Wednesday, April 30, 2008

How to Pay Family Caregiver

Getting the Government to Pay Family Caregivers

Some 44.4 million adult caregivers -- or 21% of the U.S. adult population -- provide unpaid care to seniors or adults with disabilities, according to a 2004 study by the National Alliance for Caregiving in Bethesda, Md. On average, those caregivers provide 21 hours of care a week and the average length of time spent providing care is 4.3 years.

Over the years we have received many public requests through our website. A number of these requests have been from family caregivers who had to cut back on their employment or even quit their jobs in order to take care of one or both of their parents. Invariably these caregivers assume there is a government program that will pay them to provide this care. Only recently have we become aware of some programs that will pay family members. These programs are not publicized and the public is largely unaware of them or how to receive them.

Money Follows the Person—MFP (Self-Direction in Care)In recent years, some state Medicaid programs have been experimenting with the idea of providing a budget to elderly Medicaid recipients. This money can be used to hire family or friends to provide care at home. Most of these programs are very limited, and there are waiting lists for them. Also, the amount of money available may not always be enough to compensate a family member to provide full-time care in lieu of maintaining employment.

But the attitude of government is quickly changing and there is now a new initiative to provide income for family caregivers. The Deficit Reduction Act of 2005 allocated $1.4 billion -- the largest demonstration grant in Medicaid history -- to a program called "Money Follows the Person." This program is designed to transition individuals receiving Medicaid and who are living in institutions, back into the community. In 2007, 31 states received their portion of the grant money pie to begin demonstration programs offering more choice in care besides an institution. Most of these state programs offer a concept called "self-direction" which allows a budget to be established by Medicaid for the care recipient. Self-direction allows the care recipient to spend this money hiring any caregiver of choice and this typically includes friends and family.

Unfortunately, this is not a widespread benefit for elderly Medicaid recipients and in addition only applies to bringing elderly people out of institutions and back into the community to receive care. Over the next five years, only 34,395 elderly care recipients nationwide are expected to be transitioned to community-based care through this program. Even though this represents a fraction of the elderly, who over the next five years are expected to receive Medicaid services in institutions, there is still a possibility for the family to apply for one of these programs and to have the government pay for their care services.

Using the Veterans Aid and Attendance Pension Benefit a totally overlooked source of money to pay family caregivers to provide care at home is the aid and Attendance Pension Benefit. This money is available to veterans who served during a period of war. Pension money is also available to the widows of these veterans. This benefit, under the right circumstances, can provide up to $1,843 a month in additional income to pay family members to provide care at home.

It also comes as a surprise to many people that about 33% of all seniors could qualify for the aid and attendance benefit. That's how many veterans or their surviving spouses there are in this country.

Getting the aid and attendance benefit to pay for family caregivers is not an easy task. This is because there must be a caregiver contract in place and services for care must be initiated and thoroughly documented before application can be made. Getting these applications approved requires using a consultant who understands the documentation requirements. Very few people can do it on their own.

Using Medicaid Spend down to Pay Family CaregiversIn order to qualify for Medicaid nursing care, a person must spend his or her cash assets down to less than $2,000. Instead of giving this money to the nursing home and waiting for Medicaid to kick in, the potential beneficiary can instead transfer this money to a child in return for caregiver services. This is not considered a gift and if done properly does not create a penalty for Medicaid eligibility. The strategy also allows Medicaid to take over paying its portion of the nursing home costs much sooner.
As with the caregiver contracts for VA benefits, an expert in this area of Medicaid benefits is required in order to do it right. In fact, the same type of caregiver agreements used for obtaining extra income under the veterans benefit can also be used for Medicaid. A consultant who is proficient in both the aid and attendance benefit and Medicaid personal caregiver agreements can be of great service to the community. This contracts’ consultant can help relieve a great deal of caregiver stress by providing funds to help that caregiver cope with personal financial pressures.

We are excited to help family caregivers lessen the financial stress of their caregiving commitment.

Members of the community who wish to know more about veterans benefits consultants and caregiver agreements can contact the Ricgard M. Barron by calling us at 800-939-9093 or go to our web sit at

Tuesday, March 18, 2008

Regulator Warns Consumers On Reverse Mortgages

Although a reverse mortgage can be helpful to homeowners having trouble paying their bills, it also can jeopardize the homeowners’’ financial future, warns the Financial Industry Regulatory Authority.

Financial Industry Regulatory Authority says the loans often are aggressively marketed as an easy, cost-free way for retirees to pay for lifestyles, or even for risky investments that can endanger their financial security.

