Elder Law of Louisville's Blog

Tuesday, December 14, 2010

New Medicare Premium, Deductible and Co-Pay Charges for 2011

The basic premium for Medicare Part B will be $115.40 a month in 2011, up from $110.50 in 2010 (a 4.4 percent increase). But because there will be no cost of living benefit increase for Social Security recipients for 2011, most beneficiaries will be exempted from paying this increase and will instead pay the same $96.40 premium amount they have paid since 2008.

A "hold-harmless" provision in the Medicare law prohibits Part B premiums from rising more than that year's cost of living increase in Social Security benefits. Since there is no Social Security increase, most beneficiaries -- about 73 percent -- will not have to pay any increased Part B premiums because of the hold-harmless provision. Those covered by the provision will continue to pay Part B premiums of $96.40 per month in 2011.
But this hold-harmless protection does not apply to the other 27 percent of beneficiaries -- about 12 million in all -- who either:

•do not have their Part B premiums withheld from their Social Security checks, or
•pay a higher Part B premium surcharge based on high income (see below), or
•are newly enrolled in Part B.
All Medicare beneficiaries will be subject to the new deductibles and co-payments, as outlined below.  Medicare Part B covers physician services as well as qualifying out-patient hospital care, durable medical equipment, and certain home health services, among other services.
Following are all the new Medicare figures for 2011:

•Basic Part B premium: $115.40/month
•Part B deductible: $162 (was $155)
•Part A deductible: $1,132 (was $1,100)
•Co-payment for hospital stay days 61-90: $283/day (was $275)
•Co-payment for hospital stay days 91 and beyond: $566/day (was $550)
•Skilled nursing facility co-payment, days 21-100: $141.50/day (was $137.50)

As directed by the 2003 Medicare law, higher-income beneficiaries will pay higher Part B premiums.  Following are those amounts for 2011:
•Individuals with annual incomes between $85,000 and $107,000 and married couples with annual incomes between $170,000 and $214,000 will pay a monthly premium of $161.50.
•Individuals with annual incomes between $107,000 and $160,000 and married couples with annual incomes between $214,000 and $320,000 will pay a monthly premium of $230.70.
•Individuals with annual incomes between $160,000 and $214,000 and married couples with annual incomes between $320,000 and $428,000 will pay a monthly premium of $299.90.
•Individuals with annual incomes of $214,000 or more and married couples with annual incomes of $428,000 or more will pay a monthly premium of $369.10.
Rates differ for beneficiaries who are married but file a separate tax return from their spouse:
•Those with incomes between $85,000 and $129,000 will pay a monthly premium of $299.90.
•Those with incomes greater than $129,000 will pay a monthly premium of $369.10.

The Social Security Administration uses the income reported two years ago to determine a Part B beneficiary's premiums. So the income reported on a beneficiary's 2009 tax return is used to determine whether the beneficiary must pay a higher monthly Part B premium in 2011. Income is calculated by taking a beneficiary's adjusted gross income and adding back in some normally excluded income, such as tax-exempt interest, U.S. savings bond interest used to pay tuition, and certain income from foreign sources. This is called modified adjusted gross income (MAGI). If a beneficiary's MAGI decreased significantly in the past two years, she may request that information from more recent years be used to calculate the premium.

Monday, December 13, 2010


Many people think that estate plans are for someone else, not them. They may rationalize that they are too young or don't have enough money to reap the tax benefits of a plan. But as the following list makes clear, estate planning is for everyone, regardless of age or net worth. (For more information on estate planning, see our Estate Planning section.)

