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Live shamrockElder Law Update
 
North Carolina Edition
Issue Ten
 
March 2008
 
 
In This Issue
How To Get A Rebate Check
Medicaid Basics Part IV - Asset Rules For Married Couples
Dr. Shevlin & Medicare Advantage Plans
How Social Security Benefits Are Calculated
Where Your Mortgage Rate Comes From
This Month's Favorite Links
Check Them Out!
 

Learn More About The Economic Stimulus Benefit


Social Security Benefits Calculator
Fun to Play Around With!

Bob's Basic
Special Needs Trust Explanation
 

 


Come across an interesting link?  Share it with me.

 
PLEASE VISIT MASON LAW
 
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I WANT TO KNOW
 
If you have an idea or comment that will help me make this a better newsletter please send it to me. Just click!
Dear Bob,

Irish RAMOK . . . so I have a graphics/designer sister in California who has deep-seated feelings of revenge. She got a hold of one of my stock photos and . . . had a wee bit 'o fun with her brother.

Interested in the proverbial pot 'o gold? I can't help you with that, but if you'll read below I'll explain a bit about how you may qualify to be economically stimulated to the tune of $300 or so. You may be able to get a check from Uncle Sam in the next few months and use it to do your part to rescue the economy.  Or buy a gallon of gas.

My discussion of the new Medicaid rules continues with the fourth installment below. This month's edition finishes off a discussion of the Medicaid asset rules and takes up the topic of Medicaid transfer penalties. If you missed the first three installments you can go to the Elder Law Update boneyard (archives) by clicking HERE. My ultimate aim is to edit all of the installments into a single downloadable document.

Dr. Shevlin returns this month with a subject near and dear to me: Medicare Advantage plans and why they often mislead seniors. Interesting from a doctor's perspective! After reading her article, you can learn much more by going to the Mason Law Medicare Corner where you'll find a stockpile of information.

Ever wonder how Social Security benefits are calculated? Social Security Guy Warren Coble will tell you below (in English, no less).

On a related topic, the March edition of Coastal Senior (A Savannah-Hilton Head area publication) has an article by yours truly as to why you gentlemen might need to think twice about taking early Social Security retirement benefits. You can read it by going HERE.

After you have figured out how your Social Security benefit is calculated, read Rose Devries' column below to learn how your mortgage rate is calculated.

Remember you may visit the archives for back issues of Elder Law Update. And if you believe someone you know might be interested in Elder Law Update I hope you'll forward this newsletter (there is a convenient "Forward email" link at the bottom of the newsletter).

For the benefit of my very Irish wife:  Erin go bragh!

Have a great and happy Easter.
 
Bob Mason
Certified Elder Law Attorney
 

Certified by the National Elder Law Foundation, recognized by the American Bar Association as the certifying entity for specialization in  Elder Law.

Tax Rebate - Economic Stimulus Checks 

Pot of GoldSeniors can benefit from the economic stimulus law enacted on February 13, 2008, but they need to file an income tax return. Seniors, disabled veterans, and veterans' widows will receive $300 payments if they earned $3,000 in Social Security or veterans' disability benefits in 2007.

In addition, workers who earned at least $3,000, but not enough to pay income taxes, will be eligible for payments of $300. For higher income individuals, the law provides rebate checks of up to $600 per individual. The stimulus payment begins to phase out for individuals with adjusted gross incomes (AGI) over $75,000 and married couples who file a joint return with AGI over $150,000.

In order to get a rebate, you need to file an income tax return even if you do not have any tax liability. You will need to report any Social Security income on the tax return. This does not mean you will be taxed on your Social Security income, but you must report it in order to get the rebate. If you file the tax return on time, you should receive the rebate check in May or June.

For more information on the stimulus payments and what income tax forms to file, go to www.irs.gov or call 1-800-829-1040.

MEDICAID BASICS AFTER DEFICIT REDUCTION ACT: Part IV - Married Couples
 
Bob Mason
 

This is a multipart series that will delve into the whacky world of Medicaid nursing home benefits after the Deficit Reduction Act. I don't know how many installments we will have . . . enough to get the job done.

