New Client Guide to Elder Law
This is an introduction to elder law for
you to read before our first meeting. It will give you an
overview of what is special about elder law planning. It should
also help to make our interview more efficient. Any questions
that you have as you read, you can note on the last page.
I will be happy to answer them for you when we meet.
Elder law's unique focus is on lifetime health
care planning. It is an ever-changing field, governed by federal
and state laws and regulations as well as rules of local
agencies. The field is particularly
attuned to the vulnerability of older adults and new protective
ideas are incorporated into planning approaches and documents
as they evolve. Elder law attorneys from around the Country daily share developments and ideas for computer.
II. Crisis Prevention
Clients often call me when they are facing
a crisis: A parent with a stroke; a debilitated spouse; a
demented sister or brother. But, elder law functions best
when it's engaged before a crisis. Elder law aims at crisis
For example, the backbone documents of an
elder law practice are Health Care Proxies, Living Wills,
Durable Powers of Attorney and Living Trusts. With some or
all of these documents in place, client who is suddenly incapacitated can be cared for by a legal agent whom he or she personally selected. There is no need for court intervention for the appointment of a guardian.
III. Long Term Care
I urge all of my clients to execute Health
Care Proxies (for which there is no charge) and recommend
the most current version of my Durable Power of Attorney,
as minimum protection. When spouses are alive and are the
primary beneficiaries of each others Wills, I often recommend
a re-formulation of the Wills to provide protection for the
inheritance, should the surviving spouse be disabled at the
time of the partner's death. Similarly, when assets are transferred
for estate planning or Medicaid planning purposes, I routinely
recommend a revision of the beneficiary's Will to protect the
planner, in the event of the possible premature death of the
For clients seeking a long term care plan, we review current and anticipated health and finances, family structure, relationships, and personal goals. Several alternative planning method are available to consider, including Self-financing, long term care insurance and Medicaid. If clients are not able to self- insure and not medically eligible for long term care insurance by the time we meet, however, Medicaid planning can be the best available means of preserving savings for themselves, spouses or children.
Medicaid has been a middle class program since 1988 when Congress acknowledged the widespread, bankrupting costs associated with long term care and passed legislation to protect married couples from destitution. Accordingly, in New York, some non-applicant spouses, in 2011, can retain exempt liquid resources of over $109,000 and exempt income of approximately $2,700 per month. An applicant, by contrast, can retain exempt liquid resources of $13,800 and exempt income of less than $800 per month. A home, with equity of up to $750,000 is also exempt, spouses may transfer assets freely between themselves, in order to allow applicant spouse to qualify for benefits.
All non-institutionalized Medicaid beneficiaries, married and unmarried, are entitled to retain a private home with equity of up to $750,000, a car, a $1,500 'burial fund' and certain business property. Medicaid also authorizes the retention of pre-need, irrevocable 'burial trusts,' established with a funeral home, which allow for protection of most reasonable funeral and burial expenses for not only the applicant but a spouse and immediate family members.
Medicaid planning is accomplished by a variety of legal methods, combining specialized Medicaid techniques with traditional estate planning. Clients who are properly advised qualify for Medicaid benefits without spending all their savings. Although Medicaid qualification requires ownership of limited liquid resources, carefully planned transfers of assets permit the preservation of greater amounts for later use for both applicant and family. Protected funds are often later used for the applicant for a variety of uses, such as nursing home companions, “bed holds” during periods of hospitalization and specialized physicians who are not covered by Medicaid.
download personal and financial medicaid worksheet pdf | download personal and financial medicaid worksheet word document
Supplemental Needs Trusts
For those with questions about the ethics of Medicaid planning, the State’s Highest Court provided impassioned support. Contradicting the State's objections to Medicaid planning. The Court wrote in one, long, sympathetic sentence.
Nursing homes in New York commonly charge $160,000 per year and only the wealthiest can afford them without financial collapses.
[N]o agency of the government has any right
to complain about the fact that middle class people confronted
with desperate circumstances choose voluntarily to inflict
poverty upon themselves when it is the government itself
which has established the rule that poverty is a prerequisite
to the receipt of government assistance in the defraying
of the costs of ruinously expensive, but absolutely essential
IV. Personal Goals
Your personal circumstances and goals are
critical to developing the best plan for you. Although the
documentation listed below is necessary to the technical work,
your personal feelings about your family and your assets will
drive the overall plan. Take some time in advance of our meeting
to think about some of the details which are important to
V. Specific Information
for Our Meeting
Please take a few minutes now to print out and
complete my “Client Intake Sheet.” Bring it with you to our
appointment. It will save us time when we meet. download pdf | download word document
Whatever planning we do, including planning
for a guardianship, will require both medical and financial
information. If you can assemble some of the basic data needed
and have it organized in categories, we will be able to move
quickly through the details.
Please provide me with basic medical histories
and diagnoses of the relevant party or parties. Whether we
are planning for a married individual or a couple, we will
need information about both individuals. A list of current medications and copies of recent medical or discharge records can be useful.
I will need documentation of all income, from
all sources. Tax returns provide the best starting point.
I will further need to know all assets, best shown from the most current statements of bank accounts, securities, life insurance, co-ops, houses, other real estate, boats, and cars. It will be important to know current balances/
value and exactly how the title reads on each resource, so
please bring copies of the ownership documents and
two or three years of checkbook ledgers.
and Other Important Relationships
It will be helpful to have a personal telephone
book with you for relevant addresses and telephone numbers of family
members and consultants. For estate planning, I will need
a family tree starting with the parents of the person or persons
for whom we are planning.
For all planning purposes, we will need
to know your preferences for agents you wish to name on Heath
Care Proxies and Powers of Attorney. If we are to be doing
estate planning, you will also need a list of your intended
beneficiaries and Executor. Consider also who you will want
to serve, if your first choices are unavailable
Please also bring with you copies of existing: Wills,
Living Trusts, Trusts of which you are a beneficiary, Health
Care Proxies, Living Wills and Powers of Attorney. If a currently
disabled person is to receive a gift from you, it would be
useful to have a copy of the Certification of Disability.
VI. My Office
My office is located at 477 Madison Avenue, between 51st and 52nd Streets. The closest subway stop is on the #6 line, at 51st Street and Lexington Avenue. Walking from Grand Central Station takes approximately 10 minutes.
If you drive here, a parking garage is located on the first block west on 53rd Street, close to 5th Avenue, on the south side. Others can be found nearby.
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