Long Term Care

Unfortunately, your risks are still high. According to the U.S. Department of Health and Human Services, “About 70 percent of people over age 65 need some type of long-term care during their lifetime. More than 40 percent need care in a nursing home for some period of time.” If you do need care, the costs are so high that it would not be over-dramatic to say that your life’s savings could be wiped out very quickly and well before you pass on. You could be left in poverty at the very moment in time when you are most vulnerable.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

You are not alone. Most seniors cannot afford, and might not qualify anyway, for long-term care insurance. Those who purchased a policy often find that the benefits are insufficient. The best alternative is to consult with an Elder Law attorney about creating a plan to become eligible for Medicaid benefits, and to protect your assets and income at the same time.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

There are no hard and fast guidelines – because it depends on the state of your health as well as your age. The most important thing is to inform yourself about the risks you face and the options and solutions available to you. When you are in your 60’s, it is certainly a good time to become informed, and to take some modest initial steps, such as obtaining a good power of attorney and health care proxy. Probably by the time you are in your 70’s, you should be taking steps to protect your assets against the ruinous costs of long-term care.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

If it turns out that you are among the happy few who never need long-term care, you are probably OK. However, if you don’t want to risk winding up among the 70% of persons over 65 who need home care or nursing home care, you would be best advised to explore your Elder Law options and implement a plan to protect yourself and your family against financial disaster from long-term health care costs.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

Medicare and Medicaid NY

Medicare is a federal government program that provides medical insurance for payment of expenses related to acute medical care and rehabilitation from short-term illnesses and injuries. Medicaid is a joint federal, state and local program that provides a broad range of medical and health benefits, including long-term care for those who are permanently ill, injured or disabled. The two programs are very different as to coverage, rules, and eligibility. Also, Medicare is essentially the same nationwide, but Medicaid differs, often significantly, from state to state.

You qualify for Medicare benefits at age 65 or older if you are a U.S. citizen or are a permanent legal resident, and you or your spouse has worked long enough (usually 10 years or more) to be eligible for Social Security retirement benefits. Your payroll deductions cover Part A (hospital), but you must pay a monthly premium for Part B (doctors) or Part D (drugs). You’ll also pay a premium if you decide to join a Medicare Advantage (Part C) plan, which typically covers all of your medical care on an in network basis. Medicare is medical insurance. It does not cover long-term care. The only program that covers home care, assisted living, or nursing home care, is Medicaid.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

These are common misconceptions about Medicaid. Almost everyone can qualify for Medicaid with appropriate Elder Law planning. Click here to Find Your Situation.

There is no requirement that you retain an attorney to prepare your Medicaid application. However, most people find that completing the application is a daunting and confusing task. When you prepare your own application, you risk doing it incorrectly, and making errors that may ultimately compromise or delay your eligibility for benefits. When an experienced Elder Law firm handles your application, you can be confident that it will be approved, and you’ll save yourself a lot of aggravation in the process. Also, before filing your Medicaid application, your attorney will have protected your assets and income to the extent legally permissible, and have put you and your family in the best possible position going forward.

You may see advertisements or solicitations from independent paralegals, social workers, or geriatric care managers, that they can handle your Medicaid application for a lower fee than a law firm would charge. However, none of them are qualified to give you legal advice about the steps you can properly take to obtain Medicaid eligibility, or about how you can protect your assets or income at the same time.

Yes, you can. In most cases, it makes sense to keep both, as you will have access to a greater choice of doctors and other medical providers.

In some counties of New York State, you may be encouraged to join (or be passively enrolled in) a FIDA plan that delivers both Medicare and Medicaid services on an in network basis. FIDA stands for “Fully Integrated Duals Advantage,” referring to people who are eligible for both Medicare and Medicaid. As long as you have the right to keep traditional Medicare, you may want to seek advice before enrolling in a FIDA plan.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

Medicaid Planning

Spending down virtually all of your money is one path to becoming eligible for Medicaid. However, you don’t have to do that. There are a number of entirely legal and proper strategies that can be used to protect your assets or income, and at the same time become eligible for Medicaid. Click here to Find Your Situation.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

You can qualify. Many people have the mistaken impression that they would never be approved for benefits under Medicaid eligibility requirements. That is simply not the case. With effective planning, most people can get Medicaid.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

