Each fall, the Centers for Medicare & Medicaid Services (CMS) renews the federal guidelines that seek to protect individuals whose spouses are applying for or receiving Medicaid long-term care benefits.These protections, known as the Spousal Impoverishment Standards, help to support the financial well-being of seniors who continue residing at home while their spouse on Medicaid lives in a long-term care facility, such as a nursing home.Qualifying for Medicaid Long-Term Care BenefitsLong-term care is prohibitively expensive for many, so a large share of adults aged 65 and older rely on Medicaid to help cover the costs.To qualify for Medicaid long-term care benefits, however, one must generally have very limited resources. In most states, the asset limit is set at $2,000. (Certain assets, such as personal belongings and the applicants primary residence, do not count toward this limit.) The applicants income typically goes to the nursing home as well, with some exceptions.So, what happens if a person who qualifies for Medicaid long-term care is married? How can their healthy spouse afford to remain on their own at home? This is where the Spousal Impoverishment guidelines help.2024 Spousal Impoverishment FiguresCommunity Spouse Resource Allowance (CSRA)A spouse who continues living at home while their partner receives long-term care coverage through Medicaid can keep up to $154,140 in assets starting in 2024.The healthy spouse, or so-called community spouse then has a minimum amount of assets to live on without rendering their Medicaid spouse ineligible for benefits. This special protection is known as the Community Spouse Resource Allowance (CSRA). The maximum CSRA generally rises each year; in 2023, it was $148,630.Meanwhile, according to federal law, no state can set the minimum CSRA below $30,828 as of 2024.Monthly Maintenance Needs Allowance (MMNA)In addition to CSRA, the federal government offers another level of protection for the community spouse: the Monthly Maintenance Needs Allowance (MMNA).The MMNA ensures that the healthy spouse who continues to live in the couples home maintains a certain amount of monthly income while their partner receives their Medicaid long-term care coverage. (Learn more about the ins and outs of MMNA.)In 2024, the maximum MMNA will be $3,853.50 (up from $3,715.50 in 2023). Again, this is the most in monthly income that the community spouse can keep while their spouse lives in a long-term care institution. If the healthy spouse does not make enough income to live on, this allowance comes from the income of the spouse on Medicaid.Note that the minimum MMNA for 2024 can vary depending on your state. Alaska and Hawaii typically have slightly higher minimums. The federal government updates the minimum MMNA each July.A Note on Income Cap StatesCertain states have in place a Medicaid income cap. If you reside in one of these income cap states, you will not qualify for Medicaid if your income equals more than $2,829 (in 2024) unless you have a certain type of trust in place. This trust, known to many as a Miller Trust, must hold any income you receive that is above that cap.As of 2023, the 23 income cap states were Alabama, Alaska, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, Iowa, Kentucky, Louisiana, Mississippi, Nevada, New Mexico, New Jersey, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, and Wyoming.Home Equity LimitsAs mentioned above, Medicaid does not consider the primary home of an applicant as a countable asset, unless the applicants equity interest in their home is above a certain amount.Your home equity equals your homes value minus the sum of any loans you owe on the home. In 2024, the home equity limit is set to $713,000. (Some states choose to raise this limit to $1,071,000.)Contact Entrusted Legacy Law at 412-347-1731 to schedule a complimentary 15-Minute call.

When an incapacitated person cannot make personal or financial decisions, state courts may appoint a guardian to assist the individual with determining where to live, what kind of care to receive, or how to manage finances. In some cases, guardians may wish to move their ward someone whom a court has found need a guardians protection to another state for care. However, guardianship, as a matter of state law, doesn't automatically transfer across state lines. In many cases, to transfer a guardianship, guardians must petition the state where the ward currently lives and the state to which the ward is moving. This process can be complex, as each jurisdiction has rules regulating guardianship. Inconsistencies between states can create challenges. For instance, one state court may find that an incapacitated person needs a guardian, whereas another may disagree. Even after relocating, guardians may remain subject to the reporting requirements of the state in which the guardianship was initiated. The original state can retain jurisdiction if the guardian forgets to close the guardianship. Failing to comply with reporting requirements may cause legal problems, and the state may seek to remove the guardian. The Uniform Adult Guardianship and Protective Proceedings Jurisdiction ActThe vast majority of states, as well as Washington, D.C., and Puerto Rico, have adopted the Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act (UAGPPJA), which has resulted in more efficient guardianship transfers. Individuals can request that the state where they plan to resettle the ward records the existing guardianship order. Once the UAGPPJA state records the order, it honors it, allowing the guardian to continue making critical decisions for the ward after the move. Nevertheless, even when states use the UAGPPJA, they implement it in various ways and have their own specific rules. Individuals seeking to transfer guardianships should consult an experienced attorney who can assist them with the process. When Is a Transfer Permissible? The UAGPPJA permits guardians to move wards across states when: Relocating is in the wards best interests, promoting the wards physical and mental well-being.The guardian has reasonable and acceptable plans for the wards care in the new home.No one opposes the transfer.The move is permanent; guardians cannot orchestrate temporary moves for convenience. Notice Requirement When guardians are first appointed, they must inform the close relatives of the incapacitated person, allowing them the option to contest the guardianship. This notice provision also applies to transfers: Guardians must inform close relatives when electing to take their wards to another state. Many guardianship transfers are uncontested. Should a wards relatives challenge a relocation, courts often will hold evidentiary hearings to decide whether the resettlement is legal. Although relocations can be complex, guardianships may transfer successfully when a move is uncontested and is in the wards best interests. If you're looking to transfer a guardianship to a new state, be sure to connect with a qualified elder law attorney for help.

When an older person requires help with daily living, options range from residential facilities to in-home care. Typically, less expensive than care facilities, professional in-home care can benefit older adults by allowing them to remain in a home setting. Although some view staying in ones home as favorable to nursing home care, recently released findings have shed light on the serious issues facing those who rely on in-home care. A staggering 50 percent of all older adults using professional home care aren't getting the help they need, according to an analysis of the National Health and Aging Trends Study. Half of all adults who rely on home care don't have adequate help with showering, dressing, laundry, or cooking. Compared to those residing in facilities, older adults in in-home care are more likely to miss meals and medication and remain in soiled clothing for extended periods. Older adults with in-home care were also nearly five times more likely than adults in living facilities to have persistent unmet needs. Fulfilling these needs may require care for longer durations or more complete care that addresses the full range of an adults needs, from laundry to food preparation. The Effect of Stepfamily Relationships While challenges can affect all older adults aging in place at home, the negative consequences can be more pronounced for those with stepfamilies. Societal changes have made stepfamilies more common, and one in eight older adults with mobility limitations now has a stepchild. Yet in comparison to older adults with only biological offspring, those with stepchildren are half as likely to receive help from their children, research shows.Stepfamilies might see childrens attention divided between a greater number of parents. Adult stepchildren who never received care from their stepparents because, for instance, the marriage occurred later in life, might not feel obligated to help. Children might also feel closer bonds and a sense of responsibility to their biological parents. Although biological children are more likely to help, even adults who lived with partners and had biological children still had unfulfilled needs when they remained at home.  Challenges Facing People With Dementia Who Receive Home Care Like those with stepchildren, low-income individuals with dementia are also more susceptible to the inadequate in-home care. Many older adults with dementia are dual enrollees in Medicaid and Medicare and, consequently, have fewer assets to cover in-home services. They also have less family support. Individuals with dementia are twice as likely to have unmet needs compared to older adults without dementia who utilized in-home care. Many older adults with dementia couldn't afford sufficient in-home care and had less family support to fill in the gaps in care.Older adults evaluating the benefits and drawbacks of different care options should speak with us to help them assess their unique needs and plan for their care. 

As of late 2022, more than 84 million people were enrolled in Medicaid a number that has steadily increased in recent years. Amid the pandemic, total enrollees climbed by 20 million people from 2020 to 2022 alone. Meanwhile, the debate among lawmakers on further expanding Medicaid in some 11 states continues to evolve. Depending on where you reside, passage of such an expansion could mean you become newly eligible for Medicaid. What Is Medicaid?Medicaid is a nationwide program designed to provide public health insurance for low-income individuals, including seniors and people with disabilities. Established in 1965, it serves today as the single-largest source of health coverage in the U.S.Because Medicaid is jointly run by the federal government and state governments, its benefits and your ability to qualify for them can vary greatly depending on your state. As a result, certain populations, even if they're living in poverty, may not be eligible for Medicaid. For example, in some states, a healthy, childless adult couple under age 65 with limited means may not qualify for health coverage through Medicaid if their state hasn't adopted Medicaid expansion. What Is Medicaid Expansion?Medicaid coverage across the country has evolved since the program was first created. Different states may employ different eligibility criteria, income limits, or application requirements.In 2010, the Affordable Care Act (ACA) attempted to expand Medicaid coverage to adults between 18 and 65 with incomes below a certain level, regardless of their age, family status, or health. The ACA also sought to supply those whose incomes fell within specific limits with premium tax credits that would help them afford the purchase of a private insurance plan. Yet, the Supreme Court ruled that the federal government couldn't force states to expand coverage. States can decide whether to expand Medicaid to cover more people. This has created a coverage gap: Those who have incomes below 100 percent of the federal poverty level and who live in states that have opted against expanding Medicaid may not qualify for Medicaid, or for the premium tax credits. Medicaid Expansion StatesAs of early 2023, most states have adopted the ACAs broadening of Medicaid. Per the Kaiser Family Foundation, the following states in addition to the District of Columbia have expanded Medicaid coverage per the ACA: AlaskaArizonaArkansasCaliforniaColoradoConnecticut DelawareHawaiiIdahoIllinoisIndianaIowaKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandUtahVermontVirginiaWashingtonWest Virginia States Without Medicaid Expansion States that haven't adopted Medicaid expansion per the ACA include:AlabamaFloridaGeorgiaKansasMississippi North CarolinaSouth Carolina TennesseeTexasWisconsin Wyoming Medicaid Expansion Developments The map of Medicaid expansion states continues to evolve, however: South Dakota voters approved a ballot measure adding Medicaid expansion to the state constitution in November 2022. The expansion will go into effect beginning July 1, 2023. In February 2023, the North Carolina House of Representatives passed a bill to expand Medicaid. It now awaits review in the Senate.Meanwhile, also in February 2023, the Wyoming House of Representatives declined to address a proposed Medicaid expansion bill. Arguments Against Medicaid Expansion In states without Medicaid expansion, those opposed to expanding coverage have voiced such concerns as increased costs and a higher risk of fraud. For example, some argue that Medicaid expansion would burden their states budget. Although the federal government funds the majority of expanded Medicaid, it doesn't completely cover the costs; states pay 10 percent. In the case of Wyoming, House Majority Floor Leader Rep. Chip Neiman has raised concerns that the federal government wouldn't uphold the federal match, leaving the state to bear more financial responsibility.Others contend that Medicaids most vulnerable beneficiaries may face greater competition for resources, that other health care options are available to those in need, or that expansion may not ultimately translate into better long-term health outcomes.How Older Adults Can Find Out if They're Eligible for Medicaid CoverageIn states that have adopted expanded Medicaid, you may qualify if your household income lies below 133 percent of the federal poverty level, according to HealthCare.gov. For older adults, most states provide Medicaid to those who receive Supplemental Security Income (SSI). To be eligible for SSI, individuals must have low incomes, limited assets, and be unable to work due to a qualifying mental or physical impairment. Per the Kaiser Family Foundation, some states expand Medicaid to older adults and disabled people whose income surpasses the SSI limit but falls below the federal poverty level. You may be able to qualify for Medicaid through the Medically Needy program if your state has established one. The Medically Needy program allows people to enroll in Medicaid when they have significant medical expenses. When they subtract their medical spending from their total income, they can qualify for Medicaid if their income, minus health care expenses, falls below a specified limit (which also varies by state). To find out whether you qualify for Medicaid, consider consulting the following tools:The Benefits.gov Eligibility Checker will ask you questions regarding things like household income, number of dependents, and citizenship status to help you determine whether you might be eligible for Medicaid generally. The HealthCare.gov site can offer additional insights, including:Guidance on Health Insurance Marketplace applicationsIncome calculatorsPremium tax credit informationQ&A tool to determine eligibility for cost-sharing reductionsAgain, the rules governing Medicaid and its complex eligibility criteria varies widely by state. To find out whether you may be able to receive public health insurance through Medicaid, consult with an elder law attorney in your area.

Long-term care is the care you need if you cant perform daily activities on your own for an extended period of time. There are a number of different ways that long-term care can be provided. Most long-term care involves assisting with basic personal needs rather than providing medical care. You are usually determined to need long-term care if you need help with two or more activities of daily living (such as bathing, dressing, eating, and going to the bathroom). Family members usually provide long-term care to start, but as an illness escalates paid care may become necessary. The following are the types of long-term care:Home care from family member. The most basic form of long-term care is when a family member becomes the caregiver. It can involve simple tasks like buying groceries or more complicated ones like bathing and dressing. Sometimes family members can be paid for their work.Home care aide. Home care aides provide companionship and socialization and assist with meal preparation, housecleaning, laundry, shopping, and errands. They are also called homemaker or chore aides.Home health care aide. Health care aides provide personal care (bathing, grooming, etc.), assist with range-of-motion exercises, provide some medically-related care (empty colostomy bags, dress dry wounds, check blood pressure, etc.), and provide assistance with housekeeping and errands. They are often referred to as personal care assistantsAdult day care. Adult day care allows family members to get a respite from caregiving. In general, there are three types of centers: those that focus on social interaction, those that focus on health care, and special Alzheimer's care centers.  Assisted living facility. Assisted living facilities are a housing option for people who can still live independently but who need some assistance. Depending on the facility, that assistance may include help with meal preparation, housekeeping, medication management, bathing, dressing, transportation and some nursing care. Residents usually live on their own, in small apartments. Despite the emphasis on independence, supportive services are available 24 hours a day in order to provide different levels of help with activities of daily living. The level of medical supervision depends on the facility.Nursing home. Nursing homes are the highest level of long-term care. They provide 24-hour care to residents. Staff provide help with daily activities such as feeding, dressing, and bathing along with medical care and physical, occupational, and speech therapy.Costs for care can vary widely, from a few hundred dollars a week to pay for coverage when family members are at work to $300,000 or more a year for around-the-clock home care or care in the most expensive nursing homes, perhaps with private aides hired on the side.Long-term care costs, whether at home, in assisted living or in a nursing home, are paid primarily from three sources: out-of-pocket, Medicaid, and long-term care insurance. Medicare, the health insurance for people over age 65, only pays for up to 100 days of skilled nursing facility care following a hospitalization, and only for so long as the patient is deemed to need skilled care. It will also pay for skilled care at home -- in theory indefinitely, but this may take some advocacy.

If you're looking to collect life insurance proceeds as the policys beneficiary, the process is fairly simple. However, during the emotional period immediately following a loved ones death, it can feel as if your entire world is falling apart, so its helpful to understand exactly what steps you need to take to access the insurance funds as quickly and easily as possible.Not to mention, if youve been dependent on the person who died for financial support and/or you are responsible for paying for the funeral or other expenses, the need to access insurance money can be downright urgent. Plus, unlike other assets, an estates executor typically isnt involved with collecting life insurance proceeds, since benefits pass directly to a beneficiary, so this is something you will need to handle yourself. With this in mind, weve outlined the typical procedure for claiming and collecting life insurance proceeds, along with discussing how beneficiaries can deal with common hiccups in the process. However, because all life insurance policies are different and some involve more complexities than others, consult with us, your Personal Family Lawyer if you need any support or guidance.Filing A ClaimDeath benefits are not automatically paid out from a life insurance policy. In order to collect the proceeds, you must first file a claim with the life insurance company. But before you start the claims process, you must first identify the beneficiary of the policy: are you the beneficiary, or is the policy set up to be paid to a trust?We often recommend that life insurance proceeds be paid to a trust, not outright to a beneficiary. This way, the life insurance proceeds are protected from lawsuits, creditors, and even a divorce that a beneficiary may be involved with at the time they collect the funds.In the event a trust is the beneficiary, contact us, your Personal Family Lawyer, so we can create a certificate of trust that you (or the trustee, if the trustee is someone other than you) can send to the life insurance company, along with a death certificate, when it becomes available.In any case, you (or the trustee) will notify the insurance company of the policyholders death, either by contacting a local agent or by following the instructions on the insurance companys website. If the policy was provided through an employer, you may need to contact the insureds workplace first, so they can put you in touch with the appropriate insurance representative.Many insurance companies allow you to report the death over the phone or by sending in a simple form and do not require the actual death certificate at this stage. Depending on the cause of death, it can sometimes take weeks for the death certificate to be available, so this simplified reporting option can dramatically speed up the process.From there, the insurance company typically sends the beneficiary more detailed forms to fill out, along with further instructions about how to proceed. Some of the information youre likely to be asked to provide during the claims process include the insureds date of birth, date and place of death, their Social Security number, marital status, address, as well as other personal data.Your states vital records office creates the death certificate, and it will either send the certificate directly to you or route it through your funeral/mortuary provider. Once youve received a certified copy of the death certificate, youll need to send it to the insurance company, along with all of the other forms the insurance company requires you to complete.Multiple BeneficiariesIf more than one adult beneficiary was named, each person should provide his or her own signed and notarized claim form. If any of the primary beneficiaries died before the policyholder, an alternate/contingent beneficiary can claim the proceeds. In that case, however, he or she will need to send in the death certificates of both the policyholder and the primary beneficiary.Minor BeneficiariesAlthough policyholders are free to name anyone as a beneficiary, when minor children are named, it creates serious complications, since insurance companies will not allow a minor to receive life insurance benefits directly until they reach the age of majority, which varies between statesin some its 18, and others its 21.If a minor child is named as a beneficiary, you would need to go to court to be named as the child's legal guardian in order to manage the funds until the child comes of ageand this is the case even if youre the childs natural parent. This is because unless you are specifically named as the guardian of the minors estate, you are not automatically considered the guardian of the childs financial assets, even as their parent. This is why you should never name a minor child as a life insurance beneficiary, even as a backup to the primary beneficiary. Rather than naming a minor as the beneficiary, its often better to set up a trust to receive the proceeds. In that case, the proceeds are paid into the trust, and whomever is named as trustee will collect the insurance proceeds and manage the funds for the childs benefit until he or she comes of age. Moreover, within the terms of the trust, you can also spell out exactly how youd like the trustee to manage the money for the child and even how the child can use the funds once theyve reached adulthood.In any case, you should consult with us, your Personal Family Lawyer to determine the best options for passing on your life insurance benefits and other assets to minor children. Insurance Claim PaymentsProvided you fill out the forms properly and include a certified copy of the death certificate, insurance companies typically pay out life insurance claims fairly quickly. In fact, some claims are paid within one to two weeks of the start of the process, and rarely do claims take more than 60 days to be paid. Most insurance companies will offer you the option to collect the proceeds via a mailed check or transfer the funds electronically directly to your account.Delayed PayoutsThe payout of life insurance proceeds can be delayed for a number of reasons. Beneficiaries often face delays if the policyholder dies within two years of the policy being issued. This is due to the fact that most life insurance policies contain a contestability period. Most contestability periods are typically between one to two years, and if the insured dies during this period, the insurance company can investigate the claim to ensure that the policyholder didnt commit fraud on the policy application by lying about underlying health problems, family medical history, or other conditions.That said, provided the insurance company doesnt discover fraud or other issues with the application, it will most likely pay the claim once the investigation is wrapped up. If problems with the application are discovered, the insurance company might pay a reduced benefit or even deny the claim, depending on what is uncovered.Payout may also be delayed when homicide is determined to be the insureds cause of death and the beneficiary is a suspect. In this case, the payout is typically delayed until the beneficiary is cleared of any involvement in the insureds death. A few other common reasons insurance payouts may be delayed include:The insured committed suicide within two years of the policy being issued.The insured died during the course of illegal or criminal activity, such as a robbery or driving while intoxicated.The insured omitted risky activities, such as smoking or skydiving, on the policy application.Additional InformationSometimes an insurance company will request you to send in a completed W-9 form (Request for Taxpayer Identification Number and Certification) from the IRS in order to process a claim. Most of the time, a W-9 is requested if there is some question or issue with the records, such as having an address provided in a claim form that doesnt match the one on file.That said, a W-9 is simply a way for the insurance company to verify certain information in order to prevent fraud, so dont be alarmed if youre asked for one. This is a common verification practice, and it doesnt automatically mean the company suspects you of fraud or plans to deny your claim.Were Here To HelpWhile collecting life insurance proceeds is often a simple process, dont hesitate to reach out to us if you have questions or need support in any way. As your Personal Family Lawyer, we are here to ensure the process goes as smoothly as possible for you during what is likely to be an extremely trying time. Contact us today to learn more.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention "this article that was listed on SeniorsBlueBook.com" to find out how to get this $750 session at no charge.

According to a recent national study, nearly a quarter of Americans aged 50 and older say they or a loved one needed long-term care in 2022. The findings further suggest that seniors and their caregivers could benefit from more consumer-friendly information and guidance about long-term care services, a need researchers say will grow exponentially in the future.Finding Long-Term Care Causes Wide-Ranging EmotionsResults showed that people looking for long-term care experienced a range of emotional responses in searching for a provider:53 percent of respondents reported feeling anxious about the process 52 percent described feeling frustration23 percent said they were confident during the process of long-term care for themselves or their loved one23 percent of respondents felt at peace about the choice they made for long-term careOnly 14 percent of respondents reported feeling happyRespondents Want to Feel Prepared When Deciding on Long-Term CareResearchers found that respondents want advice for seeking long-term care when it comes to the following:92 percent wanted to know what types of long-term care services are available90 percent wanted more information about paying for long-term care90 percent said advice and support on long-term care would have been helpful to them88 percent needed help understanding whether their personal or health care needs require long-term care88 percent of those surveyed also said they needed help choosing a long-term care provider86 percent said having someone to listen to them when seeking long-term care services would have been important to them84 percent of respondents wanted help deciding whether to pursue in-home care or community-based services (i.e., nursing home care)Paying for Long-Term CareA large number of respondents reported needing more information about how to pay for long-term care.Of the people who were surveyed, 63 percent said it was extremely important to have additional details about the various types of care options available. Meanwhile, 69 percent said it was extremely important to have further details about the cost of care and their payment options.Who Participated in the Survey?The survey featured responses from a nationally representative sample of more than 1,000 participants with annual household incomes ranging from under $30,000 to more than $100,000. Responses were collected in November 2022.Respondents, all aged 50 and older, were 53 percent female and 47 percent male, and represented the following regions across the United States:South 38 percentWest 23 percentMidwest 21 percentNortheast 18 percentNORC at the University of Chicago conducted the survey, which was commissioned by think tank Nexus Insights.Can This Problem be Solved?In a separate Nexus Insights report from September 2022, experts called for the creation of information hubs where seniors and their caregivers can find the resources they need to answer their questions regarding long-term care.The report also outlined seven criteria defining these proposed navigational hubs:AccessibilityConsistency in services across the countryLocal focus with a deep understanding of each communitys programs and providersVisibility among its target usersFreedom from incentives that would promote specific service providersUnbiased adviceFull serviceTo learn more about long-term care services and options, find a qualified elder law attorney in your area.

Recent findings show an information gap among Medicaid recipients regarding the need to re-enroll for benefits after the COVID-19 Public Health Emergency (PHE) ends. Medicaid recipients are inconsistently informed about the end of the PHE and its effect on their health insurance benefits in terms of the amount of information they have and where they receive their information.  The PHE has been extended several times. The latest extension expires on January 11, 2023, with a 60-day notice before the end of the PHE. The Families First Coronavirus Response Act Congress enacted the Families First Coronavirus Response Act (FFCRA) in March 2020. The FFCRA prohibits states from disenrolling Medicaid recipients until the PHE ends. In addition to the ban on disenrollment, the FFCRA stopped the redetermination of eligibility. This kept more than 20 million people covered by health insurance during the COVID-19 pandemic.When the PHE ends, the FFCRA provisions that keep low-income people insured will end, leaving many people without benefits after the redetermination of eligibility resumes.Have You Heard About the Public Health Emergency Ending? Statistically, most people covered by Medicaid do not know that the PHE is coming to an end. The end of the PHE means that Medicaid health insurance benefits will also end. Studies show the following rates of information among Medicaid participants: 62% of Medicaid recipients did not know about the end of the PHE and the need for redetermination.16.2% of Medicaid enrollees stated that they heard something about the PHE ending but did not have any further information.15.7% of beneficiaries only knew very little about the end of the PHE and the redetermination of Medicaid benefits.Only 5% of Medicaid recipients reported that they were well-informed about the end of the PHE and the need for the redetermination of benefits.Information Medicaid Participants Have: Statistics Medicaid participants are getting information about the end of the PHE and health insurance benefits from the following variety of sources:34.3% from traditional or social media24.5% from their health insurance company30.6% from a state agency17.8% from their doctor or another health care provider6.5% from some other source than those listed aboveThere is a significant information gap among Medicaid participants. The inconsistency of information may lead some Medicaid enrollees to suffer negative consequences, including unexpectedly losing their health insurance coverage.There is no one person or agency that everyone agrees should inform Medicaid participants about when redetermination resumes. Currently, Medicaid enrollees are responsible for staying updated about the end of the Public Health Emergency. To stay updated on the end of the PHE and any changes to Medicaid benefits, keep an eye on your states Medicaid website, check your mail or email for important correspondence, and visit the Medicaid.gov website for new information.

If medical personnel are able to access your medical history during an emergency, it could mean the difference between life and death. But if, for example, you're injured, in shock, suffering from dementia, or are otherwise incapacitated, you may not be able to provide that information yourself.There are several systems readily available to help make crucial contact and medical history information available to first responders. Consider taking the time to update your details with the following free tools:On Your Smartphone: Even when your smartphone is locked, you have options for inputting your emergency contacts as well as other vital information that could help save your life. Medical ID for iPhones. If you're an iPhone user, take advantage of the preinstalled Health app to input details about your medical needs so that first responders will have the information they need in an emergency. To do this, open the Health app, choose Review Medical ID, and enter your information.You can include not only your designated emergency contacts, but also such details as your birthdate, any medical conditions or allergies, your blood type, and your organ donor status. You can then choose to make your Medical ID available on your iPhones lock screen for first responders.In addition, there is an option to share your Medical ID information automatically with a dispatcher, should you ever need to make an emergency call. Emergency Information on Androids devices. Depending on your device, you may be able to find Emergency Information or My Info in your Settings, where you can enter your medical details and emergency contacts. Be sure to add anyone you wish to designate as an emergency contact into your Contacts app as well.In your Android Settings, you can also add your emergency contact information to your lock screen as a custom message. In Case of Emergency (ICE) Contact. This program, which was originally established in 2004, encouraged people to list in their cell phone their in case of emergency contacts under the heading ICE, allowing paramedics or other medical personnel to know whom to contact in the event of an emergency. Today, there is also a free ICE app for smartphones, which allows you to send an instant message, including your GPS location, directly to your ICE contacts with the tap of a button if you are in an emergency situation. Learn more about ICE.The National Next of Kin Registry (NOKR). The NOKR is a free service that allows you to register yourself and your next of kin in the event of such situations as daily emergencies or natural disasters. The information you enter is not available to the public, but it is available to emergency service agencies registered with the NOKR. If you're in an accident, emergency services personnel would be able to search the website to find your next of kin and notify them about your condition. The NOKR stores emergency contact information for those across the U.S. as well as 87 other countries. You can register online, through U.S. mail, or via fax. Learn more about registering for the NOKR.To get the most out of an emergency contact, you should make sure the person you choose as your emergency contact has agreed to act in this capacity, knows about any allergies or other factors that could affect your treatment, and knows whom to contact on your behalf.

Many employers offer critical illness insurance as part of their benefit package. What is this insurance and is it worth purchasing? Before paying for a plan, you should read the fine print and consider alternatives. While a regular health insurance plan usually offers comprehensive coverage for all types of illnesses, many plans have high deductibles and copays that require policyholders to pay a lot of money out of pocket. Critical illness insurance allows you to buy insurance to cover that gap if you have a serious health diagnosis, such as cancer or a heart attack. Critical illness insurance can also cover non-medical expenses, such as mortgage or child-care bills. Premiums for critical illness insurance policies are relatively low, which makes the coverage appealing. The policies usually pay out in a lump sum, with the amount depending on the policy purchased. There are different types of critical illness insurance policies: some cover only one illness, like cancer, while others offer coverage of a number of different illnesses. The more coverage offered, the higher the premiums. Before purchasing one of these policies, however, you need to consider the downsides. Reading the fine print on the policy is very important because the policy will only cover certain illnesses, and actual coverage may depend on the severity of those illnesses. For example, even though the policy says it covers cancer, it may only cover aggressive cancer and not a more slow-moving cancer. In addition, critical illness insurance doesnt offer the same protections that regular health insurance offers under the Affordable Care Act, so you can be denied coverage if you have a pre-existing condition. Critical illness insurance premiums also tend to rise as you get older, and you could be denied coverage once you reach a certain age. Instead of critical illness insurance, you can consider alternatives. First. you should look at your health insurance to see exactly what it will cover. In addition, a health savings plan in which you contribute pre-tax dollars can be a good way to cover unexpected medical expenses. Disability insurance can also offer protection for lost salary due to illness.

For caregivers of loved ones living with disabilities, meeting the demands of your professional life while carrying out the responsibilities of caregiving can be immensely challenging.Depending on your situation, you may qualify for an extended leave from work that will allow you to keep your job while you focus your time on caring for your loved one.What Is FMLA? The Family Medical Leave Act (FMLA) is a federal law that may protect your right to unpaid leave to care for a family member. The law, established in 1993, applies to private employers with at least 50 workers. For employees whose spouses, children, and parents have severe health conditions, the FMLA allows up to 12 work weeks of leave within a year. Twenty-four work weeks of unpaid leave are available for those caring for active service members.Under the FMLA, employers cannot fire employees because they took leave, protecting employees right to leave work when certain family members become severely ill.As a caregiver, you play a crucial role in your family as you support your loved ones, but caregiving responsibilities can conflict with work commitments. The FMLA can help employees balance their responsibilities.Is FMLA Paid?FMLA is typically unpaid leave. However, it allows you to hold on to your job while also requiring your employer to continue your health benefits while you are on leave.What Conditions Qualify for FMLA Leave?Employees who qualify for FMLA can use this type of leave in a number of different circumstances, including if they are having a baby, adopting a child, donating an organ, or suffering from a severe health problem. For those who are caring for an immediate family member with a serious health condition, FMLA may also be an option.In addition, employees with a child who is unable to care for themselves due to a disability may be able to take advantage of FMLA leave. Under FMLA, disability is defined as conditions that substantially limit one or more major life activities or bodily functions. In certain cases, such conditions may include such health issues as epilepsy, asthma, diabetes, or cancer that is in remission.The U.S. Department of Labor launched a new series of webpages over the past year to help people understand their rights under the FMLA. The webpage is a useful resource for caregivers, providing a library of guides, frequently asked questions, and fact sheets. One such fact sheet details the criteria for using FMLA leave to care for a child with a disability. Another focuses on taking leave when a family member has endured a serious injury, illness, or other physical or mental condition that has left them incapacitated.How the FMLA Resource Helps Family CaregiversThe Department of Labors dedicated family caregiver webpage addresses several challenges you could face.Being away from work can pose challenges for the caregivers career. Some employers are not supportive of employees who take FMLA leave, and employees may face illegal workplace retaliation.In addition to work obligations, many caregivers have multiple roles at home. For instance, an individual might need to care for a sick parent as well as their own children.Caring for a loved one with a severe health condition can take an emotional toll, and caregivers might feel overwhelmed.Those caring for older adults might need help finding elder care services.Information Related to the Family and Medical Leave Act and CaregivingThe U.S. Department of Labor webpage supplies information to help you navigate the workplace while also caring for a loved one.Available information includes:Speaking with an employer about taking leaveTaking leave when a family member has a serious health conditionUtilizing FMLA for a parent of a child with a disabilityUsing military family leaveLeaving to care for a parent or other past caretakerProving that you have a severe health conditionFiling a complaint against an employer, such as a complaint for retaliationAccessing caregiver resourcesLocating a nursing home, assisted living facility, or other careFinding services for veteransIdentifying state agencies where individuals can learn about their rights and apply for benefitsKnow Your Rights: Consult With an AttorneyIn addition to reviewing the U.S. Department of Labor webpage, speak with an attorney if you are contemplating taking FMLA leave. A special needs planning lawyer can help you understand your right to leave, including how to protect yourself should your employer retaliate against you. Contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call to learn what guidance we can provide for your unique situation.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

When signing up for Medicare, some people have other insurance, such as coverage from a current employer, or retirees or military insurance. Beneficiaries of Original Medicare or Medicare Advantage may keep their additional coverage, as the providers work together to bear health care costs.Can You Have Medicare and Private Insurance?People may have Medicare and other insurance simultaneously for several reasons. Some Medicare enrollees have retiree health coverage through their (or a spouses) former employer.Others remain in the workforce past 65 and are on employer-backed insurance or are enrolled in their working spouses insurance.Younger people with disabilities can receive Medicare coverage while also on their employers insurance.Active and retired service members and their families can get health coverage through Tricare while also enrolled in Medicare.Qualifying individuals with limited income and resources can obtain Medicare and Medicaid coverage at the same time. This is called being dually eligible.Allocating Coverage People with more than one insurance provider may receive more coverage, as the providers allocate costs. Depending on the situation, Medicare might be the primary payer, or the other insurance provider may act as the principal insurer. Once the primary payer has covered the maximum amount, the secondary payer contributes to the remaining costs. Each insurance source will determine what and how much coverage it provides for services and treatments.Though the coverage can be greater with multiple providers, you may be responsible for outstanding fees that neither program fully includes.For those with two insurance providers, the Medicare & You handbook as well as the guide to Who Pays First (both in PDF format) explain the protocol that determines which provider is the primary payer.In general, Medicare pays first when people have retiree health coverage or receive coverage from a smaller organization. An employers coverage typically takes precedence when it originates from current employment at a larger organization.Covering costs first, Medicare is the primary insurance for those who also have retiree health coverage.Medicare is also the first insurer for older adults with current employer health coverage when the company has less than 20 employees.It's also the primary payer for younger people with disabilities with current employer coverage from establishments with fewer than 100 workers.In other instances, Medicare is the secondary payer.The employers insurance pays first for those who receive insurance because they or their spouse currently works at a larger business (more than 20 employees). Then Medicare covers the remaining costs.For disabled people with coverage based on their or their family members current employment at a larger organization (more than 100 employees), the employers insurance is the primary payer.Tricare is the primary insurer for individuals on active duty or those receiving care in a military hospital, clinic, or federal health care provider. Others on Tricare get Medicare coverage first.How Medicare and Medicaid Work Together Those who qualify for Medicare as well as Medicaid can receive assistance from both programs. When people benefit from both programs, Medicare is the primary payer. If both Medicare and Medicaid cover the same service or treatment, Medicare pays first, and Medicaid contributes to any remaining costs.Sometimes, Medicaid will pay for expenditures that Medicare doesn't cover. Medicare Part A bears hospital fees, Part B extends to outpatient medical costs, and Part D applies to prescription drugs. However, Medicare generally doesn't take care of nursing home expenses, which Medicaid can cover.Speak to an elder law attorney to learn how having other insurance coverage affects Medicare.

If youre part of a blended family (meaning you are married with children from a prior marriage in the mix), youre no stranger to the extra considerations and planning it takes to keep your familys life running smoothly from which parent your children will be with for the holidays to figuring out the schedule for a much-needed family vacation. Youve also probably given some thought to what you want to happen to your assets and your family if something happens to you. But what you might not have realized is this: If you dont create a plan for your assets before you die, the law has its own plan for you that might not reflect your wishes for your assets, especially your retirement assets. And if youre in a blended family, this can have a significant financial impact on the ones you love and even create expensive, long-term conflict.This week, we explain how the law affects retirement distributions for married couples, and why you need to be extra careful with your retirement planning if youre in a blended family to ensure your retirement account assets go to the right people in the right amounts after youre gone.Be Aware of How ERISA Affects 401K DistributionsIf youve remarried, you and your new spouse have probably talked about updating the beneficiary designations on your retirement accounts to reflect your blended family arrangement. (If you havent talked about it, you need to talk about it ASAP). Sometimes, people who are remarried decide to leave their retirement funds to their children from a prior marriage and leave other assets like their house and savings accounts to their current spouse. You may do this to avoid future conflict between your spouse and your children over your assets.But even if you want to leave your retirement for just your children, if youre married and your retirement account is a work-sponsored account, your children wont inherit the entire account even if you name them as the sole beneficiaries. Thats because the federal Employee Retirement Income Security Act (ERISA) governs most employer-sponsored pensions and retirement accounts. Under ERISA, if youre married at the time of your death, your spouse is automatically entitled to receive 50 percent of the value of your employer-sponsored plan even if your beneficiary designations say otherwise.The only time that your surviving spouse would not inherit half of your ERISA-governed retirement account is if your spouse signs an official Spousal Waiver saying they are affirmatively waiving their right to inherit 50 percent of the account, or if the account beneficiary is a Trust of which your spouse is a primary beneficiary. IRAs Have Different Rules Than 401KsIf you want your children to inherit more than 50 percent of your work-sponsored retirement benefits, and completing a Spousal Waiver isnt an option, consider rolling the account into a personal IRA instead.In contrast to 401(k)s and similar employer-sponsored plans, IRAs are controlled by state law instead of ERISA. That means that your spouse is not automatically entitled to any part of your IRA. When you roll a 401(k) into an IRA, you gain the flexibility to name anyone you choose as the designated beneficiary, with or without your spouses consent. On the other hand, if you want to ensure your spouse receives half of your retirement savings, make sure to include them as a 50 percent beneficiary or better yet, have your individual retirement account payout to a Trust instead. With a Trust, you can:Document exactly how much of your retirement you want each of your loved ones to receiveControl when they receive the funds outrightEasily update and change the terms of your Trust without having to remember to update your financial accounts.Beneficiary Designations Always Trump Your WillWhether you have an employer-sponsored 401K or an IRA you manage yourself, there is one critical rule that everyone needs to know: beneficiary designations trump your Will.A Will is an important estate planning tool, but most people dont know that beneficiary designations override whatever your Will says about a particular asset. For example, if your Will states that you want your retirement account to be passed on to your brother, but the beneficiary designation on the account says you want it to go to your sister, your sister will inherit the account, even though your Will says otherwise.Similarly, lets imagine that you get divorced and as part of your divorce decree your ex-spouse agrees that they will not have any right to your retirement fund. However, after the divorce, you forget to take their name off of the beneficiary designation for the account. If you die before updating the beneficiary designation, your former spouse will inherit your retirement account. If you forget to update your ERISA-controlled account and have remarried, your current spouse would receive half of the account and your former spouse would receive the other half. Thats why its so important to work with an estate planning attorney who can make sure your accounts are set up with the proper beneficiary designations and ensure that your assets are passed on according to your wishes.Work With An Attorney Who Makes Sure All Your Assets Will Be Passed On How You Want Them ToUnderstanding how the law affects different types of assets is essential to creating an estate plan. But theres more to it than just having a lawyer you need an attorney who takes the time to really understand your family and your assets so they can design a custom plan that achieves your goals for your assets and your legacy. Thats why we help our clients create an inventory of all of their assets to ensure that every asset they hold is accounted for and passed on to their loved ones exactly as they want it to.Contact Entrusted Legacy Law at 412-347-1731.

