Tag Archives: Anthony Ferraro

Where might Medicare head?

  Already there is much speculation and rumor as to what changes are going to be forthcoming with the inauguration of the new president and with changes taking place in both the U.S. House of Representatives in Senate. One of the rumors being discussed is the possibility of changes to Medicaid, which is the main governmental program that provides long-term care for seniors who are nursing home. Remember, of the population in America that currently lives in a nursing home, 66 percent are funded by the Medicaid program. There is no other general entitlement program to fund long-term care. Spending …

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Taking long-term care into account

  Good retirement planning needs to take into account other issues besides cash flow and return on investments. For example, how much thought have you given to things like long-term care and how it will impact your overall health care and in turn your plans for retirement? Many people make the mistake of assuming that Medicare is going to cover all of your healthcare needs, but that’s rarely the case. The reason is that the older a person gets the more complex matters pertaining to their health become. Furthermore, there is often a need for someone to go into nursing …

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Getting Mom on Medicaid

  In Part I, we discussed getting Dad on Medicaid. Now that Dad is on Medicaid, we can shift our focus to Mom because after all these years of taking care of Dad, her health is failing. Let’s further assume that Mom is still in the home that dad transferred to her and the kids have been doing the following two things to keep her in her home: first, delivering care to her individually as in-home caregivers, and second, lending Mom money so that the real estate taxes and upkeep on the home can be paid. Now let’s assume Mom …

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The long-term-care ripple effect

  Let’s assume that Mom and Dad are still living at home with round-the-clock care. After a number of years, their asset spend-down will be enormous. Now let’s assume that the parents have spent all their money on round-the-clock care and the children are digging into their retirement savings to cover the costs. Let’s also assume that their home won’t sell quickly, as is often the case in today’s market. This is a predicament that weighs heavily on both generations of family members, both financially and emotionally. Is there another alternative? Yes, there is another alternative. The first step is …

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Do you have the right kind of trust?

  Many of our clients come into our office with trusts. Most of the time these trusts are what are called revocable living trusts (RLTs). Bluntly put, these types of trusts offer no asset protection whatsoever, even though seniors often assume otherwise. Only certain types of irrevocable living trusts (IRTs) provide asset protection for long-term care. If drafted properly, IRTs may be considered a gift by the senior to the beneficiaries, and thus removed from the senior’s estate permanently. If, however, the senior has any access to principal in the IRT, then the IRT will not provide any asset protection …

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The risks of using non-professional home caregivers

Many of our clients seek to stay home for as long as possible, without entering an assisted living facility. This is perfectly understandable, and we use our firm’s skills to allow them to accomplish this objective as long as they can remain safe in their home. However, sometimes in order to remain at home, seniors will look for in-home assistance. We see three circumstances in which this can be dangerous for the senior. First, not enough care is being delivered. Occasionally, a senior may believe they only need someone to do a little shopping, cooking, and cleaning for them. However, …

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Medicaid eligibility requirements

Applying for Medicaid for long-term care in a nursing home is a complicated matter. This article will limit itself to describing the basic eligibility requirements. The eligibility requirements break down into four categories. Medical Eligibility First you have to demonstrate that you meet the Determination of Need score, also known as the DON score, which establishes whether or not someone actually requires long-term care in a nursing home. This assessment may be administered by Catholic Charities, nursing homes, and many other organizations. Income Eligibility The income eligibility requirement is to determine if your income exceeds the private cost of care. …

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First comes the application, then comes the audit

In the previous section of our 10 part series, we talked about preparing and filing the Medicaid application. Once that application is filed, a new challenge will present itself. One or two months after the submission of the application to the Department of Human Services, the approved representative for the Medicaid applicant will receive a call from either the DHS caseworker or the caseworker for the Office of the Inspector General, depending on where the application is being audited. The approved representative will then be asked to submit additional documentation that the caseworker feels is necessary to complete the application. …

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Preparing and filing the Medicaid application

The Medicaid application process involves many steps generally described as follows: 1) Projecting Medicaid eligibility by categorical reference 2) Establishing eligibility based on countable assets and exempt assets 3) Determining income eligibility 4) Establishing the treatment of transfers and penalty periods that are result of the Medicaid applicant’s history 5) Anticipating whatever estate recovery and lien rules there may be and then applying them. Illinois Department of Human Services and Healthcare and Family Services websites have a list of documentation that applicants are to gather. For example, you’ll need to provide 60 months of statements for all accounts, copies of …

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Picking a long-term care strategy

    Minimizing the cost of long-term care requires a strategy that takes into account the intricacies of estate planning and government benefits, and the strategy you chose depends on the mode you’re in: Preplanning, Wait-and-See or Crisis. Preplanning can be done when there is no imminent threat of a long-term care. Wait-and-See Mode exists when there is a diagnosis but the senior will not be leaving home in the near term. Crisis Mode occurs when the senior is either in or soon to be in a nursing home. In Preplanning Mode, because time is on our side, we can …

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