1. Loss of capacity. What if you become incompetent and unable to manage your own affairs? Without a plan the courts will select the person to manage your affairs. With a plan, you pick that person (through a power of attorney).
2. Minor children. Who will raise your children if you die? Without a plan, a court will make that decision. With a plan, you are able to nominate the guardian of your choice.
3. Dying without a will. Who will inherit your assets? Without a plan, your assets pass to your heirs according to your state's laws of intestacy (dying without a will). Your family members (and perhaps not the ones you would choose) will receive your assets without benefit of your direction or of trust protection. With a plan, you decide who gets your assets, and when and how they receive them.
4. Blended families. What if your family is the result of multiple marriages? Without a plan, children from different marriages may not be treated as you would wish. With a plan, you determine what goes to your current spouse and to the children from a prior marriage or marriages.
5. Children with special needs. Without a plan, a child with special needs risks being disqualified from receiving Medicaid or SSI benefits, and may have to use his or her inheritance to pay for care. With a plan, you can set up a Supplemental Needs Trust that will allow the child to remain eligible for government benefits while using the trust assets to pay for non-covered expenses.
6. Keeping assets in the family. Would you prefer that your assets stay in your own family? Without a plan, your child's spouse may wind up with your money if your child passes away prematurely. If your child divorces his or her current spouse, half of your assets could go to the spouse. With a plan, you can set up a trust that ensures that your assets will stay in your family and, for example, pass to your grandchildren.
7. Financial security. Will your spouse and children be able to survive financially? Without a plan and the income replacement provided by life insurance, your family may be unable to maintain its current living standard. With a plan, life insurance can mean that your family will enjoy financial security.
8. Retirement accounts. Do you have an IRA or similar retirement account? Without a plan, your designated beneficiary for the retirement account funds may not reflect your current wishes and may result in burdensome tax consequences for your heirs (although the rules regarding the designation of a beneficiary have been eased considerably). With a plan, you can choose the optimal beneficiary.
9. Business ownership. Do you own a business? Without a plan, you don't name a successor, thus risking that your family could lose control of the business. With a plan, you choose who will own and control the business after you are gone.
10. Avoiding probate. Without a plan, your estate may be subject to delays and excess fees (depending on the state), and your assets will be a matter of public record. With a plan, you can structure things so that probate can be avoided entirely.

Wednesday, December 8, 2010

Protecting Your Home from Medicaid

While you generally do not have to sell your home in order to qualify for Medicaid coverage of nursing home care, it is possible the state can file a claim against your house after you die. If you get help from Medicaid to pay for the nursing home, the state must attempt to recoup from your estate whatever benefits it paid for your care. This is called "estate recovery," and given the rules for Medicaid eligibility, the only property of substantial value that a Medicaid recipient is likely to own at death is his or her home. If possible, you should consult with an attorney before entering a nursing home, or as soon as possible afterwards, in order to discuss ways to protect your home.

In those states that have implemented the Deficit Reduction Act of 2005, the home is not counted as an asset for Medicaid eligibility purposes if the equity is less than $500,000 ($750,000 in some states). In all states, you may keep your house with no equity limit if your spouse or another dependent relative lives there.

Transferring a Home
In most states, transferring your house to your children (or someone else) may lead to a Medicaid penalty period, which would make you ineligible for Medicaid for a period of time. There are circumstances in which it is legal to transfer a house, however, so consult an attorney before making any transfers. You may freely transfer your home to the following individuals without incurring a transfer penalty:

  • Your spouse
  • A child who is under age 21 or who is blind or disabled
  • Into a trust for the sole benefit of a disabled individual under age 65 (even if the trust is for the benefit of the Medicaid applicant, under certain circumstances)
  • A sibling who has lived in the home during the year preceding the applicant's institutionalization and who already holds an equity interest in the home
  • A "caretaker child," who is defined as a child of the applicant who lived in the house for at least two years prior to the applicant's institutionalization and who during that period provided care that allowed the applicant to avoid a nursing home stay.


While you can sell your house for fair market value, it may make you ineligible for Medicaid and you may have to apply the proceeds of the sale to your nursing home bills.

Lien on Home
Except in certain circumstances, Medicaid may put a lien on your house for the amount of money spent on your care. If the property is sold while you are still living, you would have to satisfy the lien by paying back the state. The exceptions to this rule are cases where a spouse, a disabled or blind child, a child under age 21, or a sibling with an equity interest in the house is living there.

