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Estate Planning

Nov 14
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Medicaid for Assisted Living

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Assisted Living

The RI Medicaid program covers assisted living services in State-licensed Assisted Living Residences (ALRs) that are certified to participate in the long-term services and support (LTSS) program. Covered services include on-site, 24-hour personal care assistance, homemaker and chore services, medication management, therapeutic, social and recreational activities, and health-related transportation. The amount of these services a person receives may differ based on the scope of their needs.

Medicaid does not cover ALR room and board and add-on services. A person who chooses this Medicaid LTSS option must pay from other resources housing charges and any non-Medicaid covered services (like cable and internet access) they choose to receive from the ALR. To ensure individuals applying can afford these costs, the dollar amount a certified ALR can charge for housing each month is capped. Rhode Island also has a State Supplemental Payment (SSP) program that provides financial help to low-income Medicaid beneficiaries living in ALRs. Depending on the scope of a person’s needs, access to some of the Medicaid certified assisted living residences may not be available.Assisted Living Activities

How to receive services

Case management agencies contracted by the Office of Healthy Aging assist individuals in completing a Medicaid LTSS application, assess the scope of their needs, and assist them in developing a person-centered plan of care. These agencies are also responsible for monitoring the delivery of services in the plan of care and coordinating linkages to benefits across community-based health and social service agencies.

Related Service

Nursing and skilled therapy services are not part of the Medicaid-assisted living services but may be authorized by Medicaid and/or other health insurance, as ordered by a physician.

Who is Eligible?

Adults 19-65 with disabilities, or anyone 65 or older who is eligible for Medicaid LTSS.

Need Assistance Applying?

For more information about Medicaid covered assisted living services and to apply for the same, call THE POINT at 401-462-4444.

A list of assisted living communities is located here

 

Jun 15
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A Brief History on Estate Taxation

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The First Tax

Levies on the post-mortem transfer of property originated in Egypt around 700 BC, according to a IRS history They were later imposed, around the time of Christ, by the Roman emperor Caesar Augustus, and then by feudal lords in Europe. America’s first death tax—that’s what it was officially called—was imposed as part of the Stamp Act of 1797 to cover the cost of US military skirmishes with France. The federal government charged 25 cents on postmortem bequests of $50 to $100, 50 cents on $100 to $500, and $1 on each additional $500.

Congress enacted a second round of death taxes in the Revenue Act of 1862 to raise funds for the Union to fight the Civil War. Lawmakers did so again in 1898 to bankroll the Spanish-American War. These taxes were not burdensome. In the latter case, if a wealthy man left behind $10 million—a staggering fortune—to a sibling, child, or grandchild, his estate owed the government just over 2 percent, about $219,000. All three taxes were repealed after the hostilities ceased.

By the late 1800s, however, America was transitioning rapidly from an agrarian economy to an industrial one. The old federal patchwork of tariffs and property taxes was leaving the fortunes of Gilded Age industrialists like Andrew Carnegie and John D. Rockefeller largely untouched. Reformers began calling upon the government to tax these “robber barons,” while the businessmen, as today, countered that such a move would stifle growth and quash innovation. The Revenue Act of 1916, in anticipation of the coming war effort, levied a tax of up to 10 percent on inheritances of $50,000 or more (about $1.1 million today); the levy was increased to 25 percent the following year, although it was later repealed. But Rockefeller never paid a penny. He just signed his fortune over to his son before he died, because Congress hadn’t yet passed a gift tax.

Modern Day

It wasn’t until 1976, after another six decades of tweaks, that Congress finally put in place a comprehensive, integrated gift-and-estate tax similar to what we have today. But the endless squabbling over the estate tax, which was expected to bring in just $16 billion last year, continues to this day.

Do you or a loved one need to discuss the impact estate taxes may have on your Estate? Call us for a no-obligation consultation.

Jan 04
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On-Line Accounts After Death

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So What Happens To My Facebook Page and On-Line Accounts When I die?

When we think about what will happen to our “things” when we die, we often do not consider our Facebook, twitter, google, or snapchat accounts. Technology is often the last thing on our minds.

It may be time to consider putting together a tech checklist so that your loved ones can have access to digital files like photos, videos, and other memories. Given the continuous growth in technology, it is more important than ever before to make a plan for your digital assets. This has often been referred to as a “digital legacy.”


Below is a checklist to help you put together your digital legacy plan:
1. Take inventory of your digital assets
2. Add a digital executor to your will [Note: It is problematic whether a court will allow bifurcation of an executor’s duties.] 3. Add digital heirs to your accounts
4. Plan to pass on your passwords
5. Record your stories

This will be a great start for putting together a solid plan for your digital assets.