The first three installments reviewed various types of assets to determine what "counts" and what doesn't under the Medicaid asset rules. Review the installments by clicking Installment I, Installment II or Installment III. This fourth installment examines the treatment of assets with respect to a married couple.

THE ASSET RULES (Continued)
TREATMENT OF ASSETS FOR A MARRIED COUPLE

 

A Reminder From The Last Installment

lady Lap Top 1The basic rule of nursing home Medicaid eligibility is that an applicant, whether single or married, may have no more than $2,000 in "countable" assets in his or her name. If the applicant is married, the spouse is called the Community Spouse, and there are rules concerning how many countable assets the Community Spouse may keep. This installment discusses those rules. "Countable" assets generally include all belongings except for (1) personal possessions, such as clothing, furniture, and jewelry, (2) one motor vehicle, (3) the applicant's principal residence, and (4) assets that are considered inaccessible for one reason or another.

Keep in mind, the rules discussed in this part relate to qualifying for Medicaid and have nothing to do with transferring those assets or whether those assets might be subject to estate recovery upon the death of the applicant. I'll begin discussing transfer rules at the end of this installment and continue to discuss them in detail in later installments.
 

The Medicaid asset rules are extremely complex. Please do not rely upon this simple explanation for a definitive answer.
 

SPOUSAL PROTECTIONS - ASSETS

Medicaid law provides special protections for the spouse of a nursing home resident, known in the law as the "community" spouse. Under the general rule, the spouse of a married applicant is permitted to keep one-half of the couple's combined countable assets up to $104,400 (2008). In addition, there is a minimum resource allowance for the community spouse of $20,880 (also 2008). The protected amount is referred to as a "Community Spouse Resource Allowance" or "CSRA".

The CSRA is calculated with respect to assets held by a married couple as of the beginning of the first continuous 30 consecutive day period that the applicant spouse has been confined to a hospital or nursing home or some combination of the two. For the sake of administrative convenience, DMA will actually measure the assets as of the close of the last business day of the preceding month. This is sometimes referred to as a "snapshot date". It does not matter when the Snapshot Date occurred. It is not at all uncommon to have a Snapshot Date that was triggered several years before the date of a Medicaid application.

So, for example, if a couple owns $90,000 in countable assets on the date the applicant enters theLady lap top 2 hospital and stays in it or a nursing home for 30 days or more, he or she will be eligible for Medicaid once their assets have been reduced to a combined figure of $47,000 - $2,000 for the applicant and $45,000 (one-half of $90,000) for the at-home spouse. If the couple owned $220,000 in assets, the spouse in need of care would not become eligible until their savings were reduced to $106,400 ($2,000 for the nursing home spouse and the maximum $104,400 for the community spouse).

Often, it is advantageous for the couple to try to have as much money as possible in their names on the Snapshot Date up to $208,800 so that the amount the community spouse is allowed to keep will be as high as possible. Sadly, many couples believe they understand the rules and spend half of their assets before a Snapshot Date only to later discover they must reduce their assets by half again!

After a determination has been made as to the nature and extent of an applicant's (and spouse's) assets, and whether any of those assets will be protected, the next major inquiry involves whether any assets have been transferred before the application.

This concludes the discussion of assets for Medicaid eligibility purposes. We now turn our attention to the much misunderstood (but very harsh) Medicaid transfer penalties.
 

THE TRANSFER PENALTY

Hands on face manThe other major rule of Medicaid eligibility is the penalty for transferring assets. Medicaid has always imposed some sort of restriction on transferring assets before entering a Medicaid application - were it not for such restrictions, anyone could qualify for Medicaid simply by giving assets away at the time nursing home entry became necessary.

Early in 2006 Congress passed, and on February 8, 2006, President Bush signed, the Deficit Reduction Act ("DRA"). DRA mandates tough new restrictions on the transfer of assets made on or after the effective date of February 8, 2006.

In The Next Issue . . . .
 

