Elder Law Answers

Medicare Basics • Medicare Part A (hospital insurance): Covers short-term, medically necessary skilled nursing facility (SNF) care if you meet specific requirements. Many people assume Medicare will cover a stay in a SNF indefinitely, but coverage is limited and tied strictly to skilled medical needs. • Medicare does not cover long-term or custodial care. • Maximum 100 days per benefit period: o New benefit period: starts when out of any hospital or SNF for 60 consecutive days & then have a new 3+ days hospital stay (resetting the 100-day SNF allotment and the deductible). • Coinsurance pay: Patient pays increasing coinsurance after day 20. • Understanding rules is key to avoiding unexpected bills: for older adults, people with disabilities, and family caregivers What Is Skilled Nursing Facility (SNF) Care? • Short-term, medically necessary care provided in a licensed facility following a hospital stay. • Offers a higher level of care than custodial nursing homes or assisted living communities. • Care must be provided by, or under supervision of, licensed medical professionals such as registered nurses (RNs) or physical therapists. Common reasons someone might need SNF care include: • Recovery after surgery • Rehabilitation following a stroke or serious illness • Wound care or IV therapy • Physical, occupational, or speech therapy • Monitoring and treatment of complex medical conditions • SNF care is designed to help individuals recover and regain function so they can safely return home or to a lower level of care. Medicare Part A may help pay for SNF on short-term basis if: • Qualifying inpatient hospital stay: Inpatient for at least 3 consecutive days, not counting the day of discharge. Time spent in the hospital under “observation status” does not count toward this requirement. • Admission to the SNF shortly after hospital discharge (usually must begin within 30 days of leaving the hospital). • Medical need for skilled care. The care must be medically necessary and require skilled services, such as daily nursing care or rehabilitation therapy that can only be provided by trained professionals. • Medicare-certified skilled nursing facility. Services Medicare A cover in a SNF (generally) includes: • A semi-private room • Meals • Skilled nursing services • Physical, occupational, and speech therapy • Medical supplies and equipment used during care • Qualifying medications related to the SNF stay • Ambulance transportation to the nearest provider of necessary services if other modes of transportation would pose a health risk Medicare A does Not Cover SNF Care when: • Long-term or custodial care, such as help with bathing, dressing, or eating when no skilled medical care is required • Stays not following a qualifying 3-day inpatient hospital admission • Facilities that are not Medicare-certified • Continued SNF care once no longer needs skilled services Cost of SNF Care Cost Under Medicare: • Medicare-covered SNF care is limited to up to 100 days per benefit period, and costs depend on how long a person stays. • Days 1 to 20: Medicare Part A pays the full approved cost. • Days 21 to 100: Part A covers part of the cost. o Patient pays a coinsurance: $217/day in 2026. • Days 100+: Patient pays all the costs of their SNF care. • Medigap (Medicare Supplement) some plans may cover some or all the daily coinsurance for days 21 to 100. Why Understanding SNF Coverage Matters: • Confusion can lead to financial strain and difficult decisions during an already stressful time. • Many people assume Medicare will cover a stay in a skilled nursing facility indefinitely, when in reality, coverage is limited and tied strictly to skilled medical needs.

The Great Wealth Transfer: • As baby boomers are the primary source of wealth, their death begin transferred to younger generations. • This is one of the most substantial intergenerational transfers of wealth in history & it is expected to continue for another couple of decades. • Some estimates put the amount of assets that will be transferred at $68+ trillion. • Potential to reshape individual financial futures and the broader economy. • Will provide opportunities that weren’t previously available (early retirement, investment opportunities, or funding for personal passions). • Complexities require careful planning and decision-making.

Estate Planning and Elder Law We have dedicated our entire practice to providing estate planning to families in West Virginia and Pennsylvania. Our purpose is to ensure people of all ages and their loved ones have financial security now and in the future. Visit us online at: https://www.seamonlawoffices.com

This multi-episode series will follow a hypothetical couple through their lives to see what role estate planning had on their family. This hypothetical story is based on having worked with over 1500 families over the past thirteen years, but it is not based on a specific client.

Estate Planning and Elder Law We have dedicated our entire practice to providing estate planning to families in West Virginia and Pennsylvania. Our purpose is to ensure people of all ages and their loved ones have financial security now and in the future. Visit us online at: https://www.seamonlawoffices.com

Most parents of younger children feel that nearly every day is focused on their children, but as we get older the tables begin to turn. I’ve worked with amazing children who sacrifice quite a bit to help their parents as they age. I am often touched at how much love and care so many adult children provide to their parents sometimes at the sacrifice of their own children or grandchildren. People often express that we do not take care of our elderly anymore and while there are many examples of that, I’ve been blessed to meet some pretty amazing ‘kids’ over the years. Make it easier for kids, have good estate planning documents that give the appropriate power/controls for them to protect your care decisions. Estate Planning and Elder Law We have dedicated our entire practice to providing estate planning to families in West Virginia and Pennsylvania. Our purpose is to ensure people of all ages and their loved ones have financial security now and in the future. Visit us online at: https://www.seamonlawoffices.com