Still have more questions and want to develop a plan for your digital and non-digital assets? Call us for a free consultation.

Nov 23
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FRAUD: The “F” Word of Estate Planning

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Fraud is a label to run from – not walk from

As an attorney that practices in areas of law that have both local and national scope – reading and reviewing scholarly writings and recent case decisions is critical to staying current. From these readings, we come to learn and respect the work done by other attorneys and how they are best representing their clients and their interest.

One such article came across my desk entitled “Medicaid Planning Technique Didn’t Work Exactly as Intended” a link to the full article can be found HERE.

The article examines what could be best described as a case study of one attorneys recommendations to a client who was retained to assist the family with Medicaid planning and qualification. As the title infers, the plan did not work out as explained and the clients goals and objectives were not carried out with the suggested plan proposed and enacted by the attorney. Fraud ruins any thought of a clever estate plan – and once that genie is let out of the bottle – it is hard to get it back in.

If it seems too good to be true – it probably is

The case is a lesson for both client and attorney. Just because you can do something – does not always mean you should. Deciding on an estate plan with the goal of qualifying for Medicaid benefits is something that must weigh all of the factors and rules. Knowledge of family dynamic, conflicts, tensions, and history are as important as understanding the rules of Medicaid eligibility, assets and income.

Fraud is a badge that does not wash off easily. Having to defend yourself or others from being accused of absconding with the assets of an elderly loved one is not something anyone wants to envision. There are legal consequences – which translate into strained relationships and possibly property and certainly financial penalties with the ultimate loss of liberty.

The author of the article makes the following suggestions when selecting an elder law attorney to work with:

  1. Be careful about selecting your lawyer. Do you want someone who really knows estate planning and/or Medicaid planning? Check out their reputation, their online information, and recommendations from friends and colleagues. Did you meet the lawyer at a promotional seminar at the public library or a local restaurant? Make sure you’re not being sold something you don’t really want or need.
  2. Does a particular Medicaid planning technique sound almost too good to be true? Be suspicious and ask for input from others.
  3. When a lawyer agrees to meet with you and your family member together, that suggests something troublesome. We are supposed to represent just one person, not a whole family. Recognize that your interests and those of your family member might differ, and respect the lawyer’s efforts to maintain that separation.
  4. Recognize that even though an idea — and particularly a Medicaid planning technique — might work, it might also have unintended secondary effects.

 

Nov 13
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RMD Tables To Be Updated

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Required Minimum Distributions: RMD’s

Section 401(a)(9) requires most retirement plans and individual retirement accounts to make required minimum distributions (“RMDs”) over the lifetime of the individual (or the lifetime of the individual and certain designated beneficiaries) beginning no later than such individual’s required beginning date (generally, April 1 in the year following attainment of age 72). This minimum amount is determined by dividing the individual’s account balance by the applicable distribution period found in one of the life expectancy and distribution tables (the “Tables”).

On November 12, 2020 the Department of Treasury is scheduled to publish final regulations updating the Tables, which is in response to an Executive Order issued in August of 2018 directing the Secretary of the Treasury to review the Tables to determine if they should be updated to reflect current mortality data.

RMD’s Tables are being updated

Longer Life Expectancies Reflected

The updated Tables will generally reflect longer life expectancies than presently reflected in the current Tables last published based on 2003 mortality rates. For example, the current Tables use a life expectancy of 25.6 years for a 72-year-old for purposes of calculating the RMD while the updated Tables will use a life expectancy of 27.4 years. This will result in reduced RMDs, enabling individuals to retain larger balances in retirement accounts to account for the possibility of living longer.

The updated Tables will be effective for distributions beginning on or after January 1, 2022 and will include a transition to ‘re-set’ the life expectancy for certain individuals already receiving RMDs based on the prior Tables. For example, an individual who attains age 72 in 2021 will be required to take an RMD no later than April 1, 2022. The updated Tables will not apply to calculate the individual’s 2021 RMD (paid on or before April 1, 2022), but the updated Tables will apply to the 2022 RMD (paid on or before December 31, 2022). The regulations do not include periodic automatic updates to the Tables. Instead, the Treasury and IRS will review the Tables at the earlier of 10 years or whenever a new study of mortality experience is published. The final regulation and new Tables can be found here.

Impact on Medicaid and Estate Planning

RMD’s are a factor that every estate planner must consider into calculations of income and assets for Medicaid eligibility. Understanding the new tables and income that will be forced out to a individual or spouse is important to know as there are minimum and maximum income limits. A personal consult with an estate planning attorney can best illustrate the impact this will have on your plan.