The effects of DRA have been trickling down to the states and each of them has been grappling with how to implement DRA locally. North Carolina began enforcement of the new rules on November 1, 2007. Those new rules will be explained beginning in the next issue of Elder Law Update.

CAVEAT EMPTOR! BE CAREFUL CHANGING TO MEDICARE ADVANTAGE
 

Patricia Shevlin, M.D.
 

With the start of the new year, many of our patients have new insurance plans. Most patients realize that a change has occurred and when that change goes into effect. A glaring exception has been our Medicare patients.
 

We discovered this fact in our office because many of our Medicare claims in January were rejected. As we investigated the denials, we found that many of our Medicare patients had Medicare Advantage plans they didn't think they had.

When we've called the patients to explain that we needed a copy of their new insurance card, most ofPatricia Shevlin, MD them have maintained that they still have traditional Medicare and that they only signed up for a different Medicare Drug Plan. They go on to explain that they wanted a Medicare D plan with "gap" or "donut hole" coverage and a salesperson helped them sign up for a plan that included "gap" coverage. If any other features of the Medicare Advantage plans were explained, our patients do not recall those details.

As Dr. Hodges pointed out in last month's newsletter, there are implications in these choices for long term care and rehab services which could be very important to our patients in the future. Most of my Medicare patients do not have discretionary income, so I hate to see them pay for services they may never use. Specifically, a few of these patients have very few prescriptions and would need to have a significant change in their health to get to the "donut hole". They may, however, have a spouse who could use "gap" coverage and they don't want to be on different plans. The sad reality is that if they can't understand one plan, they would not be able to decide on, or keep track of, two plans.

A slightly different situation occurred with another patient with new neurological symptoms. I explained that the patient needed an MRI and he asked me if it could wait until February 1st when he would have health coverage. Knowing he was a Medicare patient, I asked what the problem was. It seems he thought he had signed up for a Medicare Advantage plan, but when he went to fill a prescription, he was told he had no coverage. After two hours on the telephone with customer service, he was signed up for a policy but it wouldn't be in effect until February 1st. I know if he had money deducted from his Social Security check that he had coverage from someone, but I couldn't convince him or his son. He did have his scan after February 1st and happily didn't have an adverse event because he waited, but what about other patients?

How are these situations possible? We've tried to direct patients to the Senior Center and to the NC Seniors Health Insurance Information Program (SHIIP) before they choose a plan, and to the state insurance office to complain if they aren't happy later. Some of my patients do take advantage of these services but a lot do not. This is not a generation of people who are accustomed to asking for help. They also may not want to reveal their poor reading skills. The average reading level of Randolph County adults is fifth grade, so the family members who may be trying to help could be just as perplexed as the senior. It's no wonder then that our seniors fall prey to someone who appears to know the Medicare system. Caveat emptor may work if you are buying a toaster, but not so well if you are buying health care.

Patricia A. Shevlin, MD

 [The Mason Law website carries much additional information concerning Medigap Plans, Medicare Advanatage Plans, and Medicare in general  - click HERE to go there now. Editor ]

Patricia Shevlin, M.D., is a principal in Asheboro Family Physicians with offices in Asheboro, North Carolina.
 

 HOW YOUR SOCIAL SECURITY BENEFIT IS CALCULATED
-Warren Coble

 

Warren CobleEver wonder how Social Security calculates your monthly benefit?  Lots of folks have ideas, or have heard different things, such as the last 10 years, the last 3 years, the high 5 years in a row, etc., all of which are incorrect.

Benefit rates under Social Security Retirement, Survivor, and Disability programs are based on an individual's lifetime earnings.  Actual earnings are adjusted or "indexed" to account for changes in the average wages since the year the earnings were actually received.

Another way to help understand this concept is to compare the actual dollars earned, say 30 years ago, to the inflated value of that dollar today.  The benefit computation is actually based on the "indexed" or inflated dollar value.  Earnings for years age 60 and later are not indexed.  Using this formula, earnings for years after age 60 could actually be higher than earnings in a previous year, but the formula causes the previous earnings to be counted as "higher" based on the indexing. 