Estate Planning and Elder Law We have dedicated our entire practice to providing estate planning to families in West Virginia and Pennsylvania. Our purpose is to ensure people of all ages and their loved ones have financial security now and in the future. Visit us online at: https://www.seamonlawoffices.com

Estate Planning and Elder Law We have dedicated our entire practice to providing estate planning to families in West Virginia and Pennsylvania. Our purpose is to ensure people of all ages and their loved ones have financial security now and in the future. Visit us online at: https://www.seamonlawoffices.com

There are many types of trusts that can be useful depending on the client’s goals. In January, we discussed trusts in general. In February, we discussed testamentary trusts that can be designed to manage an inheritance after we have passed away. This month’s show will focus on the revocable living trust which is created for the benefit of the person creating their trust during their lifetime and it may continue on after that person’s death for the benefit of one or more beneficiaries. A major benefit of the revocable living trust is avoiding probate!

Topic: Christmas time is a season where we enjoy gathering with our family and friends to celebrate. We cherish those memories, but sometimes we notice that a loved one has deteriorated physically or mentally. Now what do we do? • Today’s society considers it healthy to have certain physical ailments because almost everybody has them, but they are definitely warning signs • Ironically, this is a very busy time for our law office because over Thanksgiving and Christmas, as the family comes together (especially if some or all of them live out of town), they haven’t realized what was going on?

Topic: Aid & Attendance Pension (established in 1952) • It is a little-known VA non-service connected disability pension that can change the lives of our wartime veterans and their surviving spouses • tax-free pension that helps defray the cost of caring for elderly veterans and their dependents who cannot care for themselves • Most veterans don’t think they can qualify because they have never qualified for or applied for any VA benefits or that they were not actually in a war zone Background: We used to talk about this quite a bit on the radio show, but due to proposed sweeping changes to the rules that affected a number of areas including net worth, asset transfers, medical expenses and income deductions we were in a period of uncertainty. We found inconsistencies in the review process. Some applications were being denied based on the new rules – which they shouldn’t have been, while others went through. • After the proposed rules were published, they met a lot of opposition due to inconsistencies and unfair provisions in the proposed changes • After some revisions, the final rules were announced September 18, 2018 & they became effective October 18, 2018 • Finally we know the rules!

Elder Law Answers Ep 9 18 Alzheimers by Seamon Law Offices

The majority of our listeners probably don’t have a will, how do we know this? Every survey we find tells us they don’t: • A 2009 survey found that almost 75% of parents do not have a will. • A 2014 survey of 2,000 adults found 64% of those surveyed did not have a will • A 2017 survey found only 44% of adults have a will

We always mention nursing homes, the high cost of care, and Medicaid. But many people really don’t understand how all of this ties together. Today, we are going to discuss some real life examples of clients we’ve worked with. Obviously, we can’t share actual client’s names, but we can share enough of the stories for our listeners to get a better understanding! Basics – Healthcare insurance such as Medicare or your Medicare Supplemental policy will not pay for long term care (nursing home) – at most it may pay for up to 100 days. LTC insurance products that are substantially more expensive may pay for a portion of this care. Easy way to remember “Medicare doesn’t care anymore if you need LTC”; what you’d need after Medicare is private pay, LTC ins., or Medicaid Home & car = exempt during your life (and your spouse’s) Crisis Planning – when a person hasn’t planned in advance and uses our services after loved one is in nursing home or needs one in near future (within 5 years) Asset Protection (ie. 5 yr. planning) – when a person/couple plans 5 years prior to a potential care need to protect selected assets Medicaid – state pays most of care costs, but patient’s income will go toward care costs, married person’s outcome may be slightly different. Care costs does not include the maintenance, insurance, taxes related to the home Estate Recovery – WV is required by federal law to recoup what they spent on a Medicaid recipient from their estate upon their death. Countable assets become part of the recipient’s estate upon their death (or their spouse’s death whichever is later. Our more recent clients have received a letter from DHHR upon their death for the state to consider what assets remain. Life insurance – Combined cash value of $1500 counts as an asset. Most people have very little knowledge about what life ins. they have and its value. Keep better records on that! Crisis Planning Rule of Thumb: Marital status: Single person: Can usually save about ½ of assets while spending about ½ of assets on care Married couple: Can usually save most of the assets Pros: Can usually save some assets or proceeds of assets, but must move quickly and liquidate asap Cons: Usually have to liquidate all or most of the countable assets, but

Doreen explains the growing trend of "elder orphans" - seniors who are aging alone, with no spouse or family support. According to the National Academies of Sciences, Engineering and Medicine, approximately 1 in 5 women in the United States now reach their 50s without having children. This figure is up from 10% in the 1970s. Ironically, many elder orphans have sacrificed their time and valuable resources as caregivers themselves, but they do not have anybody who will do these things for them. Many seniors value their independence and do not realize until a crisis they do not have the support they need so it is helpful to plan in advance. This show originally aired on WAJR Radio in January of 2018.