Estate Recovery
If your spouse, a disabled or blind child, a child under age 21, or a sibling with an equity interest in the house, lives in the house, the state cannot file a claim against the house for reimbursement of Medicaid nursing home expenses. However, once your spouse or dependent relative dies or moves out, the state can try to collect.


But there are some circumstances under which the value of a house can be protected from Medicaid recovery. The state cannot recover if you and your spouse owned the home as tenants by the entireties or if the house is in your spouse's name and you have relinquished your interest. If the house is in an irrevocable trust, the state cannot recover from it.

In addition, some children or relatives may be able to protect a nursing home resident's house if they qualify for an undue hardship waiver. For example, if your daughter took care of you before you entered the nursing home and has no other permanent residence, she may be able to avoid a claim against your house after you die. Consult with an attorney to find out if the undue hardship waiver may be applicable.

Thursday, December 2, 2010

Part 1: Why an Elder Law Attorney

Why an Elder Law or Special Needs Law attorney?

Rather than being defined by technical and legal distinctions, Elder Law and Special Needs Law is defined by the clients to be served. In other words, the lawyer who practices Elder Law or Special Needs Law works primarily with seniors and people with disabilities. Elder Law and Special Needs Law attorneys focus on the legal needs of the elderly and people with disabilities, and use a variety of legal tools and techniques to meet the goals and objectives of their clients. Elder Law and Special Needs Law attorneys typically work with other professionals in various fields to provide their clients quality service and ensure their needs are met.

Using this holistic approach, for example, an Elder Law practitioner will address general estate planning issues and will counsel clients about planning for incapacity with alternative decision making documents. This attorney will also assist clients in planning for possible long-term care needs, including nursing home care. Locating the appropriate type of care, coordinating private and public resources to finance the cost of care, and working to ensure the client's right to quality care are all part of the Elder Law practice.

Thursday, December 2, 2010

Part 2: Choosing an Attorney

Interviewing and Choosing an Attorney

Ask Lots of Questions

Ask lots of questions before selecting an Elder Law or Special Needs Law attorney. You don't want to end up spending time and resources with an attorney who can't help you. Start with an initial phone or email correspondence.  You may speak with a secretary, receptionist or office manager during the initial call or before you actually meet with the attorney. If so, ask this individual pertinent questions regarding the attorney's practice. Suggested questions are provided below

  • How long has the attorney been in practice?
  • Does his/her practice focus on a particular area of law?
  • How long has he/she focused on the particular area of law?
  • What percentage of his/her practice is devoted to Elder Law or Special Needs Law? 
  • Is there a fee for the first consultation with the attorney, and if so, how much is it?
  • Given the nature of your case, what specific information/documentation should you bring to the initial consultation?

The answers to these questions will help you determine whether the attorney has the qualifications important for a successful attorney/client relationship and resolution to your case. If you have a specific legal issue that requires immediate attention be sure to inform the office of this during the initial telephone conversation.

Questions for Your Initial Consultation

During the initial consultation, you will be asked to give the attorney an overview of your case. Be sure to organize all of the information pertinent too your case prior to the initial consultation.

After you have explained your case, ask:

  • How will the case be resolved?
  • What actions will be taken to resolve the case?
  • Are there any alternative courses of action?
  • What are the advantages and disadvantages of each possible action?
  • Will multiple attorneys within the firm handle your case?
  • If so have the attorneys handled matters of this kind in the past?
  • If a trial may be involved, will the attorney do trial work?  If not, who in the firm will handle the trial work?  How many trials has he/she handled?
  • Is the attorney a member of the local bar association?
  • Is the attorney a member of the National Academy of Elder Law Attorneys?
  • How are the attorney's fees assessed?
  • What is his/her estimate of the cost to resolve your case and when can you expect it to be resolved?