May 18
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COVID-19 Stimulus Checks and Medicaid

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Will my COVID-19 Stimulus Check impact Medicaid Eligibility?

The Coronavirus Aid, Relief, and Economic Security Act, also known as the CARES Act (passed on March 27, 2020) is a $2 trillion economic relief package intended to help offset the huge financial crisis caused by the Coronavirus (COVID-19) pandemic. As part of the CARES Act, the majority of Americans, including those who are elderly and on fixed income, will receive a one-time stimulus check from the Internal Revenue Service (IRS).

Many Medicaid beneficiaries who live at home, assisted living, adult foster care, or nursing homes are concerned the money will put them over the Medicaid income or asset limit, and therefore, disqualify them from Medicaid benefits. In addition, Medicaid applicants express the same concern that the additional money will cause them to have income or assets over Medicaid’s limits, and as a result, prevent them from becoming eligible for Medicaid.

Stimulus checks will not be counted as income and therefore will not impact Medicaid beneficiaries or applicants. However, should the stimulus money not be spent within 12 months, it may be counted as an asset, and therefore could impact eligibility in the year ahead. Therefore, make sure you spend the funds as soon as possible on eligible purchases in accordance with Medicaid regulations (DO NOT GIFT IT).

Nursing Home Residents

he receipt of a stimulus check by Medicaid beneficiaries who reside in nursing homes will not impact these individuals’ Medicaid benefits. Stated differently, the receipt of the check will not disqualify them from Medicaid nursing home care. This is because Medicaid will not count the money as income, which means it cannot push one over Medicaid’s income limit, and hence, result in the loss of Medicaid benefits.

United States Treasury stimulus payment for Coronavirus CoViD-19 outbreak disease.

While Medicaid-funded nursing home residents are required to surrender all of their income except for a personal needs allowance and a monthly maintenance needs allowance for a non-applicant spouse (if applicable) to Medicaid, the money from the stimulus check will not have to be surrendered to Medicaid. This is because, as mentioned above, the stimulus check is not considered as income by Medicaid. Rather, it can be thought of as a tax refund.

Furthermore, the stimulus check will not count as assets, given the money is spent within 12-months of receiving it. So, within this time frame, a nursing home Medicaid recipient can have possession of the money and it will not impact one’s Medicaid eligibility. However, it is imperative that the money, in its entirety, be spent within one year. If not, the money will count towards Medicaid’s asset limit and can potentially push one over the limit, resulting in Medicaid disqualification.

The money can be spent by nursing home residents in a number of ways. For example, one might buy new clothing, purchase a television for his / her room, stock up on extra snacks, or purchase an irrevocable funeral trust. What one does not want to do is to buy assets that are counted towards Medicaid’s asset limit. For instance, collectors coins would most likely be considered an investment and the value of them would be counted towards the asset limit, potentially causing one to be over the limit and lose Medicaid benefits.

The stimulus check will either be directed deposited in the nursing home resident’s bank account or be mailed to the address on one’s 2018 or 2019 tax return. To further clarify, if a refund was issued via direct deposit for one’s tax return, the stimulus check will be directed deposited in the same bank account. If not, the check will go in the mail. Persons who do not have to file tax returns, such as Social Security recipients, will receive stimulus checks in the same manner in which they receive their Social Security benefits. Therefore, if one receives his / her Social Security payment by direct deposit, the stimulus check will automatically be received via direct deposit also.

Spouses of Nursing Home Residents

Spouses of nursing home residents on Medicaid (called Community Spouses), who are not on Medicaid themselves will receive a stimulus check. The receipt of this check will not impact their spouses’ Medicaid eligibility in any manner. First, and foremost, the money from the stimulus check is not considered income by Medicaid, and even if it were, the income of a non-applicant spouse is not considered in the continuing Medicaid eligibility of his / her nursing home spouse.

For Medicaid beneficiaries, the entire check needs to be spent within 12-months of receiving it or the remaining funds will count as assets towards Medicaid’s eligibility. However, the same rule does not hold true for community spouses. To be clear, there is no time limit in which a spouse of a nursing resident must spend his / her stimulus check. Furthermore, non-applicant spouses can spend the stimulus check in any manner they choose, such as paying rent or mortgage, utility bills, food, or even on a splurge, such as a pricey piece of jewelry.

