The Centers for Medicare & Medicaid Services (CMS) 2023 federal guidelines for how much money the spouses of institutionalized Medicaid recipients may keep, as well as related Medicaid figures. What Are Spousal Impoverishment Rules? Spousal impoverishment is a concern for older couples when there is one spouse who requires long-term care and applies for Medicaid. Before the federal government enacted spousal impoverishment protections, many healthy spouses faced poverty when their partners needed long-term care. The spousal impoverishment rules are based on the idea that spouses will provide for each other. Community Spouse Resource Allowance In 2023, the spouse of a…
A durable power of attorney is an extremely important estate planning tool, even more important than a will in many cases. This crucial document allows a person you appoint — your “attorney-in-fact” or “agent” — to act in place of you — the “principal” — for financial purposes when and if you ever become incapacitated due to dementia or some other reason. The agent under the power of attorney can quickly step in and take care of your affairs. But in order to execute a power of attorney and name an agent to stand in your shoes, you need to…
A Medicaid Asset Protection Trust (MAPT) is one option a person may consider to protect their assets from Medicaid and nursing homes or long-term care. What Is a MAPT? A MAPT is an irrevocable trust created during your lifetime. The primary goal of a MAPT is to transfer assets to it so that Medicaid will not count these assets toward your resource limit when determining whether you qualify for Medicaid benefits. However, creating an irrevocable trust comes with a certain lack of control over the assets you transfer to this trust. Before making such a significant decision, consider some pros…
For better and for worse, Medicaid is the primary method of paying for nursing home care in the United States. But navigating the Medicaid system is complicated and confusing. Here are the basics. Medicaid (Medical Assistance in Maryland) is a joint federal-state program that provides health insurance coverage to low-income children, seniors, and people with disabilities. In addition, it covers long-term care for those who qualify. The coverage is in a nursing home, in Maryland there is coverage of care in an assisted living facility or at home (except for a limited amount of waivers). In the absence of any…
Federal law requires each state to attempt to recover long-term care benefits from Medicaid recipient’s estates after their death. This is known as Medicaid estate recovery. If a Medicaid recipient had failed to protect their house, it may need to be sold to settle the claim. Who Does the Medicaid Estate Recovery Program (MERP) Affect? For Medicaid recipients ages 55 or older, states must seek recovery of payments from their estate for the following: nursing facility services; home and community-based services; and related hospital and prescription drug services. States may also recover costs for any medical care…
A power of attorney is a very important estate planning tool, but in fact there are several different kinds of powers of attorney that can be used for different purposes. Before executing this crucial document, it is important to understand what your options are. A power of attorney allows a person you appoint — your “attorney-in-fact” or agent — to act in your place for financial or other purposes when and if you ever become incapacitated or if you can’t act on your own behalf. There are four main types of powers of attorney: A limited power of attorney…
A nursing home contract needs to have the following: Services and charges. A nursing home contract must describe what services the home will provide for the basic rate. The basic rate is usually a daily fee. The basic rate must include at least: room and board social services nursing care skin care, cleaning, and grooming protection from accidents and infections social and rehabilitative activities Extra fees may be charged for services not included in the basic rate. Rates and fees may not be increased without at least 45 days written notice. The contract must state the reasons why rates…
Any complete estate plan should include a medical directive. This term may encompass a number of different documents, including a health care proxy, a durable power of attorney for health care, a living will, and medical instructions. The exact document or documents will depend on your state’s laws and the choices you make. Both a health care proxy and a durable power of attorney for health care designate someone you choose to make health care decisions for you if you are unable to do so yourself. A living will instructs your health care provider to withdraw life support if…
Although people are willing to volunteer to care for a parent or loved one without any promise of compensation, entering into a caregiver contract (also called personal service or personal care agreement) with a family member can have many benefits. The Benefits of Becoming a Family Caregiver Caring for a relative rewards the family member doing the work. It can help alleviate tension between family members by making sure the work is fairly compensated. In addition, it can be a be a key part of Medicaid planning, helping to spend down savings so that the elder might more easily be…
There are some serious drawbacks to many options for giving gifts to grandchildren. For instance, there might be no tax or estate planning advantages. Or, you may have no control of the funds (or lose control after a certain point). The money could also affect a grandchild’s eligibility for financial aid. An option that overcomes many of these problems involves transferring money into a trust established to benefit a grandchild. With the help of an attorney, you can draft a trust that reflects your express wishes about when the income and principal will be available to the grandchild, and…
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