Discussing Fees

There are many different ways attorneys assess fees and each attorney works differently. Be aware of how your attorney assesses his/her fees. You will want to know how often he/she bills. Some attorneys bill weekly, some bill monthly, some bill upon completion of work. Ask these questions during your initial consultation so there will be no surprises. If you don't understand ask again. If you need clarification, say so. It is very important that you feel comfortable with your attorney.

Some attorneys charge by the hour with different hourly rates for work performed by attorneys, paralegals and secretaries. If this is the case, find out staff rates and how they will be assessed. Some attorneys simply charge a flat fee for all or part of their services. 

In addition to fees, most attorneys will charge you for their out-of-pocket expenses related to your case. Out-of-pocket expenses typically include charges for copies, postage, messenger fees, court fees, disposition fees, long distance telephone calls, etc. Find out if there will be any other incidental costs related to the case.

The attorney may ask for a retainer. This is money paid to the attorney before he/she starts working on your case. It is usually placed in a trust account. Each time the attorney bills you he/she pays himself or herself out of the account. Expenses may be paid directly from the trust account. The size of the retainer may range from a small percentage of the estimated cost to the full amount.

Get Everything in Writing

Once you decide to hire an attorney ask that your arrangement be put in writing. This agreement can be recorded in the form of a letter or formal contract. It should specifically define what services the attorney will perform for you and the fees that will be assessed for the attorney's services. If your agreement remains oral and is not put into writing, you have still made a contract and are responsible for all fees assessed by the attorney and his/her staff.

Make It a Good Experience

A positive and open relationship between attorney and client benefits both parties. The key to a successful client/attorney relationship is communication. The questions provided above will help you develop a successful relationship with your attorney. Use the answers to these questions as a guide to determine the attorney's qualifications and also to determine whether you can comfortably work with the attorney. If your concerns are not addressed, if you don't like the answers to these questions, if you don't like the attorney's responses, or if you simply do not feel relaxed with the attorney do not make an agreement for services with he/she. 

If you are satisfied with the attorney you have hired you will trust him or her to do the best job for you. Only if you have established a relationship of open communication will you be able to resolve any difficulties which may arise between the two of you. If you take the time to make sure that you are comfortable with your attorney you will make this a productive experience for both you and the attorney.

Thursday, December 2, 2010

13 Medicaid Mistakes

1. FAILURE TO TAKE ADVANTAGE OF THE MANY MEDICAID SPEND-DOWN ALTERNATIVES:  So many people are either unaware, or fail to take advantage of, the many Medicaid spend-down alternatives. When couples are told they have a spend-down to accomplish, they automatically assume they have to spend their money on the care of the patient before qualifying for Medicaid. Nothing could be further from the truth. There are a whole lot of strategies (at least 17 we have identified) you can employ to satisfy the Medicaid spend-down requirement without actually spending the money on care – strategies you can use to protect assets from Medicaid.

2. GIVING AWAY ASSETS WITHOUT A PLAN:  One of the most common "do-it-yourself" techniques is to just give assets away. Although making gifts can be an important part of an effective Medicaid asset protection plan, doing so without a plan, or, worse yet, without fully understanding the consequences and ramifications of such action, can be financially devastating, particularly since the passage of the Deficit Reduction Act (DRA) in 2006. Fortunately, the Medicaid rules which can “punish” an applicant for transferring or gifting assets in anticipation of Medicaid, also have, if you understand how the system works, significant opportunities for protecting assets. In many ways it’s the "half empty or half full" concept.

3. ASSUMING THE ANNUITY YOU BOUGHT YEARS AGO WILL PROTECT ASSETS FROM MEDICAID:  Over the past few years, many couples have purchased annuities based on assurances from the agent that the product would "protect" their assets from Medicaid, should one of the spouses ever need to go into a nursing home. All you had to do was "annuitize" the annuity and it would allow you to immediately qualify for Medicaid, while protecting those assets. Well, guess what? The rules have changed. Under the new Deficit Reduction Act (DRA), passed by Congress in 2006, the great majority of annuities that might have provided some protection in the past are no longer effective for such purposes. Most annuities already in existence, and all but a very few of those available for purchase today, do not meet the specific requirements detailed in the DRA. (Note: the key word here is "most." There are some new annuities (referred to as DRA Medicaid-compliant) that, when used properly, can provide significant protection for assets.)