The organization issued an alert urging homeowners to weigh their options carefully before proceeding with a reverse mortgage. If consumers do decide a reverse mortgage is right for them, they still need to be sure to make prudent use of the proceeds, advises Financial Industry Regulatory Authority in a new investor alert, "Reverse Mortgages: Avoiding a Reversal of Fortune."

The agency notes that reverse mortgages are expensive.
Interest rates for reverse mortgages tend to be higher than rates for home mortgages and other types of loans, while fees and costs of these loans are often significantly higher, too sometimes as high as 4% to 8% of the total loan amount.

The result is the borrower can wind up with less cash than expected, Financial Industry Regulatory Authority says.

Financial Industry Regulatory Authority also is telling potential reverse mortgage borrowers that they will still be responsible for property taxes, insurance and maintenance costs on their homes.

"If you are not able to meet these obligations, the lender may have the right to foreclose on your home, leaving you in the worst possible situation no place to live, and no more home equity to draw on," Financial Industry Regulatory Authority says.

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Thursday, February 14, 2008

Choosing Beneficiaries

Choosing Beneficiaries
You can name your spouse, children and grandchildren as beneficiaries to receive certain assets after your death, including individual retirement accounts (IRAs), life insurance policies, and annuities. Make those designations carefully, since they typically override any provisions in your will.
Consider the following points:
List all assets with beneficiaries, noting the owner, primary beneficiary, and contingent beneficiary. Also indicate the expected value of each asset.

Select the most appropriate person as beneficiary for each asset. In some cases, tax and estate planning considerations may help dictate whom to choose. For instance, spouses typically have more options when inheriting an IRA, so that may be the better choice for your IRA.

Name contingent beneficiaries. Without a named contingent beneficiary, the asset will be included in your probate estate if your primary beneficiary dies before you. Then, the asset may have to go through the probate process and may be distributed to a beneficiary you had not intended to receive that asset.

When naming more than one beneficiary, indicate what percentage of the asset each beneficiary should receive. Also decide whether each beneficiary's share should be distributed to that person's heirs or divided among the remaining beneficiaries if a beneficiary dies before you.

Assess whether your beneficiaries are capable of managing the asset. If not, you may want to set up a trust to control distribution of the asset.

Review your beneficiaries periodically to determine whether changes are necessary. A divorce, remarriage, spouse's death, or child's birth are all events that may require changes to beneficiaries. You should also review your beneficiary choices if you make changes to your will.

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Tuesday, January 29, 2008

Medicare Premium, Deductible and Coinsurance 2008

New Medicare Premium, Deductible, and Coinsurance Charges for 2008

The Centers for Medicare and Medicaid Services (CMS) has announced the new Medicare premiums, deductibles, and coinsurances. The standard Medicare Part B premium is increasing by 3.1 percent to $96.40 a month, the smallest increase since 2001.
The increase is lower than previously expected in part due to the correction of an accounting error. Money for certain hospice benefits had been inadvertently drawn from the Part B trust fund rather than the fund that pays hospital costs. In addition, the lower premium assumes that physicians will take a 10 percent cut in their reimbursement rates. It is expected that Congress will act to offset some of or all of that pay cut, meaning that future-year premiums will reflect the additional expense.

Here are all the new Medicare figures:

Part B premium: $96.40/month (was $93.50)

Part B deductible: $135 (was $131)

Part A deductible: $1,024 (was $992)

Co-payment for hospital stay days 61-90: $256/day (was $248)

Co-payment for hospital stay days 91 and beyond: $512/day (was $496)

Skilled nursing facility co-payment, days 21-100: $128/day (was $124)

As directed by the 2003 Medicare law, for the first time, higher income beneficiaries will pay higher Part B premiums. Following are the higher premium rates:

Individuals with annual incomes between $82,000 and $102,000 and married couples with annual incomes between $164,000 and $204,000 in 2008 will pay a monthly premium of $122.20.
Individuals with annual incomes between $102,000 and $153,000 and married couples with annual incomes between $204,000 and $306,000 in 2008 will pay a monthly premium of $160.90.
Individuals with annual incomes between $153,000 and $205,000 and married couples with annual incomes between $306,000 and $410,000 in 2008 will pay a monthly premium of $199.70.
Individuals with annual incomes of $205,000 or more and married couples with annual incomes of $410,000 or more in 2008 will pay a monthly premium of $238.40.

Rates differ for beneficiaries who are married but file a separate tax return from their spouse:
Those with incomes between $82,000 and $123,000 will pay a monthly premium of $199.70.
Those with incomes greater than $123,000 will pay a monthly premium of $238.40.