Thinking about your funeral may not be fun, but planning ahead can be exceedingly helpful for your family. It both lets them know your wishes and assists them during a stressful time. The following are steps you can take to plan ahead:Name who is in charge. The first step is to designate someone to make funeral arrangements for you. State law dictates how that appointment is made. In some states, an informal note is enough. Other states require you to designate someone in a formal document, such as a health care power of attorney. If you do not designate someone, your spouse or children are usually given the task. Put your preferences in writing. Write out detailed funeral preferences as well as the requested disposition of your remains. Would you rather be buried or cremated? Do you want a funeral or a memorial service? Where should the funeral or memorial be held? The document can also include information about who should be invited, what you want to wear, who should speak, what music should be played, and who should be pallbearers, among other information. The writing can be a separate document or part of a health care directive. It should not be included in your will because the will may not be opened until long after the funeral. Shop around. It is possible to make arrangements with a funeral home ahead of time, so your family does not have to scramble to set things up while they are grieving. Prices among funeral homes can vary greatly, so it is a good idea to check with a few different ones before settling on the one you want. The Federal Trade Commission's Funeral Rule requires all funeral homes to supply customers with a general price list that details prices for all possible goods or services. The rule also stipulates what kinds of misrepresentations are prohibited and explains what items consumers cannot be required to purchase, among other things. Inform your family members. Make sure you tell your family members about your wishes and let them know where you have written them down. Figure out how to pay for it. Funerals are expensive, so you need to think about how to pay for the one you want. You can pre-pay, but this is risky because the funds can be mismanaged or the funeral home could go out of business. Instead of paying ahead, you can set up a payable-on-death account with your bank. Make the person who will be handling your funeral arrangements the beneficiary (and make sure they know your plans). You will maintain control of your money while you are alive, but when you die it is available immediately, without having to go through probate. Another option is to purchase a life insurance policy that is specifically for funeral arrangements. Taking the time to plan ahead will be a big help to your family and give you peace of mind. 

The Social Security Administration provides four types of Social Security benefits: retirement, disability, dependents, and survivor benefits. Survivor benefits are available to the children and spouses of deceased individuals who qualify. If you qualify for retirement or disability benefits, your spouse and children have the right to obtain survivor benefits when you pass away. You also have a right to receive survivor benefits upon your spouses death if your spouse is qualified for Social Security benefits. Requirements for Survivor Benefits For your spouse and children to get survivor benefits upon your death, you and your family must meet specific requirements: You must be qualified for Social Security retirement or disability benefits. Older adults must have worked long enough in many cases, at least 10 years to earn 40 credits. Workers can earn up to four credits each year, depending on their income.However, people who die young may need fewer credits for their spouse and children to acquire survivor benefits. In some cases, spouses and children of workers with at least one-and-a-half credits earned in the three years preceding their death can get survivor benefits.Your children must be under 18 or disabled. (If your children are disabled, they must have become disabled before age 22.)Your spouse can receive survivor benefits at age 60, or 50 if they're disabled. Other Family Members May Be Eligible Stepchildren, grandchildren, adopted children, and dependent parents may be entitled to survivor benefits.Can Same-Sex Spouses Receive Survivor Benefits? Yes. In Obergefell v. Hodges, the United States Supreme Court held that the Constitution gives people the right to marry regardless of sex. Following Obergefell, the Social Security Administration allowed married same-sex spouses to get survivor benefits.  Can Spouses of Self-Employed Individuals Obtain Survivor Benefits?Yes. Self-employed people can contribute to Social Security and become qualified for benefits. If your spouse was self-employed, you might be able to receive survivor benefits. Can Surviving Divorced Spouses Get Survivor Benefits?In certain cases, yes. If your marriage lasted 10 years or more, you could acquire survivor benefits on your ex-spouses work record. Learn more about Survivor Benefits on the Social Security Administrations website.

Every three months, those with original Medicare receive a claims statement called a Medicare Summary Notice. As Medicare.gov explains, this notification describes all the services or supplies that providers or suppliers attributed to Medicare during the preceding three months. The document shows how much of each payment Medicare covered and the maximum amount the recipient could owe the provider. Using Medicare Summary NoticesAs the Medicare Summary Notice lays out how much Medicare covers and how much is left for the individual to cover, it is a helpful tool. Review your Medicare Summary Notices regularly. Going over the information allows you to catch discrepancies between your records and the claims statement, which is why keeping records of your care is essential.Medicare recommends keeping the following in mind when reading over your notices:Compare your receipts and bills to the care listed on the statement, ensuring you obtained all the listed care. If Medicare bills you for something you didn't receive, you can dispute the incorrect charges. For bills already paid, verify you submitted the correct amount for your medical treatments. Those with additional insurance should note whether their independent insurance takes care of services or supplies Medicare declined to cover. Difficulties With Claims Statements Beneficiaries might not get a Medicare Summary Notice in the mail for several reasons:People enrolled in traditional Medicare will only receive a Medicare Summary Notice by post if they obtained services or supplies in the past three months. Medicare doesn't send notices to people without recent care. Some might have received medical assistance in the past three months, but have not seen the notice in their mail. They might not have gotten the claims statement because they still need to update their address following a move.Keeping your address current ensures Medicare mails your notice to the correct location. Most beneficiaries can change their addresses by informing Social Security. However, those with U.S. Railroad Retirement Board Benefits should update their addresses by contacting their local United States Railroad Retirement Board field office. Responding When Medicare Denies CoverageIn some cases, claims statements inform beneficiaries that Medicare doesn't cover treatment. If Medicare denies you coverage, you can take steps to request coverage. First, it's a good idea to call your providers office to verify that they gave Medicare the correct information. Sometimes, doctors and other health care professionals make mistakes, causing Medicare to reject coverage. Fortunately, your provider can resubmit your claim with accurate information, which may result in Medicare extending coverage to your care. Should your notice state that Medicare won't cover care that you believe it should include, you can ask Medicare to pay for it by filing an appeal. The final page of the Medicare Summary Notice contains instructions on asking Medicare to reconsider its coverage decision. Online StatementInstead of mailing notices, Medicare allows beneficiaries to choose to view information about their care and coverage online. So, you can see monthly statements once you set up an account with Medicare via Medicare.gov, rather than waiting to review information every three months.It's important to note that signing up for online notices means that Medicare will no longer mail them to you. Consider whether you prefer online or mailed notifications. Assistance With Medicare Summary NoticesThose having difficulty understanding, disputing, or obtaining their Medicare Summary Notices can reach out to us for assistance. An attorney can explain the claims statement and provide representation for an appeal.

The No Surprises Act is a federal law enacted to protect patients from unexpected medical bills incurred on or after January 1, 2022. It aims to address the issue of surprise medical billing, which can occur when patients receive unexpected charges for their medical care. The Act applies to out-of-network emergency services, out-of-network air ambulance services, and certain out-of-network care received at in-network facilities.Help for SeniorsThe Act is important for all patients, but especially for seniors. Seniors are especially vulnerable to surprise medical billing because they often need more health care than other populations. They are more likely to be seen by out-of-network providers. The Act protects them from unexpected charges and provides a much-needed safeguard for their medical expenses.Under the Act, patients are not responsible for surprise medical bills beyond their in-network cost-sharing amount. This means that patients will only be responsible for paying the same amount they would have paid if an in-network provider provided the care. The Act also prohibits balance billing, which is when providers bill patients for the difference between their charges and the amount paid by the patients insurance.This can be relevant in a variety of settings seniors encounter, including emergency room visits, second opinions, surgical procedures, and even skilled nursing care where independent contractors provide services. Under the Act, providers must accept the Medicare-approved amount as payment in full. This prevents patients from being surprised with large balances and protects them from unexpected financial hardship.Exceptions to the ActThere are some providers and services that are exempt from the Acts billing protections (although your state may have a similar law that does not exempt them). These include:Ground ambulance services, which can charge you out-of-network ratesVision-only and dental-only insurances, which are not subject to balance billing protectionsIndemnity plans such as hospital indemnity insurance, which are exempt from the ActIf You Are UninsuredFor uninsured or self-paying patients, the No Surprises Act provides rules for a good faith estimate of how much a medical service will cost. You may request an estimate if you schedule a medical service at least three business days out or simply ask for one. If your final bill is $400 or more than the estimate, you may be able to dispute it. Having a good faith estimate allows patients to make informed decisions about their care.Independent Dispute ResolutionTo resolve payment disputes between providers and insurers, the Act establishes an independent dispute resolution (IDR) process. This process allows providers and insurers to submit their proposed payment amounts to an independent arbiter who makes the final decision. The IDR process aims to protect patients from being caught in payment disputes and ensures a fair resolution for all parties involved.Pricing TransparencyIn addition to protecting patients from surprise medical bills, the Act also includes provisions to increase health care pricing transparency. Health insurers must provide patients with clear and detailed information about their health care coverage. This includes a description of providers network status and estimated cost-sharing amounts. This increased transparency aims to empower patients to make informed health care decisions and avoid unexpected charges.The No Surprises Act is a significant step toward addressing surprise medical billing and protecting patients from financial harm. By implementing clear rules and procedures, patients are not caught off guard by unexpected charges and have access to fair dispute resolution. With the Act in place, patients can have more confidence in seeking medical care, knowing they will not face unexpected financial burdens.Contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call to see how we can help you. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Choosing the correct home care provider for your aging parents is a huge responsibility. This person will be looking after the needs of those who taught you to walk, talk, and care for yourself. To ensure your parents are well cared for in their golden years, consider the following as you seek out the perfect fit for a home care provider:1: Decide What Services Your Loved One RequiresAll home care is not identical. The amount of care your parents require determines the availability and cost of the services. If your parent only needs temporary care a few hours a day, you may need to employ a different provider than if they're recovering from surgery. Observe your parents needs before you commit to paying for a home care plan. Home care services can range from an aide coming into your parents home and sitting with them to providing medical services like ensuring that they take their daily medications. You may find this needs assessment worksheet from the National Caregiver Library helpful in assessing the level of care your loved one needs.The more intensive the services your parents need, the more money the service will cost. If Medicare doesn't cover your parents, you may end up footing the bill for the service. Make sure the services are within your budget before committing to a home care plan. 2: Do Your ResearchIt's important to have all the facts about a home care agency before you bring one into your parents home. A part of your research should include interviewing different agencies about what services they offer. You should streamline your search based on what services your parents require. Make sure to ask the agencies you connect with about what they offer or what services they claim as specialties.3: Get It Paid ForMedicare covers services for patients home care needs if the patient meets eligibility criteria. Patients eligible for home care coverage include those meeting the following criteria: Patients currently under the care of a doctorPatients whose doctor certifies that they're homeboundPatients in need of physical, speech, or occupational therapy who are under the care of a doctor, have a plan of care that's continually reviewed by a doctor, and require intermittent skilled nursing careCoverage is for services that are necessary and reasonable to treat an illness or injury, including such services as:Physical therapySkilled nursing careCertain durable medical equipmentMedical supplies for in-home careMedical social servicesInjectable osteoporosis drugs specifically for womenSpeech therapyMedicaid, meanwhile, varies by state, and each state may have multiple Medicaid programs. Medicaid State Plans in most states will pay for some form of home care.Invest in Home Care TodayHaving all the facts about possible services is important before you commit. Consider the above steps to ensure you make the best decision for your family so your parents are cared for during their golden years. Consider consulting with us if you need more information on securing home care.

Do you need the assistance of an attorney to file for Social Security Disability Insurance (SSDI) benefits?For completing the initial application, the short answer is probably no. Note, however, that people who get professional help with their applications are 23 percent more likely to succeed.If your application is denied and you need to have a hearing, you would be well advised to be represented by an attorney or another qualified professional. How to Apply for SSDIThe application process is fairly simple. You can apply for SSDI in any of the following ways:Using the Social Security Administrations (SSAs) online application Calling the SSA at 1-800-772-1213. (People who are deaf or hard of hearing can use the 1-800-325-0778 phone number.)Making an appointment to visit your local Social Security office (Find your local office on the SSA website.)The SSA recommends that applicants assemble a host of information prior to applying. However, if it's going to take you time to get your hands on some of the documents, it may be better to apply and then obtain the required information. Note that the SSA initially rejects approximately 70 percent of disability applications, and many applicants give up at this point this is a mistake. If taken through the appeals process, claims have a fairly high chance of being approved. But having professional assistance in this process will up your chances of success and is strongly advised. The SSDI Appeal ProcessIf your initial claim is rejected, the first step in the appeal process is to file a Reconsideration Appeal within 60 days. Most requests for reconsideration are denied, but the request can be done without an attorney if you're certain of your ability to fill out forms correctly. However, if your initial application has been rejected, you should consult with an attorney so that you have one already lined up after what will likely be a rejection of reconsideration. (Note that just 8 percent of those individuals who enter the first round of appeals are successful.)You have 60 days following the reconsideration rejection to file a request for a hearing before an administrative law judge, where you will then plead your case. You should have an attorney or other qualified representative in your corner before filing that request. How Much Does an Attorney Cost?By law, Social Security Disability attorneys or non-attorney disability representatives cannot charge an upfront fee for their services; they receive 25 percent of a claimants back payment, and this is paid only if the case is won. Representatives may, however, charge fees for things like copying medical records.It's really just foolish to go unrepresented at the hearing, says Tim Moore, a disability claimants representative who created the invaluable Social Security Disability Resource Center website. Statistics show that those who have an attorney are far more likely to be approved for benefits than those who choose to represent themselves, Moore states on his site. In addition, Moore notes, an attorney may be able to speed up the scheduling of your case before an administrative law judge, or even eliminate the need for a hearing altogether.Looking for Help at the Start of the Process?Bringing in a professional even before filing your initial claim might be the right choice if: you think you might not start the process without help;you may have trouble meeting the SSAs very tight and strict deadlines; or you want to make sure your paperwork is completed correctly. Whatever you do, don't delay. Failing to file a timely appeal could ruin your chances of obtaining retroactive disability benefits that you might otherwise have been entitled to receive based on the date of your initial application. Find a qualified elder law attorney near you.

In January 2023, the U.S. Department of Housing and Urban Development (HUD) announced it would award nearly $25 million to help fund housing for people with disabilities.Roughly 100 public housing authorities across the country will receive funding. The HUD estimates that this will result in providing affordable housing to more than 2,000 additional qualifying families with non-elderly disabled loved ones.In the news release announcing the award, HUD Secretary Marcia L. Fudge called the funding an important step forward. It will, she said, help more persons with disabilities serve as fully integrated members of their communities and allow them to live independently and with dignity.Challenges Facing Disabled Adults Seeking HousingAs rental increases have endured nationwide, people with disabilities who have limited income are especially vulnerable when it comes to securing affordable housing. This is aggravated by the fact that federal disability payouts have not kept pace with these rising rent prices, a September 2022 NPR story reported. In addition, individuals across the disability community often face discrimination when seeking housing options.Too often, people with disabilities are denied reasonable accommodation or forced to pay extra fees to rent housing, Fudge wrote in a separate opinion piece for CNN on the Fair Housing Act. Housing AssistanceAs mentioned, even with such federal disability benefits as Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), covering the cost of housing can be a challenge.The federal government offers support designed for people with disabilities seeking affordable housing of their choice.For example, non-elderly individuals with disabilities or their families may qualify for the Mainstream Voucher Program, which provides financial support in paying rent each month. This is the program that is benefiting from the $25 million award.Disabled individuals aged 18 to 61 are among those who may benefit from this federally funded housing assistance program. Other criteria must be met as well. Unfortunately, housing choice vouchers are not only in high demand, but the application process also can take time. If you are the parent of a child with special needs, investigate this option as early as possible.Another example is the federal governments Section 811 Supportive Housing for Persons with Disabilities program. This program likewise seeks to give people with disabilities the opportunity to live independently within their community.Households applying for this program must have at least one adult family member with a disability and must have very limited income.The HUD website houses a dedicated portal with detailed information on Section 811.Your state may also offer other housing assistance programs for people with disabilities. Be sure to check out Pennsylvania's organizations that may benefit you.How Do I Apply for Disability Housing Assistance?Application processes differ by type of disability housing assistance program. If you believe you may qualify for a voucher program, contact your local public housing agency. The agency will gather information from you regarding your assets, family income, and other details as part of the application process.If your family qualifies, the agency will put you on a waiting list before providing you with a housing voucher. The wait for housing may vary depending on where you live, but long waiting periods do tend to be the norm. Certain applicants may get preference such a family who has been involuntarily displaced.You can search by state for a public housing agency near you on the HUD website.For a program like the Supportive Housing for Persons with Disabilities program, HUD announces the availability of funding each year and invites applications directly from nonprofit organizations at that time.Consult With a ProfessionalAs you seek the best solution for your loved ones housing, working with Sharek Law Office will allow you to navigate the criteria for different federal and state housing assistance programs that can be complex varied. Schedule your free 15-minute call to discuss your options with our team today. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

A special needs trust (SNT) allows you to meet your needs while receiving government benefits, such as Medicaid and Supplemental Security Income (SSI). When you have a special needs trust, you can use it to pay for goods and services government benefits do not cover, such as therapy, education, housing, and travel.Since receiving income directly from your trust would jeopardize your eligibility for benefits, your trustee cannot give you cash from your SNT. When you use a credit card for permitted transactions, and your trustee pays off the balance with funds from your trust, these payments to a credit card company are not considered income. An SSI or Medicaid recipient who is capable of managing their own affairs can therefore use a credit card to make small purchases, and the trustee of the special needs trust need not micromanage every transaction.In the past, beneficiaries of SNTs sent their bills to their trustees for payment. Today, an individual with an SNT who qualifies for a personal credit card may find that using a credit card is more convenient.Credit cards have several benefits. Using a credit card to manage payments from your special needs trust allows you to maintain independence, gain access to some of the advantages of a credit card, and easily keep records while preserving your eligibility for Medicaid and SSI.Although credit cards can help people manage their special needs trusts, there are also several important restrictions and considerations to keep in mind. Consult with a special needs planner to ensure all transactions are acceptable under the trust's rules and comply with government regulations.The Benefits of Using Credit Cards When You Have a Special Needs TrustIf you have a special needs trust, using a credit card has many benefits, including:Independence: Allowing you to maintain your independence. You can use your card to make qualifying purchases yourself. Your trustee does not have to make the transactions for you.Access to the Typical Advantages of a Credit Card: Depending on your eligibility to obtain a credit card, it can be in your name. Using it responsibly can help you establish or build your credit history, which may be important for your future financial needs.Record-Keeping: Credit cards provide easy record-keeping and a convenient way to monitor transactions from your special needs trust, which can also help special needs trustees fulfill their duty to maintain records. When you use your card, your trustee can observe your purchases and ensure that all expenses are allowable under the trusts rules. Your statements can help your trustee keep track of funds leaving the trust.Benefits Eligibility: While adhering to Medicare and SSIs income and asset limits, you can access funds from your SNT. Credit cards can help prevent your trustee from accidentally providing you with cash payments that could affect your eligibility for government benefits.Considerations When Using a Credit Card for Your Special Needs TrustWhile you can use a credit card to access funds from your special needs trust for certain transactions, restrictions apply. If your trustee sees a charge on your card that could affect your benefits eligibility, they can flag it for review.You cannot use your credit card to pay for food and shelter, which SSI would cover.When administering your funds, your trustee must ensure that any expenditures are for your sole benefit if you have a first-party special needs trust.While using a credit card is appropriate, you should not use a debit card. Debit cards are considered cash income.Best PracticesWhen using a credit card for a special needs trust fund, remember several best practices.Choose a card with low fees and interest rates.Set a clear budget and monitor transactions regularly.Keep thorough records and receipts of expenses.Consult with your special needs planning attorney. They can help you navigate the rules that apply to your trust and understand how to use a credit card to preserve your Medicaid and SSI eligibility.Contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call with our staff so we can help.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

If the years since the COVID-19 pandemic have taught us anything about isolation, it is loneliness makes life much harder. A recent study found that loneliness can not only decrease a persons quality of life, but in fact accelerate aging even more so than smoking. Meanwhile, a separate study showed that levels of loneliness increased disproportionately among seniors 75 and older amid the pandemics social distancing measures.Seniors deserve a life full of joy, so preventing loneliness from negatively impacting their lives is essential. Keep reading to learn more about how seniors can prevent loneliness as they age.How Does Loneliness Affect Quality of Life? When people experience long-term isolation, their mental health suffers and their bodies show physical effects. A person has two ages chronological age and biological age, experts suggest. Chronological age is the total number of years that someone has been alive. Biological age is the age that someone seems. Sadness, loneliness, and depression, the researchers say, can add 1.65 years to a persons biological age.According to the Cleveland Clinic, a nonprofit academic medical center, loneliness can have the following physical and mental consequences: Increased risk of heart disease and vascular problems Inflammation Compromised immune systemLoss of cognitive function Anxiety Depression Increased risk of suicide or suicidal thoughts Practical Ways for Seniors to Cope With Loneliness The effects of loneliness can seem scary. Coping with loneliness can also seem hopeless. Fortunately, there are some small changes that seniors can make in their daily lives to handle loneliness. Keep In Touch  It is important to keep in touch with family and friends. Todays technology makes keeping in touch with loved ones easier than ever. It is worthwhile to learn how to FaceTime, video chat Skype, schedule meetings on Zoom, text, or voice chat. These are some ways to help you keep the lines of communication open between you and the people you love.Create a New Community  Making new friends can also decrease loneliness. Having a group of friends around you to share your life with and who understand what you are going through can increase your overall happiness. Putting yourself out there and finding a sense of community can be good for your health. Carry Out Random Acts of Kindness  Giving back to your community and those around you can also decrease feelings of loneliness. Volunteering can take your focus off negative feelings, and it can also replace any feelings of isolation with a sense of accomplishment. It can also be a good way to meet new people and help you find a new community as you age. Plan Ahead  Planning for upcoming activities, get-togethers, or events can keep your spirits up by giving you something to look forward to every day. You are less likely to feel lonely if you keep your social calendar full and keep your mind occupied.Travel If You Can  If you can travel, do it! Your family and friends would love to see you, and if they cannot make the trip to visit you, you can visit them. It is important to stay close to those who love you. Loneliness is a part of life. We all go through periods when we feel lonely, but that feeling does not need to last forever. You can take power over your life and over loneliness as you age.

Maintaining independence is fundamental for people living with disabilities. Having mobility options allows people with certain disabilities to go to doctors appointments, grocery shop, visits friends, and keep a sense of autonomy.Purchasing a vehicle can be expensive. However, grants and other resources can help meet diverse needs, including for those who need an accessible vehicle of their own.Federal Funding for Mobility Vans, Adaptive Equipment, and Accessible TransportationVarious federal funding sources can help cover the cost of wheelchair vans or adaptive equipment for your existing vehicle. Different programs may focus specifically on accessible transportation options for older adults, veterans, or people living with disabilities.Examples of these resources include the following:Veterans Affairs BenefitsThe U.S. Department of Veterans Affairs invites eligible veterans to seek out its automobile allowance benefits. Vets can also apply for its grants for accessible vehicles and adaptive equipment.Adaptations may include such vehicle adaptations as changes to seats, brakes, steering wheels, and assistive equipment. Note that each states VA office may likely have available grants specific to state residents as well.The Transportation for Elderly Persons and Persons with Disabilities ProgramThis program is headed up by the U.S. Department of Transportation. The Transportation for Elderly Persons and Persons with Disabilities Program grants money to states. The states then coordinate transportation services with nonprofits that address the mobility needs of seniors and people with disabilities.These types of grant-funded services generally do not provide accessible vehicles for individual use. However, they offer transportation services that are often free or discounted.Such public transit programs are in place in these and other states:Northwest Valley Connect in ArizonaCrossTownConnect in MassachusettsVolunteer Care Giving in North Carolinas Raleigh areaThe Rusk County Transit Commissions volunteer transportation services in WisconsinPlan to Achieve Self-Support (PASS) ProgramIf you receive Supplemental Security Income (SSI), have a disability, and want to work, the PASS program may be of interest to you. Participants receive a monthly stipend that can go toward paying for an accessible vehicle if required to achieve your work goals. Learn more on the Social Security Administration website.State and Regional Financial Assistance Programs for Accessible VehiclesAcross each state, grants for mobility vans vary widely. Be sure to consult The Mobility Resources list of state disability grants available specifically for wheelchair vans.Other state programs exist that assist people with disabilities in modifying their vehicles to make traveling with a mobility impairment easier. Unfortunately, these programs are not consistent throughout the country. Some states that provide their residents with grant opportunities for vehicle updates include:Kentucky The Spina Bifida Foundation of Kentucky makes funding for adapting vehicles available through an application process.New York The Motion Project Foundation offers qualifying residents grants that can be used for vehicle modifications and other adaptive equipment.Oregon The Blanche Fischer Foundation gives grants of up to $1,500 to residents with physical disabilities and financial need.Texas The Houston Childrens Charity Chariots for Children program awards accessible vehicles to families of children with special needs .In addition, numerous states have low-interest loan programs that can help individuals pay for modifying or purchasing a vehicle. These include:Arizona Technology Access ProgramAssistive Technology Loan Program at the Connecticut Tech Act ProjectAble Up in IowaMontana Assistive Technology Loan ProgramAccess Loan New Mexico ProgramOklahoma Assistive Technology Foundation loansMobility Rebate ProgramsCertain car manufacturers also offer rebates for approved devices, equipment, and controls that have been installed in a new vehicle.Learn more about programs available through such companies as Audi, Honda, and Subaru, among many others. (Other car companies are even launching vehicles specially designed for families with certain disabilities, such as autism.)Disability Grants for Vehicles or Equipment Through Other OrganizationsGrants for individuals may be available through foundations, nonprofits, and other types of organizations. Depending on the size of the program, some participants may receive enough money to cover the entire cost of assistive equipment and vehicle modifications. Smaller programs may be focused on supporting families with demonstrated financial need.The following are examples of organizations that provide grants to individuals and families with certain disabilities:Alyssa V Phillips Foundation. This foundation provides people with cerebral palsy financial aid that can support adaptations to qualifying vehicles.Chive Charities. This nonprofit helps veterans, first responders, and others with rare medical conditions through grants.Special Kids Fund. This fund invites families with special needs children to apply for adapted wheelchair vans that are secured through donations.Muscular Dystrophy Family Foundation. This foundation offers applicants with certain diseases financial assistance for such transportation adaptations as van conversions, transfer seats, and vehicle liftsHelp HOPE Live. Through this nonprofit fundraising website, families with special needs can coordinate crowdfunding campaigns to support their needsMultiple Sclerosis Foundation. This national foundation funds the Brighter Tomorrow Grant. This grant awards up to $1,000 for goods, services, or equipment that will improve the lives of individuals with MS. Its local chapters also often have grants specific to each state.Bryon Riesch Paralysis Foundation. This foundation awards grants to people with spinal cord injuries and disorders for specific equipment or modifications.National Mobility Equipment Dealers Association. This resource offers robust information on accessible driving solutions, funding sources, advice when purchasing accessible vehicles online, and more.Additional ResourcesNote that grant application criteria and deadlines will vary from one organization to another. Finding and applying for grants for those who need a wheelchair van or adaptive vehicle modifications can take time. Contact our law firm today for help.Note that grant application criteria and deadlines will vary from one organization to another. Finding and applying for grants for those who need a wheelchair van or adaptive vehicle modifications can take time. Contact our law firm today for help. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

According to AARP, people aged 60 and older owe upwards of $290 billion in student loan debt. Thankfully, many federal student loan borrowers have experienced payment reprieves for the past few years due to multiple payment pauses enacted during the pandemic by the CARES Act and other loan relief efforts.These pauses on making payments for federal student loans are ending in August 2023, however. Interest will resume accruing on paused loans effective September 1, 2023, and student loan payments will be due in October 2023. To help borrowers get back on track with their payments, the Department of Education is implementing several programs.Resuming PaymentsOne of the new initiatives is a yearlong return-to-repayment program designed to get borrowers back into active repayment status. Between October 2023 and September 2024, borrowers who miss payments will not be considered delinquent. Their loans will not be reported to credit bureaus as delinquent due to missed payments.In addition, they wont be considered to be in default. Although interest will still accrue, it will not be capitalized. The idea behind this program is to give borrowers time to contact their student loan servicers, explore their options, and hopefully enroll in an affordable repayment option.Fresh Start InitiativeAdditionally, the Department of Education is implementing a Fresh Start initiative. This program provides borrowers who were in default of their student loans before March 2020 with a way to get their loans out of default going forward. It allows them to request that their loans be removed from default and put back into repayment status via a simple request to their loan servicer.This is significantly different from what borrowers previously had to do to get out of default, which often included a trial repayment effort before a loan was taken out of default.The benefits of the Fresh Start program include allowing borrowers to:start paying their loans again regardless of prior missed payments,improve their credit scores,avoid administrative wage garnishment (AWG), andaccess income-driven repayment (IDR) options quickly. (IDR options often result in $0 monthly payments for low-income or fixed-income borrowers.)Avoiding Administrative Wage Garnishment (AWG)The ability to avoid AWG is significant. AWG can affect people at all stages of life, including seniors. AWG allows a federal agency to order a non-federal employer to withhold up to 15 percent of an employees wages to pay a debt owed to the agency, such as defaulted federal student loans. AWG can also mean receiving a lower tax refund or having a portion of ones monthly Social Security benefits withheld.However, if borrowers take advantage of the Fresh Start program prior to August 31, 2024, they can avoid a loan default that leads to AWG.The SAVE PlanIn addition, the Department of Education is implementing a new IDR option in mid-2024 called the Saving on a Valuable Education (SAVE) Plan. The SAVE Plan amends and replaces the REPAYE Plan.Typically, the amount a student loan borrower with an IDR plan must pay depends on their income and the size of their family. Effective July 1, 2024, the SAVE Plan will protect more of a borrowers income from monthly payments. Compared with other IDR plans, the SAVE Plan will therefore lead to reduced monthly payments. For details, check out this fact sheet from the Department of Education.Borrowers With Disabilities May More Easily Qualify for a TPD DischargeEffective July 1, borrowers with disabilities will have an easier time qualifying for a total and permanent disability (TPD) discharge. New rules allow the Department of Education to offer TPD discharges (often automatically) to borrowers receiving SSDI or SSI who:have an onset of disability date five or more years ago and have been receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) based on this disability for at least five years;SSDI or SSI recipients who suffer from a condition on the Social Security Administrations List of Compassionate Allowances;SSA beneficiaries receiving retirement benefits who met the requirements for a disability discharge before they retired;SSDI or SSI recipients receiving these benefits based on disability with a three-year disability review period; orSSDI or SSI recipients receiving these benefits based on disability with a five- to seven-year disability review period.Disabled individuals who do not meet these criteria and wish to apply for a TPD discharge based on a doctors certification may now seek out certification from professionals beyond those holding an M.D. Nurse practitioners, physician assistants, and osteopathic doctors may now sign the certification verifying a borrowers disability.Borrowers who receive a TPD discharge in this manner will no longer be subject to a three-year income monitoring rule. However, if they apply for new federal loans within three years, they may lose their TPD discharge.Forgiven Student Loan Debt Wont Result in Taxable Income (For Now)At the moment, student loan debt cancellation is not counted as taxable income to borrowers. This protection from additional taxes will remain in effect until December 31, 2025.So, if you are considering applying for a TPD discharge or completing an IDR plan you previously started that would lead to loan forgiveness, now may be the time to act. However, note that this rule only applies to federal tax liability. Borrowers may still have liability under their states income tax rules.Contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call to see how we can assist you.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

End-of-life decisions are never easy. One of the most important decisions you may make regarding health care as you age could be whether you need a nursing home or hospice care.To make the best choice for you and your family, it helps to know the difference between the nature of the care provided through a nursing home as compared with hospice.Nursing Home CareNursing home facilities offer residential care for the elderly and disabled. The treatment patients receive from a nursing home differs from what is available in hospice care. Residents at nursing homes receive treatment to extend their lives. Care that you can expect from a nursing home may include custodial and some skilled care.Custodial care includes nonmedical treatment, such as assistance with dressing, bathing, cooking, laundry, and other types of personal care. The provider does not need a medical license to give residents this type of care.Skilled nursing care is provided by licensed medical practitioners. Nursing home residents may receive some skilled care, including wound care, physical therapy, injections, and other care that they may need to ensure their physical well-being.Note that Medicare generally does not cover custodial care. And while Medicare Part A (hospital insurance) coverage may be available for enrollees with certain medical conditions, it is often limited to those who need short-term care in a skilled nursing facility, rather than a nursing home. (Learn more about Medicares limited nursing home coverage.)If you are eligible for Medicaid, a program for individuals with limited income and assets, there are nursing homes in many states that accept Medicaid patients.What Is Hospice Care?Hospice care is an option for patients who do not wish to receive treatment to help improve their condition or extend their life, but want comfort care as they reach the end of their lives. Your hospice care team may include doctors, nurses, social workers, spiritual advisors, and volunteers.A hospice care team is trained in treating end-of-life pain. Hospice care can be administered in a patients home or in an institutional setting. It also may provide support to family members and caretakers, including respite care.If a patient has Medicare Part A and meets the following qualifications, they may have hospice care services, including pain-relieving medication and home aide services, covered:A primary care physician, or a hospice care doctor, confirms that the patients condition is terminal and they will not live for more than six months.The patient is willing to receive palliative care only and not care that is intended to try and improve their condition.The patient signs a statement confirming that they will receive hospice care instead of any other Medicare-covered treatments related to their physical condition.For Medicaid recipients with a terminal illness, certain states may provide help in paying for hospice.A Note on Concurrent Care Complicating matters is the fact that Medicare will generally not cover nursing home care and hospice care, known as concurrent care, at the same time. Currently, individuals on Medicare must give up Medicare payment for care related to their terminal condition if they want to receive Medicares hospice benefit. As a result, many individuals facing a terminal illness may not opt for hospice support services.Policymakers have been pushing for a benefit within Medicare that would allow patients who wish to benefit from hospice care services (for example, a hospice aide, in-home respite care, or nutritional support) to receive curative treatment (for example, chemotherapy) simultaneously.The Centers for Medicare and Medicaid Services has spent the past several years testing various models, including one known as the Medicare Care Choices Model (MCCM). MCCM has been shown to improve the quality of patients end-of-life while also resulting in Medicare savings. However, this option has not yet been made permanent.End-of-Life Dilemma: Which Should I Choose?While considering the next steps to take in your health care plan, speak candidly with your family and health care team about your needs and how you see your future.If you have questions about coverage options that may be available to you in a nursing home or with hospice care, contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call with our staff to learn how we can help. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Most older adults want to remain in their homes and communities as they age rather than move into assisted living facilities or nursing homes.For those who wish to maintain their independence and continue living at home as they grow older, taking certain steps to protect their physical, mental, and financial welfare is essential.What Does It Mean to Age in Place?The Centers for Disease Control and Prevention defines aging in place as a seniors ability to live in ones own home and community safely, independently, and comfortably, regardless of age, income, or ability level. According to 2021 data from AARP, more than three-quarters of adults 50 and older say they would prefer to age in place.Health Considerations for Older Americans Aging in PlaceOlder adults must consider their physical, emotional, and social well-being when deciding where to spend their later years. They may consider adding supplemental services over time to help improve their quality of life.To ensure that you will have the support you need for safely aging in place, take the following into consideration:Resources to Manage Chronic DiseasesDisease management is vital for anyone, especially an older person with a chronic illness. Many older people suffer from at least one chronic illness. If a senior has a chronic disease and wants to age in place, they and their caregivers should focus on:Ensuring that spaces in the home are safe and easily accessible to make getting around easier;Learning about proper nutrition; andIncreasing access to dental health services. Research has found that proper oral care can help prevent the progression of many chronic diseases.Eating Well While Aging at HomeProper nutrition is a vital part of caring for yourself at home. In facing potential changes to your financial situation after retirement, you may need help buying nutritious meals even after budgeting.If you find yourself in need of meals, community resources may be available. Neighborhood senior centers, places of worship, and charities may provide a hot meal while you make new friends. If you cannot leave your home, some meal delivery services drop off food at your door for little or no cost.Support for MobilityExercise and maintaining your mobility can increase overall physical and mental health even as you grow older. Seniors aging in place need to be able to move around their homes and neighborhoods safely. Aging in place is a much more realistic goal if you can walk for exercise, access transportation to medical appointments and errands, and maintain a safe environment at home, free from increased fall risks.If you desire to age in place, consider simple changes you can make to your home to promote your safety. Examples of helpful modifications around the house include handrails, temporary ramps, no-slip bath rugs, and assistive seating.Mental Health, Substance Abuse, and Memory Care ServicesThere is an increased need among older adults for mental health, substance abuse, and memory care services. An estimated 20 percent of older adults have a mental health disorder, and the total number of seniors with a mental health or memory care diagnosis is likely to increase over time.Suggestions for addressing mental health concerns among older people include:Focusing on preventative care. Seniors and their caregivers should work with their primary care physician to identify warning signs of depression, anxiety, other mood disorders, and memory care problems. Preventative care can help mitigate the progress of these disorders and improve quality of life. Looking for common signs of a substance abuse problem. This is an often overlooked area of older adult mental health care. Older adults may turn to substances to deal with unresolved childhood problems or to avoid a feeling of loss of meaning and purpose. Some common signs to watch for include reduced hygiene, unexplained bruises, erratic behavior, and the smell of alcohol on their breath.If you are a seniors caregiver and suspect substance abuse, you can find resources and support through the Substance Abuse and Mental Health Services Administration (SAMHSA).The Need for Social Connection Among Aging AdultsOlder adults benefit tremendously from social connections and interaction. People over 65 are likely to live alone, so creating a community outside the home is necessary. Feeling a sense of purpose is beneficial to mental and physical health. For seniors looking to create a sense of community and purpose, they may benefit from such activities as:Joining an organization or social clubVolunteering for a cause close to their heartsLearning a new hobbyAttending a religious institutionAdopting or fostering a petUsing technology to stay in touch with friends and familyWearables and Smart Monitoring DevicesTechnology can help us not only remain connected to one another, but also monitor our health and that of our aging loved ones. Many devices make detailed health information readily available at our fingertips. These devices benefit seniors because they can learn more about their health and make the most of doctors visits by communicating effectively about their medical needs.Examples of wearable health and smart-home monitoring devices include:Smartwatches and smartphones, which can track your cardiac health, fitness activity, and sleep patternsMedical alert bracelets and personal alert necklaces, which can aid in detecting falls or contacting emergency services when necessaryContact sensors and smart locks, devices that can alert caregivers when their loved one living at home leaves a window, garage, or door open, or has forgotten to lock themSmart plugs, which can automatically turn on and off lights, space heaters, thermostats, security cameras, and moreMoney Management While Aging in PlaceMoney management can also be an area of concern for seniors and caretakers. Seniors want to make sure they have sufficient financial resources to remain in their homes and communities comfortably, eat well, care for their medical needs, and have fun.Creating a budget with the help of financial counselors and geriatric care managers can benefit someone on a fixed income. There may even be volunteers in your area that offer a similar service. Being aware of how to prevent and avoid common types of scams that target the senior population is equally as important.How Can Caregivers Help Seniors Age in Place?Seniors often choose to age in place to remain independent and avoid becoming a burden to their family. Caregivers can support their goal by teaching them to use technology to communicate and track their health, helping them establish a budget, and setting them up with a routine that may include visiting their doctor, running errands, and making time to socialize.There is nonmedical support that your loved one will need, too. Caregivers may opt to support their aging loved ones by pitching in with or hiring services for lawn care, cleaning, cooking, laundry, or pet care.Careful planning is the best way to accomplish your goal of staying home as you age. If you are considering plans to age in place and want assistance, contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call with our staff. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