4. ATTEMPTING TO HIDE ASSETS FROM MEDICAID:  Sometimes families will attempt to "hide" assets, or at least conveniently "forget" about them. After all, how is Medicaid going to find out about that piece of property that you gave to your son last year? Keep in mind that failure to disclose assets in order to obtain Medicaid benefits is a crime (Medicaid fraud) and could result in prosecution, as well as legal action to recover the cost of Medicaid benefits obtained fraudulently. It is just not something you want to even consider.

5. HAVING NO PLAN OR WAITING TOO LONG TO TAKE ACTION:  Every year in this country, hundreds of millions of dollars are lost to the nursing homes or other care facilities simply because families stood back and did nothing. Frequently it is wrongly assumed that once the patient is in the nursing home, nothing can be done. In almost all cases, though, most, if not all, of the couple’s assets (the amount depends on the circumstances) could have been saved for the spouse, but it would have required taking effective action before the money was gone. So often couples are simply overcome by events. They’re aware that the money is pouring out of the estate, but they are like deer caught in the headlights – frozen – unable to act. Of course, without getting an education and developing a real plan, what could they do anyway? Common sense tells you that the longer you wait to take action, the more money that will be lost and, therefore, the less that can be protected from Medicaid.

6. DEPENDING ON UNEDUCATED ADVICE:  It is absolutely amazing how many people will rely on the advice of his or her neighbor, brother-in-law, insurance agent, anyone except an attorney whose practice is focused on Elder Law.  These are the same people that wouldn’t think of making an investment decision without first consulting their financial advisor, but when it comes to Medicaid and the potential loss of tens or even hundreds of thousands of dollars they are more than willing to base their decisions (or lack of decisions) on hearsay and guesswork. Legitimate Medicaid planning attorneys are few and far between, but there are some out there.

7. TAKING THE ADVICE OF THE MEDICAID WORKER:  Many a plan has come to a grinding halt (or never even got started) because the family listened to the local Medicaid worker. Remember, your goals and the Medicaid agency’s goals are not the same. The Medicaid worker’s job is to evaluate the Medicaid application and determine whether an applicant is currently eligible for Medicaid benefits. It is not their job, nor are they usually interested, in helping you save assets. Besides, they are not allowed, by their agency, to give financial or legal advice. So when the worker says: "You have to spend the money on care," that is not only not in your best interest, it is blatantly false. Do not assume that the Medicaid worker, no matter how nice he or she seems, is on your side.

8. ASSUMING A LIVING TRUST WILL PROTECT ASSETS FROM MEDICAID:  Millions of seniors have purchased Living Trusts. Often times they assumed, or were led to believe, that a Living Trust would somehow provide their assets with protection from Medicaid. Although a properly drawn Living Trust may provide many benefits, protection from Medicaid is typically not one of them. Assets in a revocable Living Trust are still available to the patient and/or the spouse, and so therefore, in most cases, are still considered countable resources (for Medicaid qualification purposes).

9. PICKING THE WRONG ATTORNEY:  Often times, when long-term care strikes, the first stop is the attorney’s office. The problem is that more times than not, it’s the wrong attorney. There are only a few attorneys in the Louisville, KY area who understand the complex Medicaid rules.  The problem, for the most part, is that the average individual wouldn’t know the difference. Getting the wrong Medicaid advice, no matter how well intentioned, can be extremely costly, well beyond the attorney’s fees.

10. APPLYING FOR MEDICAID TOO SOON:  Often times, a patient who does not yet qualify for Medicaid will make application for benefits just to “see if I qualify.” After all, what’s the worst they could tell you…you don’t qualify? Well, there is something a lot worse. There are situations where families are attempting to legally protect assets, but the simple act of applying for Medicaid as little as one day too soon could result in the patient being disqualified from Medicaid benefits for years into the future. What they are doing is confusing Medicaid’s transfer disqualification penalty with the look-back period. This may be one of the easiest pitfalls to avoid, once you understand how the Medicaid system works. And although most patients are not affected by this technicality, for those that are, it can be financially devastating.

