Medicaid Planning from Morey Law

Protecting Your Parents Assets From Nursing Home CostsNursing home care costs have been rising over time, with many older Americans who require long-term care unable to afford it.With proper planning, seniors may be able to rely on Medicaid to pay for this care and still retain some of their assets by exploring several different strategies.The aging U.S. population means that more people will likely need nursing home care in the coming decades. Meanwhile, the cost of nursing home care is increasing and expected to keep increasing.With the exorbitant cost of nursing home care, many families worry about depleting their loved ones life savings to pay for the care they need. Private health insurance does not cover nursing home care, and while long-term care insurance is available to cover nursing home costs, these plans are also expensive and may come up short for long-term stays.This leaves millions of Americans reliant on Medicaid to pay for nursing home care a far from perfect solution that usually involves spending down assets to qualify. With proactive Medicaid planning, though, it is possible for someone to qualify for Medicaid and still retain some of their assets. The sooner you start planning, the more options youll have for protecting your parents assets from nursing home costs. Odds of Needing Long-Term Care Are HighThe lifetime likelihood of needing nursing home care is relatively high. About 70 percent of people who turn 65 today will eventually need some type of long-term care, including nursing home care.About 1.3 million Americans aged 65 and older currently live in nursing homes, and about 40 percent of todays 65-year-olds will spend some time in a nursing home before the end of their lives.Women are more likely than men to need long-term care, and the older a person gets, the more likely they are to need it. At the same time, there has been a growing trend of younger adults (those under the age of 65) living in nursing homes, in part due to Medicaid eligibility expansion under the Affordable Care Act. Research shows that this group increased from 10.6 percent of total nursing home residents in 2000 to 16.2 percent in 2017.Medicaid expansion has led to more people of all ages qualifying for the joint federal and state health insurance program. Intended as the payer of last resort when it comes to long-term care, Medicaid has become the primary nursing home insurance for millions of Americans due to the absence of any other public program covering long-term care.In 2020, around 6 million Medicaid enrollees used the program to pay for long-term support and services. Around one in five enrollees received institutional care, such as care provided at a nursing facility.After age 65, more than a quarter of adults receive at least 90 days of nursing home care. Thirteen percent of them receive long-term Medicaid-financed nursing home care.Medicaid typically pays for 100 percent of nursing home costs and may be the only insurance option available for long-term stays. Long-term care insurance can be purchased, but most policies have limits on the maximum daily or monthly benefit amount and the total lifetime benefit, as well as terms and health requirements that may exclude coverage.A nursing home stay isnt necessarily permanent. About 15 percent to 20 percent of admissions are for short-term rehabilitation. Among current residents, the average stay is one year and four months. More than half of residents stay for at least 100 days, while 15 percent of older adults spend over two years in a nursing home.With nursing home costs running $250 to $300 per day in some states, costs can add up quickly. The average nursing home stay of little over a year, or about 485 days, could end up costing upwards of $150,000.Extrapolate these costs over multiple years, and they are unsustainable for many families. Medicaid Planning StrategiesWhether a nursing home stay lasts months, years, or is permanent, you may have crunched the numbers and determined that Medicaid is the only feasible payment option for a parents nursing home care.This is a good news, bad news scenario. The good news is that its possible for somebody who doesnt currently meet Medicaids income and asset limits to spend down their excess assets to meet limits. The bad news is that these limits are generally only $2,000, which requires significant planning, since the average net worth of Americans is more than $1 million, including nearly $1.8 million for those 65 to 74.Another upside is that not all a persons assets count against the limit. A home, for example, is typically exempt. Someone can also own one car without exceeding Medicaids asset limits.Many Medicaid spend down strategies take advantage of workarounds that allow nonexempt assets to be converted to exempt assets, thereby excluding them from Medicaid calculations. But these strategies often involve navigating a tricky five-year lookback period where past asset transfers are scrutinized to ensure applicants dont give away assets to qualify for Medicaid.Keeping these considerations in mind, there are financial planning strategies that can help to protect a parents assets from nursing home costs and a Medicaid spend down. Medicaid-Compliant Annuities (MCAs)MCAs, a type of single premium immediate annuity, allow countable assets (like cash or investments) to be converted into a stream of income that doesnt count toward the Medicaid asset limit. The payout structure must be based on life expectancy, and once purchased, the annuity cannot be cashed out or changed; funds in the annuity are no longer accessible as assets.Annuity income may affect your parents eligibility for other needs-based government programs, such as Supplemental Security Income (SSI). In addition, the state Medicaid