What to Do When You Have No One to Help (Part 2)
Last week I presented to you the hypothetical, but very common case, of Jane who is in the hospital and has acute and chronic health issues. She has no family or she is estranged from her family. The immediate problem is that she has no designated person to act on her behalf as agent under her power of attorney or as health care representative under her health care directive. Her current mental and physical state is such that she can’t make the many decisions large and small that the hospital staff – doctors, nurses and social workers – need her to make with regard to her treatment and discharge plan. So to whom can she turn? Before I answer that question let’s talk about what kinds of decisions will need to be made? If Jane is in the midst of a serious medical crisis, doctors and nurses will administer whatever treatment is necessary to stabilize Jane if she is in immediate danger. The need for a decision maker doesn’t stop there, however. If Jane is elderly and has chronic health issues tough questions remain concerning her discharge plan. Can she go home alone or will she need supervised care?
What to Do When You Have No One to Help
I have written often about the need for everyone to have a support system in place in the event of a crisis. Think about whom you would turn to if you needed help. For most people it would be family, a spouse, child, grandchild, sibling, niece or nephew. But, what if you have no one? What would happen in that case? What kind of crisis am I talking about and what might it look like? Usually the issues come to a head because of a medical crisis. Let’s look at Jane Doe, who is admitted to the hospital because of an acute medical condition or injury. If Jane is 70 years of age or older she very well could have a mental impairment. It could be a direct result of an illness such as dementia or Alzheimer’s disease. It could be a result of trauma from a fall or a side effect of the combination of medications she is taking or has stopped taking. It could be that Jane is mentally competent but a physical ailment prevents her from attending to her needs. Whatever the reason, Jane is now in the hospital and needs care. As anyone who has
New Medicaid and VA Figures for 2017 #2017Medicaidnumbers
It’s time to update the numbers for many of the government programs that affect our clients’ lives and that we work with so often. I am talking about cost of living adjustments for the new year. For 2017, the Social Security Administration announced that Social Security recipients will receive a small .3% increase, after receiving no increase last year. Because Medicaid and the VA Aid and Attendance program adjustments are tied to the same percentage increase, this means that those benefits will also increase by .3%. So here are the numbers you need to know for 2017. The Medicaid income cap will go up slightly to $2206 per month. This number is the limit on income per month needed to qualify for most Medicaid programs. For Medicaid recipients whose income exceeds this limit a Qualified Income Trust (commonly known as a Miller Trust) must be used to achieve and maintain eligibility. The Community Spouse Resource Allowance (CSRA) will increase to $120,900. That is the maximum amount a healthy spouse may keep in countable assets (provided the married couple have at least that amount times 2 at the time the “snapshot of assets” is taken). The minimum CSRA is $24,180, meaning
Important Change to Special Needs Trust Law
In 1993 Congress enacted a law commonly referred to as OBRA 1993. The law contained major changes to the Medicaid laws. Included in the law was a provision permitting the creation of a special needs trust for disabled individuals under the age of 65, into which could be placed the disabled individuals own assets so he/she could preserve Medicaid eligibility. This type of trust is known as a “d(4)(A) trust, a reference to the section of the law which created it. It is also referred to as a 1st party special needs trust because the assets place into the trust are the disabled individuals own assets. These trusts have particular importance to disabled individuals who have received inheritances from family members or others that were not placed into what are known as 3rd party special needs trusts. They are also helpful to disabled individuals who have received personal injury settlements. In both instances, the SNT allows them to use the funds in the trust to improve their quality of life without sacrificing government assistance which pays for basic living , medical and/or long term care expenses. A quirk in the law, however, existed for 23 years. OBRA 1993 provides
How Medicaid Treats Life Insurance (Part 2)
Last week I was talking about life insurance as it affects eligibility for Medicaid. While term insurance has no value while the insured is alive and only provides a payment at the death of the insured, other types of life insurance – namely whole life and universal life – havea cash value. It is that value that counts as an asset towards Medicaid’s $2000 asset limit. What are the Medicaid applicant’s options then if he/she owns a policy with cash value? One is to surrender the policy for the cash surrender value and then spend down that amount in accordance with Medicaid’s spend down rules. When the applicant dies there will be no death benefit because the policy has been surrendered. This is a reasonable option where the cash surrender value is the same – or close to the same – value of the death benefit. If, for example, the cash surrender value is $9500 and the death benefit is $10,000 not much is lost in value if the policy is surrender. In fact, if the policy is not “paid up” but requires continued premium payments, the death benefit minus the continued premiums may turn out to be less
How Medicaid Treats Life Insurance (Part 1)
Medicaid requires the applicant to spend down all assets to under $2000 before approving an application for benefits. The question comes up frequently about life insurance. Is it an asset and if so, what is the value? In order to answer that question, we must examine what kind of life insurance we are talking about. Term life insurance is a type of insurance in which a premium is charged and paid – usually on an annual basis – and if the insured dies while the policy is “in force”, the death benefit is paid to the designated beneficiary. For Medicaid purposes, this type of life insurance has no monetary value to the owner while he/she is alive, so it is not an asset and does not count towards the asset limitation. There are other life insurance policies, however, that have a cash value. The idea is that as the premium is paid to the insurance company some of that amount goes towards the cash value which builds up over time. This cash value can be taken out by the policyholder as a loan. If the policy is no longer needed or desired, then the policy can be cancelled and