11. FAILURE TO AVOID ESTATE RECOVERY:  On occasion, families will, either through planning, or by "accident," assume they have protected some significant amount of assets while getting a spouse qualified for Medicaid. Only later, after both spouses have passed away, does the Estate Recovery Unit from the state Medicaid agency show up to "recover" every last cent of the benefits provided. In most cases, proper actions taken early on could have avoided the entire Medicaid Estate Recovery process.

12. MAKING TRANSFERS WITHOUT PROPER AUTHORITY:  Sometimes, in a family’s desperation to protect the assets of a patient who is no longer mentally competent, they will take actions (such as transferring assets, changing deeds and vehicle titles, etc.) for which they have no authority to accomplish. For example, transferring property using a Power of Attorney that doesn’t provide such authority; having the patient sign his/her name to documents when he/she clearly has no idea what is being signed or why; signing the patient’s name for him/her. (After all, who’s going to know?) Although these actions might seem harmless and/or convenient, once discovered they could come back to haunt you in a very serious way, even negating any work done to protect assets from Medicaid. And, in many states, such action could even be considered "elder abuse."

13. BELIEVING YOU CAN GIVE AWAY $13,000 AND MEDICAID WON'T CARE:   Many people believe, or have been told, that they are allowed to give away up to $13,000 every year to each of their children and grandchildren, without Medicaid imposing any disqualification penalty. Wrong! This is a very common misconception. First of all, the $13,000 exemption you have heard about is an IRS rule, and has nothing whatsoever to do with Medicaid. Medicaid will impose a disqualification penalty for virtually any gifts, regardless of the amount.

Wednesday, December 1, 2010

Discussing Long-Term Family Care During Thanksgiving

This just isn't "pretty." It's difficult to think about what happens when we get old, sick or disabled. Most people would prefer to read happy, uplifting news, Hollywood gossip, financial market analysis or even political happenings. What led me to write this blog post was a sobering conversation that I had with Tom Begley, Jr., one of the nation's leading elder care and long-term planning attorneys. He has spent more than 40 years in the field helping families, from the poorest to the wealthiest, in navigating the precarious road to providing viable, reliable, cost-effective, long-term care. When Tom began telling me about some of his clients and their plights, he commented, "We go through a lot of Kleenex in our office." Wow! This is further complicated by the huge emotional burden of a promise made to a loved one (most often a spouse of 50-plus years) that they will never put them in a facility! If only a long-term plan had been started at the time of the promise...

If you have clicked through my blog and are reading this piece, it probably means that you have some personal experience with caregiving. That's what motivated Tom Begley, Jr. He was a young, practicing attorney when he needed to deal with his own parent's care. The field was barely established some 30 years ago. Today, there is formal certification for elder law attorneys, thereby providing an extra layer of protection in the caregiving minefield. This "minefield" is laiden with a variety of dangerous explosives, including emotional, financial, and legal bombs. Don't walk alone; its impossible to understand the laws, rules and unwritten rules that pervade this bumpy, fragmented world of long-term care. Engage some expert advice from a certified elder care attorney before the crisis happens.

During our chat, Tom frequently made the distinction between a "crisis client" and a "planned client." As you might guess, he estimates up to 90 percent of his clients are "crisis-clients." A disastrous health event has already occurred and things are spirally out of control. If only a long-term care plan had been made...

