The aging of America is a reality. More of our elder citizens are reaching the age of 65 and joining the ranks of a graying population. There are already more than 45 million citizens who qualify for Medicaid. Experts forecast that this number will double by 2050. Medicaid was created to provide health coverage for the elderly, low-income adults, children, pregnant mothers and people with disabilities. The Center for Medicare and Medicaid Services (CMS) supports access to care in many ways. CMS is charged with implementing laws passed by Congress. This is accomplished by issuing guidance, reports, and initiatives. States are charged to administer these programs under specific directives. The ocean of red tape and changing guidelines especially in this toxic debate over national health care makes the need for legal assistance urgent. This is a strong case to develop a Medicaid strategy with an accomplished Medicaid planning attorney. The elderly should not wait on their 65th birthday to do this. The elderly should not ‘go it alone’. Consult an expert like a Medicaid planning attorney who has a proven track record of helping many elderly clients with securing quality healthcare, protecting assets that they spent a lifetime of work and ensure that assets pass on to heirs.
An experienced Medicaid planning attorney with work with each elderly client to complete an audit of assets, contracts, health needs, estate planning, retirement documents, investments, and any other retirement issues. A comprehensive assessment of your retirement assets and need is necessary. This will help you and your attorney to explore strengths and weaknesses as you prepare for retirement. Perhaps your health needs specialized medical attention. Maybe surgery and long term care might be unavoidable. There may be the option of assistance from close family members. This may take the form of transportation and/or living accommodations. Maybe you bought a long term home care plan decades ago. If not, it is a good idea to forecast the availability and cost of assisted living facilities or nursing home care. As an employee of a private company or public entity (municipal, state or federal), there may be available resources. Innumerable combination of scenarios makes Medicaid planning an assignment to be done with an experienced Medicaid planning attorney. Failure to do so may result in paying for services that you do not need, assuming you are entitled to benefits that you are not and leaving resources unused that could enhance your health and benefit your heirs.
An experienced attorney will organize all your retirement needs. You may need a living will. This will clearly state your instructions for medical care when you are unable to do so. If a medical condition prevents the elderly from instructing the doctor on end of life medical care, the living will instruct the doctor or medical facility to follow instructions made by the elderly when he/she was physically able and mentally competent. Another critical decision is the appointment of a health care proxy. This is a legal action where a competent adult (often a family member) who is granted power of attorney to make medical decisions for the elderly person. This person is a trusted confidante who can coordinate care with doctors, medical institutions and specialists when the elderly person is unable to do so. Importantly, you can specify what decisions the proxy can make. Conversely, the elderly person has no say in the appointment of a health surrogate. This is done by the court after the elderly becomes incapacitated and it is too late to appoint a proxy. An experienced attorney will advise the elderly client to take as much control as possible in their health care and end of life decisions by executing the legal documents that appoint a proxy. The consequences for the elderly’s care are indeed dramatic. Health care decisions include medical and surgical treatments, life-prolonging treatments, psychiatric and nursing care, home health care and organ donation.
Nursing home or assisted living facilities are very expensive. Combined with other medical care, the liquidity of the elderly and eventually all assets may be imperiled without proper Medicaid planning. An experienced attorney will be proactive. This may include transferring your assets so you can qualify for Medicaid later in life. This process has to be done along with strict legal and moral guidelines. It is not for the faint of heart. However, a skilled Medicaid attorney will develop a strategy that maximizes your rights and takes all legal steps to protect your assets and maximize income for now and years to come.
Medicaid planning attorney has several tools available that benefit the elderly. The Medicaid Asset Protection Trust (MAPT) is one such tool. It is an irrevocable trust. The elderly client is the ‘grantor’ who creates the trust and funds it with certain assets. The grantor appoints a trustee (other than the spouse) and instructs how the assets are to be managed. The principal of the trust assets will remain in the trust until the death of the elderly. Also, at that time the assets of the trust are transferred to the trustee. This is a handy and effective legal tool because the elderly heirs receive the assets without going through the lengthy probate process. MAPT is a complex process that requires a steady and experienced attorney. The elderly should research a law firm thoroughly before deciding who is best to navigate the legal and financial ramifications. The law firm should also be skilled in other areas of law including tax law, contracts, and estate planning.
Developing a long term plan for Medicaid is one of several strategies advised by an elder care attorney. Many elderly clients do not take advantage of additional exemptions available to homeowners. Also, certain assets can be converted to exempt status if invested in a home or automobile. The elder care attorney will explore gifting options and how best to do it with the retirement strategy. Perhaps trust is a good option where a family member is a trustee. The elderly client can only realize these wise decisions if an elder care attorney is engaged. Do not wait until you are 65 years old to do it.