agency must be the primary beneficiary in case of the annuitants death during the annuity period. Medicaid Asset Protection Trusts (MAPTs)Medicaid-compliant trusts, like MAPTs, hold assets for a set period, after which they transfer to beneficiaries (usually children or other family members).Assets in the MAPT are no longer considered part of your parents estate for Medicaid purposes. They are legally owned by the trust, not your parents, although they may be able to benefit from these assets, such as remaining in a home transferred to a MAPT.Creating a MAPT triggers a penalty period of Medicaid ineligibility under the lookback period thats based on the value of assets transferred. A MAPT is therefore most effective when implemented well in advance of potential Medicaid need, often in conjunction with a parents estate plan. Promissory NotesA promissory note is a legal agreement that allows your parents to lend money to someone (e.g., a family member) who agrees to repay the money with interest over time. This converts a lump-sum asset into a stream of income.Not all states recognize promissory notes for Medicaid planning. In states that do allow them, they may be subject to scrutiny by state Medicaid agencies. The note must clearly outline the repayment terms and the interest rate must be at or above the applicable federal rate (the minimum interest rate the IRS allows for private loans).Interest income from the loan may be taxed at a lower rate, and the terms can be customized to meet individual needs. For the Medicaid applicant, however, the effectiveness of a promissory note is largely dependent on the borrowers ability and willingness to repay the loan. Life EstatesA life estate lets your parents transfer ownership of their home to a child or other family member while retaining the right to live there for the rest of their lives. It removes the homes value from their countable assets for Medicaid purposes and may protect the family home from Medicaid estate recovery, a program that empowers states to recoup Medicaid expenses from the deceased beneficiarys estate.Medicaids lookback policy applies to life estates, so the transfer must be done well in advance of needing care. Your parents may also lose some control over the property, and there could be tax implications. Other Spend Down StrategiesA spend down strategy might additionally include a parent spending on needs or wants that can both enhance their quality of life and help them qualify for Medicaid.Paying off debts, making necessary home repairs, purchasing a new car, prepaying funeral expenses, or taking a family vacation are ways to spend down assets and derive an instant benefit.Gifting assets to loved ones outside of the lookback period can reduce countable assets and fit into a gifting while living strategy, but annual and lifetime gift tax exemptions apply.If only one spouse needs nursing home care, Medicaid allows the other spouse (the community spouse) to retain a certain amount of income and assets.Because state Medicaid laws and individual nursing home care needs vary, there is no one-size-fits-all strategy for protecting a parents assets from nursing home costs and a Medicaid spend down. To develop a personalized plan that avoids penalties or disqualification from Medicaid in your state and also maximizes asset protection, consult with Ashley Day.  Phone: 251-277-3377.

Many Colorado Seniors and Disabled Adults are concerned about the recent funding discussions about Federal, not State, Medicaid changes, and how they might impact Long-term Care Medicaid benefits here in Colorado. There are 40+ different Medicaid programs in the State of Colorado alone, which are funded differently. Some of these Medicaid programs will be impacted by Trumps changes.At this time, it is important to know that the Medicaid changes imposed do not affect Long-term Care Medicaid in Colorado. If you are currently receiving Long-term Care Medicaid benefits or considering applying, you can rest assured that your eligibility, services, and coverage remain intact. Long-term Care Medicaid has already been funded for 2025, therefore nothing will change this year. In addition, there have not been any major changes to Colorado Long-term Care Medicaid in 20 years, and we dont foresee any changes now. In the meantime, if you have any questions about your coverage or need assistance navigating the Long-term Care Medicaid process, please dont hesitate to reach out to Beneficent. www.DoingGoodForOthers.com/contactus

This chilling scene from The Beekeeper is a dramatic yet realistic example of a type of phishing scam directed at seniors: Eloise, a retired schoolteacher, is on her computer looking over charity accounts that she manages when a virus warning pops up. She calls the provided number, which unknowingly to her connects to a call center operated by a phishing scam operation.The call center rep portrays a support desk tech and during his conversation with Eloise, he lies about the source of the virus warning. She falls into his trap by installing fake antivirus software, which links to all the charity accounts. The connected malware drains over $2 million from the charities Eloise runs. She realizes too late what has happened and is left in despair.Among the fastest-growing cybercrimes targeting seniors today are phishing or smishing scams. In phishing/smishing scams, criminals send fake messages to trick seniors into giving away personal information, such as passwords, credit card numbers, or even one-time passwords (OTP) for account verification.Why are seniors often preferred targets for these scams, and how can they stay protected? Heres a comprehensive guide to help you and your loved ones stay safe from smishing.Why Are Seniors a Preferred Target for Phishing/Smishing Scams?Seniors