No. There is nothing illegal or improper about transferring your assets to family members or to a trust. However, if you are applying for Medicaid nursing home care, and have made transfers within the “look back” period, you may be subject to a “penalty period” during which Medicaid will not pay your nursing home bill. Note that certain transfers do not trigger a penalty (for example, transfers between spouses), and that the “look back” does not apply to Medicaid’s home care or assisted living programs. Further, even if you are subject to a “penalty period,” there are often Elder Law strategies available to reduce the penalty and save a substantial portion of your assets.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

The “look back” period is the five year period extending back from the date of your application for Medicaid nursing home benefits. Medicaid requires documentary proof of all of your financial transactions during this period, to determine whether you made any gifts or transfers of your assets. Transfers and gifts that you made within the “look back” period are subject to a penalty that may delay your eligibility for Medicaid benefits.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

The “look back” will not prevent you from applying for Medicaid, but it may result in a delay of your eligibility for nursing home benefits. It is a primary reason why it is important to become informed of your rights and options, and to plan ahead.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

If you are in a nursing home and are asking Medicaid to pay the nursing home’s bills, Medicaid will refuse to do so for a period of time if you have made any gifts or transfers of your assets during the five year “look back” period. The number of months that you are not eligible for Medicaid benefits is called the “penalty period.” Here is an example of how the “penalty period” works. Let’s say you live in New York City, and you gave your son or daughter a gift of $120,000 in January 2014. If you needed nursing home care in 2017 (or at any point up to January 2019), and you filed a Medicaid application, your gift would fall within Medicaid’s “look back” period.

Medicaid would then perform a calculation as follows: the amount or value of your gift would be divided by Medicaid’s monthly regional rate for nursing home care, resulting in a number that represents the period of time in months that you are not eligible for Medicaid nursing home benefits. The regional rate applicable to you depends on your county of residence within New York State.

In New York City, the Medicaid regional rate for 2017 is $12,157. In our example, the calculation is thus $120,000 divided by $12,157, resulting in a “penalty period” of approximately 10 months. During this time, someone other than you would have to pay for your care.

Don’t let the “look back” and the “penalty period” deter you from seeking the advice of an Elder Law attorney. He or she will likely have a strategy to save you a significant amount of money, even if you made a gift or transfer that subjects you to a “penalty period.” For a discussion of the strategies that might apply in nursing home cases, click to Find Your Situation.

No, it is not too late, even if you already in a nursing home. Most Elder Law strategies can be implemented at the last minute. If you need nursing home care, your ability to protect your assets may be more limited than if you had planned ahead. However, even in a worst case scenario, it is likely that you could still protect 40-50% of your assets. In cases involving home care or assisted living, usually all of your assets can be protected.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

Yes, of course. All of Lamson & Cutner’s recommendations and strategies are based on provisions of Federal or New York State laws or rules, and are entirely proper. They’re time-tested, reliable, and cost effective. We do not believe in taking risks or employing so-called “cutting edge” strategies for our clients. We want clients to be secure in the knowledge that they are acting properly and responsibly in seeking benefits that they are entitled to receive, and have helped pay for through their taxes and payroll deductions. If you’ve saved some money and paid your taxes, you don’t want to put yourself in a positon where you would have to live out your remaining years in poverty when Medicaid benefits are available to you.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

Estate Planning Resources

It’s generally good to have a Will, but it is totally ineffective as an Elder Law planning tool. It won’t protect your assets against the catastrophic costs of long-term care, and it will leave your executor and heirs with the chore and the expense of going to court. For estate planning purposes, you might want to consider a trust, which is a private document that avoids probate and allows for the quick and efficient distribution of your estate to your heirs. At the same time, the trust can be designed to protect your assets, and facilitate Medicaid eligibility.

Lamson & Cutner’s attorneys can help you with your Elder Law plan and your estate plan at the same time. Usually, the same strategies and legal documents serve both purposes.

Estate taxes are a concern for only the wealthiest citizens. Only about 0.1% of estates pay Federal Estate Tax. State estate or inheritance taxes might have lower thresholds, but again it will not be a concern for most people. The Federal Gift and Estate Tax exemption for 2016 is $5,450,000 ($10,900,00 for married couples). The New York State basic exclusion amount for 2016 is $4,187,500, and it is scheduled to rise to $5,250,000 by April 1, 2017.