After the actual earnings are "indexed", Social Security calculates the average indexed monthly earnings for the years you earned the most money (based on the "indexing" method).  For retirement benefits, a period of 35 years is used.  For disability benefits and survivor benefits, shorter time periods apply, with less years used for younger workers.

From the average indexed monthly earnings, a 3 step formula is then applied at 90% of a certain amount (bend-points which are determined each year), 32% of the second bend-point, and 15% of the third bend-point.  These three amounts are added together to determine an individual's full monthly retirement rate, known as a Primary Insurance Amount, or PIA.  Multiply the PIA by 75% to determine the monthly retirement benefit at age 62.

Next month we will examine additional factors which can change the amount of the retirement benefit.  For more information, log on to www.socialsecurity.gov, click on Publications on the lower right side of the web site, then English publications, then scroll down to the appropriate year for YOUR RETIREMENT BENEFIT: HOW IT IS FIGURED.


Social Security expert Warren Coble welcomes your questions regarding Medicare, Social Security and Senior Life in general! Email Warren by clicking HERE.
WHERE DOES YOUR MORTGAGE RATE COME FROM?
-Rose deVries,
 
Darby Bank & Trust Co.

Since September 2007, the Federal Reserve Bank (the "Fed") has lowered the Federal Funds RateRose deVries (the "Fed Funds Rate") 175 basis points.  Conversely, the national average for the 30 year fixed mortgage has roller-coastered, ending with a decrease of only 57 basis points for that same time period.  Surprising?

Contrary to popular belief, the Fed does not control mortgage rates.  When the Fed raises or lowers rates, it usually means that it is raising or lowering the Fed Funds Rate.  This rate is the overnight interest rate which banks charge each other when a bank needs to borrow money to meet end-of-day reserve requirements. 

So, if it's not the Fed, who comes up with these rates? 

Because Treasury obligations are backed by the "full faith and credit" of the United States, they are the benchmark for bonds such as the fixed rate mortgage.  Because a 30 year fixed rate mortgage rarely lasts longer than about 10 years before being paid off or refinanced, the closest instrument which has similar risks is the ten-year Treasury Constant Maturity.  Therefore, the ten-year Treasury is the tool of choice to track mortgage rates.

Risk and inflation are two very important factors- among many others - which affect mortgage rates. 

As noted above, treasury issues are 100% guaranteed to be repaid.  Mortgages, as witnessed by the current increase in the foreclosure rate, are not.  They carry more risk of default or early repayment and are therefore priced higher to compensate for that risk.  The average "spread or markup above the 100% secured Treasury is 170 basis points or 1.7%.  That markup widens and contracts with a range of market conditions, investor appetites and supply of available product as well as the presence of competing investment opportunities, like corporate bonds or domestic or foreign markets.  Additionally, not all increases or decreases are passed along.  Depending upon the size of the change, rates may stay the same (but fees, such as points, may change). 

Inflation also plays a significant role in raising or lowering fixed mortgage rates.  If inflation is expected to decline in the foreseeable future, you can bet that mortgage rates have some room to fall as well.  Conversely, an outlook which suggests higher inflation ahead may see mortgage rates rise.

There are many factors that affect the intricacies of mortgage rates. This has been a very simplified discussion of a very complex topic. I have not discussed a number of other important factors because my aim has been to give you a very general review of mortgage rates.


 
Rose de Vries, JD, is Vice President of Private Banking Services for Darby Bank & Trust Co. (offices in Vidalia, Lyons, Pooler and Savannah, Georgia). Rose is based in Darby's main Savannah office. You may email comments and questions to Rose by clicking HERE or by giving her a call at 912-944-2612.
 
 
The Usual Disclaimer: This newsletter is for general information only. Please do not rely on anything you read in this email as definitive legal advice applicable to you. All situations are different, including yours. Nothing you read in this newsletter is a suitable substitute for professional advice you may receive from your attorney, your accountant, or your tax advisor.

All contents copyrighted 2007 by Mason Law, PC. Contents may be republished with written permission of Mason Law, PC (which permission will usually be given!).
 
 

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