Through this opinion The Ohio Supreme Court has recognized the necessity of finding an Ohio Elder Law Attorney to assist in the Medicaid Planning process.  If you or a loved one need Medicaid planning help, contact the Elder Law Attorneys at Cooper, Adel & Associates.

The full text of the opinion may be found here:

http://www.sconet.state.oh.us/Boards/UPL/advisory_opinions/UPLAdvOp_11_01.pdf

Government Benefits in Hard Economic Times

By: Attorney Nathan Simpson

As an Elder Law Attorney at Cooper, Adel & Associates, my work focuses on helping seniors get help paying for the costs of nursing homes, assisted living, and in home care services.  This means helping clients identify and apply for a range of government programs that can help pay for medical services.  Many of my clients have been hit hard by the financial crisis, and are struggling to pay for medical and nursing care.  Additionally, they are concerned that government programs may no longer be available due to the budget cuts that have take place throughout local, state, and federal government.  However, there are many programs available including Veterans Benefits, Nursing Home Medicaid, and PASSPORT in home care.  In fact, some programs have even begun to expand in recent years.

Especially in these hard economic times, it is important to plan for the future with an Ohio Elder Law Attorney, such as the attorneys at Cooper, Adel & Associates.  We may be able to help you qualify for these programs while protecting your assets from devastating medical or nursing home bills.

 

Medicare’s Annual Open Enrollment is from Oct. 15- Dec. 7

By Roy Whited

Every year, people with Medicare get to explore new choices and pick the health and drug plans that work best for them.  This year, this Open Enrollment period is starting earlier- on October 15- and ending sooner- December 7.  This gives people with Medicare a full seven weeks to compare and make decisions, and ensures that they will have essential plan materials and membership cards in hand on January 1, 2012 when new coverage starts.

There will be a wide range of health and drug plan options available across the country, including the original Medicare.  Most people with Medicare can choose a Part D plan to help them pay for prescription drugs.  And people who have chosen to enroll in a Part C Medicare Advantage plan for their basic health care services have the option of staying in that plan, choosing a different plan, or going back to the original Medicare program.  Plans can change from year to year, so these are important choices that should be made with care.  People can turn to www.Medicare.gov, call 1-800-MEDICARE, or consult with a local State Health Insurance Assistance Program (SHIP) for help.

If you are enrolling for the first time or changing from one program to another, I would encourage you to make sure you understand what nursing home benefits are available to you as a Medicare beneficiary.  Time and time again I talk to seniors who are shocked to learn how little Medicare pays for a nursing home stay.  Remember Medicare only pays for skilled care in a nursing home.  They only pay for the first 20 days before there is a co-payment required, and further, to get your bill paid in a nursing home, you must have a 3-day hospital stay prior to going to the nursing home.

The average cost of a nursing home in the State of Ohio is over $6,000.00 a month.  Most long term stays are not covered by Medicare and the cost can be devastating to the average family.  For those who can afford the cost, like the idea, and can qualify, long term care insurance can possibly be a solution.  For those who can’t or don’t like the insurance idea there are certain planning techniques that can very helpful in protecting your assets from these situations.  The sooner you start planning, the more effective you can be in protecting your life savings.  Why not contact an Elder Law Attorney today to start the planning process?

Preserve Family Memories in a Video Gain Peace of Mind for your elders

by Barbara Penwell

medicaid attorney in ohioTwelve years ago, my father and the beloved husband of my mom, Betty passed away. One of his last wishes was for me to take care of Betty, make sure she is safe and most importantly, loved. This vow was very easy for me to embrace and keep. Betty and my father were married in 1982 and spent seventeen glorious years together before he passed. My sister and I, very quickly on, not only accepted her into our family, but also called her mom, grandmother and most recently, great-grandmother.

Betty kept numerous photos of her and dads’ life together, including the proposal evening, several travels spanning the US, Germany, France, Spain, UK,  & Egypt, attending the wedding of my nephew, experiencing the birth of a daughter and son to my nephew and wife and countless family get togethers.

Two and a half years ago, Betty suffered a stroke that resulted in short term memory loss, hence being diagnosed with Alzheimer’s disease. While not physically impaired, we were faced with the reality of her not being able to live alone.  I am her healthcare agent, Power of Attorney,  and Co-Executor of her estate, thus remembering my vow to dad, I embarked on arranging her care in an assisted living facility. On most days, her routine is challenging as her cognitive ability to function is gone. What has brought her joy, is attending the facilities’ programs that include music from her genre and watching old time movies.

Living approximately 2.5 hrs away, does not afford me the time my husband and I would like to spend with her. Thus, we came up with an idea to create a video capturing a story line of memories from the photos Betty kept over the years. She loves the big band era of music, Frank Sinatra, Tony Bennett, Bing Crosby and the like, so these artists are the musical backdrop to the video. To this day, Betty can escape her frustration of the memory loss and watch the video daily, weekly or monthly. The video brings priceless joy and warms her heart. Betty has stated we should have done a video like this years ago and has told her friends to do the same.