In helping clients prepare for their future, estate planning and elder law attorneys use many acronyms. Understanding some of the common medical and legal terms in this field can give you added confidence in your approach to planning for your own future or that of your loved ones.1. AEP (Accredited Estate Planner)An AEP is an estate planning professional who has attained a graduate-level designation in estate planning. Attorneys and other estate planning experts, including accountants, financial advisors, and financial planners, can seek this accreditation. Although accreditation isn't necessary for a lawyer to do estate planning, accredited estate planners have gone through additional education in estate planning. They're recognized by the National Association of Estate Planners & Councils.2. CCRCs (Continuing Care Retirement Communities)Older adults who want to stay in one place as their care needs progress can reside in continuing care retirement communities, which provide different levels of care as their medical and care needs change. Residents can start out living independently and then receive assisted living or nursing home care when required.3. CMS (Centers for Medicare & Medicaid Service)CMS is the federal agency that regulates Medicare, Medicaid, and Childrens Health Insurance Programs, as well as the Federally Facilitated Marketplace, an online health insurance marketplace.4. DNR (Do Not Resuscitate Order)A DNR allows individuals to choose not to have physicians prolong their lives with CPR or cardiopulmonary resuscitation. The person as well as their physician must sign the order. DNRs differ from living wills. Whereas DNRs are specific to CPR, living wills allow individuals to state whether or not they want general medical care to prolong their lives.5. DPA (Durable Power of Attorney)Using a DPA, you can appoint a trusted individual to manage your health care decisions or financial decisions in the event that you cannot make choices for yourself. A health care agent can make decisions about what kind of care you receive, whereas a financial agent can help manage your finances and pay your bills. Having a durable power of attorney in place can help you avoid needing a guardian in the future if you become incapacitated.6. GAL (Guardian ad Litem)When the court has concerns about a persons ability to handle their personal or financial affairs, it can appoint a guardian ad litem to advocate for the individuals best interests.7. IRA (Individual Retirement Account)Individual Retirement Accounts are accounts that allow individuals to save money for retirement on a tax-free or tax-deferred basis. Traditional IRAs use tax-deductible income and are tax-deferred, whereas Roth IRAs use post-tax income and aren't taxed upon withdrawal.8. MMNA (Monthly Maintenance Needs Allowance)When one spouse goes on Medicaid and enters a nursing home and the other remains at home, federal spousal impoverishment rules provide that the spouse remaining in the community can retain a certain amount of the couples income.The Minimum Monthly Maintenance Needs Allowance is the minimum amount of the couples income the spouse who remains at home must receive. When the healthy spouses income falls below the minimum, the spouse receiving Medicaid can give a portion of their income to the community spouse.9. SNF (Skilled Nursing Facility)Individuals with acute illnesses and injuries can recover in skilled nursing facilities, which are short-term rehabilitation centers. Skilled nursing facilities provide skilled nursing that meets residents unique needs and are distinct from nursing homes, which provide long-term care.10. SSA (The United States Social Security Administration)The Social Security Administration regulates Social Security retirement, survivor, and disability insurance benefits programs. It's the agency responsible for allocating the Supplemental Security Income program for individuals with disabilities and assigning Social Security numbers.11. UAGPPJA (The Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act)The majority of states have adopted the Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act, which was drafted in 2007. The Act covers guardianship transfers, making moving between states easier and more efficient.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Pharmaceutical companies Pfizer and GlaxoSmithKline (GSK) have each developed a vaccine to protect older adults from a virus known as RSV. People over 60 are at significant risk of serious complications if they contract RSV. Fortunately, with the recent FDA approval of Pfizers Abrysvo vaccine and GSKs Arexvy vaccine, along with practical safety measures, seniors can take steps to avoid the effects of this virus.What Is RSV?Respiratory Syncytial Virus (RSV) is a respiratory infection that mimics the common cold. Most people recover from RSV within two weeks after initial exposure to the virus. However, the virus can cause serious complications in older adults.Symptoms of RSV can include:CoughingFeverSneezingRunny noseDecreased appetiteWheezingNew RSV Vaccines Are on the HorizonGSK has developed an RSV vaccine that has recently received Food and Drug Administration (FDA) approval. It developed the vaccine Arexvy to prevent lower respiratory disease in older adults caused by RSV. Arexvy is the first RSV vaccine approved for use in the United States.The GlaxoSmithKline approval was based on positive data that included a showing of an overall vaccine efficacy of nearly 83 percent in older adults with at least one underlying medical condition.Before submitting its vaccine for FDA approval, Pfizer also conducted tests to determine its efficacy. The main clinical study found that Abrysvo had an efficacy of almost 86 percent in participants. The study also found that the vaccine significantly reduced the risks of adults older than 60 developing RSV-associated lower respiratory tract disease by about 83 percent.Some participants reported side effects that included injection site pain, joint stiffness, muscle pain, headaches, and fatigue. A small number of participants in the Arexvy studies developed Guillain-Barre Syndrome and acute disseminated encephalomyelitis (ADEM). The FDA is requiring GSK to complete a subsequent study to determine whether there is a significant risk that users will develop Guillain-Barre Syndrome or ADEM.RSV is a seasonal disease, with a season typically beginning in the fall and peaking in the winter. GlaxoSmithKline reports that the Arexvy vaccine is effective across two RSV seasons.Who Is at Risk for RSV?Older people are more vulnerable to contracting RSV. As we age, our immune systems naturally weaken, and we become more susceptible to disease, including RSV. Seniors at the greatest risk of getting RSV are those with chronic heart or lung disease. According to the Centers for Disease Control and Prevention (CDC), 60,000 to 160,000 older adults are hospitalized and between 6,000 and 10,000 seniors die each year from RSV nationwide.Potential Complications for Older Adults With RSVRSV can lead to serious complications in people aged 60 and over, including severe infections that can lead to extended hospital stays.RSV is an illness that affects the respiratory system, so seniors with the following underlying illnesses may experience significant problems fighting off the RSV infection:Chronic Obstructive Pulmonary Disease (COPD)Congestive heart failureAsthmaExacerbation of pneumoniaSeniors Can Adopt These Practices to Help Stop the Spread of RSVRSV is an easily transmittable disease. Fortunately, seniors can adopt simple habits to contain the spread. Some of the following practices can save your life or the life of your loved ones:Stay Away From Public Places When Youre SickIt is critical to avoid public places like grocery stores, recreation centers, nursing home common areas, and the like when you are sick. RSV is highly contagious, so if you are ill, stay away from others to avoid spreading the disease. Clean and Disinfect Frequently Touched SurfacesClean and disinfect high-traffic areas. Be sure to wipe doorknobs, countertops, and other areas that are typically frequented in your home. Avoid Close Contact With Sick PeopleYou should avoid anyone that is sick. Again, RSV is highly communicable, and an older adult may face serious consequences if they are infected. Dont Touch Your FaceNever touch your face with unwashed hands. Avoid touching your eyes, nose, or mouth with unwashed hands. Wash Your HandsWash your hands with soap and water frequently and for at least 20 seconds. If soap and water are unavailable, consider using an alcohol-based hand sanitizer.Both vaccines are expected to become available in the United States in the fall of 2023.Contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call to see how we can help. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

For families seeking nursing home care for a loved one, getting information on what a nursing home is truly like or who owns it is easier said than done. Many rely on word of mouth, referrals, or recommendations. Others must depend on their gut instincts and site visits as part of their decision-making process. Family members often find themselves playing detective or hoping for the best. Much of this is because little information has been made available to the public. However, recent events show this is changing. New Efforts to Increase TransparencyState and federal governments recognize the lack of transparency or data available to ordinary people regarding nursing homes. Some are taking action to try to change this. In September 2022, the Department of Health and Human Services announced that the Centers for Medicare & Medicaid Services will provide a way for users to search for data regarding who owns a nursing home. Similarly, Medicare provides an online tool that allows you to find nursing homes in your area and compare them against others. States such as New York have also set up sites for visitors to compare the quality of care, quality of life, safety, preventative care practices, and inspection and complaint information of nursing home facilities. There are limits to the data available. For example, the data on the Centers for Medicare & Medicaid Services regarding ownership is self-reported. This means data on hundreds, if not thousands, of nursing homes is unavailable. In addition, untangling all this information and determining whether a nursing home is a good fit is not easy and may feel like a guessing game to some. However, there is a consensus that more information must be made available to the public, and a proactive effort is underway. As the data banks grow, researchers will be able to identify facilities owned by companies with a history of poor performance within other facilities or that may have other troubles. For example, in 2022, the Department of Justice charged the owner of the nursing home chain known as Skyline with failing to pay employment and unemployment taxes for more than 15,000 employees at 95 facilities in 11 states to the tune of a bill for $29.5 million owed to the IRS. The fallout was terrible for nursing home residents all over the U.S. who had to find new homes as staff were told there was no more money to pay them.Hopefully, the search tools, once further developed, will allow viewers to see whether the nursing home they are considering is affiliated with troubled facilities they may have heard about.What You Can Do NowSo, what can you do in the meantime? Checking out the above resources is an excellent first step. Another option is to look up your states portal for nursing home complaints. Many of these are online and have links to comparison tools and other resources. Several public projects have also created a database of nursing home deficiencies cited by regulators and incidents of penalties, such as ProPublicas Nursing Home Inspect.Finally, consider seeing if the nursing home you have in mind is active in your local courts. They may frequently try to sue residents or guarantors for bills or be subject to elder abuse and malpractice complaints. Some court systems have online search systems that allow you to view the details of all filed cases online, while others may require a trip to the clerks office. This can be invaluable in giving you an idea of what the nursing home environment is like behind closed doors after all the paperwork is signed.The best position to be in is to have as much information as possible. Whether it be through online searches or in-person visits, do as much research as possible. Find more answers to your nursing home questions on ElderLawAnswers.com.

In the new year, the country continues to respond to the COVID-19 pandemic. The United States Department of Health and Human Services(HHS) recently released guidance to nursing homes and long-term care facilities on practical steps they can take to help reduce the COVID-19 infection rates among residents and staff this winter.The HHS encouraged nursing homes and long-term care facilities to focus on achieving three goals meant to reduce the hospitalization and death rate among its residents, the population most vulnerable to severe complications from COVID-19 exposure. Nursing homes and long-term care facilities are being advised to focus on these three goals:Help residents and staff access updated COVID-19 vaccinesIncrease access to testing and awareness of treatment options Improve air quality in nursing homes and long-term care facilitiesThese practical steps can promote healthy living for older Americans and the professionals that care for them in these facilities, HHS says.Helping Residents and Staff Access Updated COVID Vaccines Since the initial nationwide push to get people vaccinated against COVID-19, the rate of nursing home residents getting boosters dropped to 42 percent, and the rate of nursing home staff that received updated COVID-19 vaccines dropped to 10 percent. The Centers for Medicaid and Medicare Services (CMS) reported that increased access to COVID-19 vaccines and education about the need for boosters and updated vaccines correlated to decreased infection rates. The HHS guidelines recommend that:Nursing homes and long-term care facilities offer updated COVID-19 vaccines throughout the winter Residential facilities partner with vaccine providers to create on-site vaccine clinicsCare facilities educate residents and staff about the need for annual flu shots and updated COVID-19 vaccinesIncreasing Access to Testing and Awareness of Treatment Options Prompt testing and effective treatment are necessary to reducing the spread of COVID-19. According to HHS, residential facilities should ensure each resident and staff member who shows symptoms gets tested. Nursing homes and long-term care providers should also explain to residents or staff their treatment options and other available resources. Among these resources are the following:Weekly tests kits are available, free from the federal government, to nursing homes and long-term care facilities Telehealth and virtual care options for COVID-19 evaluation and treatmentFree at-home test kits available for residents through their health insuranceImproving Air Quality in Nursing Homes and Long-Term Care Facilities Improving air quality is correlated with decreasing the transmission rate of COVID-19, influenza, and other respiratory diseases. Health care facilities are also being encouraged by the HHS to improve air quality in their facilities. Nursing homes and long-term care facilities can improve their air quality by:Using portable air cleaners in dining, recreation, and resident rooms and other areas where people congregateUsing ceiling fans where availableScheduling an inspection for the HVAC systemReplacing air filters in ventilation systemsUsing restroom fans or kitchen vents to remove contaminated airRepairing or replacing broken or damaged windows and doors to promote air ventilationIn acting on the above guidance, the HHS states, nursing homes and long-term care facilities can help decrease the rate of COVID-19 exposure and infection among the population of Americans most vulnerable to the effects of the disease.

According to the American Heart Association, high blood pressure contributes to many significant health conditions, including heart attack, heart failure, stroke, and kidney failure. In the United States, 121.5 million adults suffer from high blood pressure, also known as hypertension. While half of these individuals have improved their conditions, others have uncontrolled blood pressure, which can harm their health. Self-monitoring ones blood pressure can help control this condition. Depending on your state, Medicaid may cover part of the cost.What Is Self-Measured Blood Pressure (SMBP)? Medical care is an important part of blood pressure management. Yet, you can also help your doctor treat you by monitoring and recording your symptoms at home. This is called self-measured blood pressure (SMBP). When combined with a doctors support, SMBP might improve your health. You can use a manual blood pressure cuff or an automated blood pressure device to monitor your BP. With at-home measurements, you can record your blood pressure levels over time. Your doctor can use this information to help treat you. The Benefits of Monitoring Blood Pressure at HomeSome evidence suggests that SMBP with clinical support may be more effective than medical care alone. When you measure your blood pressure at home, you can assess your condition regularly. You don't have to wait for a medical professional to evaluate your BP. If your blood pressure becomes dangerously high, you can inform your doctor and seek emergency treatment. By keeping track of the fluctuations in your blood pressure at home, you can give your doctor detailed information to help with your treatment. For instance, your doctor can use the information to decide what kind of medication and dosage to prescribe. Sometimes, blood pressure levels change depending on the situation. SMBP can identify forms of hypertension that present differently. At-home measurements can reveal white-coat hypertension (when a patients BP is high at the doctors office, but at a healthy level at home) and masked hypertension (when BP readings appear normal in a doctors office but are high in other settings, such as at home or work). Why Might Medicaid Beneficiaries Need Coverage for SMPB?Per Medicaid.gov, one-third of all Medicaid beneficiaries have high blood pressure. With uncontrolled hypertension disproportionally affecting low-income, non pregnant adults, SMBP coverage and reimbursement through Medicaid can be beneficial for many.Does Medicaid Cover Home Blood Pressure Monitoring?Medicaid covers SMBP in certain states. Yet not all states have coverage. Continue reading for more information.What Does SMBP Medicaid Coverage Include? Depending on your state, Medicaids coverage for self-measured blood pressure could include the following: Provider reimbursement for medical supportBP measurement devices for you to use at home (manual blood pressure cuffs or automated blood pressure devices)In most states with SMBP coverage, Medicaid takes care of medical care as well as devices. Other states cover just one or the other. The American Medical Association outlines what Medicaid provides in each state.Which States Cover Medical Support and BP Measurement Devices?The following states provide coverage to some extent for both medical support and devices: ArizonaColoradoDelawareHawaiiIdahoIndianaMichiganNebraskaNew JerseyNew MexicoNorth CarolinaNorth DakotaOhioOregonTexasVirginiaWisconsinWyomingThese states only cover durable medical equipment (manual blood pressure cuffs or automated blood pressure devices):AlaskaArkansasCaliforniaConnecticutD.C.IllinoisIowaKansas (only covers manual blood pressure cuff)LouisianaMaineMarylandMassachusettsMinnesotaMississippiMissouriNevadaNew HampshireNew YorkUtahVermontWashingtonThe following states reimburse providers for supporting patients with SMBP. However, Medicaid doesn't pay for at-home devices. GeorgiaKentuckyMontanaRhode IslandSpeak With an Attorney If you have high blood pressure, self-measurement might help. Consult with an attorney to learn more about whether you could be eligible for Medicaid coverage in your state.

It's an unpleasant thought, but death is a reality we all must face. One way to cope with the loss of a loved one is to be prepared for their final send-off. Funerals are expensive. For Medicaid recipients and their families, it's unlikely they will have the money to cover them when the time comes. Many people are unaware that there is coverage to help families lay their loved ones to rest. Depending on your state, Medicaid may cover some funeral costs and other final expenses. How Much Does an Average Funeral Cost?In 2021, the average cost of a funeral, including viewing and burial, was $7,848, according to the National Funeral Directors Association. The average cremation cost with a service was $6,970. Does Medicaid Pay for Cremation?If a person doesn't have life insurance and is a Medicaid recipient, burial or cremation costs could bankrupt a family. Most people need as much help available when facing such a massive expense.Fortunately, Medicaid recipients may receive assistance with either burial or cremation. It's unlikely that the assistance will cover the entire service, but alleviating some of the cost is still an advantage.How to Access Medicaid Funeral Assistance Access to Medicaid funeral assistance varies depending on the state. While there isn't an official checklist applicable to every state, here are some general tips that may help you obtain government assistance for a loved ones final expenses: Talk to the Funeral Home  A conversation with the funeral home is worthwhile. The funeral director you work with is the primary resource for information about how people pay for their services. They may be able to offer advice about state resources, including Medicaid.In addition, there are charities that help with funeral costs, and in some cases, state, and local funds available to cover expenses. Ensure You Found All Money Available  Your loved one may have had life insurance without you realizing it. You should double check every estate planning document they left behind. Seniors often leave information about their life insurance policies within their will.If you serve as the executor, you should work with an estate planning attorney to ensure you have all the information available about what resources the deceased left to pay for their funeral expenses. Thinking Ahead: Alternatives That Help Pay for Funeral Expenses During your lifetime, even if you aren't a Medicaid recipient, there may be other ways to make sure your own final expenses or that of a loved one are taken care of. Here are a couple of ways to help allocate money toward the funeral service, burial, or cremation: Irrevocable Funeral Trust  An irrevocable funeral trust is a trust that someone can create during their lifetime to help pay for their funeral. The terms of an irrevocable trust cannot be changed after the trust is created, so the money you put into an irrevocable funeral trust cannot be used for any other purpose.A trust guarantees there will be money to give your loved one the send-off you and your family desire for them. Each state has a limit on the amount of money that can be placed into an irrevocable funeral trust. You should speak to an elder law attorney to determine if this is the best option for you. Set Money Aside in Your Will  Setting money aside in your will may seem like a simple solution that will secure funds for your funeral, but that may not be the case. The probate process involves using the estate assets to pay debts and give heirs their inheritance. Even if you allocate money for your funeral in your will, those funds may be used to pay an estate debt if creditors file a claim against the estate. Learn More About Medicaid Funeral Assistance If you are beginning to plan for a loved ones funeral and have no idea where to start, speaking to an experienced attorney in your area is a good first step. 

Each year, 36 million older adults fall, with one out of every five falls resulting in physical trauma, the Centers for Disease Control and Prevention report. Injuries from falls, such as hip fractures, can lead to hospitalizations, surgeries, and nursing home stays. Experiencing a fall or living in fear of falls can reduce your quality of life and separate you from family and friends. AginginPlace.org provides a freely available, medically reviewed guide on preventing falls, with lifestyle, mobility, and home improvement recommendations to help you avoid falls, maintain independence, and assuage any fears you may have of falling. Lifestyle ChangesLifestyle modifications can prevent falls. Having the proper footwear is essential. Although slippers and socks can be comfortable to wear inside the home, use supportive shoes with nonskidding soles indoors. Wear properly fitted clothing. You could trip over oversized, baggy clothing. Maintain a well-organized, clutter-free living space. Items in the home, such as cords and surplus furniture, can be a tripping hazard. Decluttering can keep the interior of your living space safer.Vision problems can cause falls, so visit your eye doctor regularly. Talk to your primary care physician to learn more about any medications or health conditions that may make your gait unsteady. When you move about your home, don't rush. Take your time, moving slowly and carefully. Use short steps to avoid slipping. Mobility ExercisesStaying active and physically fit is an essential element of fall prevention. Engage in exercises such as walks, tai chi, and water aerobics regularly to maintain your fitness. Practice balance exercises that improve lower body strength and help you stay on your feet three days a week for 10 to 15 minutes at a time. Use mobility aids, such as canes and walkers, to help you stay steady. Be aware of your surroundings. Home ModificationsAs you age, you can adapt your home to your needs. Keep your home well-lit. Install lighting into dark areas, such as hallways and stairways. Nightlights can illuminate your home in the dark, allowing you to see your surroundings and avoid tripping. Place grab bars and handrails around your home in locations where you might lose your balance, such as bathrooms, hallways, and stairways. Keep everyday items within your reach. Avoid storing items in high or hard-to-access places. If you choose to keep things in high places, use a sturdy step ladder with a safety bar or a reach extender a tool for retrieving out-of-reach objects.To stop falls before they happen, look for hazards in your home and remove them. To learn more about reducing your fall risk, read the Comprehensive Guide to Fall Prevention from AginginPlace.org.

Many use the terms skilled nursing facility and nursing home interchangeably. However, they're separate care facilities. Although skilled nursing facilities and nursing homes sound similar, they have fundamental differences, including the level of medical care they provide.Whereas nursing homes are long-term residential facilities that serve people with chronic conditions, skilled nursing facilities are rehabilitation and treatment centers. Nursing homes are appropriate for long-term residents, while skilled nursing facilities support short-term recovery from acute medical issues.Duration of StayHow long a person needs to stay at a facility can determine whether they go to a nursing home or a skilled nursing facility. People usually remain in nursing homes for longer durations than in skilled nursing facilities. Many older adults move into nursing homes permanently. Those in skilled nursing facilities tend to stay for shorter periods of time and then move back home or into long-term care. According to the National Care Planning Council, people who enter nursing homes stay for an average of more than two years. The average stay in a skilled nursing facility is about a month.Skilled NursingIn addition to the length of stay, a significant difference between skilled nursing facilities and nursing homes is the type of care available. Skilled nursing facilities specialize in addressing residents unique medical needs.Skilled nursing requires qualified practitioners with advanced training and specific certifications. Licensed health professionals work at skilled nursing facilities, including:Registered nurses (RNs)Licensed practical nurses (LPNs)Speech and language pathologistsPhysical and occupational therapistsDepending on the type of care you need, note that you can obtain skilled nursing services in other settings as well, including your home and nursing homes.Types of Care Available in Skilled Nursing FacilitiesIndividuals who have severe accidents, such as falls, might need short-term care in a skilled nursing facility. Others may go to skilled nursing facilities to receive treatment for severe illnesses like cancer. People might also need to stay in a skilled nursing facility when recovering from surgery.Types of care available at skilled nursing facilities include:Physical therapyOccupational therapySpeech therapyWound careIntravenous therapyInjectionsCatheter careMedical monitoringAs part of medical care, specialized medical equipment is available at skilled nursing facilities.Nursing HomesWhen individuals can no longer live in their homes safely and need assistance with daily living, they may choose to move into a nursing home. Nursing homes also offer activities to residents, such as social events, shopping excursions, and access to religious services. Day and night, residents have access to nursing services.However, unlike skilled nursing facilities, nursing homes don't offer medical care that meets all residents specific needs. Residents at nursing homes with specific medical needs often travel to healthcare facilities to receive care. Family members can drive residents to appointments, or they may use transportation services to access medical care that meets their unique needs.In addition, while registered nurses work in nursing homes, fewer licensed professionals might be available to residents in this type of facility.Learn more about choosing and evaluating nursing homes.Assistance With Daily LivingBoth skilled nursing facilities and nursing homes provide round-the-clock activities of daily living (ADLs), including:Showering and bathingGetting dressedCooking and mealsPersonal hygieneWalkingMobilityGetting in and out of bedMoving in and out of a wheelchairThis article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

With the cost of a funeral averaging between $7,000 and $12,000 and steadily increasing each year, at the very least your estate plan should include enough money to cover this final expense. And if you are thinking of simply setting aside money in your will to cover your funeral expenses, you should seriously reconsider, as paying for your funeral through your will can create unnecessary burdens for your loved ones.Although you can leave money in your will to pay for your funeral expenses, your family wont be able to access those funds until your estate goes through the court process of probate, which can last months or even years. And since most funeral providers require full payment upfront, your family will likely have to cover your funeral costs out of pocket. Moreover, your loved ones will have to deal with all of this while grieving your death.If you want to avoid burdening your family with such a hefty bill and the stress that comes with it, you need to use estate planning strategies that do not require probate. While you should meet with us to find the solution best suited for your unique situation, the following 5 options are among the most commonly used methods for covering funeral expenses without the necessity for probate.01 | TRADITIONAL INSURANCEYou can purchase a new life insurance policy or add extra coverage to your existing policy to cover funeral expenses. Unlike money left in your will, an insurance policy does not go through probate, and it will pay the death benefit to the named beneficiary as soon as your death certificate is filed with the insurance company.02 | BURIAL INSURANCEIn addition to traditional insurance, you can also purchase burial insurance, which is specifically designed to cover funeral expenses. Also known as final expense, memorial and preneed insurance, such policies do not require a medical exam. However, youll often pay far more in premiums than what the policy actually pays out.In fact, due to the hefty premiums and the fact such policies are sold mostly to the poor and uneducated, consumer advocate groups like the Consumer Federation of America consider burial insurance a bad idea and even predatory in some cases due to the fact that these policies are often sold to lower income populations.One final point about using insurance to pay for your funeral: If you have any type of insurance to cover your funeral, its crucial that your family knows about it. Far too often, insurance policies are never cashed in because the family didnt know they existed. Dont let this happen to youmake sure your family knows about any insurance policies you have as well as how to locate the necessary paperwork.03 | PREPAID FUNERAL PLANSMany funeral homes let you pay for your funeral services in advance, either in a single lump sum or through installments. Also known as preneed plans, the funeral provider typically puts your money in a trust that pays out upon your death, or buys a burial insurance policy, with itself as the beneficiary.While prepaid plans may seem like a convenient way to cover your funeral expenses, these plans can have serious drawbacks. As mentioned earlier, if the funeral provider buys burial insurance, youre likely to see massive premiums compared to what the plan actually pays out. And if they use a trust, the plan might not actually cover the full cost of the funeral, leaving your family on the hook for the difference. Plus, most states have inadequate laws protecting funds in such plans, putting your money at risk if the funeral provider closes or is bought out by another company.In fact, these plans are considered so risky, the Funeral Consumers Alliance (FCA), a nonprofit industry watchdog group, advises against purchasing such plans. The only instancewhere prepaid plans are a good idea, according to the FCA, is if you are facing a Medicaid spend down before going into a nursing home. This is because prepaid funeral plans funded through irrevocable trusts are not considered a countable asset for Medicaid eligibility purposes.That said, if youre looking to buy a prepaid funeral plan in order to qualify for Medicaid, be sure to consult with us first, as not all pre-paid funeral plans are actually Medicaid compliant, even if the funeral home says they are. Moreover, if the irrevocable trust is not set up correctly, it may violate Medicaids look-back period, which can delay your eligibility for benefits.04 | PAYABLE-ON-DEATH ACCOUNTSMany banks offer payable-on-death (POD) accounts, sometimes called Totten Trusts, that you can set up to fund your funeral expenses. The accounts named beneficiary can only access the money upon your death, but you can deposit or withdraw money at any time.A POD account does not go through probate, so the beneficiary can access the money once your death certificate is issued. POD accounts are FDIC-insured, but such accounts are treated as countable assets by Medicaid, and the interest is subject to income tax.Another option is to simply open a joint savings account with the person handling your funeral expenses and give them rights of survivorship. However, this gives the person access to your money while youre alive too, which puts your money at risk if the person goes into debt or gets sued and their creditors come after your account to pay the other persons debt.Given this risk, we recommend you consider other options that will allow you to pay your funeral expenses, without leaving your finances vulnerable to another persons mistakes or poor money management.05 | LIVING TRUSTSWhen you work with us, you dont need to buy a pre-built trust from a funeral provider. Instead, we can create a customized living trust that allows you to control the funds until your death and name a successor trustee, who is legally bound to use the trust funds to pay for your funeral expenses exactly as the trust terms stipulate.Furthermore, you can change the terms of your living trust at any time, and you can even dissolve the trust if you need the money for other purposes. Alternatively, if you need an irrevocable trust to help qualify for Medicaid, we can create that type of trust as well, while ensuring the trust stays totally compliant with all of Medicaids requirements, so you dont run afoul of the programs many complex requirements.If you are interested in creating a trust to cover your funeral expenses, meet with us to discuss the options that are best suited for your intended purpose, budget, and family situation.USE ESTATE PLANNING TO AVOID BURDENING YOUR FAMILYAlthough thinking about your eventual death is never easy, with the proper planning, you can make dealing with the aftermath of your death significantly easier for the loved ones youleave behind. To avoid needlessly burdening your family with the expense and stress of planningand paying for your funeral, make sure your estate plan includes the necessary funds to cover this expense, and be sure to use an estate planning strategy that will allow your family to access these funds as quickly and easily as possibleideally by using an option that avoids probate. With so many different options to choose from, consult with us to find an estate planning vehicle that is best suited for your particular situation. With our guidance and support, we will develop a planning strategy that includes adequate funding to ensure your funeral services are handled in the exact manner you desireand your family wont be forced to foot the bill. Contact us today to learn more.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge.

If you're enrolled in a Medicare Advantage plan but would like to make a change, you can likely take advantage of the Medicare Advantage Open Enrollment Period. This Open Enrollment Period occurs each year between January 1 and March 31.What Is Medicare vs. Medicare Advantage?Medicare is a federal health insurance program designed for seniors aged 65 and older as well as people with qualifying disabilities.Medicare consists of several program offerings: Medicare A covers care in hospitals or similar institutions, like skilled nursing facilities. Medicare B focuses on coverage for outpatient medical care. (Together, Medicare Parts A and B are often referred to as traditional Medicare.)Medicare Part D, only available through private insurers, covers prescription medications.Medicare Advantage  also known as Medicare Part C is an alternative to traditional Medicare. These plans are available through private health insurers that contract with Medicare.What Does Medicare Advantage Cover?Medicare Part C, or Medicare Advantage, includes Medicare Parts A and B. Most Part C plans also include prescription drug coverage.Depending on the plan you choose, it may also cover such extras as certain dental services, gym memberships, or meal benefits. Costs will also depend on the plan you select.What You Can and Cant Do During Medicare Advantages Open Enrollment PeriodIf you're already enrolled in a Medicare Advantage plan, you can choose to take one of the following actions from January 1 to March 31:Change your current Medicare Advantage plan to a different Medicare Advantage planSwitch to traditional Medicare (with or without coverage for prescription drugs)You aren't required to make any changes during this open enrollment period. However, note that if you do, you can change plans only once during this timeframe.Meanwhile, you aren't permitted do the following between the January 1 and March 31 open enrollment period:Change from traditional Medicare to a Medicare Advantage planSwitch to a different prescription drug planDrop a Medicare Medical Savings Account planWhen Will My Plan Changes Go Into Effect?Changes you make during this January 1 to March 31 time period will go into effect on the first of the month after the plan you have chosen receives your enrollment information.Where Can I Get Assistance?Regardless of the time of year, you can seek out guidance from professionals via:Medicares toll-free number, 1-800-MEDICAREMedicares Plan Finder  This allows you to compare plans in terms of cost, coverage, providers, and more.Your local State Health Insurance Assistance Program (SHIP) SHIP counselors are trained to provide impartial information about Medicare.Learn MoreFor more information on Medicare Advantage, be sure to check out the following resources:Comparing Traditional Medicare and Medicare AdvantageWhat to Look for When Choosing a Medicare Advantage PlanConsider consulting with a qualified elder law attorney for additional guidance.

It's easy to burn out when you're responsible for providing full-time care to an aging or disabled loved one. In some cases, caregiver burnout can result in resentment toward the individual they care for, despite their love for them. The fact is, we all need a break sometimes. That is why respite care exists. If you're a caregiver who needs to take time for yourself, read more to learn about respite care.What Does Respite Mean?Taking respite means having a temporary period of rest. For primary caregivers, this typically refers to securing short-term care for your loved one even several weeks or months so that you can recharge amid the very real burdens of caregiving. In finding respite, you also might make time to practice self-care, from going to the gym to connecting with friends. Don't forget to find ways to maintain your sense of self while you're in the midst of giving so much of your time and attention to someone else.Caregivers Want Information About Respite Care In a 2022 survey of caregivers, Caregiving in America found that most were unaware that respite care was available. Many caregivers need more education about their options for respite care and how to build a network of support to share the load of providing financial and emotional support to an ailing loved one. Here are some of the studys findings:Fifty-nine percent of respondents reported that they were the primary emotional support system for a sick or impaired loved one.Twenty-two percent of respondents said they worked more than 40 hours per week as the primary caregiver to a disabled family member.Forty-eight percent of respondents disclosed they needed emotional support for themselves.Forty-four percent of respondents shared that they wanted information about where to find respite care.Caregivers need information about maintaining their own health while supporting a family member. It's essential to prioritize yourself when caring for an aging or disabled relative.Preventing Caregiver Fatigue The challenges of taking care of an ailing loved one can be extremely stressful. More than that, the strain of serving as a caregiver often unpaid can make a real and lasting impact on your own health if not kept in check.Symptoms of burnout among caregivers may include the following:Losing sleep and extreme fatigueFeeling hopelessHaving a quick temper Lack of interest in your favorite activitiesIf you or someone you know has taken on the responsibilities of caregiving, be aware of the signs of burnout and actively seek support. Respite care is among your potential options. (If you're caring for a loved one with dementia, you may also be interested in learning more about burnout and other specific kinds of resources available to you.)What Is Respite Care? Respite care gives caretakers a chance to relax and take a break from the responsibility of providing full-time care to loved ones who are aging or disabled. Respite programs offer short-term replacement care. These providers will step in for a short period to take on the responsibility of caring for your loved one. The types of care you can expect them to take on may include the following:Bathing and dressing Cooking and cleaning Helping your loved one eat, drink, and take their medication Getting into and out of bed Assistance with the restroom Spending quality time with your loved one Helping with exercise and personal care How Much Does Respite Care Services Cost? The cost of respite care varies depending on how long you use the service. You can schedule respite care for several days, weeks, months, or longer. Who Pays for Respite Care? Private insurance will typically not cover respite care, unfortunately. If your loved one is covered by Medicare or Medicaid, you may be able to secure five consecutive days of respite care. Your loved one must be receiving hospice care benefits for Medicare to cover respite care. Finding Respite CareSeveral organizations provide respite care. If your family member is covered by Medicaid, you can speak to a Medicaid planner in your state to determine what programs may be available. As mentioned above, Medicare covers respite care under its hospice benefit.If your loved one isn't covered by Medicare or Medicaid, dont worry; there are private organizations that provide this service. These organizations include: National Adult Day Services Association (NADSA)Your Area Agency on Aging (AAA)In addition, you may want to connect with a qualified elder law attorney in your area to talk through your options. A professional can help you how to pay for respite care, how your loved one might qualify for Medicaid, and more. Search online for an elder law attorney near you.

