Tuesday, 14 June 2016 23:41

What Does Medicare Cover?

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What Does Medicare Cover?

 

What is Medicare?  What does Medicare cover?

I can’t possibly tell you everything you want to know about Medicare, or all of the options.  What I can do is provide a bit of a birds-eye view or summary about some of the pertinent parts of Medicare and how it relates to estate planning and long-term care.

 

The program is available to most people over 65 years old.  Medicare covers medical expenses, hospital care, and post-hospital care.  It also provides some coverage for prescription drugs under “Part D”.

 

Medical expenses:

Medicare covers 80 percent of approved qualified medical expenses and includes things like doctors and surgical services.

 

Hospital Care:

Hospitalization is covered for 90 days per “spell of illness” with a deductible for the first 60 days, and a co-payment of $315 per day for the remaining 30 days.

 

Post-hospital skilled nursing home care:

If the hospital stay is at least 3 days, and only of the post-hospital care needed is “skilled care”, Medicare will cover 100% of the costs for the first 20 days, and a co-pay of $157.50 per day for the next 80 days for a maximum of 100 days of care.  Availability is very limited. 

 

Does Medicare Cover Long-Term Care?

No, Medicare does not cover long-term care.  As described above, Medicare only provides some home care and it must be under very specific situations. 

 

Other Medicare aspects include (but are not limited to):

  • There are “gaps”, and private policies can be purchased to fill these gaps.  These are “Medigap” plans. 
  • Medicare doesn’t cover hospital costs beyond 150 days
  • Medicare doesn’t cover skilled nursing home costs beyond 100 days
  • Medicare doesn’t cover ANY custodial nursing home care or non-skilled home health care

 

Medicare Part D

Medicare Part D is an optional prescription drug coverage.  It is automatic in certain situations for certain people on Medicaid and others.  There are some co-pay rules and many twists and turns that I won’t get into here.   The enrolment period is 3 months prior to, and up to 3 months after your 65th birthday.  A person can only change their plan once a year.  There are also many different plans from which to choose that I won’t get into in this (or likely any) blog.  I simply wanted to provide a general background into Medicare.

 

Please feel free to give me a call today and we can review your situation and other Estate Planning goals.  Everyone’s situation is different, and I can help create solutions. 

 

See lots of estate planning information on my website at: www.myestate-plan.com

 

William Daniel Powell (Dan)

619-980-2297

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

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This document is for informational purposes only.  Nothing in this is to be considered legal advice.  Nothing in this shall create an attorney/client relationship, nor shall it create a confidential relationship.  If you need legal advice (in California), feel free to contact me or someone licensed to practice in your jurisdiction.  I assume no liability or responsibility for actions taken, or not taken, as a result of reading this information

Also, please remember that I speak in generalities in my blog and my website. There are so many different factors that can contribute and completely change the outcome that it would be impractical to discuss all of them here.

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What is the difference between Medicare, Medicaid, and Medi-Cal?

In a Nutshell

In a nutshell, Medicare is a federal program that provides basic health insurance and prescription coverage to those 65 years of age and up, or those under 65 years old that are eligible for Social Security Disability benefits.  Medicare does not pay for long-term care.  Some skilled care is provided for a short time and if certain requirements are met, but it is not the norm.

 

Medicaid is a federal and state program that provides health care coverage for persons of all ages if they have a low income and limited resources.  The definition used is that Medicaid is a government insurance program for persons of all ages whose income and resources are insufficient to pay for health care.  Therefore, if you make over a certain amount of money, you won’t qualify for Medicaid.  Medicaid pays medical costs and long-term care costs.  Medicaid also has a right to seek reimbursement from the decedents estate for long-term care, and also for medical care costs.  There are several rules and circumstances involved, and will be discussed in another one of my blogs.

 

 

Medi-Cal is also a program that provides care to persons with low income and limited resources. It is what the federal Medicaid program is called in California, and is therefore essentially the same thing. 

 

 

All of these programs will be discussed in more detail in my blog posts.

 

Please feel free to give me a call today and we can review your situation and other Estate Planning goals.  Everyone’s situation is different, and I can help create solutions. 

 

See lots of estate planning information on my website at: www.myestate-plan.com

 

William Daniel Powell (Dan)

619-980-2297

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

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This document is for informational purposes only.  Nothing in this is to be considered legal advice.  Nothing in this shall create an attorney/client relationship, nor shall it create a confidential relationship.  If you need legal advice (in California), feel free to contact me or someone licensed to practice in your jurisdiction.  I assume no liability or responsibility for actions taken, or not taken, as a result of reading this information

Also, please remember that I speak in generalities in my blog and my website. There are so many different factors that can contribute and completely change the outcome that it would be impractical to discuss all of them here.