It is never too late to gather photos you and your loves ones have accumulated and tell your own “story”.  A video will help provide peace of mind to an elder person, as it has in the case for Betty.

Equally important, it is never too late to discuss your estate planning with family members, prepare for the future and gain peace of mind.

It is never too late to learn about nursing home planning, asset protection, family trusts, veterans benefits, medicaid planning and estate recovery from Cooper and Adel and Associates and gain peace of mind.

It is never too late to act.

 

Alzheimer’s is “a kind of death”

By Atorney Elizabeth Durnell

Ohio Medicaid AttorneyDuring my experiences as an Ohio Elder Law Attorney, I have seen many different kinds of illnesses and the many different responses to these illnesses.  We recently had a client whose husband was in a nursing home due to a completely debilitating stroke.  Her husband barely recognized her anymore.  She was very distraught when she learned that she would lose a significant portion of her assets to the nursing home and wondered how she would continue to pay for her home.  She asked us if divorce was an option for them.  It is becoming a mainstream option.  It was recently discussed by Religious broadcaster Pat Robinson on the “700 Club.”

Following is an excerpt from the Associated Press by Tom Breen.

Religious broadcaster Pat Robertson told his “700 Club” viewers that divorcing a spouse with Alzheimer’s is justifiable because the disease is “a kind of death.”

During the portion of the show where the one-time Republican presidential candidate takes questions from viewers, Robertson was asked what advice a man should give to a friend who began seeing another woman after his wife started suffering from the incurable neurological disorder.

“I know it sounds cruel, but if he’s going to do something, he should divorce her and start all over again, but make sure she has custodial care and somebody looking after her,” Robertson said.

The chairman of the Christian Broadcasting Network, which airs the “700 Club,” said he wouldn’t “put a guilt trip” on anyone who divorces a spouse who suffers from the illness, but added, “Get some ethicist besides me to give you the answer.”

Most Christian denominations at least discourage divorce, citing Jesus’ words in the Gospel of Mark that equate divorce and remarriage with adultery.

Terry Meeuwsen, Robertson’s co-host, asked him about couples’ marriage vows to take care of each other “for better or for worse” and “in sickness and in health.”

“If you respect that vow, you say ’til death do us part,’” Robertson said during the Tuesday broadcast. “This is a kind of death.”

A network spokesman said Wednesday that Robertson had no further statement.

Divorce is uncommon among couples where one partner is suffering from Alzheimer’s, said Beth Kallmyer, director of constituent services for the Alzheimer’s Association, which provides resources to sufferers and their families.

“We don’t hear a lot of people saying ‘I’m going to get divorced,’” she told The Associated Press. “Families typically respond the way they do to any other fatal disease.”

The stress can be significant in marriages though, Kallmyer said, because it results in the gradual loss of a person’s mental faculties.

“The caregiving can be really stressful on a couple of levels,” she said. “There’s the physical level. There’s also the emotional level of feeling like you’re losing that person you love.”

As a result, she said, it’s important for couples to make decisions about care together in the early stages of the illness, when its effects aren’t as prominent.

It is likely you have more options than simply divorcing a spouse with Alzheimer’s, but you need to find out about them.   If you and your loved ones are suffering through this horrible disease, please contact Cooper, Adel and Associates for a free consultation to determine your options.

 

I don’t want my parents in a nursing home – are there options?

By Attorney Elizabeth Durnell

When I meet with my elderly clients and their children, the statements I hear most often are “I don’t want to go to a nursing home” or “My parent will not go to a nursing home.”  If you are like these clients and their children, you want to know if you have options other than a nursing home to help care for yourself or your parent.

Luckily for you, there is a program run by the state of Ohio called PASSPORT or Pre-Admission Screening System Providing Option and Resources Today.  This is a Medicaid program in which an elderly person can receive a certain amount of in-home care a week.

When the state created the new budget earlier this summer, the legislatures cut the budget for nursing home Medicaid, but left PASSPORT untouched.  This is due to the fact that in-home care costs about one-third of the cost to care for someone in a nursing home.

This in-home program benefits not only the elderly parent who does not wish to enter a nursing home, but also the children who, as much as they would like to honor their parent’s wishes, may be worn out by taking care of not only their parents, but also their own children and grandchildren.

If you are in this situation, please contact Cooper, Adel & Associates for a free consultation to determine what your options are.

 

Do your own Home Projects? Maybe … Do your own Nursing Home (Medicaid) Planning ? Never!

By Attorney Thom L. Cooper

Many people like to do things themselves, and particularly where it can save you some money.  I am pretty handy, and like to do things around the home.  Just today I made a boot scraper to scrape mud off my shoes when I go out to the garden.  It involved some minor fabrication and welding and I was happy when I was done with the project.  However if the project eventually “goes South” and breaks,  I am just out the mud scraper.  I would never try to make a parachute and jump out of an airplane with it, even if it seems simple to make a parachute and even if I have a lot of friends who can give me advice about what they have heard about parachutes.  The consequences are too severe.

