If you have elderly parents, don’t wait to learn about Medicaid — sometimes referred to by a litany of other state names, like Medi-Cal and MassHealth.

What is your Medicaid IQ? Most Americans have heard of Medicaid, since it has been part of the national political debate for some time. A political discussion is one thing, but what does Medicaid mean to your elderly loved ones?

If you have elderly parents, it is high time to learn about Medicaid and how it works.

Fortunately, a recent Forbes article is a good place to start. The article is aptly titled “Medicaid And Your Parents: The Basics.” Essentially, Medicaid is a program run jointly by the federal government and each respective state government. Think of it as government insurance for, among other things, late-in-life medical care like home care or nursing home care when the one needing care has too limited financial resources.

Medicaid is “means-tested.” Consequently, having too great an income and/or too much in assets will disqualify a Medicaid applicant and create a legal hurdle to receiving benefits. Currently, in Utah for a single person to qualify for aged, blind, disabled Medicaid, that person can have no more than $2,000 in non-exempt assets. In addition, having “assets” is not the same as having the money to pay for care.

For those with assets exceeding the Medicaid limits, “giving” assets away will only disqualify them from Medicaid assistance if the transfers violate the “look back” period designed to keep them from gaming the system.  Currently the look back period is 60 months.   Of course, an elderly individual might have had innocent intentions when they made a disqualifying gift a few years ago and the need for Medicaid was unforeseen. Regardless, such transfers are a red flag when it comes to Medicaid qualification.

Each state is subtly different in its approach, but these are very real rules and they require careful thought and timing. Otherwise, it is easy to run afoul of the rules now and be disqualified from care later. You owe it to your elderly loved ones to start planning for a worst case scenario without delay.

Reference: Forbes (February 11, 2014) “Medicaid And Your Parents: The Basics”

Although most people’s estates aren’t large enough to be affected by the federal estate tax, residents in many states have to consider how state taxes may reduce their estates. Several states have their own estate tax, which can affect much smaller estates than the federal estate tax does. In addition, some states impose an inheritance tax on beneficiaries of an estate.

When it comes to taxes, where you live means everything. In fact, simply stepping over into the next state can change everything.

For those planning their estates, estate planning laws can be troublesome enough without the additional complexity of state estate and/or inheritance taxes. ElderLawAnswers recently considered this issue in an article titled “Have You Planned for State Estate and Inheritance Taxes?”

Because of the changes in the Federal Estate Tax Law, Utah currently does not collect estate tax.  Utah has always based its Estate Tax on the Federal state estate tax credit allowed on the Federal estate tax return (the “pick up tax”).  In 2005, the Economic Growth and Tax Relief Reconciliation Act (“EGTRAA”) officially phased out the pick up tax.  In response to this phase-out, some states changed their estate tax law to levee their own state estate tax.  Utah did not do so.   If your state also has a level of estate or inheritance taxation, then the applicability of such taxes is yet another obstacle to overcome. Accordingly, you should plan for them just as you would for the federal estate tax.

Note: the exemption amounts and tax rates may vary from the federal level (and in some states, they may even vary from person to person).

In addition, when it comes to state estate and inheritance taxes you need to plan for the future. Know the tax laws of your current state and any state in which you may consider in the future.

Bottom line: Be sure to plan for these unique state laws, even if the federal laws get all the press.

Reference: ElderLawAnswers (July 29, 2013) “Have You Planned for State Estate and Inheritance Taxes?”

A scenario commonly encountered within estate planning is when an individual dies while negotiating a separation agreement with their spouse, or when in the midst of divorce proceedings.  While a divorce order will void specific bequests to a spouse, merely initiating negotiations or proceedings will not.

Married couples typically plan to leave significant portions of their estates to the surviving spouse. If a divorce were to occur, a change would need to be made to the estate plan to remove the ex-spouse. Most of the time, if you do not change your estate plan after getting a divorce, a judge will ordinarily disregard any specific bequests you made to your ex-spouse.  Utah statutes under most circumstances, provide for a share to go to the surviving spouse even though the current will does not provide for the surviving spouse.  The law assumes you would not want your estate to go to a former spouse.