No matter how long it takes for the community spouse to spend the funds, and regardless of how they are spent, it will not impact the institutionalized spouse’s Medicaid eligibility. In other words, a community spouse can be rest assured that it will not cause the nursing home resident to lose his / her nursing home Medicaid benefits. This is because the assets of the non-applicant spouse are not considered for the continuing Medicaid eligibility of his / her Medicaid beneficiary spouse. (The community spouse’s assets are only considered when determining initial eligibility).

The community spouse will receive the stimulus check either via direct deposit or in the mail. Exactly the manner in which it will be received will be based on one’s 2018 or 2019 tax return and how a refund was issued. For instance, if one received a refund via the mail, the address on file will be used and the stimulus check will be mailed to that address. For those who are not required to file tax returns, such as recipients of Social Security, the check will be received in the same way in which their monthly Social Security benefit is received. This means that if it is deposited directly in one’s bank account, the stimulus check will also be directly deposited.

Please note that the institutionalized spouse will also receive a stimulus check. However, at this time, it is not known if the check will be issued separately from his / her community spouse’s check. It is our assumption that if 2018 or 2019 tax returns were filed jointly, the couple will receive one check (couples who filed joint tax returns are eligible for double the amount of a single filer), while if tax returns were filed separately, each spouse will receive an individual check. Again, for persons on Social Security, there is no need to file tax returns. In this case, checks will automatically be received in the same manner in which Social Security benefits are received.

How Much Will the Stimulus Check Be?
The amount of the stimulus check, also called an economic impact payment or recovery rebate, may be for as much as $1,200 / person.

• Individuals who earn up to $75,000 / year will receive a $1,200 check.
• Married couples, filing jointly who earn up to $150,000 / year, will receive a $2,400 check.
• Individuals who earn up to than $99,000 / year will receive a check, but it will be for less than $1,200.
• Married couples, filing jointly who earn up to $198,000 / year, will receive a check, but it will be for less than $2,400.

Payments will be based on one’s tax returns from 2018 or 2019. Please note that for disabled persons and seniors who receive Social Security payments, it is not necessary for a tax return to be filed. (Persons who receive Social Security benefits generally do not have to file a tax return). Rather, the IRS will automatically send out economic impact payments to these individuals.

Checks will be received either via direct deposit or in the mail.

SOURCE: American Council On Aging 

May 23
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Protecting Asset for the Healthy Spouse

By Estate Planning

How Can I Pre-Plan Now to Protect Assets For the Healthy Spouse?

Under the Medicaid rules, if either spouse moves to a nursing home, he or she will become eligible for Medicaid to pay for his or her care when the savings have been spent down to $4,000 for the institutionalized spouse and, after no more than $126,420 is deemed available for the community spouse (in 2019). If you took no other planning steps, the balance of your savings would have to be spent down to these levels. However, three approaches can permit you to keep most or all of your savings: (1) purchase an immediate annuity, (2) create and fund an irrevocable income only trust; or (3) spend the excess assets on permissible goods that preserve their value.

Purchase an Annuity

The spouse at home has the option of transforming his or her excess assets into an income stream by purchasing an annuity. The terms of the annuity must be carefully observed, which will be important with respect to the annuity’s passing muster with the Medicaid regulations.

Create and Fund and Income Only Trust

You can make transfers to your children or into trust for their benefit, reserving the ability to live in any real estate transferred and to receive income from the assets in the trust. Doing so would cause up to five years of ineligibility for Medicaid. So you would need to be comfortable with the amount of funds you would keep for yourselves. This option is very popular with many clients as it offers a great deal of protection with a manageable amount of loss of control and access to transferred assets. Understanding the rules of the trust are important before using this trust.

Spend Down Excess Resources

You may also pay off any debts you may have or pay for goods and services you may need or desire. This includes repairs to your house, clothing, personal items, prepaying your funeral, and anything else you may like. Medicaid penalizes transfers or gifts, but not spending if the spending is for the benefit of the Medicaid applicant or his or her spouse.

In addition to taking one or more of the steps described above, if one of you moves to a nursing home, you should transfer all of your assets into the other’s name. He or she should also have a will that disinherits the nursing home spouse. Otherwise, if the healthy spouse passes away first, all of his or her assets will go to the nursing home spouse and have to be spent down to $4,000.

As you can see, there are a number of options available. You cannot choose the best one ahead of time because the proper course of action depends on your situation when one of you moves to a nursing home, which hopefully will be many years away, if it happens at all. At that time, it is critical to meet with an attorney to discuss these options and decide on a course of action that best fits for you while maintaining Medicaid eligibility.