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Tuesday, 07 June 2016 00:24

Long Term Care - Part Two

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Long-Term Care Part 2

 

What Can I Do to Plan for Long-Term Care?

 There are a few options available in planning for long-term care.  Some of these options are:

  1. Private long-term care insurance
  2. “Self-Insurance” or paying out-of-pocket for expenses
  3. Life insurance to replace depleted assets used for funding long-term care
  4. Utilizing a Trust to provide some asset protection
  5. Use up all of your assets and live out your days in a nursing home

  

Some of the options are more desirable than others, and some may be out of reach for some people.

 

1. Private Long-Term Insurance

 Using insurance to pay for long-term care can be a great option if it is available to you.  First of all, you must be “insurable”.  This may vary from company to company.  Next the premiums must also be affordable.  Quotes for premiums are higher for older persons, and go up as you age.  Premiums for women are also usually higher than those for men.  I guess that’s the price of living a longer life!

Some questions and benefits that you should look for in long-term care insurance include (but aren’t limited to):

  • The ability to stop paying premiums while you are receiving benefits
  • Home care as well as nursing home care
  • Sufficient benefit payout to cover costs ($250 per day or more)
  • Duration of benefits (How long will the benefits be paid? 4 years? 5 years?)
  • When do benefits begin after it is established that care is needed
  • Is renewal guaranteed?

  

2. Self-Insurance

 Here, option 2 and 5 are pretty close to the same.  The real difference being how much income do you have and will it continue during your incapacity.  If it won’t continue, do you have sufficient net worth to provide your own long-term care and still provide all that you wish to your spouse, family, and loved ones?  Costs for long-term care obviously varies with the level of care required, and quality of life desired.  Do you want to live in an assisted living facility in La Jolla, your home, El Cajon (not that I have a problem with El Cajon!) or somewhere else?  If you can afford about $100,000 per year for long-term care, this may be a good option for you.  Also, you could use option 3 to replace or supplement consumed resources used for long-term care if you so desire.

  

3. Life Insurance to Replace Depleted Assets Used for Paying for Long-Term Care

 This option may be used in conjunction with any of the other options if you choose.  As long-term care costs arise, and as the bills are being paid, your assets are being depleted.  Life insurance can be employed to replace that value so that your spouse, family, and loved ones are still taken care of.  Should you not need to consume assets for long-term care, the life insurance and the assets will be there for your beneficiaries.

  

4. Utilizing Trusts for Long-Term Care

 The use of a Trust will be discussed in another blog. 

  

5. Use Up All of Your Assets and Live Out Your Days in A Nursing Home

 Again, like option 2, you are basically taking care of long-term care costs on your own.  If you have sufficient assets, then you have lived a blessed life.  If you do not have many assets and do no other planning, this will unfortunately be the default plan.  One hopes to never need long-term care, and I think most of us would prefer another option to this choice.  Choices are great, and we need to use them when we have the opportunity.

 

See lots of estate planning information on my website at: www.myestate-plan.com 

 

Please feel free to give me a call today and we can review your situation and other Estate Planning goals.  Everyone’s situation is different, and I can help create solutions. 

 

William Daniel Powell (Dan)

619-980-2297

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

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This document is for informational purposes only.  Nothing in this is to be considered legal advice.  Nothing in this shall create an attorney/client relationship, nor shall it create a confidential relationship.  If you need legal advice (in California), feel free to contact me or someone licensed to practice in your jurisdiction.  I assume no liability or responsibility for actions taken, or not taken, as a result of reading this information

Also, please remember that I speak in generalities in my blog and my website. There are so many different factors that can contribute and completely change the outcome that it would be impractical to discuss all of them here.

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Sunday, 05 June 2016 02:51

Long Term Care - Part 1

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Long-Term Care Part 1

 

The 65-year-old and over segment of our population is growing, and growing faster than those under 65 years old.  From the year 2000 to 2050, those in the age group of 65 years of age and older will grow by 147%, while those younger than 65 will only grow by 49%.  Moreover, on average, 2 out of every 5 persons 65 years of age or older will need some type of long-term care.  If you don’t have the proper planning in place, the high cost of care can force you out of your own home and into a nursing home.  I think it is fair to say this is a result that none of us want.  Forty percent of us will need some type of long-term care, so all of us should plan.