Lamson & Cutner’s attorneys can help you with your Elder Law plan and your estate plan at the same time. Usually, the same strategies and legal documents serve both purposes.

Avoiding probate is probably not the most important concern for seniors, but it is nevertheless a worthwhile goal and is generally easily achievable. Probate is a court proceeding. It can be frustrating, expensive and subject to delays of all kinds. Also, probate sometimes results in a prolonged dispute among disgruntled family members or others, which increases expenses and delays distributions to beneficiaries.

Lamson & Cutner’s attorneys can help you with your Elder Law plan and your estate plan at the same time. Usually, the same strategies and legal documents serve both purposes.

Yes, by all means. Trusts are the main “workhorses” of Elder Law planning. They are the most prudent way to protect assets, create an effective estate plan, and facilitate Medicaid eligibility.

Lamson & Cutner’s attorneys can help you with your Elder Law plan and your estate plan at the same time. Usually, the same strategies and legal documents serve both purposes.

The basic difference is that Elder Law planning seeks to preserve your income and assets for use while you are alive. That way you can continue to maintain your lifestyle if you receive home care, or have the funds available to be as comfortable as possible if you enter a nursing facility. Estate planning is primarily concerned with implementing your wishes and distributing your assets after you pass on, in the most efficient and tax advantaged way. The two go hand-in-hand. Without a good Elder Law plan to preserve and protect your assets and income, you may find that, while you have lovely estate planning documents, you have no estate.

Lamson & Cutner’s attorneys can help you with your Elder Law plan and your estate plan at the same time. Usually, the same strategies and legal documents serve both purposes.

Lamson & Cutner

We believe that there are several qualities about Lamson & Cutner that make us stand out. First, our sole practice area is Elder Law. We are not trying to attract new business by offering legal services in a broad range of practice areas. By keeping our focus on the concerns of seniors and the disabled, we believe that we can offer a depth of knowledge and experience that few other law firms could match. And few, if any, could match our track record of successful Medicaid applications. Second, Elder Law is about helping people and families. Each of our attorneys and staff members has a real passion about what we are doing. We’re happy and proud to achieve great results for our clients. Third, we want our fees to be cost-effective for clients, and we think that is good business. In most cases, we will offer a fixed fee, and we’ll assume the risk of your matter becoming more complicated than anticipated. Fourth, we provide a high level of personal service. We are always available to our clients, and welcome the opportunity to address your questions and concerns as our work progresses on your behalf.

For effective planning, if you are making any transfers of your assets now, the five-year look-back period must be taken into account.

We do not offer free consultations, but our fee is modest. We put a lot of time and effort into our consultations, and we take as much time as needed to understand your situation fully and answer all of your questions. The goal of every consultation is to explore your options and provide you with a plan of action. At that point, we will also let you know the exact amount of our fees to complete the legal work necessary to implement your plan. Clients frequently volunteer that their consultation was extremely valuable.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

You’ll sit down with an Elder Law attorney who will make a detailed assessment of your situation, your financial status, your needs for health care now and in the future, the needs of your spouse or others close to you, and your estate plan. The consultation will focus on how to get the care you need or might need in the future, and how to pay for it. If Medicaid benefits are desired and are appropriate, the process of gaining approval of an application for home care or nursing facility care will be thoroughly explained to you. The firm will map out an effective strategy to protect as much of your money, income and assets as legally possible, and to create your estate plan at the same time.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

To make your consultation as effective and complete as possible, Lamson & Cutner will want to know about financial situation and other things about you as well. The firm will send you an Initial Consultation Checklist of items to bring with you.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.

Each situation is unique, and fees can only be quoted once a full assessment is made at your Initial Consultation. Lamson & Cutner wants its services to produce an excellent, cost-effective, result. We won’t take your case, or suggest a strategy, unless we have a very high degree of confidence that we will succeed in meeting your goals.
In most cases, we will propose a fixed fee, so you will know in advance exactly how much our legal services will cost. Because of our deep knowledge and experience in Elder Law, we accept the full risk that your case might turn out to be more complicated than anticipated. There are never any extra fees or hidden costs, and you can feel free to contact the firm at any time with your questions or concerns while your matter is pending.

For effective planning, if you are making any transfers of your assets now, the five-year look back period must be taken into account.