Apr 05
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Medicare Update 2019

By Estate Planning

Medicare 2019 – Everything You Need To Know

Medicare is an important piece of the American insurance landscape, not only for people age 65 and older, but for all Americans. That said, this benefit is not easy to navigate. Eligible individuals must be thoughtful about the coverage they need, the timing of enrollment, and coordination with other healthcare benefits, if they want to make the most of the Medicare program.

Attached is a report recently published by Northern Trust that recaps the Medicare program and is a good resource for people wanting to learn more.

It addresses the following questions:

  1. What does Medicare cover? Do I still need Private Insurance?
  2. How much does it cost?
  3. I am thinking about early retirement but I am concerned about health insurance coverage and eligibility. What are my options?
  4. I am turning 65 next year and still working, should I transition from private insurance to Medicare and if so, how do I do that?

CLICK HERE TO READ THE FULL REPORT wpi-medicare 2019

Medicare is a critical component of every persons health insurance portfolio but it does not cover long-term skilled nursing. The Medicaid program covers eligible individuals cost for long term skilled nursing, however, there asset and income limits before someone becomes eligible. Generally, a person must have countable assets below $4,000 and monthly income below $10,000 to be eligible. A person who is on Medicare and then transitions over to Medicaid will be required to maintain their Medicare coverage. Medicaid being a welfare program, is an insurer of last resort, whereas Medicare is a primary insurance for people.

Still have questions about planning for your future healthcare needs including long term care planning? Contact us for a no cost consultation.

Matt Leonard

Feb 14
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How Can I reduce Capital Gains Taxes?

By Uncategorized

Consider Transferring Highly Appreciated Assets to a Parent

If property is held by someone at their death, the “basis” in the property used by the seller to determine taxable gain on its sale is re-set to the fair market value at the date of death.

Income and capital gains tax rates have increased over the last 10 years, and during that time the exemption to avoid estate tax has increased dramatically. This combination (which did not generally exist before now) creates a tremendous opportunity to reduce income tax on property sales. There are many ways to do this. One simple technique is to transfer a highly appreciated asset to a parent. When Mom or Dad passes away, the basis in the asset is increased to its fair market value at the date of death (even though there is no estate tax), which can eliminate income tax on the gain on a sale thereafter, or permit much greater depreciation deductions when re-acquired by the owner.

So for example, if basis is stepped up by $1,000,000, then the tax on sale of the asset will be reduced, which tax savings could easily be $300,000. Note this is an after-tax savings!

There are related issues that should be addressed to protect the asset, account for timing and further enhance the tax benefits.

Dec 21
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Medicaid Eligibility Update

By Uncategorized

Rhode Island has updated its rules to become Medicaid eligible.

If you are a Rhode Island resident and you are seeking Medicaid benefits, you should be aware of some recent changes approved by the Rhode Island Department of Human Services as to your eligibility under the program. Final rules are expected to be published and release shortly but here is a recap of the expected changes:

  1. Income cap of $9,581 meaning that if the applicant has more than $9,581 in income, then they can never become eligible for Medicaid, nor can they start the penalty period.  If they have income under $9,581 but greater than $6,700 and they want to start a penalty period, they can do so but cannot get community Medicaid benefits, like Rx copays and doctor bills.   If their income is under $6,700, then nothing changes.    This went into effect in September and is effective for applications for eligibility delivered after 10/1/18.   50-00-2.4

    Changes Are Coming

  2. Long term care insurance is not considered countable income for purposes of the above income cap.   However, once on Medicaid, it would need to be spent as part of the patient share.    50-00-6.5.2(B)
  3. Burial Funds & Irrevocable Funeral Contracts have new limits which are helpful and could affect clients.  The new cap on Irrevocable funeral contracts is $15,000 and anything over that would be considered a countable asset.   40-00-3.5.5 A(1)(f)
  4. Life insurance is now exempt up to $4,000 of cash surrender value, with anything over being countable.  40-00-3.5.5 A(1)(h)
  5. Retirement Funds now have a new definition, but as long as they are income producing and the client gets at least the RMD, then they should still be fine. 40-00-3.5.5 A(2)(g)
  6. Penalty Divisor is $9,581 since mid September.

Like any social program, the figures and rules for eligibility are constantly revisited and updated based on changes in federal law, budgets, and program changes and advances. Staying current on the latest rules is the challenge.

If you or a loved one is facing serous medical issues requiring skilled nursing care, the Medicaid program will help pay for those costs for applicants who have assets and income within program limits. Contact us to discuss your estate plan and if your estate plan should be revised so as to become eligible for these valuable benefits.

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