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New York Elder Law Attorney Blog

Medicaid planning in New York: The sooner, the better

Medicaid planning for nursing home and home health care expenses in New York is almost essential, no matter what situation families with elderly relatives find themselves in. The fact of the matter is that long-term elder care requires some sound Medicaid planning if families want to avoid depleting a lifetime of careful savings in a shockingly brief period of time. Especially as individuals age and the chance increases for the development of complicated, slow-working diseases like Alzheimer's, it's nearly impossible to estimate just how substantial the total costs of health care may end up being.

Long-term nursing home or in-home care for an individual with Alzheimer's or similar conditions can quickly deplete all of an elderly individual's assets. This, then, leaves nothing for any children or relatives to inherit, no matter how carefully the individual has saved over the years. If and when Medicaid does kick in, individuals can only qualify after they are left with almost no remaining assets or savings.

Could a back-up plan help your trust-based estate?

As a well-organized person, you may have been exploring your estate planning options for some time. Because you certainly do not want to leave your family in a difficult position in the event of your passing, you want to make sure that you have made the best planning decisions possible for your estate's specific needs. In the end, you may have settled on creating a trust-based estate plan.

The idea of helping your family avoid probate and allowing your assets to be distributed through terms that you set when creating the trust may have acted as strong factors in your decision to go this route. However, you may still have some concerns. For instance, what will happen if you leave some of your assets out of the trust?

Medicaid planning for custodial care in New York

Many aging residents of New York believe that, after the age of 65, they will be able to rely on Medicare for their health care and assisted living needs. One issue that most people are unaware of, though, is that of something called "custodial care." Custodial care is different from skilled nursing home care and, much to the chagrin of many, is not covered by Medicare. In fact, without proper Medicaid planning, this small distinction in type of care could end up costing elderly New Yorkers and their beneficiaries everything.

So what, exactly, is the difference? Custodial care is distinguished from skilled nursing home care as being routine daily living assistance for basic activities, as opposed to specialized medical care. If, for example, an elderly individual needs help with tasks such as cooking, eating or bathing, but these tasks could be performed by an unskilled home health aide, this is considered custodial care, and Medicare will pay nothing.

It's never too early to create an advance health care directive

Living wills. Advance health care directives. Medical powers of attorney. While these terms may sound familiar to aging residents of New York, it's likely that few are aware of everything these documents entail, and even fewer may have in place an advance health care directive. However, this legal document is powerful and important, and one that everyone, regardless of age, should consider.

An advance health care directive, also known as a living will, is a legal document that gives individuals the ability to exert some control and make their personal wishes known for medical care and treatment when they are unable to communicate those wishes directly. The document typically contains instructions for end-of-life medical treatment, but tries to address a variety of situations – such as a coma or degrading mental health – in which the person might become incapable of requesting or denying certain treatments or of making medical decisions. It can cover, for example, whether or not the person would wish to receive an organ donation, artificial nutrition or hydration.

The benefits of estate planning early with knowledgeable counsel

For individuals with aging family members, helping them prepare for the future involves more than just Medicaid planning. In fact, advisors recommend an estate planning process that involves not only the creation of a will, but also a living will or advance health care directive. For the elderly in New York and across the country, it's never too soon to begin planning, especially if the aging individual does not have a spouse.

One issue for consideration is a living will or advance health care directive. This document is important in situations when an elderly individual suffers an incapacitating illness or injury. Living wills typically dictate individuals' wishes for medical treatments and procedures they may wish to receive and which they want to forgo, such as prolonged life support in cases of coma.

Medicaid planning is a delicate balance of now and then

If your parent spent the last years of his or her life in a nursing home, you probably understand the financial toll. In fact, your loved one may have put off seeking long-term care because of the astronomical cost, but in the end, it was unavoidable. Your parent may have had to sell your childhood home and use up all his or her assets to qualify for Medicaid, leaving you and your siblings with no inheritance and perhaps lingering medical and funeral expenses.

You have spent years earning a living to raise your family in comfort with the hope that you will leave them with some sort of security. The last thing you want is to burden them with the worry and cost of your long-term care, but you know that in a matter of weeks, the cost of a nursing home could wipe out everything you own. The question is how do you plan your estate to provide for long-term care?

Long Island New York Medicaid planning attorney helps avoid myths

Medicaid is a means-based benefits program meant to help elderly individuals with the cost of long-term nursing home and home health care expenses. Unfortunately, Medicaid comes with a host of regulations and requirements that, if not followed to the letter, often result in penalties or even outright disqualification. There are a lot of confusing myths and half-truths surrounding the program. Luckily, a Long Island New York Medicaid planning attorney can help individuals separate fact from fiction.

For example, one common misconception is that inheritances are automatically protected from Medicaid spenddown, but this is incorrect. Spending down is the process of liquidating assets and spending savings on care costs before an individual can qualify for assistance. While there are ways to separate inherited assets from other types of assets, working within a Medicaid context is complex. Far too often, those who forgo the assistance offered by a legal professional with experience regarding these issues suffer negative consequences due to these or similar common misconceptions.

New York Medicaid planning and the caretaker child exception

As most adult children with aging parents in New York can likely attest, caring for a beloved elderly relative may sometimes feel like the equivalent of a full-time job. Of course, it's a job most loving family members are more than happy to do, but it can be a bit onerous nonetheless: rearranging or even leaving actual paying jobs, or spending time and money to ensure aging parents receive the best care possible. Thankfully, with Medicaid planning and legal guidance, there are ways seniors can help give back to their adult children.

There is a transaction known as the caretaker child exemption that allows an elderly parent to transfer his or her home directly to a child, with a few stipulations. First, the child needs to have resided with the parent in that parent's home for at least the previous two years, and second, the child needs to have provided care that allowed the parent to remain in the home, rather than entering an assisted living facility or nursing home. With a lawyer's guidance, all this can be done legally to help a loving parent compensate his or her adult offspring for personal sacrifices made in exchange for parental care.

Medicaid planning increasingly important as medical costs on rise

While aging – and the additional needs it inevitably brings – is an issue few residents of New York like to dwell on, experts are urging individuals to begin planning for the cost of long-term health care now. With expenses rising ever-higher on an annual basis, families with aging loved ones are well advised to start considering their options now, as issues like Medicaid planning are typically only beneficial when begun well in advance. Waiting too long often has unfortunate consequences, from a rushed spending down of assets to difficulty mustering resources and more.

The costs associated with nursing homes, especially, can be financially devastating, at an average of over $8,000 a month. This is an increase of over 5 percent from just the previous year. In fact, long-term care costs rose across the board in the past year by an average of 4.5 percent, the second-highest increase in the past 13 years.

Establishing powers of attorney before it's too late

For aging and elderly New York residents, there is a lot to think about when it comes to preparing for the future. Medicaid planning, asset protection and the like are a few of the issues that need to be addressed to make sure that family members and loved ones are cared for and not overburdened financially. But for the senior individuals themselves, one of the most important aspects may be that of establishing powers of attorney.

Individuals can designate whether the named agent has powers to conduct financial matters, health care issues, or both. A health care power of attorney means the agent has authority to make medical decisions once the individual is no longer able to make them for him or herself because of a medical condition. Advisors recommend discussing the aging individual's wishes and having the power of attorney documentation drawn up and executed with a lawyer far in advance, before the individual begins having any difficulties with specific aspects of life.

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