In order to help clients, Tom (and other certified elder care attorneys) drafts a detailed step-wise plan. One of the most important action items is to identify assets and create a spend-down plan to protect assets while qualifying for the all-important and comprehensive Medicaid benefits. Tom says, "Medicaid benefits are meant for the public. It gives me great satisfaction to help families preserve their life savings." "Spending down" is a method of deploying assets towards necessary expenses, including paying the attorney for this work, pre-paying funeral expenses, making home improvements, buying a new car, etc. The idea of "spending down" is the one of the most controversial aspects of a long-term plan. Most middle-income families are proud of their life's savings, which may represent 50-plus years of work. The notion of "giving" away money to children and other family member's creates an emotional reaction of "No, it's my money and I saved it for my retirement." This is a knee-jerk reaction to the perception that they are no longer in "control" of their money, life, etc., and that they are now on "public assistance." Nothing could be farther from the truth! Long-term planning and gifting assets legally can assure more control and longer at home care as a result of preserving the caregiver's health and well-being through planning rather than crisis control. Medicaid, Medicare and veteran's benefits are for the benefit of the public, and that means you!

Here are the five essential steps of long-term care planning:

1) Define your goals. What is the level of care desired? Usually remaining at home, when possible.

2) Buy long-term care insurance, if possible. Recently, Metropolitan Life announced a discontinuance of this type of coverage. Others will surely follow suit.

3) Hire home aides through an agency. They will be screened, bonded and supervised by an agency whose business relies on providing such caregivers. Get references!

4) Consider hiring a geriatric care manager to independently assess caregiving needs, create a plan of care, monitor and make changes to the plan as needed. This outsourcing will remove considerable burden from the family.

5) Retain a certified elder law attorney and to assist in financial and legal planning and, most importantly, to help in accessing public benefits like Medicaid, Medicare and veteran's benefits.

While each of these steps does cost money now, it can insure the best-quality long-term care and save you money in the long run. This is not easy! This isn't a fluffy story about finding a lost dog, the latest antics of the Kardashians, NASDAQ quotes or even Obama's current ratings; this is hard news and tough love. I blog about this because I feel compelled to alert others to the tsunami of caregiving that will occur as the burgeoning population ages, and this wave will continue for many years to come.

As a mother, I can tell you that providing guidance to your children in anticipation of life's challenges is good parenting: I strive for the goal of preparing my children for life's ups and downs. You are a child, parent, aunt, uncle, mother, father, sister, brother or grandparent or some combinations of these roles. I urge you to talk to your family this Thanksgiving and begin the conversation of "What will our family's long-term plan look like?"

At that point, you will see which family members will push their plates away and which will begin to overeat! Please pass the turkey!

Wednesday, December 1, 2010

Medicaid Financial Elibility Standards - A 50 State Survey

Click this link to access AARP Public Policy  Institute's "Access  to Long-Term Services and Supports: A 50-State Survey of Medicaid Financial  Eligibility Standards"

Thursday, October 14, 2010


On Tuesday, a federal judge in Gulfport, Mississippi ordered two former bank employees to serve 8 1/2 years in prison and pay more than $3.4 million in restitution for their role in a multimillion-dollar scheme to defraud the bank and its elderly clients.  Margaret Migues, former branch operations manager at Hancock Bank’s main branch in Ocean Springs, Mississippie and Willie Doris Burney, a former teller there, admitted to the embezzlement and offered their apologies to their families and Hancock Bank officials prior to sentencing.

The embezzlement scheme

A federal investigator first tipped off bank investigators to the embezzlement scheme after he realized $150,000 was missing from his then-73-year-old mother’s account there, Assistant U.S. Attorney Ruth Morgan has said. An investigation started, and Migues immediately confessed to wrongdoing.  Migues and Burney had started stealing money around 1982 from the accounts of elderly people they’d befriended. An independent audit showed a total of $2,386,451.84 stolen from customer accounts between 1995 and July 2009, when both women were abruptly fired. There were no bank records before 1995 so the amount embezzled from the early 1980s to 1995 is still unknown. All 44 of the victims were between the ages of 71 and 102.