 

 

What is Long-Term Care?

Long-term care is a variety of both medical and non-medical needs that are performed for us by another.  The needs could include help with cooking, eating, cleaning, dressing, bathing, mobility, or medical care provided by a skilled nurse.  This assistance may be provided either in your own home, or in an assisted living facility, or at a nursing home.     

  

What does Long-Term Care Cost?

 There is no simple answer other than to say it can cost a lot.  The cost will depend on the amount of care required.  Is it just help cleaning and cooking?  Or does the person require 24-hour care?  Towards the lower end, the cost can easily be several thousand dollars per month.  Health insurance and Medicare does not cover long-term care in your home, assisted living facility, or nursing home.

  

How Do I Plan for Long-Term Care?

 The good news is that there are a couple of options available to help us plan for long-term care.  Everyone’s situation is different, so I strongly suggest you consult an attorney to discuss options more fully.  Some options include:

  • Private long-term care insurance
  • “Self-Insurance” or paying out-of-pocket for expenses
  • Life insurance to replace depleted assets used for funding long-term care
  • Utilizing a Trust to provide some asset protection
  • Use up all of your assets and live out your days in a nursing home

 

As you can see, some of these options are more desirable than others, and some may be out of reach.  These and other options will be discussed in future blogs.  Thanks for reading.

 

Please feel free to give me a call today and we can review your situation and other Estate Planning goals.  Everyone’s situation is different, and I can help create solutions. 

 

See lots of estate planning information on my website at: www.myestate-plan.com

 

William Daniel Powell (Dan)

619-980-2297

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

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This document is for informational purposes only.  Nothing in this is to be considered legal advice.  Nothing in this shall create an attorney/client relationship, nor shall it create a confidential relationship.  If you need legal advice (in California), feel free to contact me or someone licensed to practice in your jurisdiction.  I assume no liability or responsibility for actions taken, or not taken, as a result of reading this information

Also, please remember that I speak in generalities in my blog and my website. There are so many different factors that can contribute and completely change the outcome that it would be impractical to discuss all of them here.

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The Longevity Risk – Don’t Outlive Your Money, and Leave Some for the Kids – Part 2

  

What is the Longevity Risk?

 We have discussed what the “Longevity Risk” is in another blog, but it will serve us well to repeat the definition again.  Longevity Risk is the risk of living a long life, but needing so much personal care, such as assisted living or nursing care, that you outlive your money.  When this happens, all of the property and money you were hoping to give to your kids or others may be completely used up and gone. 

 

I Already Have an Estate Plan, Won’t That Protect My Assets?

 Not necessarily.  Many people I’ve run into in San Diego have created some kind of Estate Plan.  Most of the time the Estate Plan will consist of a Pour-Over Will, a Revocable Living Trust, an Advance Healthcare Directive (or ACHD, or AHD), a Durable Power of Attorney (a DPOA or POA), a HIPPA (Health Insurance Portability and Accountability Act) release and some other documents.  That’s great, but that alone doesn’t provide asset protection.  As we get older our needs change.  For most of us our assets also change as we mature.

  

What Can I Do to Protect my kid’s inheritance?

 There are choices available to most of us.  Call me and let’s discuss options and we will see if we can keep the golden years golden.  Please see my Blog for more discussion on the topic of planning for the elderly and asset protection.

 

See lots of estate planning information on my website at: www.myestate-plan.com

 

Call today and let’s discuss your Estate Planning goals.  Thanks for reading my blog.

 

William Daniel Powell

619-980-2297

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

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This document is for informational purposes only.  Nothing in this is to be considered legal advice.  Nothing in this shall create an attorney/client relationship, nor shall it create a confidential relationship.  If you need legal advice (in California), feel free to contact me or someone licensed to practice in your jurisdiction.  I assume no liability or responsibility for actions taken, or not taken, as a result of reading this information

Also, please remember that I speak in generalities in my blog and my website. There are so many different factors that can contribute and completely change the outcome that it would be impractical to discuss all of them here.

****************

The Longevity Risk – Don’t Outlive Your Money, and Leave Some for the Kids.

What is the Longevity Risk?

God willing you and I will have this “problem” and live to be very old, but without the need for a lot of personal care.  The Longevity Risk is the costs associated with living to be old.  Although old age isn’t as much a prerequisite as is failing health and the need for some – or constant care. 

 

 

Why does the Need for Living Assistance Create a Risk?