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Wednesday, January 23, 2008

Creating a Trust for Your Pet

Creating a Trust for Your Pet

Who will care for your dog or cat when you pass away? What will happen to your bird should you become incapacitated? For many people, providing care for their pet after they pass away or become incapacitated is a very big concern and most states have statutes that provide for the enforcement of trusts created for the benefit of pets.

An animal cannot be a beneficiary of your will. Instead, pet owners need to designate someone to take care of their pet after they die or become incapacitated. Any money left in a last will and testament to an individual “for the care of a pet” is merely a request and unenforceable.

Setting up a trust for your pet is much like setting one up for a person. The trust is a legal entity into which you put money and then designate a trustee who is responsible to safeguard and administer the money. You designate a caregiver and then the trustee is in charge of making payments to the caregiver for your pet’s expenses. It is always a good idea to name one or more alternate trustees and caregivers in the event something should happen to them. You will also need to designate where the money you have set aside for your pet will go after their death. Many people chose to have the remaining balance go to the caregiver or a charitable organization.

It is important to keep your trust up to date with current information and to ensure nothing has changed in your designated caregiver’s situation that might warrant changing designees. It is also a good idea to give a copy of the trust to your chosen caregiver, and family members who may be involved with the care of your pet.
Creating a trust for your pet is not just for the wealthy or the eccentric. It is a relatively inexpensive and practical way to ensure you have provided for your pet when you can no longer do so because of death or incapacity.

Monday, January 21, 2008

One of Veteran Administrations Best-Kept Secrets

One of Veteran Administrations Best-Kept Secrets

One of the Veteran Administration's best-kept secrets and an excellent source of funds for long-term care (either at home or in an assisted living facility) are benefits for non-service connected disabilities. Most VA benefits are based on wartime injuries but another benefit, called "Aid and Attendance" ("A&A") is for individuals who are disabled due to Arthritis, Alzheimer's or other ailments of aging.

"A&A" is available to veterans or surviving spouses needing assistance to safely bathe, dress, prepare meals, etc. Benefits for 2008 are:

Housebound, one dependent $1, 427.00
"A&A," one dependent 1, 843.00
Housebound, no dependents 1, 139.00
"A&A," no dependents 1, 554.00
Death Benefit w/ household allowance 764.00
Death Benefit w/ "A&A" 999.00

Applicants need only show that they are in need of regular help. Someone who's 65, housebound or in assisted living is presumed by the VA to need A&A.

This program has income and asset limits but certain expenses can reduce income to a level that may qualify applicants. Specifically, un-reimbursed medical expenses can reduce income, as can the costs of assisted or independent living facilities.

To find out more, seek the involvement of a Veteran's Service Officer, or an experienced elder law attorney who can provide the appropriate pre-filing consultations to determine the best steps to take for asset preservation, before applying, and the coordination of future Medicaid benefits. Request your FREE "Consumers Guide to Veteran Benefits for the Veteran and their Widow"

Seven Reasons Why It’s Important to Talk To An Attorney Who Understands the Needs Of Hospice Patients and Their Families

Seven Reasons Why It’s Important to Talk To An Attorney Who Understands the Needs Of Hospice Patients and Their Families

Hospice is an approach to medical care for patients nearing the end of their life. The goal is to enhance the quality of life for patients who have a terminal illness. With that in mind, hospice focuses on pain management and symptom relief while addressing the patient’s emotional, social and spiritual needs-as well as the needs of the family members. Hospice lets patients and their families share their end-of-life experience with dignity, and in most cases, in the comfort of their own homes.

There are often legal issues which arise at this time. There may be decisions to make on how to handle things ranging from healthcare decisions making to financial management to how your property should pass at your death. Following is a list of some of the reasons why it’s important to deal with an attorney skilled in helping families during this difficult time.

1. It’s important to deal with an attorney who concentrates his or her practice on these types of issues. Helping families through this difficult time takes a special set of skills. Not only is it important to have an attorney who understands the technical part of the law, but it’s also critical to have an attorney who understands the emotional aspects. You want someone you will be comfortable with, and someone who has provided the services to countless families going through the same issues you and your family face now.

2. The attorney’s staff must also be well-trained. Hospice caseworkers are a special group of people. Once you’ve dealt with them, you quickly find that to be true. And while it’s important to deal with an attorney who is sensitive and understands the issues you’re’s also crucial to deal with an attorney whose practice is geared toward helping you and your loved ones. Plus it’s important that the attorney’s staff also understands all of the challenges you are facing since you may be dealing with the support staff often.