At some point two other unnamed co-conspirators participated in the embezzlement and apparently accepted their share of the stolen money.  Only Migues and the two other alleged co-conspirator handled the victims’ transactions, making any changes to the accounts that were needed to further conceal their dealings. In many cases, Morgan said, that would involve the transfer of money from one customer’s account to another.  Migues kept track of the embezzled money in a handwritten ledger so she’d know what the balances on the affected accounts were supposed to be, should questions arise.

What this means for you

This is a reminder to those with elderly loved ones.  Even with full capacity and function, an elderly person can easily be taken advantage of by people they trust.  Check their financial affairs, even if they do not want your assistance.  Iff they do not want a family member to check the finances, use a professional -- a CPA or elder law attorney.

Courtesy Sun Herald

Thursday, October 14, 2010


It has been a while since any posts were made to this blog.  I apologize for that.  We have had a busy couple of weeks!  First up was the Senior Day Out event at the Louisville International Convention Center.  I spent the morning speaking with seniors as well as other vendors.  My goal is always to bridge the cap between senior needs and senior services.  Our doors are open to all seniors, even if no legal services are needed.  We are happy to direct seniors in the proper direction so they get the help they need.  That is one of the reasons we belong to the Metro Louisville Aging in Place Council.  A group of business owners dedicated to assisting seniors to stay in their homes as long as safely possible.

Speaking of the Council, the second big event was the Candidate Roundtable.  Candidates from several political races answered questions relating to seniors, senior services, funding for community centers, transportation, property taxes, and so on.  Congressman Yarmuth and his opponent, Mr. Lally, spoke.  Then the mayoral candidates, Greg Fischer, Hal Heiner and Jackie Green, had their turn.  This was followed by candidates for Jefferson County Attorney, Sheriff, and PVA.  Finally the candidates from several Metro Council districts took turns.

Eileen and I were proud to co-sponsor the event as well as volunteering to set-up, work during, and clean up the event.  My favorite part of the event was getting to personally speak with so many candidates.

Check for the candidates answers to all the questions.

Monday, October 4, 2010

KY Medicaid Now Provides Help to Stop Smoking.

Kentucky Medicaid recipients are now eligible for nicotine replacement products and drugs to help them quit smoking, Gov. Steve Beshear announced Monday.  “This is a great opportunity for Medicaid recipients to stop smoking or using tobacco,” Beshear said at a news conference in the Capitol.  The 2010-12 state budget provides $3 million for the program, which will be matched with $8.4 million in federal funds, Beshear said.

The program, which began Oct. 1, has been sought for years by health advocates. They say it will improve the health of Kentuckians and save money in the long haul because treatment for tobacco-related illness costs the state Medicaid program nearly $500 million a year.  Amy Barkley, of the Campaign for Tobacco Free Kids, praised the governor and General Assembly for including funding for the program in a lean state budget.  “Providing smoking cessation coverage for Kentucky Medicaid recipients is good economic and health policy,” Barkley said in a news release. “It benefits individual patients and Kentucky businesses while helping to improve the long-term financial prosperity of the state.”

Under the program, Medicaid recipients will be given a tobacco cessation assessment to determine their tobacco usage, willingness to quit and coping skills, as well as any barriers to quitting.  Recipients will enroll in a counseling program and select a cessation program. Nicotine replacement products such as gum or patches and tobacco cessation drugs will, if necessary, be prescribed by the recipient's provider.

About one in four Kentucky adults smoke, but the rate is about 40 percent among Medicaid recipients, said Tonya Chang of the American Heart Association.  Kentucky Public health Commissioner William Hacker said only 1 to 5 percent of individuals who try to quit on their own succeed. But about 28 percent are successful under the type of comprehensive program now being offered by Medicaid.

Beshear said Kentucky along with West Virginia “still leads the nation in the percentage of adults who smoke. We also are second in the nation in number of pregnant women who smoke.” He also said nearly 8,000 Kentuckians die prematurely each year because of tobacco use.  “We cannot, and we must not, ignore these statistics,” he said.

Health and Family Services Secretary Janie Miller said recipients who want to enroll in the program should consult their health care provider.

Courtesy of Courier-Journal.

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