In creating an estate plan, you are proactively taking steps to ensure that your assets will be distributed according to your wishes in the wake of your death.One tool available to you in estate planning is known as a trust. There are numerous kinds of trusts. If you wish to maintain control, during your lifetime, over the assets you place in a trust, you may choose to establish a revocable, or living trust most likely, along with a pour over will.First, What Is a Living Trust?A living trust is a strategy in estate planning. When you create a living trust, you set certain assets aside within it. This might include things like a vacation home, a bank account, or an art collection.With a living trust, you have the flexibility to modify or dissolve it at any point in your life.How Do Living Trusts Work?When you place assets into this type of trust, you continue to have access to those assets. You can select a designated individual, called a trustee, who would serve as the manager of your living trust should you pass away or ever become unable to manage your affairs.For example, you may become incapable of handling your property, finances, and other aspects of your life if you fall ill, suffer from dementia, or endure an injury or accident that renders you unable to communicate. Should you die or become incapacitated, the trustee you have chosen manages the living trust on your behalf, following any terms you have outlined in the trust document.Assets in your living trust are distributed to your beneficiaries, according to your wishes typically without having to go through probate. This is often seen as one of the main advantages of a living trust.For one, depending on your state and the size of your estate, the probate process can last several months to a year or more.Avoiding probate also means that information about the distribution of your assets to your loved ones is kept private. This could be helpful if you have people in your life from whom you would prefer to shield the details of your estate, such as children from a previous marriage or estranged or combative family members. However, perhaps you acquired new assets, such as an investment property, a bank account, a car, or valuable furniture or jewelry, after setting up your living trust. You may not have transferred them just yet. This is where establishing what is known as a pour over will can be an important piece of your estate plan.What Is a Pour Over Will?A pour over will is a type of estate planning document. It works in concert with a living trust and goes into effect if you become incapacitated or pass away. In such a scenario, this document ensures that any assets you had not transferred to your existing living trust are directed (or poured over) to it.A pour over will ensures that your assets are ultimately passed on to your beneficiaries as you intended. In addition, information about the distribution of any of your remaining assets, once moved to your living trust, will be kept confidential as part of the trust.Note that laws can depend on the state, so it is important to consult with a qualified estate planner like Sharek Law Office when setting up any estate planning documents.Do Pour Over Wills Mean You Avoid Probate?Not necessarily; while the property controlled by a pour over will eventually goes to your living trust after your death, that does not mean your family avoids probate. Before your assets are owned by the trust, they may first need to pass through the probate process. The regulations can also vary according to the state; in some states, for example, if your probate property is valued below a specific threshold, it is possible it could pass through probate more quickly.If you want to avoid the probate process, you must ensure that your living trust has in it all of the assets that you wish to pass on to your beneficiaries. Essentially, a pour over will acts as a kind of backup.Seek the Advice of an AttorneyNote that laws governing trusts and estates can vary widely by state and can be complex. Living trusts and pour over wills are also not suitable for everyones situation. It is important to consult with a qualified estate planner when setting up any estate planning documents.Call Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call with our staff to discuss your needs today.  This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Retirement is an expensive affair, and planning for it involves managing finances even after you've left the workforce.It's commonly estimated you should have about 70 percent to 90 percent of your pre-retirement income to maintain the same living standard after you retire. A secure retirement means planning your finances efficiently, saving for the future, and paying debts.Though planning your finances and retirement savings is relatively easy while working, doing this while carrying a debt burden isn't. It's long been debated whether it's ideal to save for retirement or first pay off ones debts. Focusing exclusively on paying off debts can reduce your retirement savings, while saving alone won't prove fruitful if your debts have piled up. So whats the best approach?Generally, first pay down any high-interest debts you may have, then move on to a combination of debt repayment and saving strategy.Here are some types of debts and the best ways to get out of them before you retire:Consolidate your credit card debtWhile credit cards are an excellent financial tool, not being able to manage your balances can pose problems. Getting rid of these high-interest debts at the earliest opportunity should be your priority.Consolidating credit card debts can help you pay off your debt sooner and improve your financial situation. For instance, through a debt consolidation loan, you can merge several debt accounts into one which can mean not only a reduced interest rate, but also a lower monthly payment than the typical credit card.Once you have paid your credit card debt, avoid falling back into the red. Instead, target paying off other high-interest debt next.Explore the repayment plans for student loansHaving student loans is another big hurdle to retirement planning. Or, perhaps you're a co-signer on a student loan for a family member. Co-signing a loan can put you at financial risk and affects your credit score.The first step to clearing your student loans is to know exactly how much you owe. Then find out what repayment plans and options are available to you. There are several student loan repayment plan options, including standard repayment, income-driven repayment, and extended repayment. Keep in mind that you can pay more than the minimum payment to speed up the process and focus on retirement savings.Refinance your mortgage and car loansWhile mortgage and car loans are relatively low-interest loans, you still need to plan them practically. In the case of car loans, rethink whether you need more than one car. You may consider selling one off and using that money toward the loan and insurance of one car.With mortgage loans, consider two possibilities: Invest some money and use the returns toward paying off the loan. Or, refinance these loans for a lower interest rate and a shorter payoff term. This can lower your overall payment, which means you have more money on hand.Bottom lineIn addition to the above, it is advisable to avoid taking up any new debt as you near age 50. Once you prioritize your debt, getting out of it shouldnt be a hurdle for long.

Physical therapy helps elders recover from injuries and illnesses, manage chronic conditions, and prevent future injuries. It can be an essential component of health care for older adults.Medicare covers physical therapy (PT) when it is medically necessary to treat a disease or injury, according to Medicare.gov. Those who qualify for Medicare because of age or disability could receive covered physical therapy services.What Is Physical Therapy?Physical therapy helps people improve their balance, movement, muscle strength, joint mobility, and overall health. Highly trained professionals specializing in activity and exercise prescribe exercises to help patients enhance their physical capabilities and control pain. Older adults can require physical therapy for several reasons. Following a health incident, such as a neurological event, surgery, or a fall, physical therapy can help a patient restore mobility. For instance, a physical therapist could help a stroke patient regain movement. WebMD reports that physical therapists can also help older adults with such conditions as osteoporosis, balance problems, certain cancers, and incontinence. PT helps people recover from injuries and manage chronic conditions, while also reducing the risk of future injuries. In addition, it may help prevent injuries and mitigate functional declines associated with aging, according to the National Council on Aging.The Benefits of Physical TherapyIn treating and preventing injuries, physical therapy can benefit many older adults, as it helps restore and maintain physical health. PT may:Reduce pain. After undergoing treatment, you may need less pain medication. Research shows that physical therapy significantly reduces patients long-term opioid use. Expedite recovery. According to Medicare.org, physical therapy can speed up recovery following an injury or surgical procedure. It can also reduce the need for future surgeries. Preserve your autonomy. Physical therapists can help seniors to maintain their independence. With physical therapy, older adults may continue to perform activities of daily living on their own, like showering, using the toilet, and dressing.Improve mobility. Per St. Lukes Health, PT can help older adults can continue to move around without a cane or walker. For people with Parkinsons, prescribed PT exercises can help increase mobility as well. As John Hopkins Medicine reports, physical therapists can help patients reinforce movements that the disease affects. Lower your risk of falling. Seniors can reduce their risks of falls with PT. According to the Centers for Disease Control and Prevention, one in four Americans over 65 suffers a fall every year. Improving flexibility, strength, and balance can help older adults avoid falls. When Does Medicare Pay for Physical Therapy?Given the benefits of physical therapy, Medicare recipients might seek services to treat injuries, manage chronic conditions, and maintain physical health. Medicare helps cover the cost of PT in certain circumstances. A doctor or another health care provider, such as a nurse practitioner, clinical nurse specialist, or physician assistant, must certify that the patient needs physical therapy. Qualifying beneficiaries can get covered PT services via Medicare Part A or Part B.Part A covers physical therapy in inpatient facilities, such as hospitals, skilled nursing facilities, and rehabilitation centers, according to AARP.org. For homebound individuals eligible for home health benefits, Part A covers in-home PT, where a therapist visits the patient at their residence. Out-of-pocket costs depend on where the patient receives services. Outpatient physical therapy services fall under Part B.This includes PT in any of the following:a doctor or therapists officea hospital outpatient departmenta skilled nursing facility providing outpatient careMedicare Part B also covers in-home PT when an individual doesn't receive Part A home health benefits.Once individuals pay the Part B deductible, which is $226 in 2023, Medicare covers outpatient PT. When coverage kicks in, beneficiaries are responsible for 20 percent of the Medicare-approved payment. This may include outpatient occupational therapy, physical therapy, and speech-language pathology. Be sure to ask your health care provider any questions you may have about coverage for PT services or related tests. Speak with an elder law attorney in your area as well to learn more about Medicare.

Safe housing that meets older adults needs is essential to healthy aging in communities. Many seniors with low, fixed incomes struggle to balance housing expenses with the costs of health care, transportation, and groceries.Finding inexpensive, safe, and accessible housing can be challenging. However, several affordable housing options are available for older people with low incomes.Section 202 Supportive Housing for the ElderlyThe Section 202 Supportive Housing for the Elderly Program provides affordable housing and supportive services for older people with limited means. Through this program, seniors can maintain independence while receiving benefits such as transportation and assistance with activities of daily living (ADLs). The support allows them to continue living independently.The United States Department of Housing and Urban Development (HUD) requires Section 202 facility owners to maintain the buildings and regularly inspect them to ensure the tenants have a safe environment. Rent typically comprises 30 percent of the tenants income.Older adults who meet specific thresholds may enroll in Section 202 Supportive Housing for the Elderly Program.The head of the household must be 62 years old or older.There are also income requirements, which vary depending on location. Seniors must meet HUDs income limits criteria. Generally, it is less than 50 percent or less of the areas median family income.The program has several benefits for those who qualify:Low housing costs provide peace of mind and stability.Units designed for older adults are more accessible, including features such as wheelchair ramps, wider doors, and bathroom grab bars.Senior communities ease loneliness and foster social connections.Housing VouchersHousing vouchers are another option for seniors. Local housing agencies provide housing vouchers to low-income households that help cover rent. These vouchers are available to families living below 50-80% of the poverty level. Dwellings must satisfy housing quality standards and owners must maintain the units.While families can obtain vouchers regardless of age, elders and those with disabilities can receive an additional deduction.Although housing vouchers can help some older adults and their families, limited availability and long waiting lists characterize housing voucher programs. Per the Center on Budget and Policy Priorities, only one in four qualifying households receive vouchers.Home SharingHome-sharing programs can help older adults living alone stay in their homes while providing an affordable housing option for older adults. In addition to helping with costs, home-sharing can prevent loneliness, particularly benefiting older adults whose spouses have passed or children have moved away.Through Senior Homeshares, older adults with homes can find housemates who are also elderly, helping to lessen the cost of living. The service pairs older adults with spare rooms in their homes with those on fixed incomes searching for safe, affordable housing.Additional OptionsMost affordable housing programs, such as Section 202 and housing vouchers, have waiting lists as demand exceeds availability. Additional options exist for older adults who need more immediate help with housing costs.Older adults who own their homes can apply for a reverse mortgage, allowing them to continue living at home. Reverse mortgages draw upon existing equity in a home to supply regular payments, which can supplement retirement income. The federal government insures the Home Equity Conversion Mortgage (HECM).For those with health care needs who have very low incomes and few assets, Medicaid could cover the cost of nursing home care.Medicare pays for certain in-home health services for homebound older adults. Although Medicare does not cover rent or mortgage payments, in-home care covered by Medicare can lessen total expenses.Individuals might consider moving in with family or friends to share living expenses and benefit from support.For older adults struggling to afford housing costs, several options exist. The best choice depends on your unique circumstances. For assistance obtaining more affordable housing as you age, call Sharek Law Office at 412-347-1731 or click here to schedule your free 15-minute phone call consultation. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

It has been a tumultuous few years. Amid a continuing pandemic, tense midterm elections, and a war in Ukraine, we have grappled with more than our fair share of grim news. However, with the new year upon us, there are some silver linings in particular for seniors. Here are five reasons for seniors to celebrate in 2023:1. Social Security Benefits Are Seeing the Biggest Increase in 40 Years.Social Security beneficiaries will find that their monthly checks are increasing by nearly 9 percent, come January 2023. This cost-of-living adjustment (COLA) is the largest boost to Social Security benefits in more than four decades.For more than 65 million individuals currently receiving these benefits, payments will rise by about $140 on average per month.If you're a Social Security beneficiary, you can get an estimate of how much more you'll be receiving in 2023 by using the online My Social Security portal on the Social Security Administration website. 2. Medicare Part B Premiums Are Lower.For the first time in more than 10 years, Medicare Part B enrollees will see some of their costs decline.The Centers for Medicare and Medicaid (CMS) announced that the following will take effect in 2023:The Medicare Part B basic monthly premium is decreasing by $5.20 per month (savings of $62 for the year).The Medicare Part B annual deductible is decreasing by $7 per month (savings of $84 for the year).Note that beneficiaries with higher incomes pay higher monthly premiums. Read more in the news release from CMS.3. You Can Contribute More Than Ever to Retirement.The IRS is allowing record increases in 2023 for contributions to 401(k)s, Roth IRAs, and traditional IRAs.If you're working and have a 401(k), 403(b), or 457 plan, you can contribute up to $22,500 to that account in 2023. Working individuals who are 50 years and older can contribute another $7,500.If you have a Roth IRA or IRA, you can now contribute $6,500 in 2023 (up from $6,000 in 2022).4. You Dont Have to Wait Months for Medicare Part B Coverage to Begin.A new rule is also setting seniors up with improved access to health care coverage. In the past, if you waited until the last three months of your Initial Enrollment Period (IEP) to enroll in Medicare, you would have to wait another two to three months before your coverage began.As of January 1, 2023, if you enroll in Medicare during the last three months of your IEP, your Medicare Part B coverage will begin on the first day of the month after you sign up. You won't have to wait several months to receive benefits.If you sign up for Medicare during the General Enrollment Period, which runs from January 1 to March 31, you used to face a coverage gap. Coverage did not begin until July 1. Starting in 2023, your coverage will start the first day of the month after you enroll.5. SSI and SSDI Benefits Are Also Seeing a Boost.If you're a beneficiary of Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), you'll see modest increases in your monthly benefits payouts before the new year. Beginning on December 30, 2022, SSI individual recipients will receive $73 more a month. Couples will receive $110 more in SSI benefits per month.Meanwhile, SSDI benefits will see a monthly increase of about $119 more on average for those who are not blind. Access a comprehensive list of all 2023 Social Security changes in PDF format. 

Hospice care is a type of health care that patients with terminally ill conditions rely on at the end of their lives. This type of care focuses on pain management and emotional, spiritual, and familial support for patients nearing the end of their lives.There are several options for receiving hospice care, including being cared for at home. The type of intimate care a patient receives while in hospice is more conducive to being received at the patients home. This becomes a team effort, and it helps to have a peaceful environment when receiving care.Patients with serious illnesses like cancer, heart disease, dementia, kidney failure, or other fatal conditions benefit from hospice care. This type of care can help the patient live a more comfortable life while decreasing the emotional burden of grief for families by preparing them for the loss of their loved one.When Is Hospice Recommended?Hospice care should not only be considered by those who have loved ones nearing the end of their lives. While most of these services are generally reserved for people with six months or less to live, early hospice care can be beneficial for patients and their families as well.You may wish to consider such services in the following cases:The patient has a serious decline in their physical well-being.After a diagnosis of Alzheimers disease or dementia.You have decided to forgo any treatment to improve your physical treatment or care for your illness.Who Makes Up a Hospice Care Team?Your hospice team can consist of many different types of people. Various professionals and volunteers may be involved in end-of-life care. Some of those you may see on your care team can include:DoctorsNursesSocial WorkersDeath DoulasSpiritual AdvisorsTrained VolunteersWho Pays for Hospice Home Care?Like any other health care option, these services can quickly become very expensive. Fortunately, there are several ways to cover the cost, including:Government ProgramsIf you qualify for government assistance, there may be insurance plans specifically designed to cover the cost of hospice care.Seniors enrolled in Medicare Part A may qualify for a Medicare hospice care benefit. This benefit program allocates money to pay for such care at home. For terminally ill patients on Medicaid, hospice care may be covered depending on the state. The Department of Veterans Affairs may also provide coverage for these care benefits for seniors who have served our country.Private InsuranceCheck the terms of your insurance policy to determine if your health insurance covers hospice care. Your policy may cover all or part of your hospice care needs.Options for Uninsured PatientsEven if you do not have health insurance, you may still have coverage options. There are charitable organizations that work with elderly and disabled individuals who need help paying for hospice care services. Hospice care organizations also often have internal departments that work with patients who qualify for this type of care but are indigent or do not have health insurance.Is In-Home Hospice Right For You?Making this choice is an important part of your end-of-life care plan. Be sure to gather as much information as you can before deciding whether this type o care is best for you. For example, you may want to consult Medicares hospice compare website or CaringInfo.orgs website for other hospice locator tools.If you have questions about Medicare or Medicaid, schedule your free 15-minute introductory call with Sharek Law to discuss options available for your family to learn more.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Talking about estate planning is a difficult, emotional topic but its essential for every family.Unless youre certain your parents have an up-to-date will and a wider plan for what should happen in the event of their passing, you shouldnt assume everything will be taken care of.According to a 2017 survey, less than half of Americans have a will. If your mother or father dies intestate meaning without a will such a situation could lead to added emotional strain and stress. And it could have financial implications for all their children and/or other family members.The following eight tips can help you discuss the hard topics thoroughly and respectfully and prepare you for the road ahead.1. Plan What You CanDiscussing estate planning and all it entails isn't something that should happen without any planning. Make a list of topics and questions, then let your parents know what you want to chat about with them.If possible, set a time and date and choose a private venue that everyone will feel comfortable in. Be aware that you may need to schedule a few conversations as there could be too much to cover in one sitting. Remember to use language thats respectful and supportive, and to take a breather if emotions run high or the stress becomes overwhelming.2. Identify Key PeopleThere are several key people you may need to contact for estate planning purposes. Ask your parents for the names and contact details of their:DoctorsAttorneyFinancial planner and/or accountantInsurance brokersMinister of religionClosest friends3. Address the Topic of a WillDetermine whether there is an existing will in place and whether the document is up to date. If a will was created more than five years ago, check to see if theyd consider reviewing it to ensure its a true reflection of their wishes. Establish where they keep the document and confirm who theyve appointed as the executor/s. The same goes for any trust that may have been created.4. Talk About Power of AttorneyFind out whether your parents have appointed someone to manage their financial and other affairs if they become incapacitated. If they havent given someone power of attorney, suggest they consider doing so.5. Discuss End-of-Life WishesEven though the subject may be uncomfortable to talk about, you should discuss your parents end-of-life wishes with them. Their estate plan will be incomplete without these directives, so its important to include them. The form those directives take depend on the state in which you live, and they may include:The appointment of a health care proxy who can make medical decisions for your parents if they become incapable of making those decisions themselves. You can obtain the relevant forms from an elder law attorney or from a hospital or nursing home.A medical advance directive that explains what sort of care they would like and whether life support should be used to keep them alive or not. These directives can be included in the document that appoints the health care proxy. The directive must refer to the Health Insurance Portability and Accountability Act (HIPAA) when naming the proxy.A living will contains instructions regarding the withdrawal or termination of life support under specific conditions, such as your parents becoming terminally ill, becoming comatose, or entering a vegetative state.Physician Orders for Life-Sustaining Treatment (POLST), which provides more explicit directives regarding the type of treatment your parents would or wouldnt want.6. Ask About Insurance PoliciesTalk about the type of insurance policies in place. That includes:Health insurance Medicare or privateLife insuranceHome insuranceLong-term care insuranceDisability insuranceIn some cases, there may be seniors funeral insurance or other policies intended to cover funeral or burial payments. Youll need to know about these too and have all their details.If you havent already done so, take note of the names and contact details of the insurance brokers. Check where the policy documents are kept, and if possible, make certified copies of them.7. Request Access to Tax ReturnsIt can be helpful to know where tax return paperwork is stored. While these documents may not be necessary after death, they could be required if the estate becomes complicated. Confirm where you can find these documents and that theyre all up to date.8. Discuss All Other PracticalitiesIn addition to subjects such as power of attorney and insurance, there are several other practicalities you should include in your conversations.Make a list of their accounts financial accounts such as bank and mutual fund, credit accounts, and store accounts.Check if they are registered organ donors or whether they would consider donating their organsTalk about the memorial service they want and whether they want to be buried, cremated, or some other option.ConclusionEstate planning conversations are tough no matter how you tackle them. Try your best to be patient with your parents and transparent with other family members about what youre doing. If you have siblings, invite them to be part of the conversation.Accept that these talks can take time and avoid placing pressure on those involved to get it all done in a few hours. The smaller details are critical and should not be rushed. Lastly, always consult with us if youre unsure about the legal aspects or implications of any of the points mentioned above.

The Centers for Medicare & Medicaid Services (CMS) has released the 2023 federal guidelines for how much money the spouses of institutionalized Medicaid recipients may keep, as well as related Medicaid figures.What Are Spousal Impoverishment Rules?Spousal impoverishment is a concern for older couples when there is one spouse who requires long-term care and applies for Medicaid. Before the federal government enacted spousal impoverishment protections, many healthy spouses faced poverty when their partners needed long-term care. The spousal impoverishment rules are based on the idea that spouses will provide for each other.Community Spouse Resource AllowanceIn 2023, the spouse of a Medicaid recipient living in a nursing home (called the community spouse) may keep as much as $148,620 without jeopardizing the Medicaid eligibility of the spouse who is receiving long-term care. Known as the community spouse resource allowance (CSRA), this is the most that a state may allow a community spouse to retain without a hearing or a court order. While some states set a lower maximum, the least that a state may allow a community spouse to retain in 2023 will be $29,724.Monthly Maintenance Needs AllowanceMeanwhile, the maximum monthly maintenance needs allowance (MMMNA) for 2023 will be $3,715.50. This is the most in monthly income that a community spouse is allowed to have if their own income is not enough to live on and they must take some or all of the institutionalized spouse's income. The minimum monthly maintenance needs allowance for the lower 48 states will be $2,288.75 ($2,861.25 for Alaska and $2,632.50 for Hawaii) until July 1, 2023.In determining how much income a particular community spouse is allowed to retain, states must abide by this upper and lower range. Bear in mind that these figures apply only if the community spouse needs to take income from the institutionalized spouse. According to Medicaid law, the community spouse may keep all their own income, even if it exceeds the maximum monthly maintenance needs allowance.The new spousal impoverishment numbers (except for the minimum monthly maintenance needs allowance) take effect on January 1, 2023.Home Equity LimitsIn 2023, a Medicaid applicants principal residence will not be counted as an asset by Medicaid if the applicant's equity interest in the home is less than $688,000. States have the option of raising this limit to $1,033,000.

Yuletide is just around the corner. They say its the most wonderful time of the year. However, you should take care of yourself during the holiday, especially if you're a senior. Proper nutrition is key to maintaining good health. This is especially true during the holiday when there are many temptations to indulge in unhealthy foods and drinks. Fret not. Here you will find some healthy holiday nutrition tips for seniors. Keep reading to see how you can enjoy the season while promoting good health and overall well-being.How Older People Can Stay Healthy During the HolidayHolidays could mean devouring processed foods and drinking carbonated and alcoholic beverages. The temptation to indulge is strong, but doing so can lead to weight gain and other health problems. That said, seniors should maintain healthy eating habits, whether at home or in an assisted living facility. Follow these five nutrition tips to enjoy the season without compromising health:1. Eat healthy foodsProper nutrition begins with a balanced diet vital during the holiday season. It means eating healthy foods from all the different food groups. The World Health Organization (WHO) recommends maintaining a healthy diet for proper nutrition by eating:Whole fruits and green, leafy vegetablesFoods from animal sources (lean meat, fish, eggs, and milk)Staples like cereals or starchy tubersLegumes (lentils and beans)Rich in nutrients, fruits, vegetables, and lean proteins can help you feel fuller for longer, reducing the temptation to snack on unhealthy foods. 2. Always stay hydratedHydration is vital for overall health, and seniors are particularly vulnerable to dehydration. Make sure to drink plenty of water throughout the day. Likewise, avoid sugary and alcoholic beverages, which further contribute to dehydration. According to the Mayo Clinic Organization, your daily fluid intake (DFI) should be:3.7 liters for men (15.5 cups)2.7 liters for women (11.5 cups)Drinking plenty of water keeps you feeling full and prevents you from overeating. It also helps flush out all the toxins in your body, so make sure to meet the required DFI every day. Consider keeping a water bottle on hand to ensure staying hydrated is even more convenient.3. Limit salt, sugar, and fat intakeAnother vital tip is to watch your intake of salty, sugary, and high-fat foods. They're often abundant during the holiday season, which can be very tempting. Try to limit your intake of these high-calorie choices and look for low-sugar, low-salt, and low-fat options. Be mindful of the number of these ingredients in the foods and drinks you consume. Choose healthier options, such as fruits, vegetables, and lean proteins.For your reference, take the WHOs health recommendations on this:Limit added sugar to less than 10 percent of your total energy intake. (Energy intake refers to calories, which should be balanced with energy use.) Less than 5 percent proves extremely beneficial to ones health.Keep the salt that you add to your food at less than 5 grams per day. On nutrition labels, look for a sodium count of less than 2 grams.Reduce your total fat intake to less than 30 percent of the total energy intake. Reduce saturated fats to less than 10 percent, and trans-fats to less than 1 percent. Better yet, replace both saturated fats and trans-fats with unsaturated fats.4. Resort to portion controlOvereating is prevalent during the holiday season. It can be easy to overindulge, especially when surrounded by delicious foods. So, in addition to eating a balanced diet, pay attention to portion sizes.To avoid consuming too many calories, consider using smaller plates. Those who use smaller ones will likely eat less than those with larger ones. You can also try filling half your plate with fruits and vegetables and the other half with lean proteins and whole grains. According to Nancy Mitchell, RN at Assisted Living, portion control is an effective way to maintain a healthy weight. We're wary of what we put on our patients plates, she says. Not only do we use smaller plates, but we also track their food consumption. We want to ensure our residents avoid consuming too many calories and increasing their risk of chronic diseases.5. Stay physically activeThis part is a bonus because physical activity isnt necessarily a nutrition tip. However, it indirectly affects seniors nutrition and overall health. You'll probably eat and drink more during the holiday. So, being physically active during this time of the year is even more necessary.Incorporate physical activity into your daily routine. Of course, you dont necessarily have to hit the gym or attend a dance class. Whether it is doing household chores or taking brisk walks around the neighborhood, any form of physical activity will do.The Bottom LineThe holidays can be challenging when it comes to maintaining a healthy diet. This is especially true for seniors, who should be wary of what to eat and drink.That said, follow the healthy holiday nutrition tips discussed above:Eat a balanced dietDrink plenty of waterRestrict your salt, sugar, and fat consumptionRegulate your portion sizesEngage in a regular physical activityWith deliberate planning and conscious effort, it's possible to have a happy and healthy holiday season.

In November 2022, the Centers for Medicare and Medicaid Services (CMS) announced that Medicare coverage will be expanded to include medically necessary dental services. This change in Medicare rules will allow people with life-threatening conditions to receive dental care and operations related to conditions approved by CMS. The provisions in the final rule become effective on January 1, 2023. What Makes Dental Care Medically Necessary? The final rule expanded the definition of medically necessary. Medicaid currently defines medically necessary as health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine.When it goes into effect, the final rule will include dental care in the definition of medically necessary care.The final rule also expanded the definition of physician to include dentists and oral surgeons. What Dental Care Is Included in the Final Rule? The types of dental care and procedures covered will be limited to patients who: 1.       Have a jaw fracture and need their teeth stabilized or immobilized. 2.       Need a tumor surgically removed, and ridge reconstruction must be performed to remove the tumor. 3.       Have a neoplastic disease, and teeth extraction is necessary to prepare the jaw for radiation. 4.       Have certain heart diseases and need to receive examinations and treatment before receiving cardiac valve replacement, organ transplant procedures, or valvuloplasty. 5.       Need dental splints (only if they get this treatment in connection with a medically necessary treatment). In addition to the above services, Medicare coverage will be applied to other necessary medical care, including: AnesthesiaX-raysThe use of an operating room to perform dental services Expanded Dental Coverage Does Not Apply to Patients With Diabetes Neither the final rule nor the interim rule expanded dental coverage for diabetes patients. The final rule does not cover normal dental examinations for diabetic patients, despite the importance of regular dental checkups for this population. However, coverage could expand over the next several years.The Effect of Having Dental Coverage on Medicare RecipientsThe expansion of Medicare dental coverage will have a positive impact on some seniors, while others will not receive any benefit. Because of the language included in the final rule, some seniors will receive savings for dental care if dental work is required to treat qualifying medical conditions. Seniors who do not qualify for the expanded dental care coverage in the final rule are still required to pay a fee for services not covered by Medicare. Patients with diabetes can expect to continue to pay for dental examinations and surgeries out-of-pocket if Medicare does not cover the procedure. The Future of Expanded Coverage for Medicare RecipientsSeniors enrolled in Medicare can expect more changes to coverage in the future. CMS announced its intention to complete an annual review of covered services, as well as possibly expand the definition of medically necessary and include more services for dental care.

Hospice care is a type of health care that patients with terminally ill conditions rely on at the end of their lives. This type of care focuses on pain management and emotional, spiritual, and familial support for patients nearing the end of their lives. There are several options for receiving hospice care, including being cared for at home. The type of intimate care a patient receives while in hospice is more conducive to being received at the patients home. This becomes a team effort, and it helps to have a peaceful environment when receiving care. Who Can Benefit From This Type of Care? Patients with serious illnesses like cancer, heart disease, dementia, kidney failure, or other fatal conditions benefit from hospice care. This type of care can help the patient live a more comfortable life while decreasing the emotional burden of grief for families by preparing them for the loss of their loved one. When Is Hospice Recommended? Hospice care shouldn't only be considered by those who have loved ones nearing the end of their lives. While most of these services are generally reserved for people with six months or less to live, early hospice care can be beneficial for patients and their families as well. You may wish to consider such services in the following cases: The patient has a serious decline in their physical well-beingAfter a diagnosis of Alzheimers disease or dementiaYou have decided to forgo any treatment to improve your physical treatment or care for your illnessWho Makes Up a Hospice Care Team? Your hospice team can consist of many different types of people. Various professionals and volunteers may be involved in end-of-life care. Some of those you may see on your care team can include:DoctorsNursesSocial workersSpiritual advisors Trained volunteers Who Pays for Hospice Home Care?Like any other health care option, these services can quickly become very expensive. Fortunately, there are several ways to cover the cost, including: Government ProgramsIf you qualify for government assistance, there may be insurance plans specifically designed to cover the cost of hospice care. Seniors enrolled in Medicare Part A may qualify for a Medicare hospice care benefit. This benefit program allocates money to pay for such care at home. For terminally ill patients on Medicaid, hospice care may be covered depending on the state.  The Department of Veterans Affairs may also provide coverage for these care benefits for seniors who have served our country. Private InsuranceCheck the terms of your insurance policy to determine if your health insurance covers hospice care. Your policy may cover all or part of your hospice care needs. Options for Uninsured PatientsEven if you don't have health insurance, you may still have coverage options. There are charitable organizations that work with elderly and disabled individuals who need help paying for hospice care services. Hospice care organizations also often have internal departments that work with patients who qualify for this type of care but are indigent or don't have health insurance. Is In-Home Hospice Right For You? Making this choice is an important part of your end-of-life care plan. Be sure to gather as much information as you can before deciding whether this type of care is best for you. For example, you may want to consult Medicare's hospice compare website or CaringInfo.orgs website for other hospice locator tools. If you have questions about Medicare or Medicaid, contact a qualified elder law attorney in your area to learn more.

A newly released study finds that seniors who get less than five hours of sleep a night may be at higher risk for chronic diseases. More than 7,000 midlife and senior men and women were part of the study on sleep duration over the course of 25 years.In high-income countries today, the researchers cite, more than half of seniors have been diagnosed with at least two chronic diseases. Having two or more chronic conditions at the same time, such as diabetes, dementia, cancer, or heart failure, is known as multimorbidity. Higher multimorbidity, in turn, can reduce quality of life, put more pressure on the health care system, increase the need for prescription medications, and lower work productivity.Study participants who reported sleeping less than five hours a night compared with individuals who slept seven hours per night were at consistently greater risk of developing more than one chronic disease. For example, people aged 50 who slept five or fewer hours a night were 20 percent more likely to receive one chronic disease diagnosis. Worse still, individuals in this age range were 40 percent more likely to develop two or more chronic diseases.Not getting enough sleep may negatively impact ones metabolic processes, level of inflammation, and circadian rhythm, the researchers suggest.

A health savings account may help you save money on medical expenses, depending on your insurance type. If you're eligible, you can use your health savings account (HSA) to cover certain medical costs, according to HealthCare.gov.How Does an HSA Work?If you have a high deductible health plan, you can contribute to an HSA and use the untaxed money to cover medical costs, decreasing your total medical expenses. High deductible health plans typically have lower monthly premiums than other insurance plans. However, individuals may pay more for medical services before coverage starts, per HealthCare.gov. What Do Health Savings Accounts Cover?You can use an HSA to pay for deductibles, copayments, and coinsurance. Examples of typical expenses for which you can use a health savings account include: AcupunctureAmbulance costsDoctor visits Hearing aidsMedications Psychiatric care and psychological therapyCertain long-term care services However, you generally cannot use money from an HSA for monthly insurance premiums, unless you receive Medicare, health care continuation coverage, or unemployment compensation. For long-term care insurance, you may be able to pay your premiums through a health savings account. The Benefits of Health Savings AccountsThe advantage of using a health savings account is that funds aren't subject to federal taxes when you contribute or withdraw money to pay for qualified medical expenses. You can also earn tax-free interest. Should you have money left over in your account at the end of the year, it rolls over. The funds stay active, remaining in your account until you need them. Even if you change jobs or retire, you can keep your HSA. In some cases, you can use your health savings account to cover your spouses and dependents medical expenses, even if they aren't on your plan. Health Savings Account Rules2023 Contribution Amounts The Internal Revenue Service sets contribution limits on HSAs. For 2023, individuals can contribute up to $3,850, and families can put up to $7,300 into a health savings account, Investopedia reports. People who are 55 and older by the end of the tax year can make an additional $1,000 catch-up contribution. Other Insurance TypesOther insurance plans can disqualify you from contributing funds to an HSA. Individuals with dollar-first insurance plans in which the insurer takes care of its share of an included service before the insured individual pays deductibles or copayments cannot put funds into a health savings account for their outstanding health care fees. Those on Medicare cannot add money to health savings accounts, though they can withdraw capital from their accounts to pay medical expenses that Medicare doesn't cover. While people using health savings accounts typically cannot use the funds to cover monthly premiums, there is an exception for Medicare beneficiaries.Penalties Although health savings accounts have several advantages, they also impose restrictions on how you use your money. Taking money from your account for nonmedical or unqualified expenses before you reach 65 results in a 20 percent tax penalty. The 20 percent tax penalty for ineligible withdrawals doesn't apply if you're 65 and older. Still, you must pay income tax. Opening a Health Savings Account There are several ways to open an HSA. Employers can offer them, with the employer and the employee jointly funding the account. Some health insurance companies provide health savings accounts with high deductible health plans. Banks and financial institutions offer accounts for individuals. How Does Medicare Affect Your Health Savings Account? When you enroll in Medicare, you can no longer contribute pre-tax dollars to your health savings account. To put untaxed money in an HSA, you must have high deductible health insurance without additional disqualifying coverage, such as Medicare. Once you have Medicare, you can no longer add tax-free funds to your account. After you enroll in Medicare, however, you can still access your health savings account. One of the advantages of health savings accounts is that they're vested. As a Medicare beneficiary, you can continue using untaxed funds to cover the medical expenses your insurance doesn't bear, such as deductibles, coinsurance, and copayments. You cannot, however, use tax-free money to pay for Medicare supplemental insurance. While the Internal Revenue Service (IRS) prohibits people from using untaxed capital for high deductible health insurance plan premiums, the rule differs for Medicare. When you enroll, you can use your HSA to pay your Medicare premiums without taxes.Withdrawing Money From Your HSA People over 65 can withdraw funds from their health savings accounts for nonmedical expenses. Although these withdrawals are no longer tax-free, older adults don't incur the 20 percent tax penalty the IRS imposes on younger people taking funds HSAs for ineligible expenses. Since medical costs tend to increase with age, many prefer to keep their money in their health savings accounts to cover eligible medical expenses tax-free. Delaying Medicare Enrollment Some people with health savings accounts enroll in Medicare when they initially become eligible, forfeiting the ability to make HSA deposits for Medicares coverage. Others delay enrollment in order to continue making health savings account contributions.According to the Journal of Accountancy, only individuals with employer-sponsored high deductible health insurance as their primary coverage can continue adding to their health savings accounts past retirement age by delaying Medicare enrollment.Individuals with private insurance, continuation of health coverage (COBRA), or a health care exchange cannot fund their HSAs after reaching retirement age. People who continue to work at small companies after becoming eligible for Medicare must enroll in the program immediately to have any health insurance coverage.Per MedicareInteractive.org, Medicare must be the primary insurance for those working at companies with fewer than 20 employees. Since the small employers health plan doesn't have to pay until after Medicare contributes, these individuals risk losing health coverage if they delay enrolling in Medicare. Deferment also results in a late penalty. Those with health insurance from businesses with 20 or more employees can put off Medicare enrollment and continue placing funds into their health savings accounts. Because the company insurance would remain the primary insurer when they join Medicare, they can continue receiving health insurance coverage without Medicare. Individuals who wish to delay enrolling in Medicare shouldn't accept Social Security payments. This is because Social Security automatically registers beneficiaries for Medicare Part A, rendering them unable to make HSA deposits. Medicare and the IRS recommend that people who have delayed enrollment after becoming eligible should cease health savings account contributions six months before joining Medicare to avoid a tax penalty. A six-month lookback period applies, as Medicares coverage is retroactive.If you have an HSA, whether you should delay Medicare enrollment depends on your situation. The decision could significantly impact your finances. Speak to us to learn more about your options for your health savings account as you approach retirement age.