are often targeted by scammers for several reasons:Less Familiarity with Technology: Many seniors arent as familiar with new digital threats, making them more vulnerable to smishing and phishing techniques.Trusting Nature: Scammers exploit the trusting nature of seniors, knowing that they may be more likely to believe the legitimacy of a message.Isolation: Scammers often prey on seniors who may be isolated or lonely, making them more willing to respond to messages, even from unknown numbers.Financial Independence: Many seniors control their own finances or have access to retirement funds, which makes them valuable targets.Keep reading for more about the different types of phishing and smishing scams and how to recognize and avoid them.Common Types of Phishing and Smishing ScamsOne-Time Password (OTP) ScamOne-time passwords (OTPs) are security codes sent to your phone to verify your identity when logging into accounts or making transactions. Scammers try to trick seniors into giving up these codes, allowing them to take control of their accounts.Example  Your Venmo account login is suspicious. Please verify your identity by providing the OTP sent to your phone.In this case, the scammer is pretending to be a trusted company and trying to get the OTP that was sent to you for your own security. Never share your OTP with anyone, especially through text messages or phone calls. If you receive an unexpected OTP request, its a red flag that someone may be trying to access your account.Bank Account and Credit Card ScamsThese messages often warn of suspicious activity on your bank account or credit card and ask you to take immediate action by clicking a link or providing your details.Example  Your account at Bank of America has been temporarily locked due to unusual activity. Click here to unlock your account: www.fakebanklogin.com.Banks will never ask you to verify your account through a text link. Always contact your bank directly using the phone number from your card or statement if you suspect an issue.Delivery ScamsScammers will send messages claiming that you have a package waiting for delivery, but they need additional information to process it.Example  UPS: We tried to deliver your package but need additional information. Please provide it here: www.fakedelivery.com.These messages are often designed to capture your personal information or steal credit card details. Always check with the delivery service directly through their official app or website.Fake Tech Support ScamsScammers impersonate tech support from well-known companies, claiming that your device has been compromised.Example:   Microsoft: Your device has been infected with malware. Click here to install antivirus software immediately.Legitimate tech support will never contact you this way. These scams aim to trick you into downloading malicious software that can steal personal data.Government or Tax ScamsScammers impersonate government agencies like the IRS, warning about unpaid taxes or offering refunds in an attempt to steal personal information.Example  IRS: You have an overdue payment of $1,500. Please pay immediately to avoid legal action.Government agencies will never ask for personal information or payments via text. Contact the agency directly if youre ever unsure.How to Report a Phishing/Smishing ScamIf you or a loved one encounters a suspicious text message, its important to report it to help stop the scammer from targeting others.Heres what you can do:Forward the Scam TextIn the U.S., you can forward scam texts to 7726 (SPAM). This service is provided by most major mobile carriers, and they will investigate suspicious messages.Report Scam to the FTC (Federal Trade Commission)You can report smishing and other frauds to the FTC by visiting their website at ftc.gov/complaint. Reporting these scams can help law enforcement track and shut down fraud rings.Report Scam to the Company Being ImpersonatedIf the scam text appears to be from a well-known company (like Amazon, your bank, or the IRS), you can report it directly to their fraud department.Block and Delete the Number from Suspicious MessageIf you receive a suspicious message, block the sender immediately and delete the text. Never engage with the message, as scammers can collect information based on your replies.Tips for Seniors to Protect Yourself from Smishing ScamsBe Skeptical of Urgent RequestsSmishing messages often create a sense of urgency, pressuring you to act quickly. Dont let the panic take overslow down and think it through.Verify with the Company DirectlyIf a message seems to come from a known company or institution, contact them using their official phone number or website. Never use the contact information provided in the suspicious message.Look for Red FlagsCommon red flags include poor grammar, generic greetings, and unsolicited offers. Trust your instinctsif something feels off, it probably is.Never Share Personal Information via TextLegitimate organizations will never ask for your passwords, credit card numbers, or OTPs via text. Always keep this information private.Install Security SoftwareThere are security apps that help detect and block phishing or smishing attempts. Consider installing one to safeguard your mobile device.Educate Your Loved OnesTalk to seniors about these common scams, and make sure they feel comfortable asking for help if they receive a suspicious message. Staying connected and informed can make all the difference. Keep Alert for New Scams Targeting SeniorsBy educating yourself and your loved ones about smishing and other scams, you can reduce the risk of falling victim to these harmful schemes. Always be cautious, never share personal information through text, and report suspicious activity immediately. Remember: when in doubt, dont click, dont reply, and always verify.