3. You want an attorney who understands the government programs that are available to you. In this day and age, it’s difficult for any professional to know all there is to know about any given topic. That’s especially true when it comes to issues of government benefits like Medicare and Medicaid. It’s important that you deal with an attorney who works frequently in this area and who is used to dealing with the State. You need an attorney who knows how to help you and your family.

4. It’s important to deal with an attorney who knows how to help you to protect your life’s savings. No matter the size of your estate, you worked hard to earn it. It’s important to you and it’s important to your family that you pass along as much of it as possible. When selecting an attorney, be sure that he or she is knowledgeable on how to help you arrange things so that you receive the care you need and so that your assets will be preserved for your family to the greatest extent allowed by the law.

5. How to avoid probate - For many hospice patients, one of the most important concerns in the even of their death is that they want their estate to pass to their loved ones without going through probate. There are many ways to accomplish this, ranging from simple beneficiary designations to gifting strategies to trust planning and so on. It is important that you deal with an attorney who understands the various ways that property passes...and who can show you how to arrange your estate to avoid probate where that is appropriate.

6. It is important to work with an attorney who knows the value of a dollar. One of the biggest gripes people have in dealing with legal professionals is that they feel like they are “on the clock” and will be charged extra for every question they ask or every time they pick up the phone. Where possible, you should consider an attorney who works on a flat fee basis. Ideally, you want someone who will not charge for the initial phone call or consultation, and then who will tell you to the penny exactly what will be involved and what the cost will be. That way you can be a smart consumer and get the most for your dollar, while making sure that things are handled in the most appropriate manner.

7. Select an attorney who makes house calls. Dealing with clients on hospice is unlike most other types of legal practice. Usually the family has to go to the attorney’s office for a consultation. Not only can this be stressful, but it also takes a lot of time. An attorney who deals with hospice, on the other hand, will make house calls when needed. This makes things easier on the family, especially in the late stages, since often times hospice patients have great difficulty getting around.

All of these are reasons why it is important to deal with someone who practices in this important area of the law and who has a sensitivity to the needs of hospice patients and their families.

"The Top 8 Mistakes People Make With Medicaid"

"The Top 8 Mistakes People Make With Medicaid"

Finding the right nursing home, getting the best care there, paying for it properly, protecting yourself and your family..... all of these can be accomplished if only you know who to talk to and what to ask.

The decision to place yourself or a family member into a nursing home is one of the most difficult decisions you may ever be asked to make. That’s why it’s important to have a plan and to know what mistakes to avoid.

In a perfect world, you’d have plenty of time to visit the nursing homes, talk to the residents, meet the care staff, sample the food and so on. Unfortunately, we don’t live in a perfect world. Often decisions have to be made quickly and without a lot of information or comparisons.

Our Mission is to Help Our Clients.....
Find the right nursing home
Get the best care there
Pay for it without going broke
Legally protect their assets and income
Next, you need to know what mistakes to avoid with Medicaid. Here are the top 8 mistakes:

1.Thinking it’s too late to plan.
It’s almost never too late to take planning steps after a senior has moved to a nursing home.
2. Giving away assets too early.
First, it’s your money (or your house, or both), make sure you take care of yourself first. Don’t put your security at risk by putting it in the hands of your children. Precipitous transfers can cause difficult tax and Medicaid problems as well.
3. Ignoring Important safe harbors created by Congress.
Certain transfers are allowable without jeopardizing Medicaid eligibility. These include; transfers to disable children, caretaker children, certain siblings and into trust for anyone disabled and under age 65; a transfer to a "pay-back" trust if under age 65; and a transfer to a pooled disability trust at any age.
4. Failing to take advantage of protections for the spouse of a nursing home resident.
These protections include the purchase of an immediate annuity, petitioning for an increased community spouse resource allowance, and in some instances petitioning for an increased income allowance or refusing to cooperate with the nursing home spouse’s Medicaid application.
5. Applying for Medicaid too early.
This can result in a longer ineligibility period in some instances.
6. Applying for Medicaid too late.
This can mean the loss of many months of eligibility.
7. Not getting expert help.
This is a complicated field that most people deal with once in their lives. Tens of thousands of dollars are at stake. It’s penny wise and pound foolish not to consult with people who make their living guiding clients through the process.
8. Confusion about the difference between lifetime liens on property and estate recovery.
There are a number of exceptions to lifetime liens on property, but estate recovery there is only a deferral for a surviving spouse and a hardship waiver.