It's a very good idea to create advance directives in order to plan for the possibility that you may one day be unable to make your own medical decisions. In doing so, there can be confusion about the difference between a living will and a "do-not-resuscitate" order (DNR). While both these documents are advance medical directives, they serve different purposes.A living will is a document that you can use to give instructions regarding treatment if you become terminally ill or are in a persistent vegetative state and unable to communicate your instructions. The living will states under what conditions life-sustaining treatment should be terminated. If you would like to avoid life-sustaining treatment when it would be hopeless, you need a living will. A living will takes effect only when you're incapacitated and is not set in stone -- you can always revoke it at a later date if you wish to do so.When drawing up a living will, you need to consider the various care options and what you would like done. You need to think about whether you want care to extend your life no matter what or only in certain circumstances. A living will can dictate when you want a ventilator, dialysis, tube feeding, blood transfusions, and other life- saving or life-prolonging options. A DNR is a different document. A DNR says that if your heart stops or you stop breathing, medical professionals should not attempt to revive you. This is very different from a living will, which only goes into effect if you are unable to communicate your wishes for care. Everyone can benefit from a living will, while DNRs are only for very elderly and/or frail patients for whom it wouldn't make sense to administer CPR.In addition to a living will, you will also need a health care proxy or broader medical directive. 

Medicare is federal health insurance for people over 65, some younger people with disabilities, and those with end-stage renal disease. Coverage of housekeeping services under Medicare can depend on several factors.Is There Coverage for Housekeeping Under Original Medicare?Medicare is comprised of Part A and Part B coverage. It is often referred to as original Medicare.Part A is free for most people and covers a certain number of days related to hospital inpatient stays, care in a skilled nursing facility, hospice care, and some home health care. Part B covers doctors services, outpatient care, medical supplies, and preventive services. There is a monthly premium for Part B Medicare, plus cost sharing of any care received pursuant to Part A or B.Original Medicare doesn't generally cover housekeeping services. Original Medicare labels these services as homemaker services, which also include shopping, cleaning, and laundry. If you cannot clean your home for medical reasons, then these costs would be out of pocket. Does Medicare Advantage Pay for Housekeeping Services?However, some Medicare Advantage plans may cover cleaning services. A Medicare Advantage Plan also commonly referred to as Medicare Part C  is another way to get your Medicare coverage, except through a private insurance company. Many Medicare Advantage plans will cover things original Medicare may not cover and provide additional benefits. However, these companies must follow the rules set by Medicare.Medicare now allows these private insurers to pay for some limited housecleaning if it is linked to a specific health issue. For example, if you suffer from asthma or breathing conditions, these plans may cover filtration or air cleaners, periodic washing of linens, vacuuming and carpet cleaning, and other similar services. If you suffer from an immune deficiency condition, it may be possible to get coverage for periodic disinfectant cleaning services. However, ongoing or regular services aren't likely to be covered.A seniors eligibility for Medicare Advantage plan options will depend on what plan options are offered in their area. For more information on Medicare coverage, reach out to an elder law attorney in your area.

While a guardian can support the protected person by making important decisions, in some cases, an individual may wish to change or dissolve the arrangement.The ward, their family, or other involved people might feel that the guardian isn't doing a good job. They may then petition the court for the removal of the guardian, replacing them with another person.In other cases, they might think guardianship is no longer appropriate. For instance, if the ward regains the ability to make personal or financial decisions, the guardians role may become obsolete. In some cases, the protected person or another individual asserts that guardianship was never needed. A less restrictive option, such as supported decision-making, could be a better fit.How Hard Is It to Terminate Guardianship?Removing a guardian and terminating guardianship both require the courts involvement.Ultimately, the court decides whether to replace the guardian or disband the guardianship completely, restoring the rights of the person subject to the arrangement.Reasons for Removing a GuardianThe court can remove the guardian for several reasons.When guardians fail to perform their duties, the court can expel them. For instance, state laws require that guardians file annual reports with the court, describing the protected persons condition, living situation, and regular activities, and summarizing the guardians contact with the ward. When guardians fail to inform the court on a regular basis, the court can remove them.The court can also remove guardians who act improperly, such as those who abuse the individuals under their care. The state can also charge them with a crime when there is evidence of abuse.Other grounds for removal include misusing the wards income and assets, commingling funds, and failing to manage the protected persons estate appropriately.Disputes between guardians and those they protect are common. In some cases, the guardian and the ward might mutually agree that another person would better fit the role. Voluntarily, the guardian might agree to step down.Petitioning the CourtTo request the removal of a guardian, the ward, the guardian, or a person affected by the guardianship can petition the court. Then, the court will hold a hearing and issue a decision.When the court replaces a wards guardian, it maintains that the individual under the guardianship still cannot make personal or financial decisions independently and needs the protection of a responsible person.In contrast, the court ends the guardianship altogether when it finds that the ward can make independent choices.Ending the GuardianshipThe court terminates guardianship when it finds that the person no longer needs a guardian because of a change in circumstances.For example, the court might find that a person who doesn't have an active power of attorney for health care needs a guardian when the person becomes incapacitated due to a severe illness. If an individual becomes unconscious or cannot communicate for an extended period, a trusted person might need to make medical decisions and handle money on the incapacitated persons behalf. When the wards health improves such that they can express their wishes, assistance with decisions is no longer necessary.In other instances, courts end guardianships by finding that the control was never appropriate. Sometimes, individuals feel that a courts initial decision to order guardianship was wrong and challenge it. They can file a petition for termination with the court that oversees the case. Following a hearing, the court decides whether to terminate the guardianship, change its terms, or maintain the arrangement.To learn more about ending guardianship or removing a guardian, speak to an attorney.

It's tough to know when you should step in and help your parents with their finances. You may go back and forth about when to take over. Deciding whether your parents still have the cognitive ability to manage their money is a difficult call to make. A recent report reveals why it may be important for you to get involved.The Study Results An analysis published in September 2022 showed that seniors with cognitive impairment are struggling to handle their financial affairs. Reviewing a survey of 8,800 men and women aged 65 and older, the researchers found that seniors continued to maintain control over their finances even when experiencing some sort of cognitive decline. In the population studied, almost 14 percent of these older adults suffered from cognitively impaired nondementia (CIND). Another 6 percent were experiencing dementia. The study reported that cognitive impairment problems disproportionately affected groups who reported having less education or who identified as a member of a racial minority group.  Does Your Parent Show Signs of Cognitive Impairment? There are some signs that may indicate diminished cognitive ability. Watch out for the following if you suspect your parent is experiencing diminished mental capacity: Your parents are confused and get lost in familiar places Your parents may lose their train of thought throughout a conversation with you Your parents are more forgetful Your parents forget about important events (like birthdays, holidays, and doctors appointments) Your parents are making impulsive decisions Are Your Parents Financial Resources at Risk? If your parents have a large estate, you should take care to determine whether they have any cognitive impairment. The study found that many of the men and women surveyed had large amounts of money or property valued at more than $100,000. Risky financial assets, like valuable stock portfolios, may be particularly susceptible to mismanagement in those with cognitive impairment, the researchers state.What Can I Do For My Parents? Ensuring that your parents are properly cared for as they age is a priority for many children. However, knowing what you can do for your parents finances if they have any cognitive impairment is hard. If you suspect your parents are having a difficult time managing their money because of a cognitive deficiency, consider the following.  Get Them Screened for Cognitive Impairment The best first step is to confirm your suspicion with a cognitive impairment screening. Typically, patients are asked simple questions about themselves and their surroundings, including their name, address, the time, and to recall information. Learn more about cognitive assessments from the Alzheimers Association.Find Financial Counseling You may need professional assistance to ensure your parents affairs are handled appropriately. You may want to speak to an accountant if your parents estate is extensive and includes many assets. If you suspect cognitive impairment, but haven't confirmed it, you may wish to appoint a power of attorney or a financial agent to handle your parents financial affairs.

A recent survey by the American Advisors Group (AAG) finds that 55 percent of adult children say they're not financially prepared to help their Baby Boomer parents cope with rising inflation and living expenses.Americans want to see their parents age with grace and dignity and have the resources they need to live comfortably, but for many families the current economy is making that difficult, AAG Chief of Marketing Martin Lenoir said in a news release.AAG surveyed more than 1,500 adult children, ages 40 to 55, across the country. Known as the sandwich generation, this group faces the responsibilities not only of raising their children, but also of serving as caregivers for their aging parents. Among the surveys other key findings:More than a third of adult children say they worry that their parents will become a financial burden for them. Nearly 60 percent say they cannot afford any kind of professional elder care for their parents.Yet almost half admit they've never broached the subject of finances with their senior parents. A full 50 percent of them don't know how much debt their parents are carrying.1 in 3 Adult Children Already Assisting Their Parents Financially Another survey, conducted in 2020 by GoHealth, Inc., explored GenXers and millennials involvement in their parents financial and health care needs. It found that one in three GenXers and millennials are supporting their parents financially. Nearly the same number are managing, or helping to manage, their parents health care.The surveys 2,000 GenX and millennial respondents also reported the following:On average, they spend 11.5 hours per week managing their parents health care by providing transportation, scheduling doctor visits, and explaining insurance claims. They also estimate theyll spend 14 to 16 years continuing to do so.2 in 5 spent more than $10,000 of their own money supporting their parents in 2020.The vast majority (86 percent of GenXers and 82 percent of millennials) worry about having enough money to support themselves and their parents. Squeezing the Sandwich GenerationAdult children will continue to feel the pressure for the foreseeable future. Every day, on average, 10,000 Boomers (those born between 1946 and 1964) reach age 65, and another 10,000 of them turn 75. According to research by the Blackstone Group, an independent research firm, nearly 80 percent of middle-income Boomers don't have any savings designated to cover their retirement care. Meanwhile, 30 million Boomers retired from the workforce amid the COVID-19 pandemic. Saddled with college debt, as well as rising inflation and housing costs, those GenXers and millennials who still depend on their parents for financial assistance or housing may no longer be able to count on that support.Have The TalkIts important for families to have an honest and respectful financial conversation before a medical event occurs or the need for care arises. Talking about money with aging parents can be a delicate matter, but its necessary to understand both the degree of care that may be needed and the financial resources available to provide it.For help planning for the future of your Boomer parents, or for your GenXer and millennial children, consult a qualified attorney in your area.

When creating an estate plan, people are often most concerned with passing on the big things like real estate, bank accounts, and vehicles. Yet these possessions very often arent the items that have the most meaning for the loved ones we leave behind.Smaller items, like family heirlooms and keepsakes, which may not have a high dollar value, frequently have the most sentimental value for our family members. But for a number of reasons, these personal possessions are often not specifically accounted for in wills, trusts, and other estate planning documents. However, its critical that you dont overlook this type of property in your estate plan, as the distribution of such items can become a source of intense conflict and strife for those you leave behind. In fact, if you dont properly address family heirlooms and keepsakes in your estate plan, it can lead to long-lasting disagreements that can tear your family apart.Heirlooms & Keepsakes: Little Things With Big ValueHeirlooms and keepsakes are both prized for their sentimental value, but these possessions are slightly different from one another in terms of the manner in which the items are passed on. Heirlooms: Heirlooms are passed down among family members for generations, and the passing of heirlooms sometimes involves traditions. For example, the first daughter to marry inherits grandmothers heirloom wedding ring.Keepsakes: Keepsakes, on the other hand, are possessions that are given or kept specifically for sentimental or nostalgic reasons, and these items may only get passed on once. For example, photo albums are a typical keepsake that are treasured by many families. If a keepsake gets passed on multiple times, it may eventually become a family heirloom.Although just about any personal possession could be considered an heirloom or keepsake, some of the most common examples of these items include the following:JewelryPhotographsBooksArtMusical instrumentsFurnitureClothingBiblesRecipesFamily documents (such as birth certificates, baptism records, and citizenship papers)Collections (such as sports memorabilia, coins, stamps, and doll collections)Issues Raised By Passing On Heirlooms & KeepsakesIn the legal world, both heirlooms and keepsakes are considered non-titled personal property. As mentioned earlier, when there is no plan in place for the distribution of these items following the owners death, it can create bitter conflicts among family members. Indeed, fights over heirlooms and keepsakes can cause close family members to never speak with one another again. In her book Who Gets Grandmas Yellow Pie Plate? Professor Marlene S. Stum, an expert in family social science at the University of Minnesota, warns of the infighting that can occur when theres no plan for who inherits these personal effects. What surprises many people is that often the transfer of non-titled personal property creates more challenges among family members than the transfer of titled property, says Stum. Research has shown that disputes over inheritance and property distribution are one of the major reasons for adult siblings to break off relationships with one another. Given the potential trouble the distribution of heirlooms and keepsakes can cause for your heirs, youll want to take extra care in seeing that these family treasures are passed on properly. And this means incorporating them into your estate plan in one way or another. Strategies For Peacefully Distributing Heirlooms & KeepsakesWhile there is no one perfect way to distribute these items in your estate plan, your primary goal should be to maintain harmony among your loved ones during an already emotional time. As with most sensitive issues, clear communication is vital to this process.Because your family members can have vastly different values associated with certain heirlooms and keepsakes and you may have little idea about how each person feels, you should speak with each family member in advance. By talking with family members about their feelings and expectations regarding your possessions ahead of time, you will have a much better idea how to distribute these items to your loved ones with the least amount of conflict.Additionally, you should decide ahead of time if you need to have any of your heirlooms or keepsakes appraised. In doing so, you provide your heirs with the necessary documentation to gauge the monetary value of these items, and you can save them from extra work while they are mourning your death. Again, the manner in which you distribute your heirlooms and keepsakes will depend largely on the items you have to pass on and your specific family situation. That said, here are a few estate planning strategies to consider when passing on these precious possessions.Gifting during your lifetime: Of course, you dont have to wait until you die to pass on your heirlooms and keepsakes, and you may prefer to give away certain special items while you are still living. By doing so, you get to personally witness the joy your loved ones experience when they receive the gift, and you can also personally explain the reasons you want each person to have a particular item. If your heirlooms and/or keepsakes have a high monetary value, you should keep gift tax issues in mind when you give them away. That said, the IRS has a high annual gift tax exclusion ($16,000 in 2022) and an equally high lifetime exclusion ($12.06 million in 2022), so few people will need to worry about such taxes. Keep in mind, the lifetime exclusion amount will revert back to its pre-2018 level of around $5 million per individual in 2026, so if you are considering gifting high-value possessions, you may want to do it sooner, rather than later. In any case, if you have possessions you want to give away that might trigger gift taxes, meet with us, your Personal Family Lawyer to discuss your options.Include items in your estate plan using a personal property memorandum: As with other assets you want to pass on after your death, you should include heirlooms and keepsakes in your estate plan by adding them to your will or trust. The best way to do this is by using whats known as a personal property memorandum. A personal property memorandum is a separate document that is referenced in your will or living trust. The memorandum allows you to list which items you wish to leave to each individual and detail the reasons you are giving each item. In many states, if its properly incorporated into your will or trust, a personal property memorandum is a legally binding document. Furthermore, unlike a will or trust, you can create and update your memorandum without a lawyers help. You can change your memorandum as many times as you like, just make sure you sign and date it each time to ensure authenticity. Your memorandum can be as long or short as you like, which allows you to account for even the smallest or seemingly insignificant possessions. Most types of tangible personal property can be included in your memorandum, but its important to note that you cannot list certain assets in a memorandum, including titled property, such as real estate and vehicles; assets with a beneficiary designation, such as life insurance, 401(k)s, and bank accounts; or intellectual property, such as works protected by a copyrights or trademark. If you are unsure if you should include a certain possession in your personal property memorandum, consult with us.Although you dont need a lawyer to create or modify your personal property memorandum, if you need any help or support with yours, reach out to us, your Personal Family Lawyer. That said, you should always enlist our assistance if youd like to create or update your will or trust.Pass on the values & stories behind the possessions: You may want to consider making audio recordings to accompany your heirlooms and keepsakes. In this way, your loved ones not only get to hear your voice, but they will also be able to learn the stories behind the possessions, as well as the reasons why you gave each person a particular item. These stories not only help connect you with future generations, but having a strong family narrative also helps young people develop strong personal identities and boosts their self esteem. In the New York Times article, The Stories that Bind Us, author Bruce Feiler comments on this phenomenon: The more children knew about their familys history, the stronger their sense of control over their lives, the higher their self-esteem, and the more successfully they believed their families functioned.Best of all, you dont have to worry about creating these recordings yourself, as we offer this exact service during our Life and Legacy Interviews. In every estate plan we create for our clients, we will personally guide you to create a customized recording for the people you love, and then we will provide you with the recording digitally to ensure it will survive long after you are gone.Dont Let Anything Fall Through The CracksOf course, if no one can find your heirlooms and keepsakes, they arent going to do anybody any good. For this reason, its vital that you create and maintain a comprehensive inventory of all of your assets, including each of your family heirlooms and keepsakes. Fortunately, this is another service we offer all of our clients at no additional charge. Indeed, we will not only help you create a comprehensive asset inventory, we have systems in place to make sure your inventory stays consistently updated throughout your lifetime. Schedule a meeting with us, your local Personal Family Lawyer to incorporate your inventory with your other estate planning strategies.Keep The Peace After You're GoneTo ensure your heirlooms and keepsakes dont create any unnecessary conflicts among your heirs, make sure that your estate plan includes all of your assets, especially your family heirlooms and keepsakes. As your Personal Family Lawyer, we can support you to ensure these precious treasures are protected and preserved as part of your Life & Legacy Plan, and that they pass to each of your loved ones in exactly the manner you would want, without causing a family feud. Contact us today to learn more.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge.

For years people have been worried about Social Securitys future, but what is the actual outlook? According to the federal government, unless Congress acts to intervene, Social Security shortfalls are expected beginning in 2035.   Social Security retirement benefits are financed primarily through dedicated payroll taxes paid by workers and their employers, with employees and employers splitting the tax equally. Employers pay 6.2 percent of an employee's income into the Social Security system, and the employee kicks in the same. Self-employed individuals pay the entire 12.4 percent Social Security payroll tax. This money is put into a trust fund that is used to pay retiree benefits. The trustees of the Social Security trust fund have reported that if Congress doesnt take action, the funds balance will reach zero in 2035. This is because more people are retiring than are working, so the program is paying out more in benefits than it is taking in. Additionally, seniors are living longer, so they receive benefits for a longer period of time. Once the fund runs out of money, it doesn't mean that benefits stop altogether. Instead, retirees benefits would be cut. According to the trustees projections, the funds income would be sufficient to pay retirees 77 percent of their total benefit. Congress can act to shore up Social Security before this happens. Some ideas include eliminating the cap on income subject to tax. Right now, workers only pay Social Security tax on the first $137,700 of income. That amount can be increased, so that higher-earning workers pay more in taxes. The Social Security tax or the retirement age could also be increased.Social Security is immensely popular and lawmakers are unlikely to allow steep benefit cuts to take place. The last time the program was in financial trouble and received a major overhaul was in 1983, when President Ronald Reagan and congressional Democrats struck a deal to increase taxes and gradually raise the retirement age from 65 to 67.

Including a Trust as part of your estate plan is a smart decision. It allows you to avoid probate, maintain privacy, and distribute your assets to your loved ones while also providing them with a lifetime of asset protection, if you choose it for them. But, heres the thing you might not know, and is critically important to remember: simply creating a Trust is not enough. For your Trust to work, it has to be funded properly and may need to be updated over time.Funding your Trust means transferring ownership of your assets from your own name into the name of your Trust. This can include bank accounts, investments, real estate, and other valuable possessions. By funding your trust properly, you ensure your assets are managed according to the terms of your Trust and will be distributed according to your wishes when you die or if you become incapacitated.But, if you fail to fund your Trust, it becomes nothing more than an empty vessel. Your assets will not be protected or distributed as intended, at least partially defeating the purpose of creating a Trust in the first place! While your assets can still get into your trust and be governed by your Trust after your death, that means that your family still goes to court to get your assets there, and that is a costly endeavor.To make sure your Trust works for you, avoid these funding fiascos and work with an attorney who will ensure that everything that needs to get into your Trust does.Forgetting to Update Your Account BeneficiariesMany people mistakenly believe that a Will or Trust alone is enough to dictate how their financial accounts should be distributed after they die. However, this isnt the case. Without proper beneficiary designations on your accounts, your wishes may not be honored and your assets could end up in the wrong hands.Remember, the beneficiaries you designate on your accounts supersede any instructions in your Will or Trust, so this step is vitally important. Take a moment to review your various accounts, such as bank accounts, retirement plans, and life insurance policies. Ensure that each account has your Trust named as your designated beneficiary, unless youve made different plans for that specific account. When you are working with a lawyer, make sure your lawyer has a plan for each one of your beneficiary-designated assets, communicates that plan to you, and that the two of you decide who will handle updating your beneficiary designations. Then, make sure you review your beneficiary designations annually. In our office, we support our clients to do all of this with well-documented asset inventories, and a regular review process built into all of our plans.Your Attorney Didnt Move Your Home Into Your TrustFor many of us, our home is our most important and valuable asset. But if your attorney doesnt deed your home into your Trust, your home wont be included under the terms of your Trust if you become incapacitated or pass away. That means your home could end up going through the long and expensive probate court process in order to be managed during an illness or passed on to your loved ones after you die. If you own a $300,000 home, that means your family could lose up to $15,000 or more just to transfer your home to your trust and then distribute your home pursuant to the terms of the trust - and thats not including any other assets that would have to go through probate.A knowledgeable estate planning attorney shouldnt miss this step, but it happens. And if youre using a DIY service online to create a Trust without the help of any attorney at all, its bound to happen!Thats why its so important to work with a lawyer who takes the time to make sure every asset you own is in your Trust before they say their farewells.Not Reviewing Your Plan and Accounts Every Three YearsYou might wonder how not reviewing your estate plan every few years could really make your plan worthless. Well, the good news is that failing to review your plan is unlikely to completely eliminate the benefits it provides you because an estate plan is made up of a number of moving parts, not just a Will or a Trust.But, failing to keep your financial assets up to date and aligned with your estate plan can result in huge issues for you and your family and can even make the Trust you invested in worth little more than the paper its printed on!Thats because your Trust cant control any assets that dont have the Trust listed as the owner or beneficiary. By reviewing your accounts every 3 years, you can help catch any accounts that dont have your Trust listed in this way.For example, its very common for clients to open a new bank account and forget to open the account in the name of their Trust or add their Trust as a beneficiary.Thankfully, by comparing my clients' financial accounts to their estate plan at least every 3 years, Im able to catch simple oversights like this that could cause their assets to be completely left out of their Trust.Make Sure All of Your Assets Are Included In Your Plan with Help From Your Personal Family LawyerGetting your legal documents in place is an important step, but it's equally important to know that the documents themselves are not magic solutions (as magical as they may seem!). Merely creating a Trust or naming beneficiaries on your accounts does not guarantee that your wishes will be carried out unless all of the pieces of your plan are coordinated to work together. If you arent experienced in the area of estate planning, trying to coordinate all these pieces yourself can be a recipe for disaster.Thats why I work closely with my clients to not only create documents but to create a comprehensive plan that accounts for all of your assets and how each one needs to be titled to make sure your plan works for you the way you intended. Plus, I offer my clients a free review of their plans and financial accounts every three years to ensure that their plans accurately reflect their lives and their wishes for their assets and loved ones.If you want to know more about my process for funding your Trust and making sure nothing is ever left out of your plan, contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

The United States population of aging adults has grown exponentially over the past decade. According to projections published by the U.S. Census Bureau, the number of Americans aged 60 and older increased by 34 percent from 55.7 million to 74.6 million between 2009 and 2019. Unfortunately, amid their growing numbers, more and more seniors are facing a substance use disorder problem that in large part has remained silent.What Are Substance Use Disorders?According to the Centers for Disease Control and Prevention, substance use disorders include treatable, chronic diseases characterized by a problematic pattern of use of a substance or substances leading to impairments in health, social function, and control over substance use.Seniors are an overlooked group regarding substance abuse issues, but the problem is growing nationwide. Learning the extent and cause of substance abuse among seniors can help improve outcomes for this population.Rates of Substance Abuse and Misuse Among Older AdultsSeniors often get disregarded in conversations about substance misuse. Yet according to some estimates, nearly 1 million adults aged 65 and older were reported to be living with an addiction as of 2018. Today, that number could be much higher.Drug AbuseDrug abuse among older adults is a dangerous problem, in part because health care providers and caregivers so often overlook it. It may even be diagnosed incorrectly as a health condition related to aging.Seniors are likely to use one or more prescription medications. Adverse drug interactions between multiple prescriptions, nutritional supplements, and over-the-counter medication can inadvertently harm ones health.Misuse of certain prescriptions can also lead to a substance use disorder. Opioids, for example, have been prescribed to millions of people suffering from chronic pain. The proportion of U.S. adults aged 55 and up who have sought treatment for opioid use disorder has been surging over the past two decades; between 2013 and 2015 alone, it jumped more than 50 percent. One 2006 study stated that at least one in four older adults were using prescription drugs that have potential for abuse.Many seniors are at risk of developing a dependence on nonprescription, over-the-counter, and illicit drugs as well. Meanwhile, research has suggested that American seniors use illicit drugs at a higher rate than older adults from most other countries. Alcohol UseSurveys show that alcohol use among people 65 and older has increased 22 percent over the past two decades. The extent of alcohol abuse remains unknown due to the impact of underreporting. However, seniors in some studies do report binge drinking and at-risk drinking.People binge drink when they have five or more drinks in one setting. According to one study, more than a tenth of older adults in the U.S. are regular binge drinkers.Research published by the National Library of Medicine defines at-risk drinking as consuming more than three drinks on one occasion or having more than seven drinks in one week. The prevalence of at-risk drinking among men is estimated at 16 percent and 10.9 percent among women.Note that the National Institutes of Health offers a series of free worksheets that can help you evaluate your use of alcohol and learn how to make positive changes.Why Do Seniors Abuse Substances?Seniors are less likely to abuse substances for a euphoric effect. Older adults typically use drugs and alcohol to self-medicate against the physical and emotional pain that comes with aging.Some common causes of substance abuse among people aged 65 and older include:Loss of a spouse or family memberDecreased incomeChange in living arrangementsTrouble sleepingA mental and physical decline in healthConflicts with familyLack of purposeRetirementA seniors coping style early in life may correlate with late-life substance abuse. People with avoidant coping styles tend to rely on substances to deal with stress and change. If seniors spend their lives avoiding stress or problems, they are more likely to develop a late-life drinking problem than those who cope in other ways.Social Factors Leading to Substance Abuse Among Older AdultsVarious social factors appear to increase the chance of late-life drug and alcohol abuse. The following social factors are among those that may lead to increased substance misuse:Unexpected or forced retirementSocial isolationBeing divorced, separated, or singleLack of religious affiliationAffluence or feeling comfortable with the availability of financial resourcesGriefPhysical Factors Leading to Substance Abuse Among Aging AdultsOlder adults with substance abuse disorder typically have these physical factors in common:ComorbiditiesChronic medical conditionsReduced mobilityChronic painPoor health statusPsychiatric Risk Factors Leading to Substance Abuse Among SeniorsPsychiatric risk factors among older adults with substance abuse disorder include:History of substance use disorderCurrent or previous mental illnessFeeling socially isolatedHaving an avoidance coping styleSymptoms of Substance Abuse Among Older AdultsSubstance abuse is a serious medical condition. Prompt diagnosis and treatment can help seniors get the help they need to improve their quality of life. Caregivers and medical providers should watch out for the following symptoms of substance misuse:Depression and loss of interest in previously enjoyable activitiesUse of a prescription drug more often than what is outlined in the instructionsMemory problemsChange in appetiteSocial withdrawalIrritability and sadnessChange in sleeping patternsDecline in hygieneLeading Substance Use Disorders According to RegionSubstance misuse is occurring everywhere in the U.S., regardless of age, but certain areas are seeing abuse of specific types of substances. The Agency for Healthcare Research and Quality compiled the following data for 2016 through 2018 about regions nationwide:New Jersey and parts of Appalachia have a concentration of opioid-related substance use disorders.The Midwest, Appalachia, Rhode Island, and Nevada saw a higher concentration of alcohol dependency issues than other parts of the country.Appalachia saw a more-significant-than-average concentration of sedative-related substance use disorders.Stimulant-related disorders appeared more in the Midwest, the South, and Appalachia.Cannabis-related substance abuse disorders occurred in Mississippi and other Southern states.Health Impacts of Substance Abuse on SeniorsThe health implications of substance abuse disorder are more significant for older people. Older people are more vulnerable than other groups to the effects of drug use on mental health. Seniors who take prescription medication risk negatively impacting their mental state by mixing their medicine with recreational drugs or by abusing alcohol.Drug and alcohol abuse can also lead to increased fall risk, physical impairment, adverse psychiatric effects, worsening of other physical conditions, and death.In fact, among people aged 65 and over, certain types of opioid overdose deaths increased by 53 percent between 2019 and 2020 alone. The number of alcohol-related deaths for this age group rose by 18 percent over the same timeframe.Recovery Options for Older AdultsWhether a senior should receive inpatient or outpatient treatment depends on their needs. Older adults with a substance use disorder may benefit from inpatient treatment if they meet some of these criteria:A high likelihood of relapseSuicidal thoughts or thoughts of self-harmLikelihood of experiencing withdrawal symptomsNo familial supportPrevious attempts at detoxCo-occurring severe medical conditions that need continuous monitoringSeniors may also need the following to get the most out of recovery:Careful case managementFamily, group, and individual counselingCognitive behavioral therapyHow Can the Health Care Industry Help Older Adults With Substance Use Disorder?Much work is needed to decrease the substance abuse rates among older adults. There is a critical need to address this problem.Primary care physicians are the first line of defense. Education for clinicians should include skill and strategy development to treat substance abuse issues among older adults. Health care workers should know how to identify substance misuse with proper screening and assessments. Understanding co-occurring disorders and the connection between mental illnesses and substance use disorders is also crucial.If you notice signs of addiction in a loved one, it is essential to get them professional help. In addition to improving their quality of life, you may save them from succumbing to this disease.Contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call to learn how we can help. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Raising the minimum wage by as little as 10 percent would significantly improve the safety and health of nursing home residents, according to new research.Most direct care in nursing homes is provided by nursing assistants, who make up about 40 percent of the nursing home workforce and are among the lowest-paid workers in the U.S. economy. Nursing assistants help residents with activities of daily living like eating, bathing and dressing, and work with certified nurses and elder care teams to monitor patients conditions.Due in part of their low wages, nursing assistants frequently change jobs for better pay or working conditions.  Between 60 percent and 85 percent of nursing assistants leave their employers each year, most often to go work in other nursing homes, writes Krista Ruffini, a visiting scholar at the Minneapolis Federal Reserve. Nursing homes frequently report difficulty in recruiting and retaining staff, she says.Ruffini recently looked at the impact increasing the minimum wage has on nursing home staff turnover and quality.  She compared facilities in hundreds of U.S. counties that had increased their minimum wage with those that hadnt between 1990 to 2017.In findings based on her preliminary data published in a working paper, Ruffini found that increasing the minimum wage by 10 percent would reduce the number of health inspection violations by 1 percent to 2 percent, the number of residents with moderate to severe pressure ulcers [bed sores] by about 1.7 percent, and the number of deaths by 3 percent.  The 3 percent reduction in deaths, she notes, translates to 15,000 fewer deaths in nursing homes each year.Ruffini found that raising the minimum wage reduced turnover and increased tenure among nursing assistants.  This greater continuity of care, she says, translated into improved health and safety conditions for the patients.  At the same time, nursing home profits held steady because the extra costs were passed on in the form of higher fees.Ruffini notes that her findings have particular relevance in a time when the coronavirus pandemic is overwhelming nursing homes.  Comparing a facilitys number of COVID-19 deaths with its quality-of-care performance, she concluded: The data provide some suggestive evidence that higher service quality is associated with fewer deaths from COVID-19 in nursing homes.

Those who obtain a workers compensation settlement for future medical expenses must create a Medicare Set-Aside (MSA) Account to preserve their eligibility for Medicare. This separate, interest-bearing account pays for medical costs related to the workers injury. After the funds are exhausted, Medicare provides coverage for medical fees related to the injury.Why You Should Create an MSA AccountFailing to establish an MSA can have significant consequences for Medicare eligibility. Neglecting to create an MSA can result in losing Medicare, as well as means-tested government benefits like Medicaid. In certain cases, not using an MSA following a settlement can lead to liability.Keep Your Medicare CoverageIndividuals who receive settlements or judgments to cover future medical care must use these funds for that purpose to preserve Medicare coverage. For these expenses, Medicare is not the primary payer. Payments for the injury kick in only after the account is depleted and the beneficiary files a report with the Medicare Secondary Payer (MSP) Recovery Contractor. (Learn more about the Medicare Secondary Payer Act.)Receiving a settlement for future medical expenses without setting up an MSA jeopardizes Medicare eligibility. Someone who ignores the requirement to create an MSA could forfeit Medicare coverage entirely. This could mean losing coverage for all medical expenses, including those unrelated to the injury.If Medicare acts as the primary payer meaning that Medicare pays first when funds should have come from workers compensation, Medicare has a right of action. It can take legal action against the primary payer responsible for the payment, as well as those who received Medicares funds.When beneficiaries are unaware of the rules and fail to create an MSA, they could lose coverage.Stay Eligible for Public Benefits Programs With Asset LimitsNot having an MSA, or setting one up that is ineffective, can also make individuals ineligible for means-tested benefits such as Supplemental Security Income (SSI) and Medicaid.The Social Security Administration counts settlement funds as assets. Without a proper MSA, a person who acquires money to cover prospective medical costs following an accident could lose their public benefits.Increases in assets can also disqualify beneficiaries of the following programs:Supplemental Nutrition Assistance Program (SNAP)Temporary Assistance for Needy Families (TANF)Low-Income Home Energy Assistance Program (LIHEAP)People who obtain workers compensation settlements can continue to receive means-based benefits, along with Medicare, when they have a well-structured MSA. According to the Special Needs Alliance, embedding a special needs trust (SNT) within an MSA can allow a person to continue accessing government benefits. This is because the funds in an SNT are not countable assets.Avoid Liability After a Workers Compensation SettlementThe Centers for Medicaid and Medicare Services (CMS) requires that workers compensation settlements reasonably consider Medicares interests. A workers compensation settlement requires a person to create an MSA. If they fail to do so, they could face legal consequences for breaching their settlement agreement.CMS can also obtain restitution from anyone involved in the settlement, including the worker, workplace, insurance companies, and attorneys.Consult With a Special Needs Planning AttorneyCreating and maintaining an MSA can be complex. If you wish to keep your Medicare eligibility while receiving compensation for an injury, working with an attorney to help you set up and manage an MSA is critical.Consider consulting with a special needs planning attorney like Sharek Law Office. We can help you stay eligible for Medicare after acquiring a workers compensation settlement. Call our office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call with our staff to discuss your needs today. Learn More About MSAsFor more information about Medicare Set-Asides, check out the following articles:What Is a Medicare Set-Aside and When Do You Need One?What Happens When You Have a Medicare Set-Aside and Don't Need Treatment?What Happens If My Medicare Set-Aside Runs Out? This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

If you have grandchildren or are getting ready to welcome one you know the special joy they bring. After all, you can now leave all the heavy lifting to the parents and just enjoy connecting with them.Many grandparents who enjoy financial freedom are often more than generous to grandchildren. And some even wish to see their grandchildren enjoy an inheritance now instead of waiting to pass along assets after they are gone. If thats you, here are seven things you should think about before you make gifts to grandchildren.Clarify The GiftMost grandparents gift outright, no strings attached. But if you think you are providing a loan or an advance on an inheritance, you need to clarify that in writing. Equal TreatmentIt is not unusual for a grandparent to be closer to some grandchildren than others, but when you are gifting assets, unequal treatment among grandchildren could lead to family resentments. Even if you give more to some than others during your life, consider treating all grandchildren equally in your estate plan.TaxesWith the federal gift tax threshold at $12.92 million (double that for married couples), most people wont have to worry about paying federal gift taxes. However, any gift to an individual that exceeds $17,000 each year ($34,000 for married couples) must be reported on a gift tax return.EducationYou can help with a grandchilds college tuition by making payments directly to their educational institutions, which dont have to be reported. And there is no limit on these contributions. Investing in a 529 plan for each of your grandchildren is also a great way to help them (and their parents!) save for college, building a tax-deferred account that will never be taxed as long as it is used for educational purposes.Your Own NeedsIts tempting to be too generous in making gifts to grandchildren, but you should not give to the detriment of your own needs. Finding the right balance will help ensure your children and grandchildren dont have to support you because you gave too much to them.Long-Term CareChances are that you will need some kind of long-term care at the end of your life, research shows that most of us will. If you cant afford long-term care and need help, any gift of assets you have given could make you ineligible for Medicaid benefits for five years.Consider A TrustThere are many reasons why you should not give gifts of cash or assets to grandchildren, some that you may not even be aware of. Lots of cash could be fuel on the fire of bad behavior or undermine your own childrens goals for their children. To make a lasting gift, consider using a trust that will pass assets along to grandchildren safely and protect those assets from bad behavior, bad marriages and bad credit.If you have questions, contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call with our staff to learn how we can helpThis article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Taking on the responsibility of providing full-time care for an aging or disabled loved one can be a rewarding experience. Being a primary caregiver helps you rest assured that your loved one is receiving compassionate care from someone who will go above and beyond to ensure they're comfortable and looked after. Despite your good intentions to create a comfortable environment for your loved one, full-time caregiving is a significant time commitment. There is also a financial reality that the caregiver must face. Fortunately, family members who want to serve as caregivers may have options to help cover the expense.What Is a Caregiver, and What Do They Do? Professional caregivers work intimately with seniors to meet their needs as they age. As individuals get older, their needs change and they may need more help going about their day. Examples of the kinds of help caregivers provide include:Bathing and groomingHelp with toileting Medical appointments and medication complianceTransportationCompanionshipCooking, cleaning, and grocery shoppingCare for animals LaundryCoordinate benefit care/speak to insurance companies on the seniors behalf, if authorized Family Caregivers: Know the DownsidesHaving a family member serve in the role of caregiver can make for a better experience for your loved one and, in some ways, give you peace of mind as well. However, there are some downsides to be aware of if you're considering becoming a family caregiver.Your own health, both physical and emotional, can be negatively affected when taking on the burden of caring for a family member. Be sure to engage in self-care, maintain a healthy diet, and watch out for signs of stress and burnout. When you do need a break, consider looking into respite care.If your loved one has specific medical issues that will require the attention and expertise of a professional health care provider, you may want to reassess whether you should take on the role of family caregiver.Taking care of a loved one who is getting older or who is disabled will likely require a great deal of your time, too. You may find yourself not performing as well at work or having a longer commute as you fulfill the needs of your ailing loved one. Not to mention that your own immediate family may be missing out on valuable time with you while you're caregiving elsewhere.In turn, this could mean you will have less time to hold down a full-time job. In fact, a 2020 AARP survey showed that about 20 percent of family caregivers reported experiencing a high level of financial stress. Nearly 30 percent of them stopped saving altogether as a result of providing care for their loved one.In these challenging economic times, you must be able to support yourself while ensuring the best care for your aging family member. Can Family Members Get Paid for Their Work as a Caregiver? Fortunately, certain programs are available to help family members care for ailing relatives. You may need to do a bit of research to find the right option for your circumstances.Medicaid Self-Directed CareFor individuals on Medicaid, the Medicaid Self-Directed Care Program is one option that gives them the authority to manage their services. In certain states, this program offers recipients the ability to use the resources allocated for home care to pay a family member to help them with their daily needs. The Medicaid Self-Directed Care Program lets seniors have more autonomy over their care.Note that such programs vary by state, however, and not all states will have an option like this. Each state may also use different criteria to define who qualifies as a family caregiver. Find your local Area Agency on Aging to learn more about the possibilities, or call your local Medicaid agency.Note that, generally, Medicare will not cover the costs of caregiving by a family member.Veterans Benefits If your loved one is a military veteran, there are special benefits available to cover their home care, including the Veterans Directed Home and Community Based Services program. This program gives veterans a flexible spending budget that the veteran can use to pay a family member to act as their caregiver. National Family Caregiver Support ProgramNote that this program doesn't pay caregivers directly. Rather, it helps fund several different types of services for family caregivers, from training in caregiving to respite care. Learn more about this program.Long-Term Care Insurance If you're thinking ahead to who will care for you as you age, you may consider long-term care insurance when creating an estate plan. Certain long-term care insurance policies allow the policyholder to pay family members to work as caregivers. However, that's not true for every policy. Some policies don'qualified attorney in your areat allow policyholders to pay family members to work as caregivers if they live in the policyholders home.Before taking out this type of insurance policy, you should speak to a qualified attorney in your area to ensure you're properly advised.