However, as the Wills, Trusts & Estates Prof Blog points out in a recent article titled “When Death Occurs Mid-Divorce,” the same thing is not true if you are in the divorce process but your divorce has not yet been finalized. This is a common problem when a divorce has been filed and one of the parties passes away during the process. When that happens, it can cause issues with a family home that is owned by both parties. If the home is owned as joint tenants, then the property will automatically pass to the survivor. If the divorcing couple owns the home as tenants in common, however, the deceased party’s share of the home will go to his or her heirs.

As most couples own their property as joint owners, it is important to talk to an estate planning attorney as early in the divorce process as possible. It might be in the interests of both you and your spouse to sever the joint tenancy in the home before the divorce is finalized. When getting divorced, there are many other estate planning issues you will need to consider during the process as the terms of the divorce will have a large impact on your eventual estate.

Reference:  Wills, Trusts & Estates Prof Blog (July 25, 2014) “When Death Occurs Mid-Divorce”

f you have a Medicare Advantage plan, your plan may overrule your doctor and refuse to cover a treatment or procedure that it deems to be medically unnecessary or experimental … However, there is an appeal process to resolve these conflicts.

Medicare Advantage plans can make certain decisions regarding their plans and what will be covered, as they should. After all, this discretion is what keeps them in business and from being “gamed” by scammers. That noted, the plans are not always right when exercising their discretion to deny doctor-prescribed treatments or procedures.

If you (or a loved one) have a Medicare Advantage plan, then it is important to be prepared should the plan itself overrule your doctor and deny you coverage. That certainly would be an unfortunate turn of events! Fortunately, you can seek to overrule coverage denied by your Medicare Advantage plan, but you must know how.

While you can be denied coverage, it is important to remember that the Medicare Advantage plan is not the final arbiter and you can appeal their decision. This is an important right built into the very structure of Medicare. A timely article in ElderLawAnswers.com titled “Appealing Medicare Advantage Plan Decisions” provided some insights into this process.

Did you know that above every Medicare plan is the judicial oversight of an Administrative Law Judge (ALJ)? When the plan makes an adverse coverage decision, first you should appeal to their better judgment. If you are unsuccessful, then you can go over their heads and appeal to the ALJ.

But wait, there is more. If you are unsuccessful before the ALJ, then go even higher to the Medicare Appeals Council (MAC). Be aware, however, that at this level the process becomes a matter of litigation and all that entails time and money. Nevertheless, litigation is sometimes a necessary evil to pursue necessary care (and justice).

You may never need to challenge a denial of coverage. In case you do, however, it is best to be prepared and that means being well-informed regarding your rights.

Reference: ElderLawAnswers.com (last modified September 26, 2013) “Appealing Medicare Advantage Plan Decisions

Sorry, kids, but I was never gracious, and it just gets harder and harder. I want the right, at 86, to play kick-the-can, to do whatever I choose, and that right has been forfeited to age and decrepitude, and I mind it terribly. Which makes me a very ungrateful old lady.

Life is a cycle.  We start off life as children being cared for by our parents and then become parents ourselves  and then to be cared for by our children.  To live with and care for an elderly loved one is not an easy thing. On the other hand, it is not an easy thing to be cared for either. Over and above all the medical issues, the time crunches, or the money concerns, oftentimes it is the emotional issues (and even the fighting) that can wear on you.

What you need is a little bit of empathy.  Remember, if you will, when you were children and you yearned for your independence. Ah to be able to go where you wanted without reporting to your parents.  Remember first time you were able to make choices on your own?  Think of that desire for independence now that your elderly parents are now losing theirs and you are now making choices for them.

In the name of empathy, then, especially as we sit down with our loved ones for the holidays – a trying time for some – consider a recent piece reported in The New York Times titled “‘A Very Ungrateful Old Lady.’”

In this instance, the “old lady” is none other than Sheila Solomon Klass. She is an English professor and a blogging grandma at the seasoned age of 86. Nevertheless, Klass is someone’s elderly loved one, too.

As the title of her essay suggests, Klass considers herself a burden and confesses that she is not always good about expressing her gratitude, without expressing frustration instead.

As you click over to her original essay, think about yourself and your own loved ones. Think of A little dose of empathy can go a long ways.

Reference: The New York Times – The New Old Age Blog (November 8, 2013) “‘A Very Ungrateful Old Lady’”