Yet this is precisely what many people do when their family member faces a catastrophic health care situation, which may involve a nursing home stay.  They talk to their friends or a family lawyer with little experience in this area and then “jump out of the airplane.”   What are the consequences if you goof up?  The loss of you life savings and home.

It is my opinion that Nursing Home law is the most difficult area of Law that I practice.  Let’s see what some of the Courts think about this area of the law:

This is what the Supreme Court of the United States has said about the Medicaid Act:

The Medicaid Act is “an aggravated assault on the English language, resistant to attempts to understand it.” See Schweiker v. Gray Panthers, 453 U.S. 34, 43 (1981).

Let’s see what other courts think:

1)  Medicaid has been described as equivalent to the “Serbonian bog” referenced in John Milton’s Paradise Lost: “A gulf profound as that Serbonian bog . . . Where Armies whole have sunk.” See Ross v. Giardi, 680 A.2nd 113 (Conn. 1996): “[W]e are required to wade once again into the virtually impenetrable ‘Serbonian bog’ of federal and state laws governing the Medicaid system.”

  1. One of the Circuit Courts, just below the Supreme Court, had this to say:

The Medicaid Act is one of the “most completely impenetrable texts within human experience” and “dense reading of the most tortuous kind.” Rehab. Ass’n of Va. v. Kozlowski, 42 F.3d 1444, 1450 (4th Cir. 1994).

3)  From the Memorandum Opinion of the Honorable Jay C. Waldman in Mertz v. Houston, No. 01-2627, Eastern District of Pennsylvania (July 30, 2001):

“The Medicaid Act is actually a morass of interconnecting legislation. It contains provisions which are circuitous and, at best, difficult to harmonize.”

If you or a family member is facing a catastrophic health situation,  please don’t jump out of the airplane with your home made parachute.  Seek the help of an elder law attorney experienced in this matter.

Can My Parents Keep Their Home If They Have To Go Into A Nursing Facility?

By Jordan Myers

The simple answer to this question is, “yes”. However, If you have spent any time at all helping your parents plan for the unfortunate event that they might have to enter a nursing home, you know that “simplicity” is a luxury not often afforded in this situation. In today’s blog, I will elaborate on some of the restrictions that you must keep in mind when planning for you parents, or yourself, to enter a long-term care facility.

To pass the “asset test” for qualifying for Medicaid in Ohio an individual must have less than $1,500 in assets. The primary place of residence and one car are exempted from making this determination. If only one parent is going into a care facility then the other can remain in the home, but not free and clear. Any individual that receives Medicaid assistance is subject to Estate Recovery.

Estate Recovery is a program through the Office of the Attorney General that attempts to recoup any cost associated with providing Medicaid assistance at the time of the recipient’s death. The restriction with Estate Recovery is that the liens can be placed for no more than the amount spent on the individual’s care. With the rising costs of health care, a one to two year stay in a facility can deplete the majority, if not all, of the value of the home!

In the scenario where a parent’s spouse has pre-deceased them and there are no dependents, the home will then be considered to be a “countable” asset. This means that the equity in the home must be used to pay for the homeowner’s healthcare costs. The Ohio Administrative Code (OAC) does, however, allow each Medicaid recipient a 13-month “right to return home” in which the home cannot be considered a countable resource.

There are many complex scenarios and restrictions on the treatment of the home for Medicaid purposes, and many strategic plans that can be used to protect the parent’s home and the family’s heirs. The best way to discuss your specific scenario and develop the best overall plan is to meet with the experienced staff of Elder Law Attorneys at Cooper Adel & Associates. Call today to schedule your FREE consultation.

As always, remember that it is better to look ahead with preparedness than to look back with regret!

 

Federal Medicaid changes and what they mean to you

By Attorney Liz Durnell

Medicaid funding may soon undergo a major Federal funding change.  Currently, the Federal Government pays each state a fixed percentage of incurred Medicaid costs.  However, there is a possibility that Medicaid may be converted to a block granting system.

What does this mean for your state and for you? Under a block grant, the federal government provides each state with a fixed amount of funding regardless of the states actual costs.

The effects of this could be devastating to our aging population.  The fact that the the baby boomers are adding to the elderly population and the current economic climate are forcing more individuals to rely on Medicaid benefits. If Medicaid block grants are enacted, states will not have enough money to cover the needs of their populations, resulting in a decrease in the number of individuals qualifying for benefits and the amount of benefits available to those who do qualify.

The United States House of Representatives recently passed a resolution to convert Medicaid to a block granting system.  Even though the resolution failed in the United States Senate, the issue is still not dead.  Medicaid block grants will more than likely be a bargaining chip during the current debt ceiling debates.

Pre-planning is even more important now to avoid the hazards created by these possible changes that may affect your quality of life as you age.  Please contact Cooper, Adel and Associates for your free consultation to determine your best course of action in an ever-changing political world.

 



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