Telehealth allows you to connect with your health care provider virtually and have an appointment without going to a physical location. You can share information about your health concerns through telemedicine and receive professional opinions from your home. Patients connect with health care professionals using computers, phones, and tablets.Types of Care Available Through Telemedicine Although some medical services require in-person contact with a health care professional, many types of care are available through telehealth. Telemedicine encompasses a wide variety of care, including:Assistance with recurring conditionsDermatology appointmentsManaging viral and bacterial infectionsLab test resultsPhysical therapyPrescription managementPost-surgery careMental health servicesThe Rise of Telehealth Amid the PandemicAccording to the U. S. Department of Health and Human Services, the pandemic sparked an increase in the use of telehealth, as people sought care without the risk of exposure to the coronavirus. Before the pandemic, telemedicine was less common, often primarily used for psychotherapy and monitoring chronic conditions.In 2020, the Centers for Disease Control and Prevention (CDC) advised people to contact physicians online to avoid spreading COVID-19. From March 2019 to March 2020, the CDC reported a 154% increase in telehealth use. Today, telehealth continues to be an option for people seeking medical care. Using Telehealth With telehealth, you can have a virtual appointment with your doctor and communicate via phone or video call. Using remote monitoring, you can send your doctor information about your vital signs. Outside of your appointment time, you can exchange secure messages and pictures with your health care provider.You can share lots of detailed information with your doctors, such as your weight, blood pressure, and vitals, as well as medical records and images of wounds or other conditions. Your doctor can give you instructions about how to manage your health problems at home and can provide suggestions for how to improve your quality of life.Benefits of Telehealth Although some severe medical concerns require in-person visits to doctors offices or emergency rooms, telehealth benefits many patients:Reduction in risk of infection. With the pandemic a significant concern, telehealth reduces the risk of contracting COVID-19 or another infectious disease at the doctors office. People with underlying conditions or in high-risk groups can avoid infection.  Better resource allocation. Per the CDC, telemedicine also helps medical professionals allocate resources effectively in a pandemic, as it preserves personal protective equipment and reduces patient demand in health care facilities. Easier access. For those who have trouble driving or leaving their home or who live in remote places, telemedicine makes health care more reachable.  Timesaver. Visiting the doctor this way can also save time, as you don't have to commute to an office. Faster communication. Patients who have difficulty traveling independently or who are self-isolating may be able to receive faster care over the internet. Online communications and appointments can alert doctors to severe medical concerns quickly. In some cases, doctors may advise patients to seek emergency medical attention.As it supplements in-person care, telehealth can help patients communicate with their providers more efficiently and effectively, making health care more accessible.

An estate plan often focuses on tangible property such as jewelry, artwork, money, and vehicles. However, in this age of technology, it is important to remember to include your digital assets. Digital assets consist of everything we own online. Because we spend more time on computers and smartphones than we ever did before, you may not realize how much digital stuff you own, from photos and videos to online accounts, cryptocurrency, and nonfungible tokens (NFTs).Why Is It Important to Plan for Digital Assets?Planning for digital assets is important for several reasons. First, without a plan, digital assets may get lost in the Internet ether and not pass to your loved ones after your death due to the simple fact that their existence is unknown. Second, planning now means your family will not have to worry about hunting for these items upon your death while also grieving a beloved family member. Third, like most adults (roughly 70 percent of them), you want certain aspects of your digital life to remain private. If you do not create a plan, your loved ones may learn things that you wish to keep secret. Finally, planning now can minimize the risk of identity theft, which happens to 2.4 million deceased Americans each year. Keep reading to learn more about why it is important to include digital assets in your estate plan and how to account for them.Digital Assets: What Are They?Instead of existing in photo albums and on videotapes and DVDs, most of our family photos and videos are now digital. Even if they lack commercial value, they certainly have sentimental value that you want to preserve for your family and friends. Social media accounts containing your photos and videos can also have value to your loved ones when you are gone. For example, a Facebook account can serve as a memorial after you pass away. When you consider all of the other accounts that you log into (more than 130 on average), the list becomes quite lengthy. Digital assets that you may own include the following:Social media accounts (e.g., Facebook, Twitter, LinkedIn)Financial accounts at brick-and-mortar and online institutionsBusiness documents and other files stored in the cloudCryptocurrencyNFTsDatabasesDevice backupsInternet domain names and uniform resource locators (URLs)Streaming service accounts (e.g., Netflix, Peacock, Hulu)Merchant accounts (e.g., Amazon, Etsy, eBay)Gaming tokensVirtual avatarsPoints-based loyalty programs (e.g., for groceries, gas stations, airlines, and hotels)Rights to intellectual property, artwork, and literatureOnline betting accountsMonetized video contentIncluding Digital Assets in Your Estate PlanTaking inventory of your digital assets may take some time, but it is worthwhile. If something were to happen to you, your estate planning attorney or another trusted person should have complete access to your online footprint. This includes usernames and passwords for all accounts. Tools such as Dashlane or the password manager integrated in your browser can be used to simplify the storage of usernames and passwords. In addition, you should continuously back up all digital assets, including photos and important documents, to the cloud, and ensure that your attorney and trusted person can easily access them when the time comes. Because they are not controlled by governments or banks, cybercurrency and NFTs must be handled carefully. You do not have the option of calling customer service to reset your password if you forget or lose it. NFT and cryptocurrency passwords should be stored online in a hot wallet, or in an offline device known as a cold wallet. Either way, someone needs to know how to access your passwords when you cannot. Other estate planning considerations for digital assets include the following:Your estate plan can provide that your digital possessions be handled by one or more cyber successors who can distribute your digital assets like tangible property.One cyber successor can control your Instagram account, for example, while another can take possession of your Bitcoin. Keep in mind that passwords should not be memorialized in your will, especially regarding cryptocurrency, as they could be made public if the will is submitted to probate court. Consider how technologically savvy a person is before appointing that person as your cyber successor.Next Steps for Your Digital AssetsTalk to your estate planning attorney about your digital assets and cyber successors. Have a conversation with potential cyber successors about how they would handle your assets, and make sure that they would carry out your wishes before appointing them. Digital assets can be placed into a trust or distributed through your will, or you could grant access to them through a power of attorney. With the help of an experienced estate planning attorney, you can feel relieved that your digital assets will be easily located, managed, and passed to your loved ones.

An annuity can be a useful tool for long-term care planning, but annuities are also complex financial products that are hard to understand. If purchasing an annuity, you need to consider your options carefully. An annuity is a contract with an insurance company under which the consumer pays the company a certain amount of money and the company sends the consumer a monthly check for the rest of his or her life, or for a certain term. Annuities come in many flavors. They can be deferred (begin paying out at a later date) or immediate (begin paying out right away). They can pay a fixed amount each month or pay out a variable amount based on how the money is invested. While a fixed immediate annuity can be a good Medicaid planning option for a married couple, other annuity products can be quite complex and confusing and are not right for everyone. If you have decided an annuity is the right choice for your long-term care or retirement plan, you need to shop around to find the right product. The following are some purchasing tips:Check the terms. Be sure to read the annuity contract carefully. Annuities often have surrender charges that penalize you for withdrawing your money too early. You need to understand for how long you wont be able to access your money and when payouts begin. There may also be other fees associated with the annuity as well as optional riders. Understanding the fees will allow you to shop around to find the best product. Choose your salesperson. Insurance companies often pay generous commissions to the brokers who sell their particular annuities, payments that many of the brokers don't disclose. They also generally don't disclose whether they are paid more or less by one insurance company than another or whether the annuity being sold is the best option for the consumer. Ask your broker questions to determine how they are paid. You may want to seek a second opinion to make sure your salesperson isn't steering you into a product that isn't right for you. Select a sound insurance company. Annuity payments are often supposed to last a lifetime, so you want an insurance company that will stick around. Make certain that the insurer is rated in the top two categories by one of the services that rates insurance companies, such as A.M. Best, Moody's, Standard & Poor's, or Weiss.  

In 2022, the cost of raising a child in the U.S. to age 17 was roughly $17,000 per year. For families of children with disabilities, that estimate runs far higher.The costs of such necessities as health interventions and behavioral therapies, assistive technology, medications, child care, and sensory-friendly items can mean parents raising a child with autism to adulthood will pay about $60,000 annually, according to nonprofit Autism Speaks. Depending on the severity of the childs disability, those costs can easily escalate further.Children with Autism Spectrum Disorder (ASD) who meet certain criteria outlined by the Social Security Administration (SSA) may be able to secure public benefits that can offset these costs to some degree.What Is SSI?Supplemental Security Income (SSI) is one such public benefits program. It is a federal assistance program that provides modest financial support in part to help families caring for children with disabilities. SSI is also a means-based program; to be eligible, the recipients resources cannot exceed extremely strict and specific limits. Note that the income and assets of the childs parents can affect SSI eligibility.Is Autism a Disability According to the SSA?The Social Security Administration lists autism as a disability. Children with ASD could meet the SSAs definition of disability, qualifying for SSI. Autism is a spectrum disorder affecting individuals differently. Eligibility depends on the severity of autism and how it affects a persons abilities. For children and adults, the SSA lays out the medical criteria for determining whether individuals with autism can receive benefits.The SSA recognizes youths with autism as disabled when they have medical documentation of deficits in verbal and nonverbal communication and social interaction, as well as significantly restricted, repetitive patterns of behavior, interests, or activities.They must also have an extreme limitation in one, or marked limitation of two, of the following mental functioning domains:Understanding, remembering, or applying information.Interacting with others.Concentrating, persisting, and maintaining pace.Adapting or managing themselves.When children with ASD receive SSI, they get a monthly payment that helps cover certain needs. In addition to using monthly payments to cover basic needs, families who may have limited resources can also use SSI to cover expenses related to autism, such as therapy, educational programs and summer camps, communication devices and sensory tools, and respite care.Accessing Supplemental Security Income Benefits for Children With AutismChildren who meet the SSAs disability criteria for autism must also have resources that fall under the SSAs limits. The administration considers the income and resources of a child as well as family members. Even if a child spends time in a residential program, household members finances factor into the decision.To access SSI benefits for a child with ASD, families need records to show that their childs autism significantly impairs them. These records typically come from health care providers as well as schools.How Much Does a Child With Autism Get From SSI?In 2023, the maximum monthly benefit for SSI is $914 per individual. However, the amount of Supplemental Security Income that a child with autism can receive depends on numerous factors:The childs financial status, including the income and resources of parents and guardians; additional sources of income offset monthly Supplemental Security Insurance payments.The childs state of residence; states have different rules determining how much assistance they provide. Some states supply additional payments to SSI recipients to offset the cost of living.In many states, children with ASD who receive SSI benefits are automatically eligible for Medicaid, a joint federal and state health insurance program for people with low incomes and limited resources. Other states have different eligibility rules for Medicaid, and SSI recipients may need to apply separately for Medicaid coverage.How to Apply for SSI for a Child With AutismParents can apply for benefits for their children by taking the following steps.The first step is completing the Child Disability Report. This includes providing information about the childs medical conditions, medical records, and education.After completing the Child Disability Report, you must contact the Social Security Administration to complete the application. The state agency decides whether the child is eligible for SSI.To make this decision, the agency reviews the information the applicant provides and conducts a disability interview. If needed, the agency can request additional evaluations at its expense.It can take three to five months to receive a decision. Applicants can appeal if they disagree with the outcome.Consult With an AttorneyIf you are considering applying for SSI benefits for a child with autism, consider speaking with a special needs planning attorney. An attorney can guide you through the process, help you present a robust application, and address your unique needs.Here at Sharek Law Office, we are qualified to help you and yours in special needs planning. Call us at 412-347-1731 or click here to schedule your free 15-minute introductory phone meeting to discuss tools like special needs trusts and ABLE accounts for you and yours.  This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Spousal impoverishment is a concern for older couples when one spouse needs long-term care and applies for Medicaid. If one spouse requires care in a skilled nursing facility and the other remains at home, the spouse at home might face significant financial hardships. The high costs of nursing homes combined with Medicaids strict income and asset requirements risk leaving the community spouse with little income and assets. Medicaids Spousal Impoverishment RulesBefore the federal government enacted spousal impoverishment protections in 1988, many healthy spouses experienced poverty when their partners went on Medicaid. Medicaid has strict income and asset restrictions. Yet nursing home care is expensive, with monthly care fees ranging from $5,000 to $8,000. Many couples didn't meet Medicaids income and asset requirements, but couldn't afford care. Before receiving Medicaid, many families had to spend down their assets, leaving few assets for the spouse at home. Prior to qualifying for Medicaid, many couples paid nursing home fees out-of-pocket. Only when they could no longer pay would government assistance become available. Once all their funds went to long-term care expenses, the spouse living at home had little support. Medicaids 1988 spousal impoverishment provisions responded to these concerns, protecting spouses from loss of money and resources when their partners require long-term care. The spousal impoverishment rules rest on the principle that both spouses have a duty to provide for each other. Although the spouse at home must support the spouse receiving long-term care, the spouse receiving care also has a responsibility to the community spouse. The regulations allow the community spouse to keep a certain proportion of the couples combined resources and income, preventing impoverishment. MMNA and CSRAPer the spousal impoverishment rules, the Minimum Monthly Maintenance Needs Allowance (MMNA) and Community Spouse Resource Allowance (CSRA) permit the healthy spouse to keep a portion of the couples assets and income. The Minimum MMNA applies when one spouse is the primary earner. When the spouse with an income applies for Medicaid, the individual can transfer a portion of the monthly payment to the healthy partner.The CSRA protects some of the couples assets for the community spouse. Generally, to be eligible for Medicaid, a person cannot have more than $2,000 in assets. However, when one spouse applies for Medicaid and the other is healthy, the healthy spouse can keep more than $2,000 in resources. The federal government determines the minimum and maximum Community Spouse Resource Allowance yearly. Some assets, such as the couples home, car, furnishings and appliances, and personal possessions, don't count toward Medicaids assets requirements. Home and Community-Based Services The original spousal impoverishment protections only applied to married couples where a spouse needed nursing home care. In 2014, Section 2404 of the Affordable Care Act extended Medicaids spousal impoverishment protections so that when one spouse applies for home and community-based services, the other can retain some funds to support themselves.

Health Affairs estimates that 4 million older adults can only leave their homes with assistance, making accessing care challenging.The Centers for Disease Control and Prevention reports that 1.3 million Americans receive care in nursing homes. According to A Place for Mom, more than 810,000 reside in assisted living.Home health care presents an alternative to nursing homes and assisted living, providing care for homebound people. Those who receive home health care can remain in their residences, reducing expenses, preserving autonomy, and maintaining community ties.Although Medicare funds some home health care services, a recent study has found that Medicare beneficiaries are underutilizing the programs home health care options. Many older adults do not receive the home-based clinical care or home-based long-term services and supports that could benefit them.Medicare Coverage of Home Health ServicesMedicare Parts A and B cover certain home health services. Homebound individuals can receive part-time or intermittent skilled services. Part A covers home health care for people following a hospital stay or a stay in a skilled nursing facility. Part B provides home health care for homebound adults who need skilled nursing care.A Medicare beneficiary is considered homebound in the following situations:Because of an illness or injury, they have trouble leaving their home without help, such as a cane, wheelchair, walker, or crutches, special transportation, or another persons assistance.Their physician recommends staying at home.Leaving their residence takes a major effort.The program covers medically necessary part-time or intermittent skilled nursing care and health assistance, durable medical equipment, and medical supplies for use at home.Medicaid also covers long-term services and supports (LTSS), which include medical and personal care services that aid with activities of daily living (ADLs). These are the kinds of services an assisted living facility typically provides.Use of Home-Based Clinical Care and Long-Term Services and Supports Among Homebound Older AdultsA 2023 study published in the Journal of American Medical Directors Association looked into home-based clinical care and home-based LTSS among homebound older Medicare beneficiaries. The researchers examined the Medicare claims of 974 beneficiaries to shed light on their use of in-home services.The study found that while homebound individuals used these services, no group received high levels of all care types.Homebound individuals more commonly utilized LTSS services than home-based clinical care.Approximately 30 percent of participants received some home-based clinical care.About 80 percent of the sample received home-based LTSS.The researchers identified three levels of home clinical care and LTSS usage among older adults:Low Care and Services (46.6 percent). The largest group of participants received little home-based care. These individuals tended to be younger with fewer chronic conditions and functional impairments.Home Health Only with LTSS (44.5 percent). While this group used some home health services, such as assistance with ADLs, they received little home-based clinical care.High Clinical with LTSS (8.9 percent). Only a few participants had extensive home-based clinical care. In addition to tending to be older, they were more likely to have dementia and live alone.In finding that only roughly 9 percent of participants receive high levels of clinical care and LTSS, the study points to a gap between those who could benefit from these services and the care provided. Although in-home care and support could meet the needs of older adults, many homebound older adults do not take full advantage of the services available.Learn More About Your OptionsIf you or your loved one need help with medicare care of activities of daily living at home, contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute call to learn more about your options.  This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

A child may be eligible for Social Security benefits when at least one parent qualifies for Social Security retirement, disability, or death benefits. Children receive these benefits based on their parent's work records. In 2021, the Social Security Administration (SSA) provided an average of $2.8 billion in benefits to 4 million children each month.Children who may get Social Security benefits can also include: Adopted children Step-children Financially dependent grandchildrenChildren of a retired or disabled parent or grandparent may receive up to one-half of the parent's full benefit amount. When a parent who worked long enough to meet the SSA's criteria dies, their child may receive up to 75 percent of the deceased parents survivor benefits. These benefits may be granted to children until age 18. However, if a child is still in elementary or high school, the child may continue to get benefits until he or she either graduates high school or else reaches the age of 19 years and 2 months old. Children who became severely disabled before turning 22 may continue acquiring benefits as adults. In most cases, a child with a disability must be unmarried to receive benefits. The maximum family paymentThe SSA applies a maximum family payment to families receiving benefits through a parent's work record. The maximum family payment ranges from 150 percent to 180 percent of the parent's full benefit amount. Sometimes, the amount payable to all family members surpasses the limit. When that happens, the SSA decreases each family member's benefit proportionately. In other words, children with more siblings may receive smaller individual benefits than children with fewer siblings.Other SSA Programs SSI  Supplemental Security Income (SSI) is separate from Social Security retirement, disability, and death benefits.SSI is a needs-based program that provides benefits to individuals, including children, with certain disabilities and who reside in low-income households. According to the SSA, for a child to qualify for SSI, the child must have a severe physical or mental condition that limits the child's activities and has either lasted one year or is expected to be fatal.With regard to household income, the SSA subjects families receiving SSI to strict income thresholds and periodically reviews each child's disability status. SSDI  Upon turning 18, an individual with a severe disability may be eligible for Social Security Disability Insurance (SSDI), another SSA program. The individual must have become disabled before age 22.When a child with a disability turns 18, parental income no longer determines whether the individual will receive benefits. Instead, the SSA looks at the individual's income. If the individual is married, the SSA considers the spouse's income. Thus, children who weren't eligible for SSI because of parental income may qualify for SSDI upon turning 18. Applying for Social Security benefits Parents and guardians may apply for Social Security benefits for their children. To apply, you may need:The parent's Social Security numberThe child's Social Security number The child's birth certificateProof of adoption, such as the adoption certificate, for adopted childrenEvidence of the parent's death, such as the death certificate, for survivor benefitsThe medical documentation of the child's disability for children with disabilitiesVisit ssa.gov to learn more.

As of late 2022, more than 84 million were enrolled in Medicaid a number that has steadily increased in recent years. Amid the pandemic, total enrollees climbed by 20 million people from 2020 to 2022 alone. Meanwhile, the debate among lawmakers on further expanding Medicaid in some 11 states continues to evolve. Depending on where you reside, passage of such an expansion could mean you become newly eligible for Medicaid. What Is Medicaid?Medicaid is a nationwide program designed to provide public health insurance for low-income individuals, including seniors and people with disabilities. Established in 1965, it serves today as the single-largest source of health coverage in the U.S.Because Medicaid is jointly run by the federal government and state governments, its benefits and your ability to qualify for them can vary greatly depending on your state. As a result, certain populations, even if they're living in poverty, may not be eligible for Medicaid. For example, in some states, a healthy, childless adult couple under age 65 with limited means may not qualify for health coverage through Medicaid if their state hasn't adopted Medicaid expansion. What Is Medicaid Expansion?Medicaid coverage across the country has evolved since the program was first created. Different states may employ different eligibility criteria, income limits, or application requirements.In 2010, the Affordable Care Act (ACA) attempted to expand Medicaid coverage to adults between 18 and 65 with incomes below a certain level, regardless of their age, family status, or health. The ACA also sought to supply those whose incomes fell within specific limits with premium tax credits that would help them afford the purchase of a private insurance plan. Yet, the Supreme Court ruled that the federal government couldn't force states to expand coverage. States can decide whether to expand Medicaid to cover more people. This has created a coverage gap: Those who have incomes below 100 percent of the federal poverty level and who live in states that have opted against expanding Medicaid may not qualify for Medicaid, or for the premium tax credits. Medicaid Expansion StatesAs of early 2023, most states have adopted the ACAs broadening of Medicaid. Per the Kaiser Family Foundation, the following states in addition to the District of Columbia have expanded Medicaid coverage per the ACA: AlaskaArizonaArkansasCaliforniaColoradoConnecticut DelawareHawaiiIdahoIllinoisIndianaIowaKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandUtahVermontVirginiaWashingtonWest Virginia States Without Medicaid Expansion States that haven't adopted Medicaid expansion per the ACA include:AlabamaFloridaGeorgiaKansasMississippi North CarolinaSouth Carolina TennesseeTexasWisconsin Wyoming Medicaid Expansion Developments The map of Medicaid expansion states continues to evolve, however: South Dakota voters approved a ballot measure adding Medicaid expansion to the state constitution in November 2022. The expansion will go into effect beginning July 1, 2023. In February 2023, the North Carolina House of Representatives passed a bill to expand Medicaid. It now awaits review in the Senate.Meanwhile, also in February 2023, the Wyoming House of Representatives declined to address a proposed Medicaid expansion bill. Arguments Against Medicaid Expansion In states without Medicaid expansion, those opposed to expanding coverage have voiced such concerns as increased costs and a higher risk of fraud. For example, some argue that Medicaid expansion would burden their states budget. Although the federal government funds the majority of expanded Medicaid, it doesn't completely cover the costs; states pay 10 percent. In the case of Wyoming, House Majority Floor Leader Rep. Chip Neiman has raised concerns that the federal government wouldn't uphold the federal match, leaving the state to bear more financial responsibility.Others contend that Medicaids most vulnerable beneficiaries may face greater competition for resources, that other health care options are available to those in need, or that expansion may not ultimately translate into better long-term health outcomes.How Older Adults Can Find Out if They're Eligible for Medicaid CoverageIn states that have adopted expanded Medicaid, you may qualify if your household income lies below 133 percent of the federal poverty level, according to HealthCare.gov. For older adults, most states provide Medicaid to those who receive Supplemental Security Income (SSI). To be eligible for SSI, individuals must have low incomes, limited assets, and be unable to work due to a qualifying mental or physical impairment. Per the Kaiser Family Foundation, some states expand Medicaid to older adults and disabled people whose income surpasses the SSI limit but falls below the federal poverty level. You may be able to qualify for Medicaid through the Medically Needy program if your state has established one. The Medically Needy program allows people to enroll in Medicaid when they have significant medical expenses. When they subtract their medical spending from their total income, they can qualify for Medicaid if their income, minus health care expenses, falls below a specified limit (which also varies by state). To find out whether you qualify for Medicaid, consider consulting the following tools:The Benefits.gov Eligibility Checker will ask you questions regarding things like household income, number of dependents, and citizenship status to help you determine whether you might be eligible for Medicaid generally. The HealthCare.gov site can offer additional insights, including:Guidance on Health Insurance Marketplace applicationsIncome calculatorsPremium tax credit informationQ&A tool to determine eligibility for cost-sharing reductionsAgain, the rules governing Medicaid and its complex eligibility criteria varies widely by state. To find out whether you may be able to receive public health insurance through Medicaid, consult with your attorney.

Many older adults face difficulties accessing and preparing meals. Yet eating a nutritious diet is essential for maintaining health, particularly as we age. For those with barriers getting to the grocery store and preparing food, meal delivery services can help. Meal delivery can support individuals to remain in their homes and live independently. Local organizations distribute free or low-cost meals to older adults. Qualifying individuals can receive delivered meals for free from Medicaid and Medicare Advantage. Private companies also offer paid meal delivery. Local Nonprofit OrganizationsCommunity-based programs supply dinners to older adults who are homebound. The Older Americans Act (OAA) established support for Area Agencies on Aging, for example. These local nonprofits address the needs of older adults in the area and provide social and nutrition services.Supporting these nonprofit organizations, the OAA funds meals and other services such as senior centers and transportation. Many senior centers also offer neighborhood meals, which in turn help in fostering social connections. Meals on WheelsThe OAA also provides one-third of the funding for Meals on Wheels. With divisions nationwide, Meals on Wheels serves community members who have difficulty accessing meals because of physical limitations or financial constraints. Volunteers deliver hot meals directly to individuals homes. In addition to providing food, they check on the clients. For many meal recipients, the meal delivery person becomes a friendly contact, lessening feelings of isolation.Meals on Wheels reports that 40 percent of its clients live in poverty, and more than 20 percent are veterans. Most clients are adults aged 60 and older. The cost is a sliding scale, depending on how much the recipient can pay. Those who cannot afford to pay can receive meals for free. Although most clients are 60 and older, younger individuals can also get meals. However, they may be asked to contribute more financially than older adults.Unlike enrolling in Medicare and Medicaid, people do not have to meet stringent requirements to enroll in Meals on Wheels. When facing high demand, however, the organization may prioritize homebound older adults over those who can visit senior centers and cafes. Find a local Meals on Wheels provider on the Meals on Wheels America website.Medicaid BenefitSome individuals who qualify for Medicaid can receive food from a meal delivery company. Coverage for meal delivery is often part of the Long-Term Services and Supports (LTSS) program. Waiver programs that expand Medicaid access to individuals who might not otherwise qualify can also include food delivery services. Medicare AdvantageAlthough traditional Medicare does not encompass meal services, select Medicare Advantage plans come with this benefit. These programs typically supply meal delivery coverage for a limited period following a hospital discharge. Companies Providing Paid Senior Meal Delivery ServicesMany companies offer meal delivery. Verywell Health evaluated the premade meal delivery options available to seniors. It named Freshly the most favored option overall, and Moms Meals the best value. Moms Meals offers a meal plan tailored to people with diabetes and another for those recovering from the hospital. Speak with an elder law attorney to learn more about how to get free or low-cost meals to your home. 

Though most people dread the thought of their own death, through a well-conceived and properly executed estate plan, you can protect your loved ones by leaving an organized strategy with your wishes instead of a mess.You should have at least the Big 3 documents (as I like to call them), which are the Will, Power of Attorney, and Healthcare Directive. Without having all three of these documents in place, you leave gaps in your plan that could cause conflict among your loved ones and possibly require court intervention. Lets walk through these documents in the order that you might need to use them so that you can better understand what purposes they serve.In Pennsylvania, three components work together in a Healthcare Directive document, which affects access to healthcare information and the power to make medical decisions. First, a HIPAA Authorization will allow you to name loved ones to have access to your medical status or records from a doctors office or hospital. Next, a Healthcare Power of Attorney names your healthcare agents, in the order that they can serve to make medical decisions for you if you can not do so for yourself. Lastly, a Living Will communicates detailed instructions for others to follow if you end up in a permanent vegetative state due to irreversible brain damage or suffer from an end-stage medical condition where you no longer have the capacity to voice your own opinion about your medical care or treatment.A Durable Power of Attorney grants another person (known as an agent) the power to make all of your financial and legal decisions. Or simply putif you can do something for yourself, then your agent can do it for you. These powers include significant ones like banking and investments, changing beneficiaries on policies, taking out credit cards and life insurance, or filing taxes.A Last Will and Testament spells out how you wish for your assets to be distributed after your death through probate. In order for this to happen, you also need to name an executor of your estate. An executor takes on a fiduciary role to collect your assets and then will pay any final bills, funeral expenses, attorney fees, or other debts owed. Then, that executor will distribute your remaining assets according to your wishes.Editors Note: This article was written by Ashley E. Sharek, Esq., Sharek Law Office, LLC. She may be reached at 412-347-1731 or contact@shareklaw.com. 

As we near retirement, we may assume that once Medicare kicks in, our medical insurance premiums will be fixed. However, many people may not realize there are special rules regarding how much they pay for Medicare Parts B and D if they're in a higher income range. What Is IRMAA?If the Social Security Administration (SSA) determines you have a higher income, you'll have to pay more for your Medicare Part B or Medicare Part D coverage. This surcharge is referred to as the income-related monthly adjustment amount (IRMAA). It's paid in addition to your monthly premium amount.Note that Medicare Part B pays for doctor visits, outpatient care, and related services. Medicare Part D is related to your prescription drug coverage.How Is IRMAA Calculated?To determine whether you must pay higher Medicare Part B or D premiums, the SSA bases the decision on your most recently filed tax return. Because of timing issues, this can often be your tax return from two years prior, as your most recent one may not yet be filed or in the IRS system. If the SSA finds that you must pay a higher premium, they use a sliding scale based on your modified adjusted gross income (MAGI) to determine by how much. MAGI equals your total adjusted gross income and any tax-exempt interest income you've received in a tax year. 2023 IRMAA BracketsThe IRMAA 2023 threshold for married couples is $194,000. For any other filing status, the threshold is $97,000. Once you cross these thresholds, you'll pay more for coverage. How much more depends on how much you exceed these numbers. The SSA provides a chart to show you what you can expect in 2023.The SSA calculates your IRMAA every year. So, while you may be subject to IRMAA for one year, you may not be subject to it the following year. If the SSA determines you'll be subject to IRMAA, they inform you of this and its effect on your premium in writing.How Will IRMAA Affect My Premiums?Lets start by understanding how IRMAA may affect your Medicare Part B and D premium. Usually, the split between SSA and you is 75 percent/25 percent. In other words, Medicare pays 75 percent of the premium, and you pay 25 percent. If you exceed the income thresholds, the split changes, and you may pay anywhere from 35 percent to the total cost, depending on your income level.Again, refer to the SSAs 2023 chart for your situation. So, for example, if you're filing taxes as a married couple and make between $194,000 and $228,000 in 2023, you'll see on the 2023 chart that your Part B premium will increase by $65.90. Your Part D premium will go up by $12.20.What If I Dont Think I Should Be Subject to IRMAA? What happens if your income listed on your most recently available tax return was much higher than what you're currently making or receiving? There is a way for you to inform SSA of the change in your finances. For example, if you divorced, were laid off, or are making less money and you can document this, you can complete the Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event form. This will inform SSA and ask them to reassess any imposition of IRMAA in your case.You can also appeal the SSAs decision where there was a change in your income but not necessarily in the form of a life event. For example, if you filed and IRS accepted an amended tax return for the year that is being used to calculate your IRMAA, you may be able to get the SSA to change its decision. Sometimes the SSA gets erroneous information about you from the IRS, and this may also be a basis to appeal.There are a few different ways to appeal the SSAs IRMAA determination. The appeal can be submitted in any of the following ways:online,in writing by completing a Request for Reconsideration, or through your local SSA office.Speak With a ProfessionalIf you have questions about IRMAA and your particular circumstances, it's best to speak with a professional. Timing matters, so seeking professional guidance as soon as possible after you receive notice of the IRMAA surcharge is essential.

Seniors as well as their caregivers should be aware of the risks posed by Medicare scams and how to avoid falling victim to this type of fraud.Each year, Medicare loses tens of billions of dollars to abuse and errors. Older adults who receive Medicare may be subject to this type of fraud perpetrated by identity thieves, scammers, and deceitful health care providers.Safeguard Yourself From Medicare ScamsTo start, there are several easy ways for you to lower your risk of being scammed in the first place.Dont share your Medicare number over the phone.Have your Medicare card with you only when necessary. Otherwise, leave it at home. (Think of it like a Social Security card or credit card and protect it in the same way.)Be aware that Medicare representatives will never come to your residence uninvited. They also will not call you out of the blue to verify your information or to offer free or low-cost equipment, such as a back or knee brace.Hold onto your receipts and bills from past medical appointments so that you can compare them to your Medicare statements.Always look through your Medicare Summary Notices when you receive them. Keep an eye out for any errors or discrepancies regarding services, tests, or medical supplies that you did not receive, or that you were charged for more than once. You can call your health care provider and ask them to explain a charge and, if necessary, you have the right to dispute charges that are wrong.Why Do I Need to Report Medicare Fraud?Medicare abuse is far from being victimless. Reporting fraud to the proper authorities is crucial to help stop it.If someone steals your Medicare card or number, you could receive bills for health services you did not receive or become a victim of identity theft.A health care provider who may be fraudulently charging you for services can spell trouble for more than your wallet. A dishonest provider could be misdiagnosing you or even subjecting you to treatments or services you do not need or that could potentially negatively impact your health. Sometimes, billing errors are made by accident, but if you find that your provider makes these types of mistakes frequently, it may signal a potential case of fraud.Ultimately, fraud that goes unchecked can lead to higher Medicare costs for you as the consumer.What to Do If You Suspect Medicare AbuseThere are a number of options for reporting incidents that you suspect may constitute Medicare fraud:Call the Office of Inspector General hotline at 1-800-HHS-TIPS or file your complaint online.Call 1-800-MEDICARE to report suspected abuse by a Medicare provider.In addition, each state (and the District of Columbia) has a dedicated Senior Medicare Patrol, or SMP. This service can monitor your Medicare account for fraud and TBD. Search online for your local SMP.Experienced elder law attorneys are also equipped to help protect you from abuse. Contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call to learn how we can help. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Individuals experiencing illnesses can benefit from having someone attend appointments with them and support their best interests. Often, close friends or family take on this role. Professional patient advocates, however, can step in when friends or family cannot be at the hospital or a patient prefers having the help of a qualified professional who understands the healthcare system.Experienced patient advocates may have legal and medical knowledge that friends and family lack. Many professional patient advocates have experience as doctors or nurses, or as social workers or lawyers.Hospital patient advocatesSome hospitals provide a professional patient advocate for you. Many insurance programs cover hospital-based patient advocates, making their services a cost-effective option for some patients. Additionally, some patients may appreciate that their hospital has already vetted their patient advocates. You may still prefer, however, to hire an independent patient advocate who may provide objective advocacy.The cost of professional patient advocatesHiring a patient advocate can be expensive charging between $75 and $500 per hour.However, patient advocates who understand healthcare rules and regulations can use their knowledge to help their clients avoid unnecessary expenses. For instance, patient advocates can help make cost-effective travel arrangements, review hospital bills, and assist with insurance claims.How professional patient advocates can helpProfessional patient advocates can assist patients in other ways as well, including:Scheduling appointmentsAttending appointments with patients, taking notes, and asking questionsCommunicating medical information to family membersEnsuring nurses wash their hands and follow other safety procedures when a patient is staying in the hospitalResolving disputes with doctorsFinding specialists in the patient's insurance networkReviewing statements and identifying billing errorsAppealing insurance denialsAlthough professional patient advocates can help patients understand their illnesses and treatment options, they don't make healthcare decisions for the patient. Only the patient, a healthcare agent under a healthcare power attorney, or a legal guardian can decide whether to prolong a patient's life and what kind of end-of-life medical interventions to carry out. Professional patient advocates also need the patient's consent to get private health information from the patient's healthcare provider.How to find a professional patient advocateProfessional patient advocates are certfied by the Patient Advocate Certification Board. If you wish to hire a professional patient advocate, consider asking for references and reviewing a professional patient advocate's background before employing them.For a directory of professional patient advocates, check out the following resources:The National Association of Healthcare Advocacy ConsultantsAdvoConnectionThe Alliance of Professional Health AdvocatesGreater National Advocates

In October 2022, the Internal Revenue Service (IRS) announced contribution limitation adjustments for employee retirement plans in response to inflation. The IRS issued Notice 2022-55, which describes cost-of-living adjustments for retirement and pension plans. The changes are effective January 1, 2023.Increases to Contribution Limits for Retirement Plans in the New YearBeginning in 2023, workers maximum allowed contributions to 401(k), 403(b), 457 plans or, for federal employees, the Thrift Savings Plan will increase to $22,500 from $20,500. The catch-up contribution limit for employees 50 years and older will increase to $7,500 from $6,500. So, if you're working and are aged 50 or older, you can contribute up to $30,000 ($22,500 + $7,500 = $30,000) to these types of retirement accounts in 2023 in addition to your employers contributions.Employees with individual retirement arrangement (IRA) accounts may contribute up to $6,500 in 2023. The annual cost-of-living adjustment won't apply to the IRA catch-up contribution limit for workers 50 years or older; their limit remains $1,000. The catch-up contribution limit for SIMPLE plans increases to $3,500 from $3,000 for workers aged 50 and older in 2023. Phase-Out RangesYour annual income level also affects how much you can contribute to certain types of investment accounts. The IRS, which outlines these phase-out ranges, announced several changes to the phase-out ranges for traditional and Roth IRAs.In 2023, if a taxpayer or their spouse has a workplace retirement plan, an IRA contribution can be reduced until it reaches $0. Again, applicability depends on income.Traditional IRA 2023 Phase-Out Ranges For married taxpayers filing jointly if the contributing spouse has a workplace retirement plan: Between $116,000 and $136,000 (up from $109,000 to $129,000). For single taxpayers with a workplace retirement plan: $73,000 to $83,000; this is an increase from $68,000 to $78,000. For someone with an IRA not through their workplace and who is married to someone covered by a workplace retirement plan: $218,000 to $228,000, an increase from the 2022 range of $204,000 to $214,000. For a married individual filing separately who is covered by a workplace retirement plan: The yearly cost-of-living adjustment for phase-out ranges does not apply. The phase-out range remains $0 to $10,000. Roth IRA Phase-Out Ranges for 2023 For married taxpayers filing jointly: $218,000 to $228,000, which is an increase from the 2022 range of $204,000 to $214,000. For single taxpayers: $138,000 to $153,000; this is up from $129,000 to $140,000 in 2022. For married person filing separately: The yearly cost-of-living adjustment for phase-out ranges doesn't apply to a married person filing separately. The phase-out range remains between $0 and $10,000. The IRS also announced changes to the qualifying income limit for the Savers Credit. The following are the new income limits that will apply starting in 2023: Married couples filing jointly can earn up to $73,000, an increase from $68,000. Heads of household can earn up to $54,750, up from $51,000. Singles and married people filing separately can earn up to $36,500, an increase from $34,000.Further Government Efforts to Increase Retirement SavingsMore retirement protections in response to inflation may be coming. In March 2022, the House of Representatives passed the SECURE Act 2.0. If Congress passes this bill, workers 50 and up will have more opportunities to increase their retirement savings.

