Elder
Law Update
North Carolina Edition
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PLEASE VISIT MASON LAW
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I WANT TO KNOW
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If you have an idea or comment that will help me
make this a better newsletter
please
send it to me. Just
click! |
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Dear Bob,
OK
. . . 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.
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Tax Rebate -
Economic Stimulus Checks
Seniors
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. |
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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
The
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 the
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
The
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.
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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 of
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.
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HOW
YOUR SOCIAL SECURITY BENEFIT IS CALCULATED
-Warren Coble
Ever
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 Rate
(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.
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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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