Medicaid Planning in a Turbulent Economy

In the current turbulent economic climate people are finding that the values of their assets from their homes to their investment portfolios to their retirement accounts are declining substantially. Such decline of value has implications for those who are seeking to engage in Medicaid asset preservation planning.

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Estate Plan Check Up

Many people are in the habit of visiting their doctors for an annual physical or other regular check-up.  Still more visit their accountants each year to assist them with their income taxes.  And most people regularly visit their auto mechanics to change the oil in their cars every three months or so.

The practice with lawyers is different, however, and people may put themselves in peril if they do not periodically review their affairs with their attorney.

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Expanding our Reach

William M. Gatesman has joined the law firm of Michael G. Day & Associates, which firm serves clients in western Maryland. Mr. Gatesman will continue to serve clients in other parts of Maryland and in the District of Columbia through the Gatesman Law Office.

Medicaid Estate Recovery after Schoukroun

A technical Article for Maryland Elder Law Practitioners

Soon after the opinion was issued, this writer posted an article discussing the case, Schoukroun v. Karsenty (Md. App. December 11, 2007), which article you may access by clicking on the case name in this sentence. That article suggests that the court-created augmented estate rule set forth in that opinion might have implications in the Medicaid planning context.

There are other rules that are important for Elder Law Practitioners to bear in mind when considering the implications of Schoukroun.

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Medicaid Largesse

When people think about using Medicaid to pay for nursing home care, they generally think that the program will pay only after most of their assets are gone. However, there are little known rules that allow people to keep certain substantial assets and still get Medicaid for nursing home care. Some of these rules apply only if there is a spouse living at home, and others apply even if a single person is seeking Medicaid benefits.

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Tying the Hands of Your Health Care Agent

This office has recommended, and most estate planners will agree, that one should consider appointing a trusted individual to make health care decisions for you in the event you are unable to do so. I wrote a comprehensive article on that topic on October 7, 2007.

Maryland law not only allows one to appoint a Health Care Agent, the statute provides forms one may use to do so. While I have always recommended that one seek experienced legal counsel when appointing a Health Care Agent – one of the statutory forms curiously omits a significant provision – such advice is even more compelling in light of a new ruling by Maryland’s Attorney General.

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Beyond Dollars and Cents: The Five Stages of Grief

Much of elder law practice revolves around dollars and cents, dealing, for example, with questions of how to save the house to pass onto future generations, how to find alternative sources of payment for nursing home care, or how to avoid estate taxes, to name but a few. However, elder law practice involves much more than that.

In my elder law practice, I counsel clients dealing with significant life changing circumstances. While it is clear that people suffer grief when their spouse, parent, or other loved one dies, it may not occur to some that other events likewise will trigger the grief cycle.

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Is it a problem to apply too early for Medicaid?

Some families make large gifts to family members — to enable a child to purchase a house, for example, or to assist a grandchild by paying college expenses. Others make the conscious choice to make a large gift of assets to their children to ensure that those funds will stand in the place of an inheritance should the parents ever require long term care in a nursing home. Without such large gift, those funds might otherwise be depleted by high nursing home costs.

Considering Future Medicaid Eligibility

When making such gifts, seniors must pay close attention to the affect such gifts would have on their ability to obtain government benefits to pay for future nursing home care. As long as sufficient time passes from the time of the gift and an application for Medicaid benefits, those assets will be protected and the gift-giver’s children will not be required to pay back the gift to cover the gift-giver’s care costs.

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