Long-term care for seniors is always evolving. One possible next step for you or your loved one may be geriatric care. You may be wondering: What does this type of care entail? Is it any different from the arrangements I have previously made for my aging family member? What does geriatric even mean? Keep reading to learn about geriatric care and the growing need for these services across the United States. What Is Geriatrics? Geriatrics is a medical specialty dedicated to the care of aging people. There is no specific age when someone should seek geriatric care. However, most people over 75 tend to need skilled care focused on the challenges seniors begin to face as they age. The need for this type of care will grow in the future. According to the United States Census Bureau, in 2030, everyone in the Baby Boomer generation will be 65 or older. With the expected increase in need, it's important for seniors and their caregivers to learn more about this type of care.Common Medical Problems Older Adults Face Older people tend to need more substantial medical care than other populations. They suffer from chronic health conditions at a higher rate, and certain medications may cause negative reactions in their bodies. Geriatric physicians, also known as geriatricians, are specially trained to meet these needs. Common medical issues that seniors suffer from can include: Dementia, including Alzheimers diseaseIncreased risk of falls Delirium Increased confusion and agitationMuscle atrophyHeart disease Gradual or acute loss of mental capacity Other chronic illnesses How Do Seniors Benefit From Geriatric Care? Geriatric care may aid in allowing seniors to receive necessary medical care while remaining in their communities. They can build a health care team that addresses each of their needs. Doctors specializing in this field don't replace primary care physicians. As patients age, a primary care doctor works with the geriatrician to address any underlying conditions and create a treatment plan. Having a strong health care team working for them allows seniors to live healthier and more independent lives. Adding a geriatrics physician to your loved ones health care team may improve their quality of life. Some of the benefits of geriatric care include: More accurate diagnoses Decreased dependence on nursing home care Improved quality of life Improved cognition and mental functionLowered rates of depressive episodes How Can a Geriatric Care Manager Help Caregivers? You may be struggling to provide care for aging loved ones. Perhaps you live in another state, have a full-time job, or have serious health conditions of your own. Geriatric care managers may be able to offer support. These professionals act as advocates for your aging family members. They tend to have formal education and experience in such disciplines as nursing, gerontology, health care administration, or social work.Note that they usually serve families whose incomes are too high to qualify for Medicaid coverage or other government assistance.Geriatric care managers provide some of the following services: Assisting with long-term care arrangements Communicating with out-of-state family members about their loved ones condition and care plan Explaining complexities of long-term care to seniors Evaluating and coordinating hired caregivers (including home health care givers) Helping seniors apply for social servicesResearching governmental assistance programs or other programs available in your community

You might think that only the super wealthy need to worry about asset protection planning. But the truth is that if you dont have millions, you may be at even greater risk. Like all types of planning, you must have your asset protection strategies in place well before something happens.  Here are four essential strategies to consider for safeguarding your familys most valuable assets.1. Invest In InsuranceInsurance is always the first line of defense when it comes to asset protection. Anyone can file a lawsuit against you at any time and basically for any reason. And whether you are ultimately found at fault or not, defending yourself in court can be extremely costly.A Personal Family Lawyer will evaluate your current insurance policies and advise you about the types and amounts of insurance you should have for maximum protection of your assets.2. Take Advantage Of Statutory ExemptionsAnother way to protect your familys assets is by taking full advantage of federal and state laws that make certain types of assets exempt from creditor claims and judgments.Similarly, federal and state laws also classify many retirement plans, such as 401(k)s and IRAs, as exempt assets. Additionally, some states offer significant, or complete, exemptions for life insurance policies and annuities.3. Use The Right Business EntityOwning a business can be a major wealth-generating asset for your family, but it can also be a serious liability. Without the proper protection, your personal assets are at serious risk if your company ever runs into trouble.4. Put The Proper Estate Planning In PlaceIf you become incapacitated or die without proper estate planning in place, your assets and family will face a number of potentially tragic outcomes. Without proper planning, your assets will get stuck in the court system, which could result in those assets passing to family members you would never want inheriting them, or if the assets eventually do pass to the loved ones you would want inheriting them, those assets could be seriously depleted or even lost. Planning in advance is one of the greatest gifts you can give those you love most.A Personal Family Lawyer can help safeguard your familys most valuable assets.Editors Note:  This article was written by Attorney Ashley Sharek of Sharek Law Office, LLC.  Ashley can be reached at 412-347-1731 or visit her website at www.shareklaw.com. 

Hospice care is a type of health care that patients with terminally ill conditions rely on at the end of their lives. This type of care focuses on pain management and emotional, spiritual, and familial support for patients nearing the end of their lives.There are several options for receiving hospice care, including being cared for at home. The type of intimate care a patient receives while in hospice is more conducive to being received at the patients home. This becomes a team effort, and it helps to have a peaceful environment when receiving care.Who Can Benefit From This Type of Care?Patients with serious illnesses like cancer, heart disease, dementia, kidney failure, or other fatal conditions benefit from hospice care. This type of care can help the patient live a more comfortable life while decreasing the emotional burden of grief for families by preparing them for the loss of their loved one.When Is Hospice Recommended?Hospice care should not only be considered by those who have loved ones nearing the end of their lives. While most of these services are generally reserved for people with six months or less to live, early hospice care can be beneficial for patients and their families as well.You may wish to consider such services in the following cases:The patient has a serious decline in their physical well-beingAfter a diagnosis of Alzheimers disease or dementiaYou have decided to forgo any treatment to improve your physical treatment or care for your illnessWho Makes Up a Hospice Care Team?Your hospice team can consist of many different types of people. Various professionals and volunteers may be involved in end-of-life care. Some of those you may see on your care team can include:DoctorsNursesSocial workersSpiritual advisorsTrained volunteersWho Pays for Hospice Home Care?Like any other health care option, these services can quickly become very expensive. Fortunately, there are several ways to cover the cost, including:Government ProgramsIf you qualify for government assistance, there may be insurance plans specifically designed to cover the cost of hospice care.Seniors enrolled in Medicare Part A may qualify for a Medicare hospice care benefit. This benefit program allocates money to pay for such care at home.For terminally ill patients on Medicaid, hospice care may be covered depending on the state. The Department of Veterans Affairs may also provide coverage for these care benefits for seniors who have served our country.Private InsuranceCheck the terms of your insurance policy to determine if your health insurance covers hospice care. Your policy may cover all or part of your hospice care needs.Options for Uninsured PatientsEven if you do not have health insurance, you may still have coverage options. There are charitable organizations that work with elderly and disabled individuals who need help paying for hospice care services. Hospice care organizations also often have internal departments that work with patients who qualify for this type of care but are indigent or do not have health insurance.Is In-Home Hospice Right For You?Making this choice is an important part of your end-of-life care plan. Be sure to gather as much information as you can before deciding whether this type o care is best for you. For example, you may want to consult Medicares hospice compare website or CaringInfo.orgs website for other hospice locator tools.Knowing where to start is intimidating, but help is available. Contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call with our staff to discuss your needs and to get the process started today.

A hospitals classification of you as inpatient or outpatient can significantly affect Medicares coverage, shaping how much you pay for services and whether your coverage includes care in a skilled nursing facility. Medicare Part A pays for inpatient hospital and post-hospital extended care, including care in a skilled nursing facility following admission to a hospital. However, it doesn't cover outpatient care, which typically falls under Medicare Part B. To receive coverage for post-hospital nursing home care under Part A, you must have been an inpatient in a hospital for at least three days. As Medicare.gov explains, individuals become inpatients after the hospital formally admits them per a doctors order. The day the hospital discharges them constitutes the last inpatient day. Who Is Considered an Outpatient?Individuals who receive care in hospitals that don't formally admit them are regarded as outpatients. People receiving emergency department services, observation services, outpatient surgeries, lab tests, or X-rays are outpatients. Even when these individuals spend the night in the hospital, Medicare still considers them outpatients. When a hospital reclassifies you from an inpatient to an outpatient receiving observation services, you could lose Part A coverage. This is because Medicare Part A doesn't cover post-hospital extended care for those classified as outpatients. If your hospital changed your status from inpatient to outpatient, you have the right to challenge the status change. Upon your appeal, Medicare must reconsider its decision and might change your status back to inpatient, allowing Medicare Part A coverage to take effect. Court OrderIn the past, beneficiaries lacked the right to appeal status changes from inpatient to outpatient. The Center for Medicare Advocacy secured these appeal rights for Medicare beneficiaries in a 2020 class action lawsuit, which the federal court affirmed in January 2022. The court required Medicare to have appeal procedures in place for hospitalized beneficiaries reclassified from inpatients to outpatients getting observation services. Appeals ProcessMedicare.gov explains the process for appealing a reclassification and who qualifies for an appeal. You have the due process right to appeal if you meet the following requirements: On or after January 1, 2009, a hospital accepted you as an inpatient, then designated you as an outpatient receiving observational service. A Medicare Outpatient Observation Notice (MOON) or a Medicare Summary Notice (MSN)notified you that Part A doesn't cover your observation services. To appeal, you must also meet one of the following criteria:At the time of your hospital stay, you weren't enrolled in Medicare Part B. Alternatively, you were enrolled in Part B, stayed at the hospital for three or more concurrent days without being an inpatient for at least three days, and entered a skilled nursing facility within 30 days after your hospital stay.You can also appeal if its been less than 30 days since your hospital stay. When Can You Appeal? According to Medicare.gov, the appeals process for reclassifications has yet to be made available. Generally, Medicare has a five-step appeals process.If you win your appeal, Medicare must disregard your reclassification as an outpatient. It also must consider you an inpatient to determine Part A Benefits, including coverage for your stays in a hospital and skilled nursing coverage facility. Speak to us to learn more about challenging your status change.

Caring for a loved one with dementia is a challenge that millions of families undertake each year. As a caregiver, understanding how a dementia diagnosis affects your loved ones legal decision-making is crucial to ensuring their wishes are honored and that you are providing them with the best possible care.In this blog, we'll explore the importance of estate planning, even after a dementia diagnosis, as the best method to ensure the wishes and rights of your loved one are protected.Understanding IncapacityDementia is a progressive condition that affects memory, cognition, and daily functioning. As dementia causes your loved one's cognitive abilities to decline, there may come a time when they are no longer able to make sound decisions about their finances, healthcare, and overall well-being. When the effects of dementia make it difficult for a person to understand information and make sound decisions, that person is considered to be incapacitated, which means they can no longer legally make healthcare or financial decisions for themselves. This change in their memory and cognition can be emotionally overwhelming for both your loved one and your whole family, and without proper planning, can require court involvement.But, theres still some good news. Thoughtful estate planning can ensure that your loved one is cared for by the people they know and trust if they can no longer care for themselves, and even if youre loved one has already been diagnosed with dementia, it is still possible for them to create a legally-binding estate plan during the early stages of the disease.Estate Planning In The Early Stages of DementiaEvery adult should create certain legal documents to protect their rights and wishes, and this is no different for a loved one with a dementia diagnosis. What is important to remember is that in order to create a legal document, you need to have mental capacity meaning you need to be fully aware of what you are doing and what the consequences of your choices will be.Thankfully, a person does not need to constantly be in a state of capacity to create an estate plan. As long as your loved one has the mental capacity at the moment they sign their estate plan documents, the documents will be valid, even if they regress into a state of incapacity afterward.In the early stages of dementia, and ideally long before any health problems surface, your loved one should create the following estate planning documents:General Durable Power of AttorneyA General Durable Power of Attorney (POA) is a legal tool that allows your loved one to appoint someone to make financial and legal decisions on their behalf. Their POA can write checks, pay bills, maintain their home, and manage their financial assets. This document becomes especially significant as dementia progresses. Encourage your loved one to designate a trusted individual as their Power of Attorney while they are still able to make such decisions. A Revocable Living TrustA General Durable Power of Attorney is an important tool, but many financial institutions place constraints on the use of a POA or dont acknowledge their authority at all. To make sure your loved one has complete protection of their financial wishes, encourage them to establish a Revocable Living Trust and move their assets into the name of the Trust. As part of creating a Trust, your loved one will name the person they want to manage their assets, called the Trustee. The Trustee and Power of Attorney are usually the same person, but not always. By having these two estate planning tools in place, you can rest assured that the people your loved one knows and loves will be able to manage their assets for them as their dementia progresses. Power of Attorney for HealthcareSimilar to a General Durable POA, a Power of Attorney for Healthcare (HPOA) appoints someone to make medical decisions on behalf of your loved one when they are unable to do so for themselves. Discussing and establishing a Healthcare Power of Attorney early on allows your loved one to express their medical preferences and ensures their wishes are honored. Their Power of Attorney for Healthcare should also include a Declaration to Physicians, also called a Living Will, that outlines their desires regarding medical treatment, life support, and end-of-life care. Creating a Declaration to Physicians and discussing their wishes with you ensures that their preferences regarding life-sustaining treatment, resuscitation, and other medical interventions are documented and respected.Plan As Early As PossibleOne of the most crucial steps in preparing for the challenges of dementia is to help your loved one complete their estate planning while they still have the capacity to do so. Waiting until the later stages of the disease can limit their options and increase stress for everyone involved. By addressing legal matters early on, you can ensure that your loved one's wishes are respected, and their affairs are managed.As dementia progresses, estate planning must become more proactive and strategic than ever to avoid court and conflict over your loved ones wishes in the future. If dementia becomes too advanced before planning is complete, the question of who will manage your loved ones assets and care will be left to a judge who doesnt know your loved one or their wishes.  Keep reading to learn what steps need to be considered when estate planning for someone with more advanced dementia.Seek a Cognitive EvaluationIf your loved ones cognitive capacity is in question, seeking a professional evaluation is a prudent and proactive step in the estate planning process. Schedule an appointment with your loved one's primary care physician or a specialist in dementia care to assess their mental state and make a recommendation on your loved ones ability to make estate planning decisions.During this evaluation, the medical professional will talk to your loved one and ask them questions about their everyday life, how aware they are of their circumstances, and what they would do in certain situations, such as if a stranger came to the door or if a pipe burst in their home. Your loved one doesnt need to remember every detail about their life for the evaluation to be beneficial. The professional will be most concerned with your loved ones ability to analyze a scenario and make a thoughtful decision on how to respond. For example, your loved one may not remember what day of the week it is but may remember they shouldnt open the door for a stranger.Receiving a report from your loved ones doctor stating they have the cognitive ability to make estate planning decisions (at least when they are in a lucid state) protects their ability to make decisions for their finances and healthcare, and dissuades any future debate from third parties as to whether your loved one had the ability to make a plan in the first place.Encourage Private Meetings Between Your Loved One and Their LawyerIt may be second nature to help your loved one with appointments, especially if hearing and memory troubles make it difficult for your loved one to follow along. But as much as possible, allow your loved one to meet with their lawyer independently. A private meeting between your loved one and their lawyer will provide them with the opportunity to express their wishes without external influence. Even if you have your loved ones best intentions at heart and they would prefer to have you present during the meetings, encouraging your loved one to have private conversations with their lawyer when possible helps avoid questions about whether or not you influenced their estate planning decisions.If it isnt feasible for your loved one to have an entire meeting with their lawyer alone, make sure they at least have opportunities to talk to their attorney in private by leaving the room while your attorney confirms their wishes.Be sure to document every time your loved one meets alone with their lawyer and ask their lawyer to document it as well. Make Sure Their Estate Plan Is Executed CarefullyUnfortunately, errors that occur at the time an estate plan is signed are common. Every state has different laws for how estate planning documents are executed, how they can be signed, and what witnesses or notaries are required to make the document binding. If your loved ones plan isnt executed properly, it can result in your family needing to involve a judge to determine whether the estate plan is still valid. This also creates an opportunity for family members to question whether your loved one had the mental capacity to create the plan at all.Its also essential to document your loved ones capacity at the time the estate plan documents are signed. Make sure that their lawyer reviews the documents carefully with your loved one before they sign them, that the documents reflect your loved ones wishes, and that your loved one is creating the plan of their own free will.If you have any concerns about other family members questioning your loved ones estate planning decisions or mental state at the time, ask your loved one and their attorney if they could record the signing meeting to dispel any claims that your loved one was coerced into planning or didnt know what they were signing. ConclusionIf your loved one received a dementia diagnosis and hasnt addressed their legal matters, don't despair - but act fast. Even in the advanced stages of dementia, individuals may have moments when they can participate in decision-making and estate planning. But, due to the progressive nature of dementia, time is of the essence for your loved one to create an estate plan, and the sooner they plan, the easier it will be for them to get the help they need as their condition progresses.In cases where your loved ones capacity is severely diminished and estate planning hasnt been completed, your family will need to pursue a court guardianship. This legal arrangement involves a court appointing a legal guardian who assumes responsibility for making decisions on behalf of the person with dementia. This process can be stressful, and its possible the court will appoint someone your loved one never would have wanted to manage their assets or healthcare decisions. Contact Entrusted Legacy Law at 412-347-1731 to schedule a complimentary 15-Minute call.

A newly proposed rule by the Social Security Administration (SSA) could ultimately change the way in-kind income is defined for recipients of Supplemental Security Income (SSI).What Is SSI?Supplemental Security Income (SSI) is a federal public benefits program that provides monthly payments to individuals with limited means, including people with disabilities and seniors. In many cases, recipients of this type of benefit automatically qualify for Medicaid as well.In 2023, the federal SSI payment standard is $914 per month for an individual ($1,371 per month for a couple).SSI Income GuidelinesIndividuals who receive SSI must meet very strict guidelines in order to continue qualifying for these public benefits.For people with disabilities, these guidelines include having an impairment that meets the SSAs narrow definition of disability as well as maintaining specific monthly limits on their assets and income.SSAs Definition of IncomeAs SSI support is intended for those with limited means, any additional income could potentially put an SSI recipients benefits in jeopardy.According to the SSA, income includes any item an individual receives in cash or in-kind that can be used to meet his or her need for food or shelter.An SSI recipient whose income exceeds their monthly SSI award even if it is unintentionally can result in the individual losing their benefits or having them lowered by a certain amount.Historically, SSA has included free food in its definition of income. SSI recipients must provide the SSA with details about their food expenses. A recipient who accepts so-called in-kind support and maintenance (ISM) in the form of food, such as a supply of groceries brought to the recipient by a family member or friend, generally will have their benefits reduced by about one-third.Fortunately for SSI recipients, this is something to which the SSA is now proposing a shift.Proposed RuleIn February 2023, the SSA announced its proposal to omit food from its calculations of ISM. If put into effect, Supplemental Security Income recipients who receive this type of support may no longer see their benefits shrink as a result. In addition, they would no longer need to report their food expenses to the SSA.The complexities of our current food ISM policies may outweigh their utility, the SSA states in its proposed rule. The current requirements for reporting in-kind food receipts could discourage SSI applicants and recipients from receiving an often informal but important form of help.In addition to simplifying reporting requirements for SSI recipients as well as processing time for the SSA, the SSA says the new rule would provide increased financial security to impacted beneficiaries; provide consistent treatment of food support regardless of source; and facilitate improved food security among beneficiaries.The SSA will be seeking public comments on this proposed rule up until April 17, 2023.Additional ResourcesTo learn more about these benefits, refer to this introduction to SSI, or consider consulting with a qualified special needs planner in your area.Contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call to learn how we can help. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

A power of attorney is among one of the most important incapacity planning documents you can have. It designates someone you trust with taking care of your affairs if you become unable to do so.In a power of attorney, you give one or more trusted people of your choice the right to manage your affairs if you cannot do so because of a medical emergency, mental incapacity, or other life event.Every state has its own rules for the format, content, and provisions of powers of attorney. In New York, for example, the statutory form states that, once executed, the POA shall not be affected by a persons subsequent incapacity unless they have specified otherwise in the form. This is often referred to as a durable power of attorney.A power of attorney may be helpful in avoiding confusion among your family members and loved ones by putting specific people in charge of your affairs ahead of time. For example, you could appoint your spouse as well as a professional as co-agents, separate agents, or primary and secondary agents in your power of attorney.Agency Further ExplainedMany POA forms allow for a variety of options in designating who may act as your agent. First, you will have to designate your primary agent. Depending on the rules of your state, this can be one person or more than one person. They may be able to act independently of each other, or you may be able to require that they act together. These technicalities are usually form- and state-specific.In most POAs, you also have the opportunity to choose a successor or backup agent. Again, this can be one or more person(s) who may act separately or together. In some instances, you may be able to provide specific rules of succession.Powers Conferred on AgentsA POA gives your agent(s) control over a wide range of subject matter. This can include the following:Real estate transactionsPurchase of personal property or other goodsBanking, bond, stock, brokerage, and other transactionsBusiness operationsInsurance mattersEstate transactionsClaims and litigationPersonal and family maintenanceSigning agreements on your behalfDealing with your creditorsGiftingManagement of benefits from governmental programs or civil or military serviceFinancial matters related to health care (records, reports, and statements)Retirement benefit transactionsTax mattersMany states do not allow a POA to confer power on an agent to make medical or health care decisions on your behalf. Instead, this must be done through another form, such as a health care proxy.Legal Responsibilities of AgentsMost state laws have specific sections that govern the legal responsibilities of an agent acting pursuant to a POA.An agent, dual agent, or successor agent has a fiduciary relationship with the principal and, as a result, the following duties:To act according to any instructions of the principal or, if no instructions are available, then in the best interest of the principal.To avoid conflicts of interest.To keep the principals property separate and distinct from any other property owned or controlled by the agent.However, many states specify this does not apply to property jointly owned by the principal and agent at the time of the execution of the power of attorney. It also may not apply to property that becomes jointly owned after the execution of the POA.Not to make gifts of the principals property to himself or herself without specific authorization in a power of attorney.To keep records of all receipts, disbursements, and transactions entered into by the agent on behalf of the principal and freely disclose to third parties if requested by the principal.To share such records with:any monitor, co-agent or successor agent named in the power of attorneyany government entity investigating whether the principal needs protective services or is being abused or neglectedcourt-appointed evaluator or guardian ad litem, guardian, or conservator of the principalpersonal representative of deceased principal, andany other persons designated by law.Agents can be liable for conduct or failures to act that violate any fiduciary duty. A states law will usually define the extent of their liability, so it is important to become familiar with this law before entering into a POA or agreeing to serve as an agent.A power of attorney can be durable or springing. The terms of a power of attorney usually become effective when the agents and principal sign it, or upon the occurrence of an event specified in the document.Disputes Between Dual AgentsIf you have elected to have dual or co-agents, you should consider whether you wish for them to be able to act concurrently or separately. Each agent has equal power to decide on the matters that the principal has specified in the POA.However, if you have specified that the dual agents must act together and they disagree about what action is in your best interests, they could find themselves in court, needing a judge to act as the tiebreaker, so to speak.Waiting for a judges decision can cause a delay in situations where this is not desirable. For example, if a health aide needs to be hired, or government benefits need to be applied for, and there are disagreements, this could impede appropriate care.For this reason, many professionals recommend avoiding these situations by allowing agents to act separately, not choosing people who have the potential for conflict, or appointing one primary agent and a successor agent.A successor agent can step in where your primary agent is unable or unwilling to serve. In addition, you may be able to appoint a monitor, which is a person who can be kept informed of decisions and actions your agent is taking. As mentioned above, if your state permits the appointment of a monitor, they are entitled to a record of all transactions done or made on a principals behalf. The monitor can obtain this information from the agent or third parties upon request.Can I Terminate the Power of Attorney?You can terminate a power of attorney if you see fit, as long as you are of sound mind. There are several ways to end a dual power of attorney. You can terminate your dual power of attorney in the following ways:Put it in writing and notify all parties to the power of attorney the agent, co-agent, successor agent, monitor, etc.If the situation is more complex, a third party may be able to file an action in the appropriate court and ask the court to remove or replace the agent.A power of attorney will also terminate in the following circumstances:The death of either the principal or an agentThe roles and responsibilities of serving as agent have been completed (for example, where a power of attorney is solely for purposes of completing one real estate closing or transaction)A clause in the power of attorney provides that the arrangement would end once triggeredSetting up a power of attorney requires the expertise of a professional, especially because POA laws vary by state. Here at Sharek Law Office, we can provide guidance and ensure that your power of attorney meets your states requirements. Call us today at 412-347-1731or click here to schedule your complimentary 15-Minute Introductory Call to learn more about options for your specific needs.  This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

As baby boomers age, more and more millennials are becoming caregivers. Many are taking on this role while just getting started in their own lives, leading to difficult decisions about priorities. Proper planning can help them navigate this terrain. The term sandwich generation was coined to refer to baby boomers who were taking care of their parents while also having young children of their own. Now millennials are moving into the sandwich generation at a younger age than their parents did. According to a study by the AARP, one in four family caregivers is part of the millennial generation (generally defined as being born between 1980 and 1996). And a study by Genworth found that the average age of caregivers in 2018 was 47, down from 53 in 2010. Gretchen Alkema, vice president of policy and communications at the SCAN Foundation, told the New York Times that the rise in younger caregivers may be because baby boomers had kids later in life than their predecessors and many are divorced, so they don't have a spouse to provide care. Younger caregivers have different challenges than older caregivers. They may have younger kids to manage and careers that are just beginning, rather than established. In addition, more millennial men are caregivers compared to previous generations. The AARP study found that millennials spend an average of 21 hours a week on caregiving, and one in four spend more than 20 hours per week. More than half (53 percent) also hold a full-time job in addition to their caregiving duties and 31 percent work part time. Younger caregivers are also less likely to discuss their caregiving duties with their employer than previous generations.Managing caregiving duties, family, and employment is stressful. Having plans in place can help alleviate some of the stress, and the earlier you plan ahead the better. The following are resources you can use to put together a long-term care plan: Long-term care insurance can help lessen some of the costs of caregiving if it's purchased early enough. A geriatric care manager can help determine what care is needed and where to find resources. An elder law attorney can draft essential documents like a power of attorney and a health care proxy, as well as advise you on available benefits, such as Medicare, Medicaid, or Veterans Administration benefits. Adult day care can give caregivers a much-needed break. Having resources in place will help, but you also need to be mindful of when you need help. Recognize when you're being stretched too thin and consider your priorities. If possible, talk to your employer about flexible hours. Consult with other family members and don't be afraid to delegate tasks. Take care of yourself by eating well, exercising, and finding time to relax. For an article on the unique caregiving challenges facing the women of Generation X, click here.

If you are an individual with a disability who holds an ABLE account, your annual contributions to this type of account generally must not exceed $17,000 a year, as of 2023. However, ABLE account owners who are employed can contribute their work income to this type of account beyond the typical $17,000 annual threshold until the end of 2025.What Is an ABLE Account?ABLE accounts are a type of savings account designed for people with disabilities. They permit individuals with disabilities to save money, tax-free, without putting their means-tested public benefits at risk.As of 2023, up to $17,000 per year can be set aside into an ABLE account. The account holder is allowed to have a total of up to $100,000 in their ABLE account and remain eligible for such assistance programs as Medicaid and Supplemental Security Income (SSI). Under current law, individuals who became disabled before the age of 26 are eligible to open an ABLE account. Its funds can be used to cover the costs of education, assistive technology, transportation, and other items.ABLE accounts came into effect following the 2014 passage of the Achieving a Better Life Experience (ABLE) Act. Several years later, an ABLE to Work provision made it possible for ABLE account owners who work to start saving more. However, the ABLE to Work Act is currently slated to expire at the end of 2025.Who Can Benefit From the ABLE to Work Act?If you are living with a disability and hold an ABLE account, you may benefit from the ABLE to Work Act. There are a few rules of which you should be aware.First, if youre contributing to your ABLE account, you cannot also contribute to your employers defined contribution plan (for example, a 401(k) plan).

With the 2024 presidential election in the not-too-distant future, coverage of heated debates over the nations government budget, including how to secure the future of public benefits programs like Social Security and Medicare, has dominated the daily headlines. In one recent development, President Joe Biden, who has pledged to bolster such federal programs, has announced a proposal to fund Medicare through the year 2050. What Is Medicare?Medicare is a federal program providing health insurance to individuals who are 65 and older as well as those with qualifying disabilities. More than 65 million Americans are currently enrolled in it a number that is only expected to grow as the population of the country ages. When Will Medicare Funding Be Depleted?By 2028, however, the programs funding source is estimated to run short, meaning that Medicare will no longer be able to pay out full benefits for its enrollees.Finding solutions to ensure Medicare remains solvent have therefore been under intense discussion among lawmakers as of late. While the Biden Administration cites protecting Medicare as one of its top priorities, Republicans in Congress have also stated in recent months that cutting Medicare, as well as Social Security, is a measure that is off the table.With Medicare spending now accounting for about 10 percent of the federal budget $689 billion in 2021 questions remain about how the government will cover the costs of this program as they continue to rise.Proposal Includes an Additional Medicare Tax for High-Income EarnersUnder Bidens proposal, those who make more than $400,000 per year would face a Medicare tax increase of 5 percent, up from 3.8 percent.High-income people are supposed to pay a 3.8 percent Medicare tax on all of their income, but some high-paid professionals and other wealthy business owners have managed to shield some of their income from tax by claiming it is neither earned income nor investment income, the White House stated.Also included in the plan is a proposal to limit the cost to Medicare Part D enrollees for certain generic prescription medications for chronic illnesses to $2 per month.Read more in the White Houses fact sheet. The proposal on Medicare is part of a more comprehensive budget plan from the Biden Administration that is slated to be unveiled this week.

Many older Americans choose to have their family members care for them as they age. Despite the comfort a familiar face may provide, there's a significant cost for the loved ones who sacrifice their time, and often their upward economic mobility, to ensure that they can secure proper care for their senior parent. In a report issued in March 2023, AARP stresses the importance of supporting family caregivers in their financial, emotional, physical, and professional lives. The analysis gives a glimpse into the experiences of family caregivers and also offers recommendations on policies, practices, and programs across public as well as private realms that policymakers should consider enacting or enhancing in support of caregivers and the individuals who are in their care.How Much Does It Cost to Be a Family Caregiver? Being a family caregiver can come at a great financial cost. The average cost of caregiving has risen exponentially in the past several years, and the trend is expected to increase more over time. In its report, AARP estimates the value of family caregiving in 2021 at $600 billion dollars in unpaid contributions up from $470 billion dollars in 2017. The monetary value of caregiving is not the only cost of care. For family caregivers, some of the intangible costs of included: spending an average of 18 hours per week to tend to the needs of their loved onesfacing higher risks of chronic loneliness, which may have negative health effectsneglecting their own self-careWhat Are the Major Issues in Family Caregiving? According to the AARP report, by 2034, the population of people over 65 will outnumber the population of children under 18. With this historic shift, the researchers suggest that the impact on family caregiving will become even more prominent in several key areas:The Need for Tailored Support for Diverse Caregivers and Their FamiliesFamily caregivers across diverse cultures, ethnicities, sexual orientations, and gender identities often face concerns about access to support that is specific to their community. Ensuring that affordable, inclusive, readily available policies and services are in place to meet these needs of these caregivers will continue to be critical.Direct Care Workforce ShortageAmid a shortage of professional caregivers that only worsened during the COVID-19 pandemic, AARP notes that the turnover rate among the direct care workforce averages between 40 percent and 60 percent each year. Failing to recruit and retain a dedicated workforce in caregiving as the aging population grows will inevitably add to the burden carried by unpaid family caregivers.Economic Impact on Working Caregivers Most family caregivers nearly two-thirds of them in 2019, according to AARP hold a full- or part-time job in addition to caring for their loved ones. These workers often take an economic hit because they need to split their time between their jobs and their home responsibilities. Without such supports as telecommuting, paid leave, and respite care, they may have no choice but to call out of work, turn down promotions, or even leave their job altogether to dedicate themselves fully to providing care. This can then mean additional financial stress as well as adverse effects on their career and future earning potential.A Growing Sandwich Generation In 2019, about 30 percent of older Americans were living with their children or grandchildren. The so-called sandwich generation represents those who are responsible for caring for their children and their aging parents at the same time, while also working. These caregivers, who are likely to report more emotional and financial pressure, now tend to include workers across an ever-expanding age span from 35 to 64.Recommendations The AARPs report recommends specific policies and practices to support family caregivers going forward. These recommendations to policymakers include the following:Including family caregivers in planning and decision making across health care settingsImproving access to respite care for family caregiversEnsuring that publicly funded programs and supports for caregivers are inclusive, culturally appropriate, and designed to meet the needs of diverse populationsOffering family caregivers a tax creditExpanding protections for workers who rely on the Family and Medical Leave Act and related state programs while providing long-term care for family members, including instituting paid leave for working family caregiversAllowing for other programs that pay family caregiversImproving Social Security benefits for people who provide long-term care services to family membersAdditional Resources Having a care plan in place for your loved ones in advance may help decrease the financial costs and other stresses associated with paying for long-term care for aging adults. An elder law attorney can help you create a comprehensive long-term care plan that will address the costs associated with tending to the people you love. 

You may be nervous about whether Medicare will cover a second opinion if you wish to confirm whether a medical treatment or surgery is right for you. Given the cost of doctor visits today, the prospect of an out-of-pocket expense for a second opinion is understandably concerning.Under Medicare Part BMedicare Part B will help pay for a second opinion if a doctor recommends that you pursue a medically necessary surgery or another major procedure. In fact, the Department of Health and Human Services recommends that a person get a second opinion when their doctor tells them surgery is needed to diagnose or treat a nonemergency but medically necessary health issue. Remember, before seeking any second opinion on a procedure, confirm that the doctor accepts Medicare. Third opinions may also be covered if the first two opinions are different from each other.If the second doctor orders additional tests, as long as they're medically necessary, Medicare will also help pay for these expenses. The payment structure will be the same as for the first opinion. After you meet your yearly Part B deductible, Medicare pays 80 percent of the approved amount, and you pay 20 percent, plus any copay.What About Medicare Advantage? You should also be able to get coverage for a second opinion if you have a Medicare Advantage Plan. Just remember that some Medicare Advantage Plans will only cover a second or third opinion if you have a referral from your primary care doctor and the second doctor is in-network.Readers should also remember that just because Medicare may cover a second or third opinion, coverage of the therapy, surgery, or procedure is not guaranteed. 