Living assistance costs money, plain and simple.  Having a person come into your home and help with some of the tasks depends on the level of care and skill required and a bit on the area you live in.  We here in San Diego know that things tend to be a bit more expensive than other places.  Modestly, however, I think the costs of having someone help with tasks such as bathing, cleaning, dressing, etc. can cost several thousand dollars a month.  That adds up over time.  If you need to go into a full or even a part-time assisted living facility, you can be looking at $5000 to $6000 a month and more if even more care is required.

  

Am I going to be at Risk of Losing all my Kids Inheritance?

Statistics show that the over 65-year-old segment of our population is predicted to grow by about 147% from the year 2000 to 2050, while the rest of the population will only grow by about 49%.  That means the senior-citizen segment of our population is growing, and growing fast.  Moreover, statistically we are all living longer than ever before.  The longer we live, the higher the likelihood that we will need some degree of care in our senior years. 

 

If we end up needing assistance with our day-to-day living, it is quite possible that we will end up using all of our assets, and potentially living our final years in poverty.  Not a very happy ending.  I can help.

  

You Have Choices

There are choices available to most of us.  Call me and let’s discuss options and we will see if we can keep the golden years golden.

 

Please see my Blog for more discussion on the topic of planning for the elderly and asset protection.

 

Please feel free to give me a call and we can establish your Living Revocable Trust, ILIT, or other Estate Planning goals today.  If you have specific estate planning objectives, I can help create solutions to achieve your specific purpose. 

 

See lots of estate planning information on my website at: www.myestate-plan.com 

 

Thanks for reading my blog.

 

William Daniel Powell

619-980-2297

This email address is being protected from spambots. You need JavaScript enabled to view it.

****************

This document is for informational purposes only.  Nothing in this is to be considered legal advice.  Nothing in this shall create an attorney/client relationship, nor shall it create a confidential relationship.  If you need legal advice (in California), feel free to contact me or someone licensed to practice in your jurisdiction.  I assume no liability or responsibility for actions taken, or not taken, as a result of reading this information

Also, please remember that I speak in generalities in my blog and my website. There are so many different factors that can contribute and completely change the outcome that it would be impractical to discuss all of them here.

****************

Elder Law Planning Part 1

 

What is Elder Law?

 

Elder law is simply the legal practice that focuses on the issues that affect the elder or older population.   That is kind of a big answer isn’t it? Well, it is. Elder law is not just cases that involve elder abuse, but any issue that affects the elderly. I am an Estate Planning attorney here in San Diego, and many issues that affect almost all of my clients, young or old, also affect the elderly among us. Estate planning touches almost all of the elder law issues that come to mind first such as:

  • Preventing elder abuse
  • Preventing elder financial abuse
  • Protecting and preserving assets
  • Providing for and planning for incapacity
  • Passing on our property to those we wish to pass it to
  • Managing healthcare costs
  • Managing long term care

 

An Estate Planning Attorney Better Understand Elder Law Issues

 

If estate planning and elder law are not inextricably linked, they are fast becoming more and more blended. With the issues of elder law that cross-over to estate planning, and the growing population of seniors, an estate planning attorney does his or her client a disservice by not addressing these issues with the client, even if the client does not take it upon themselves to ask. The Society of Actuaries has said that the population is aging, and growing faster than the general population. The Society of Actuaries has said that from the year 2000 to 2050, those in the age group of 65 years of age and older will grow by 147 percent, while those younger than that will only grow by 49 percent. You can look at the Society of Actuaries website here.

 

This increase of longevity is concerning because for many of us it presents a “risk” to our financial well-being. It is a risk to our financial well-being because of rising healthcare costs, problems that the Affordable Care Act (or ACA or Obama-Care) created, and because long-term care costs are also going up.

 

 

All of these issues and more will continue to be addressed in my blog.

 

See lots of estate planning information on my website at: www.myestate-plan.com

 

Please feel free to give me a call today and we can review your situation and other Estate Planning goals. Everyone’s situation is different, and I can help create solutions.

 

Thank-you for reading.

 

William Daniel Powell (Dan)

619-980-2297

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

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This document is for informational purposes only. Nothing in this is to be considered legal advice. Nothing in this shall create an attorney/client relationship, nor shall it create a confidential relationship. If you need legal advice (in California), feel free to contact me or someone licensed to practice in your jurisdiction. I assume no liability or responsibility for actions taken, or not taken, as a result of reading this information

Also, please remember that I speak in generalities in my blog and my website. There are so many different factors that can contribute and completely change the outcome that it would be impractical to discuss all of them here.

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