Medicaid is a state- and federally funded health program for lower-income persons of all ages. For applicants who fall into certain categories, Medicaid imposes specific rules on how much income and resources they can have and still qualify for benefits.Each state has different rules for how much an applicant may have in income and assets to qualify for Medicaid. To qualify for Medicaid, you must fall under your states corresponding limit, which can be as low as $2,000 for an individual and $3,000 for a married couple.These resource limits can also vary depending on whether a person applies for institutional or nursing home care, community-based services, or regular Medicaid.If your assets are above the resource limit that would allow you to qualify for Medicaid, you may be able to engage in planning that will allow you to qualify for Medicaid. This planning often involves establishing a Medicaid Asset Protection Trust (MAPT) or an equivalent planning device permitted under your states laws. When a MAPT or similar trust is properly drafted and implemented, it can protect your assets from Medicaid while enabling you to qualify for this benefit.How Does a MAPT Work?A MAPT is an irrevocable trust created during your lifetime. The primary goal of a MAPT is to transfer assets to it so that Medicaid won't count these assets toward your resource limit when determining whether you qualify for Medicaid benefits.A MAPT must be in writing and properly acknowledged. You must also pick a trustee (not yourself) to manage the trust and its assets. The trustee can be a family member whom you trust. In addition, assets to be put in the MAPT actually need to be transferred. In the case of real estate, you must transfer the deed to the trust. Stocks and bonds must be registered in the name of the MAPT.A MAPT must be created with sufficient time to avoid running afoul of Medicaid lookback periods. When it comes to qualifying for Medicaid, transfers to trusts are subject to a 60-month lookback period. That is why this type of planning should be done before the need for Medicaid arises, preferably as early as possible.While you no longer own assets after they're transferred to a MAPT, and assets may not revert to you, you can still benefit from these assets. For example, if you transfer your home to a MAPT, you may still be able to live there. In other situations, income generated from the trust principal may be paid to you (although you cannot liquidate or withdraw the principal). However, note that this income can be counted as available income for purposes of Medicaid eligibility.Can You Protect Your Home With a MAPT?People frequently wish to use a MAPT to protect their homes because it's their biggest asset. Although Medicaid may not count your home as an asset that falls within your resource limit, this doesn't mean that your home is safe from Medicaid. For example, the home isn't exempt from Medicaids estate recovery program. Following a persons death, Medicaid usually tries to recover what it paid for their care by filing a lien against the persons estate. This often includes the family home. A proper planning strategy, which may include using a MAPT, can avoid this scenario.MAPTs also offer a certain degree of flexibility. For example, if you need to downsize to a smaller home, the MAPT can sell the house, receive the proceeds of the sale, and then purchase an apartment where you may reside. The new property is still protected from Medicaid, and the lookback doesn't start over. There are also some other features of MAPTs that lessen the sting of irrevocability. You may retain the power to change the trustee or beneficiaries of the trust.Assets That Can Be Placed in a MAPTMany types of property can be placed in a MAPT to help you qualify for Medicaid. Examples include:Bank accountsStocks and bondsMutual fundsBrokerage accountsCertificates of depositReal estate (subject to some exceptions)Other investmentsHowever, there are some assets you cannot place in a MAPT. For example, many retirement plans, IRAs, and other retirement resources cannot be transferred to a trust. They would have to be liquidated first. In addition, in some states, transferring your home into a MAPT may not protect it from Medicaid. The fees associated with preparing a MAPT can be costly, ranging from a few to several thousand dollars. Every persons situation is unique, and you shouldn't assume a MAPT is suitable for you without speaking with a qualified elder attorney. An elder law attorney in your area can consider how a MAPT may affect other benefits you receive, your overall estate plan, its tax consequences, and much more.

Many senior citizens may need the services of a nursing home or at-home care at some point in their life. You might assume that government assistance or health insurance will step in and cover the cost if you cannot afford these services. Unfortunately, neither health insurance nor Medicare covers long-term care. Because obtaining long-term care insurance can be very expensive, Medicaid could become your only option.Medicaid coverage isn't a given, however. If you have assets or recently transferred assets, Medicaid may determine you don't qualify for coverage until a certain amount of time has passed. If this happens, you and their family can face significant medical bills. If you cannot pay, nursing homes may take you to court to get reimbursed.What steps can you take to avoid this? First, before applying for Medicaid, get a better understanding of the timelines in your state known as lookback periods that can affect your eligibility. Then you can engage in proper Medicaid or asset protection planning in advance of these timeframes. A good age to begin planning is around age 65, although everyones situation is different.Individual states run Medicaid programs, and every state has different rules regarding Medicaid eligibility. These programs were designed as a payor of last resort in other words, to qualify, you must meet strict requirements. There are two primary types of Medicaid benefits: home care and skilled nursing home care. Lookback PeriodsYou must submit an application to your local Medicaid office to qualify for these benefits. As part of this process, the state will look at any money or property you may have transferred within a certain lookback period. In New York, for example, this period of time will soon be 30 months for home care and 60 months for skilled nursing care. These lookback periods can have serious consequences. If you haven't engaged in appropriate asset protection planning, you may not be able to qualify for home care or nursing home care for many months. The result is that many elderly individuals must then spend down their savings and liquidate their assets to pay privately for their home care before Medicaid starts covering anything. If a person no longer has resources and is subject to a disqualification penalty period, family members may have to step in and bear these costs on their own.So, what can you do? The answer is to start planning as soon as is practical.Options to ExploreSpeaking with an elder law attorney can help you and your loved ones explore options available to avoid you or them being personally responsible for the costs of your care. Medicaid Asset Protection Trust  One common approach is placing assets in a Medicaid Asset Protection Trust. You may be able to use this to shelter various assets such as stock accounts, savings, a home with unprotected equity, and much more. Pooled Income Trust  Another option you may explore is contributing income that exceeds Medicaid allowances to a Pooled Income Trust. This can allow you to qualify for Medicaid while diverting excess income to a trust that pays qualified expenses on your behalf. This will enable you to benefit from the income and not spend it on things Medicaid could have otherwise covered.Spousal Refusal  Your spouse may also have options that can help you qualify for Medicaid. One such option includes exercising a right of spousal refusal a process available in some states by which the income and assets of your spouse can be removed from consideration in your Medicaid eligibility analysis.Finally, an attorney can help you understand if certain transfers are permissible under Medicaid rules without triggering a penalty period.Without proper planning, individuals with assets and income exceeding specific state-set thresholds would have to spend this income and their assets on their care or exempt items before they can receive Medicaid benefits. For assistance in planning, consult with a qualified elder law attorney in your area.

Making sure your end-of-life wishes are followed no matter where you happen to be is important. If you move to a different state or split your time between one or more states, you should make sure your advance directive is valid in all the states you frequent.An advance directive gives instructions on the kind of medical care you would like to receive should you become unable to express your wishes yourself, and it often designates someone to make medical decisions for you. Each state has its own laws setting forth requirements for valid advance directives and health care proxies. For example, some states require two witnesses, other states require one witness, and some states do not require a witness at all.Most states have provisions accepting an advance care directive that was created in another state. But some states only accept advance care directives from states that have similar requirements and other states do not say anything about out-of-state directives. States can also differ on what the terms in an advance directive mean. For example, some states may require specific authorization for certain life-sustaining procedures such as feeding tubes while other states may allow blanket authorization for all procedures.

There are two types of trusts: revocable and irrevocable.A revocable trust is like a treasure chest where you store all of your assets during your lifetime, but you do not close the lid or lock it. You can continue to put assets in or take them out. A revocable trust allows you to maintain absolute control of the assets in the trust during your lifetime. You can also revoke or dissolve your revocable trust at any time. Most people create a revocable living trust to avoid probate. They may want to keep their assets private and avoid the public probate process.An irrevocable trust serves different purposes: it can be used either to mitigate the tax burden of high-net-worth individuals or to prevent assets from being counted for Medicaid qualification purposes. Either way, an irrevocable trust, once formed, remains irrevocable.  Consequently, once you transfer assets into this type of trust, the lid of the treasure chest is closed and locked.Irrevocable trusts are effective because you essentially give up ownership of the assets in the trust. As the trustmaker, you appoint an independent trustee (someone other than you) who controls the trust and the assets it holds. There are several types of irrevocable trusts, each of which functions because the original owner no longer has a legal right of possession or access to the assets. Though giving up ownership and control of assets can be difficult, the significant benefits of a properly drafted and funded irrevocable trust make this document a powerful tool.Each type of trust serves different purposes, and each can be a useful estate planning tool when it is created to meet your specific needs. But you must fully fund your trust for it to work.Merely signing a trust document is not enough to protect your assets. You must transfer your assets into the trust by retitling deeded property or updating beneficiary designations on financial policies to name the trust as the beneficiary. Without a fully funded trust, you simply have a useless stack of paper that has no effect on your estate plan.Editors Note: This article was submitted by Attorney Ashley Sharek of Sharek Law Office, LLC. Ashley can be reached at 412-347-1731.

As people age, accessing healthy meals can become more challenging. According to Feeding America, one in five older adults was food-insecure in 2020. Some older adults struggle with affording healthy foods, whereas others have difficulty going to the grocery store and preparing meals when recovering from an illness or injury. Although original Medicare does not offer food benefits, some Medicare Advantage plans provide a grocery allowance or cover meal delivery. Some programs also include nutrition education and cooking classes. Certain Medicare Advantage plans may provide Part C food benefits in addition to Part A hospital, Part B medical, and Part D prescription drug coverage. They may also supply vision, dental, and hearing coverage. The Medicare Advantage plans available to you depend on your state. Medicare AdvantageMedicare Advantage differs from traditional Medicare, as private companies contract with Medicare to offer Medicare Advantage plans. Plans vary, and finding insurance that fits your unique needs is essential. Potential enrollees should also be wary of predatory marketing practices and evaluate their options before committing to a plan. Even if you qualify for a Medicare Advantage plan with food benefits, traditional Medicare could be a better option for you, depending on your circumstances. Special Needs Plans Special needs plans, which tailor membership to beneficiaries who meet specific criteria, offer grocery and meal benefits options. Qualifying for grocery benefits through a special needs plan generally requires an individual to have an underlying condition. Examples of conditions that can qualify a person for Medicare Advantage food benefits include diabetes, cancer, heart disease, kidney disease, end-stage renal disease, arthritis, an autoimmune disorder, and obesity. Grocery BenefitsWhen Medicare Advantage plans have grocery benefits, they typically give beneficiaries a card that they can use to check out at approved stores like Kroger and Walmart.The benefits only cover whole foods such as vegetables, legumes, meat, and dairy, as well as pantry staples and water. Only covered food items can go on the card. Enrollees must pay out of pocket for soda, baked goods, and processed foods like chips. Meal Delivery Services Instead of grocery benefits, some Medicare Advantage Part C plans cover meal delivery services. Meal delivery services can benefit those who face challenges getting to the grocery store and preparing meals. A service must meet Medicares nutritional guidelines for Medicare Advantage to cover it. Many Medicare Advantage plans only supply meal delivery for a set period. This type of plan can suit those discharged from a hospital or skilled nursing facility who only need help with meals for a set time. Less common is long-term meal delivery coverage for those homebound with chronic medical conditions.Other Meal Delivery OptionsFor older adults who do not qualify for a special needs program with meal benefits or who do not elect to enroll in original Medicare, alternative meal resources are available. Meals on Wheels is a federally funded meal delivery program for people aged 60 and above who meet location-specific eligibility requirements. You use the Administration for Community Livings Elder Care Locator to find meal delivery organizations. Speak with us to access your options before selecting a Medicare Advantage program with grocery or meal benefits.

Prepaying for your funeral is one way to ease the burden on your family following your death and make sure your wishes are carried out. But pre-paid funeral plans come with risks, so you need to exercise care when purchasing a plan. Funerals are expensive and can take a lot of effort to plan. To help relieve your family of some of this expense and effort, you can pay for your funeral in advance with a pre-paid funeral plan purchased through a funeral home. In addition to making things easier for your family during a difficult time, pre-paid funeral plans can also be a good way to spend down money in order to qualify for Medicaid.However, consumers lose money every year when funeral homes go out of business before the need for the funeral arises. If the funeral home mismanages your funds, there may be no way to recover them. In addition, customers aren't always entitled to refunds if they change their minds, and some funeral homes sell policies that require additional payments or that can't be transferred if the customer moves. If you decide to go ahead with a pre-paid funeral plan, the following are things to consider:Shop around. Prices among funeral homes can vary greatly, so it's a good idea to check with a few different ones before settling on the one you want. The Federal Trade Commission's Funeral Rule requires all funeral homes to supply customers with a general price list that details prices for all possible goods or services. The rule also stipulates what kinds of misrepresentations are prohibited and explains what items consumers cannot be required to purchase, among other things. Make sure you have a reputable funeral home. There have been cases of unscrupulous funeral providers taking advantage of customers, so make sure you choose a funeral home with a solid reputation. Read the contract carefully. Before signing, it's important to know what you're agreeing to. Can you cancel the plan and get a refund? Is the plan transferrable if you move to another area? Are you paying just for merchandise or for funeral services as well? If prices for funeral merchandise and services rise, will your estate be responsible for paying additional costs? Find out where your money goes. The pre-paid plan should provide information on what the funeral home will do with the money you pay them. Some states have protections in place to make sure the money is safeguarded, but other states offer no protections. Is the money put into a trust account? What happens to the interest income? Is there a plan if the funeral home goes out of business? What happens to any money left over?Make sure the plan won't affect Medicaid benefits. If you're buying the policy as part of Medicaid Planning, you must purchase an irrevocable plan, which means you can't cancel or change it once it's bought. Once you've purchased a plan, be sure to tell your family about the plan you've made and let them know where the documents are filed. If your family isn't aware that you've obtained a plan, then the plan is useless.

When it comes to filing your 2022 federal tax return for the 2023 tax season, you may be able to access several forms of assistance for free. Filing Online: IRS Free FileIn January 2023, the Internal Revenue Service (IRS)s Free File service opened to taxpayers. Through IRS Free File, you can prepare and file your federal individual tax online at no cost to you. The service is made possible by volunteers and enables you to file your taxes from your computer, smartphone, or tablet. The product options available to you may vary based on such factors as your gross income, location, and number of dependents:If you're a taxpayer who made $73,000 or less in 2022, you may qualify for IRS Free File Guided Tax Preparation. This service assists you in preparing as well as filing your federal income tax return through an IRS partner site for free. Taxpayers who made more than $73,000 in 2022 may be interested in taking advantage of the IRS Free File Fillable Forms. These are digital federal tax forms that you can complete, sign, and file online at no costDo I Need to Apply for Free File?You don't need to apply for Free File. Simply visit the IRSs Free File Lookup Tool and answer a series of questions to find out what product(s) you may be eligible to use. Learn more about each service on the IRS website.In-Person Support: Saturday Walk-In HoursFor those who would prefer in-person help, the IRS will now also be offering special Saturday hours to aid taxpayers at locations across the country. There's no need to schedule an appointment for these special hours; you can walk in to speak directly with an IRS employee. When Will Special IRS Saturday Hours Be Held?Special Saturday hours will be from 9 a.m. to 4 p.m. in many states as well as Washington, D.C., and Puerto Rico on the following dates:Saturday, February 11, 2023Saturday, March 11, 2023Saturday, April 8, 2023Saturday, May 13, 2023Prior to visiting an IRS office offering this service, be sure to double-check the IRS website for details regarding its Saturday hours.These walk-in locations are critical, and funding from the Inflation Reduction Act is allowing us to add more employees across the nation to better assist taxpayers this filing season and beyond, Acting IRS Commissioner Doug OConnell said in an IRS news release. These special Saturday hours will help people get the services they need.Find more information about locations offering special Saturday hours, what to expect during your visit, what documents you will need to bring, and more.Volunteer Income Tax Assistance (VITA) ProgramIn addition, the IRS provides free assistance in tax return preparation for seniors, people with disabilities, taxpayers with annual income below $58,000, and taxpayers who aren't fluent in English. It's called the Volunteer Income Tax Assistance (VITA) Program. Where Is the VITA Program Available?You can find a VITA office near you on the IRS website; search by your ZIP code. TCE: Free Tax Preparation for SeniorsSeniors can also benefit from the Tax Counseling for the Elderly (TCE) Program, which is also free. If you're a taxpayer aged 60 or older, you can connect throughout tax season with a volunteer who can help you prepare your tax return. Locate an office with this service near you.When Is Tax Season, Exactly?The 2023 tax season officially began January 23, 2023. This is the date on which the IRS begins processing tax returns from the 2022 tax year. Tax season ends each year in mid-April.When Are Tax Returns Due for the 2023 Tax Season?In most cases, you should file your individual income taxes for the 2022 tax year by April 18, 2023. Extensions are available in certain circumstances. If you request an extension, your deadline for filing is October 16, 2023.

Elder law attorneys specialize in estate planning, incapacity planning, and/or end-of-life care for seniors. These practitioners are essential because they work to protect a vulnerable population. To plan for their future and their care, seniors and their families should consider hiring an elder law attorney.How Can an Elder Law Attorney Help My Aging Loved One?Having a plan for your aging loved ones care can relieve anxiety for you and the senior. Elder law attorneys can help their clients by providing some of the following services.Long-Term Care PlanningThe number of Americans living past age 65 has exponentially increased over the past few decades and will continue to grow over the next few years. According to the Centers for Disease Control and Prevention (CDC), there will be more than 80 million seniors in the U.S. by 2040. This increase requires more people to pay close attention to the need for long-term care planning.An elder law attorney can help seniors create a plan to pay for their care needs for the rest of their lives. Many seniors may worry about a lack of financial resources to pay for food, rent, medical care, and transportation in the years to come. Others hope to stay in their homes as they age but arent sure what the options may be for in-home care if it becomes necessary.An elder law attorney can help you create a customized plan for your needs and assist you in allocating money to pay for the essentials as you age. In addition, with expertise specific to elder law at the federal level and in your state, they can aid you in determining what public benefits you could qualify for, such as Medicaid and Medicare, and help you successfully apply for them.Estate Planning Document PreparationMost people contact an elder law attorney whose expertise includes estate planning when they need end-of-life documents drafted. Yet, it is smart to start estate planning when you are still healthy.Elder law attorneys may draft for their clients such documents as a last will and testament, health care directive, and power of attorney. By carefully crafting these documents, an attorney can help protect a seniors legal rights when it comes to their retirement benefits, estate administration, and medical decision-making authority.At the same time, having a comprehensive estate plan in place may not only ease the stress your family members encounter upon your passing, but also help them avoid any potential disputes regarding their inheritance.Create a Plan for IncapacityA related piece of the puzzle is incapacity planning. This could mean having an elder law attorney advise you on documenting your wishes for care at the end of your life, in the wake of a disability, or after a diagnosis of dementia.For instance, according to the Alzheimers Association, 6.7 million Americans aged 65 and older suffer with Alzheimers disease. As the senior population increases across the United States, the number of seniors with memory care needs will likewise increase.Because people with memory issues may reach a stage when they can no longer care for themselves, it is essential to have a plan in place for when a senior is incapacitated. An elder law attorney can assist seniors and their families as they try and protect the seniors financial and physical well-being as their condition progresses.Combating Elder Abuse and ExploitationSeniors who are victims of elder abuse, whether at the hands of a family member or in a long-term care facility, are protected by the law. Elder law attorneys know the rights of nursing home residents and seniors under guardianship, are familiar with the tools that can protect you and your assets, and can help you connect with other advocates.What to Look for in Elder Law AttorneysIt is vital to know what to look for when you are hiring an elder law attorney. You want to have the best partner helping you protect yourself or your loved one. Here are some tips when looking for an elder law attorney:Interview multiple attorneys.Ask each attorney you meet with about their experience in the area.Get a referral from a friend or search for a qualified elder law attorney in your area, like Sharek Law Office.Keeping your elderly loved ones safe is essential to supporting their care and protecting their legacy. Hiring an elder law attorney you trust can help you accomplish this and keep your parents, grandparents, or other aging relatives protected. Call our office at 412-347-1731 to schedule your free 15-minute introductory phone meeting today.  This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

For better and for worse, Medicaid is the primary method of paying for nursing home care in the United States. But navigating the Medicaid system is complicated and confusing. Here are the basics. Medicaid (sometimes called by other names, such as "Medi-Cal" in California, "MassHealth" in Massachusetts, and "TennCare" in Tennessee) is a joint federal-state program that provides health insurance coverage to low-income children, seniors, and people with disabilities. In addition, it covers long-term care for those who qualify. This coverage has traditionally meant care in a nursing home, although coverage of care in an assisted living facility or at home are possible (see below). In the absence of any other public program covering long-term care (Medicare provides only limited nursing home coverage), Medicaid has become the default nursing home insurance of the middle class. Lacking access to alternatives such as paying privately or being covered by a long-term care insurance policy, most people pay out of their own pockets for long-term care until they become eligible for Medicaid. Each state operates its own Medicaid system, but this system must conform to federal guidelines in order for the state to receive federal money, which pays for about half the state's Medicaid costs. (The state picks up the rest of the tab.) This complicates matters, since the Medicaid eligibility rules are somewhat different from state to state and they keep changing. To be certain of your rights, consult with us to guide you through the complicated rules of the different programs and help you plan ahead. While the majority of nursing homes accept Medicaid patients, there are some that don't. Even nursing homes that accept Medicaid recipients may only have a limited number of Medicaid beds available. Nursing homes must be certified by the state in order to accept Medicaid payments. Check with the facility before applying for admittance. To qualify for coverage, applicants must have limited assets and income. You typically cannot have more than $2,000 in assets; the figure may be slightly higher in some states. To lower your assets, you need to spend them down by paying for things that benefit the Medicaid applicant. You cannot simply give away your resources in order to qualify for Medicaid. Income limits vary by state. In some states you can keep excess income in trust; in other states you must pay your excess income to the nursing home. In addition to the strict income and asset limits, you must meet level of care requirements in order to qualify for nursing home coverage. Each state sets its own level of care criteria and the criteria is not always clear. The state looks at an applicants functional, medical, and cognitive abilities to determine if they need care in a nursing home. You're usually determined to need long-term care if you need help with two or more activities of daily living (such as bathing, dressing, eating, moving, and going to the bathroom). But to need a nursing home level of care, you may also need frequent medical care, such as assistance with medication, injections, IVs, or other medical treatment. The state may also consider your cognitive abilitiesi.e., whether you have the ability to make decisions on your own. Once you qualify for Medicaid, the program pays for all your basic expenses, but nursing home residents may be charged extra for certain amenities, like a private room, comfort items, or specially prepared food. In addition to nursing home care, Medicaid may cover some home care services or in limited circumstances, care in an assisted living. Home care is typically provided through home- and community-based services "waiver" programs to individuals who need a high level of care, but who would like to remain at home. States vary widely on how to qualify and what's covered. Almost all state Medicaid programs will cover at least some assisted living costs for eligible residents.To apply for Medicaid, contact your local Medicaid office. We can help you navigate the Medicaid process. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

If your loved one is entering a nursing home, you may worry whether you could be liable for their care. Under federal law, a facility cannot require a family member or friend to co-sign an admission agreement and take on personal liability. However, nursing homes around the country still try to do so, and often these matters end up in court.What can you do to prevent this from happening to you? It starts with educating yourself on what is and isn't allowed. A law known as the Federal Nursing Home Reform Law prohibits a nursing home or facility from requiring or asking for a financial guarantee from a third party. Federal regulations regarding Medicare and Medicaid have similar restrictions.These laws and regulations state that a home cannot have a residents family member or friend co-sign an admission agreement to take on financial liability. However, a nursing facility may obtain the signature of the residents agent, who has access to the residents income or assets, agreeing to use these resources to pay for care. Still, this agreement may not impose personal financial liability on the agent.Review Before You SignIf you're assisting a loved one with entering a nursing home, you should carefully review all the admission paperwork before you sign it. Many facilities have unscrupulous practices of using admission agreements that violate federal law or regulations. You don't have to sign or volunteer to sign a financial guarantee that makes you personally responsible. It's incorrect if a nursing home claims a guarantee is necessary because the federal law only applies to Medicaid-eligible individuals. Nursing homes are also not allowed to condition admitting or keeping a person on receipt of a third-party guarantee.Today, the most common tactic used by nursing homes is an admission agreement that obligates the signor as an agent with supposed control over the residents money. These agreements stipulate the agent will apply these resources to the nursing home expenses and apply for Medicaid on the residents behalf. Often, the person signing this document doesnt know how to handle this situation, doesn't have this control, or makes mistakes in the residents Medicaid application, causing coverage to be denied.What follows may be a lawsuit by the nursing home, claiming the agent violated their duties in the agreement and must pay the care costs. Courts have gone both ways on whether these agreements are enforceable, and the agents conduct often influences a courts decision. Egregious conduct can lead to courts ruling in favor of the nursing home. An example is where an agent used the residents money for luxury items or other peoples expenses rather than their loved ones care.Plan Ahead As Much As PossibleThe best action is to plan before nursing home care is necessary. This can put you or your loved ones in a position to be ready to apply for Medicaid should the need arise. At the same time, an aging individual can do proper asset protection planning and avoid look-back periods creditors could otherwise exploit against the resident or an agent. However, this isn't always possible for many older adults and their family members. Individuals who will take on the responsibility of being an agent should understand what this entails and seek the advice of an elder law attorney in your area before starting the admission process.

The Senate and House have cleared the passage of a year-end $1.7 trillion appropriations bill that will benefit older adults on a number of fronts. The bill, which runs more than 4,000 pages and includes a wide variety of legislation, heads to President Biden next for his signoff.Here is a breakdown of some of the highlights that relate to supporting older Americans:Health and HousingOpt to age at home  The Money Follows the Person (MFP) Program has been helping older adults age in their own home or a community setting, rather than in nursing homes, since 1972. The newly passed bill extends MFP through September 2027.Age in place safely  The omnibus bill has also doubled funding for the federal governments Older Adult Home Modification Program from $15 million to $30 million.For seniors with limited income, this program covers the cost of simple, low-cost home modifications such as railings and temporary wheelchair ramps that help them age in place safely.Provide for your healthy spouse if you are on Medicaid in a nursing home  Medicaid beneficiaries who must reside in a long-term care facility but have a spouse still living at home will continue to see their healthy spouse protected from poverty.Known as spousal impoverishment rules, these protections ensure that the healthy spouse receives income while their institutionalized spouse keeps their Medicaid eligibility. These protections, which are adjusted each year, will continue to be in place until September 2027.Continue to see doctors online  Lawmakers have extended access to telehealth services for Medicare enrollees for another two years.Find affordable housing with support services  The Housing for the Elderly Program has received a billion-dollar bump in funding as well.This program seeks to aid seniors with very limited income in securing housing that is within their means while also offering supportive services such as assistance with cooking and cleaning.Retirement SavingsContribute more to retirement  For older workers, the omnibus bill raises what are known as catch-up contribution limits for retirement savings. Taxpayers ages 60 to 63 will be allowed to contribute an extra $10,000 to their 401(k) starting in 2025.Access 401(k) funds for emergencies  If you need to take money out of your 401(k) before reaching age 59, under certain circumstances you will no longer have to pay the 10 percent penalty fee for withdrawing money early. As of the end of 2023, you will be allowed to withdraw up to $1,000 a year for unforeseen emergencies without incurring a penalty.Wait longer to withdraw money from your retirement accounts  Previously, you were required to begin withdrawing money from your retirement plan account starting at age 72. This mandatory withdrawal is known as a required minimum distribution (RMD).As of January 1, 2023, the new bill allows you to hold off until age 73 to take funds from these types of private retirement accounts. 

These days, more and more young people are delayingif not totally foregoinga life that involves marriage and parenting. The lack of jobs, crushing student debt, multiple recessions, and the pandemic have pushed many young people into a life path that leaves little room for settling down with a partner and getting marriedand even less room for having children. Yet, for other young adults, staying single and childless is simply a matter of choice. Regardless of the reason, as more young adults opt for non-traditional lifestyles, the number of single childless households is likely to steadily increase in the coming years.While most adults dont take estate planning as seriously as they should, if you are single with no children, you might think that theres really no need for you to worry about creating an estate plan. But this is a huge mistake. In fact, it can be even MORE important to have an estate plan if you are single and childless.If you are single without kids, you face several potential estate planning complications that arent an issue for those who are married with children. And this is true whether youre wealthy or have very limited assets. Indeed, without proper estate planning, youre not only jeopardizing your wealth and assets, but youre putting your life at risk, too. And thats not even mentioning the potential conflict, mess, and expense youre leaving for your surviving family and friends to deal with when something unexpected happens to you. With this in mind, if youre single and childless, consider these three inconvenient truths before you decide to forego estate planning:1. Someone Will Have to Handle Your StuffWhether youre rich, poor, or somewhere in between, in the event of your death, everything you own will need to be located, managed, and passed on to someone, which can be a massive undertaking in itselfone that few families are properly prepared for. In fact, following a loved ones death, American families spend an average of 500 hours and $12,700 over the course of 13 months (20 month if probate is required) to finalize the person's affairs and settle their estate, according to the first annual Cost Of Dying report released this March by tech startup Empathy in partnership with Goldman Sachs. Look for additional articles in the coming weeks covering the Cost Of Dying and the new role Empathy is playing in the end-of-life industry.On top of the logistical complications involved with finalizing your affairs, without a clear estate plan, including a will or trust, your assets will go through the court process of probate, where a judge and state law will decide who gets everything you own. In the event no family steps forward, your assets will become property of the state.Why give the state everything you worked to build? And even if you have little financial wealth, you undoubtedly own a few sentimental items, maybe even including pets, that youd like to pass to a close friend or favorite charity.However, its rare for someone to die without any family members stepping forward. Its far more likely that some relative you havent spoken with in years will come out of the woodwork to stake a claim. Without a will or trust, state intestacy laws establish which family member has the priority inheritance. If youre unmarried with no children, this hierarchy typically puts parents first, then siblings, then more distant relatives like nieces, nephews, uncles, aunts, and cousins.Depending on your family, this could have a potentially troublingand even deadlyoutcome. For instance, what if your closest living relative is your estranged brother with serious addiction issues? Or what if your assets are passed on to a niece with poor money-management skills, who is likely to squander her inheritance?And if your estate does contain significant wealth and assets, this could lead to a costly and contentious court battle, with all of your relatives hiring expensive lawyers to fight over your estate. In the end, this could tear your family apart, while making their lawyers richall because you didnt think you needed an estate plan.As your Personal Family Lawyer, we will work with you to create an estate plan that ensures that your assets will pass to the proper people, while avoiding both unnecessary court proceedings and family conflict.2. Someone Will Have Power Over Your HealthcareEstate planning isnt just about passing on your assets when you die. In fact, some of the most critical aspects of estate planning have nothing to do with your money at all, but are aimed at protecting you while youre still very much alive.Proactive planning allows you to name the person you want to make healthcare decisions for you in the event you are incapacitated and unable to make such decisions yourself. This is done using an estate planning tool known as a medical power of attorney.For example, if youre incapacitated due to a serious accident or illness and unable to give doctors permission to perform a potentially risky medical treatment, it would be left up to a judge to decide who gets to make that decision on your behalf. If you have a romantic partner but arent married and havent granted him or her medical power of attorney, the court will likely have a family member, not your partner, make those decisions. Depending on your family, that person may make decisions contrary to what you or your partner would want.And if you dont want your estranged brother to inherit your assets, you probably dont want him to have the power to make life-and-death decisions about your medical care, either. But thats exactly what could happen if you dont put a plan in place.Furthermore, your family members who have priority to make decisions for you could keep your dearest friends away from your bedside in the event of your hospitalization. Or family members who dont share your values about the type of food you eat, or the types of medical care you receive, could be the ones making decisions about how youll be cared for.To address these issues, you need to implement an estate planning tool that provides specific guidelines detailing exactly how you want your medical care to be managed during your incapacity, including critical end-of-life decisions. This is done using an estate planning vehicle known as a living will.Bottom line: If you are single with no kids, you need to create an estate plan in order to name healthcare decisions-makers for yourself and provide instructions on how you want those decisions made should you ever become incapacitated and unable to make those decisions yourself.3. Someone Will Get Power Over Your FinancesAs with healthcare decisions, if you become incapacitated and havent legally named someone to handle your finances while youre unable to do so, the court will pick someone for you. The way to avoid this is by granting someone you trust durable financial power of attorney.A durable financial power of attorney is an estate planning vehicle that gives the person you choose the immediate authority to manage your financial, legal, and business affairs if youre incapacitated. This agent will have a broad range of powers to handle things like paying your bills and taxes, running your business, collecting your Social Security benefits, selling your home, as well as managing your banking and investment accounts.Without a signed durable financial power of attorney, your family and friends will have to go to court to get access to your finances, which not only takes time, but it could lead to the mismanagementand even the lossof your assets should the court grant this authority to the wrong person.Whats more, the person you name doesnt have to be a lawyer or financial professional; it can be anybody you choose, including both family and friends. The most important aspect of your choice is selecting someone whos imminently trustworthy, since they will have nearly complete control over your finances while you remain incapacitated. And besides, with us as your Personal Family Lawyer, your agent will have access to our team as their trusted counsel should they need guidance or help.Dont Leave So Much At RiskGiven these potential risks and costs for yourself and those you care about, it would be foolhardy if you are single without kids to ignore or put off these basic estate planning strategies. Identifying the right estate planning tools is easy to do, and it begins with a Family Wealth Planning Session. During this session, us, your local Personal Family Lawyer will consider everything you own and everyone you love, and guide you to make informed, educated, and empowered choices for yourself and your loved ones.In the end, it will likely take just a few hours of your time to make certain that your assets, healthcare, and finances will be managed in the most effective and affordable manner possible in the event of your death or incapacity. Dont leave your life and assets at risk or leave a mess for the people you love; contact us, your Personal Family Lawyer to get your estate planning handled today.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article that you found on SeniorsBlueBook.com to find out how to get this $750 session at no charge.

An advisory issued in June warns people against using a series of adult portable bed rail models after at least three people including one in a nursing home and another in an assisted living facility were entangled in them and died of asphyxia.The U.S. Consumer Product Safety Commission named the following 10 models of Mobility Transfer Systems adult portable bed rails in which it says users may become trapped, resulting in serious injury or death:Freedom Grip (model 501)Freedom Grip Plus (model 502)Freedom Grip Travel (model 505)Reversible Slant Rail (model 600)Transfer Handle (model 2025)Easy Adjustable (model 2500)30-Inch Security Bed Rail, single-sided (model 5075)30-Inch Security Bed Rail Extra Tall, single-sided (model 5075T)30-Inch Security Bed Rail, double-sided (model 5085)30-Inch Security Bed Rail Extra Tall, double-sided (model 5085T)The Commissions advisory urges consumers to immediately stop use, disassemble, and dispose of these bed rails, which have been on the market since 1992 and available through such online retailers as Walmart.com and Amazon.com.Users can report any incidents related to these rails at www.SaferProducts.gov.

Funds held in a properly drafted special needs trust (SNT) will not affect a Supplemental Security Income (SSI) or Medicaid recipients benefits. However, funds disbursed in a manner that violates SSI or Medicaid rules can impact these benefits. It's important to understand what an SNT can and cannot pay for in order to avoid this.What Is an SNT?An SNT can play an important role in preserving the financial security and lifestyle of a person with special needs. It allows the individual to benefit from supplemental resources while still qualifying for public benefits, such as SSI and Medicaid.There are several categories of SNTs, including first-party SNTs, third-party SNTs, or pooled trusts. Depending on your circumstances, one of these may be more suitable for you or your loved one. For example, the age of the beneficiary, the individual or entity that's funding the trust, and other factors can dictate which type of SNT is best for your situation.Special Needs Trust Rules: Permissible Uses of SNT FundsIn general, money or funds shouldn't be used to pay for food, clothing, or shelter because this is what SSI is intended to be used for. An SNT is meant to supplement, and not replace, SSI.The first general rule of thumb when considering whether the use of SNT funds is permissible is to ask if the funds will be used for the sole benefit of the disabled beneficiary. Disbursements must primarily and directly benefit the beneficiary and only indirectly benefit others. So, for example, if a beneficiary needs to travel somewhere and needs an aide to accompany him or her, an SNT may pay for both of their travel costs.Some examples of allowed uses of SNT funds are the following expenditures made on behalf of the beneficiary:ActivitiesEntertainmentBooks, newspapers, and magazinesTV, internet, and phoneEducation or trainingInsurance, subject to certain limitationsTherapiesMedical equipment or services not covered by MedicaidServices rendered to the beneficiary by professionalsElectronics, computers, and softwareTransportation/travel costsVehicle and maintenance or operation costsHousehold itemsPersonal itemsTaxesCare managementWhenever possible, an SNT should purchase an item or service in the name of the trust and not the beneficiary. This is because, in some scenarios, if a beneficiary receives an asset as the result of a permissible expenditure, it could be considered income to the beneficiary or an available resource. This may disqualify them from benefits in the month when the asset is received.Where is it not possible for an SNT to directly purchase an item or service, the purchase should be billed to the SNT. For example, when a beneficiary purchases fuel for their car, they could do so with a gas credit card billed to the SNT.What Special Needs Trusts Should Not Pay ForIn general, an SNT should refrain from giving the beneficiary money from the SNT to make purchases on their own. Instead, an SNT trustee should pay for items directly to the vendor or provider.If an SSI beneficiary receives cash (or a cash equivalent, like a refundable gift card) from an SNT, their benefit can be reduced by $1 for each dollar received, up until the point that they lose SSI completely. This is a hard-and-fast rule and should be disregarded only after a serious conversation with a special needs professional.In addition, a beneficiary shouldn't be given cash or a cash equivalent or pay for food or shelter. If an SNT pays for a beneficiarys food or shelter directly to a landlord, restaurant, or store, the beneficiary could lose up to one-third of their SSI benefit. There are some workarounds to this problem, which a qualified professional can help you consider.Paying bills for housing-related expenses like mortgage payments, real estate taxes, utilities, and condo fees are considered payments for housing that can also cause a similar reduction in benefits. A one-third decrease in benefits might be a small price to pay for guaranteed shelter and meals. But if the beneficiary works or receives other income, the additional one-third reduction could cause the beneficiary to lose SSI and accompanying Medicaid benefits entirely.As with anything, there are exceptions to this guidance. In some situations, the benefit to a beneficiary of paying for these items outweighs the impact of potentially losing government benefits. Because each SNT and the situation of its beneficiary is unique, it's crucial to speak with a professional when considering making disbursements that could lead to a loss of benefits.Contact Your AttorneyOnce you've taken cash, housing, and food off the table, an SNT can typically pay for most other things a beneficiary might need to supplement their lifestyle.These rules can be complicated, so it's best to speak with your attorney to discuss what may be done with SNT funds before making any payments to anyone. This is a cost that, under most circumstances, can be paid for by the SNT, and the advice you receive may save you a lot of headaches.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Many seniors find themselves in need of Medicaid to pay for their long-term care but are surprised to learn that their modest monthly income may disqualify them. The reason for this is that Medicaid is a means-tested benefit. In other words, you must not have income exceeding certain thresholds in order to qualify and receive Medicaid benefits. For example, in New Jersey, the monthly income limit for nursing home or community-based services is $2,523 for individuals and $5,046 for married couples.Medicaid expects all of an applicants monthly income, besides a monthly personal needs allowance and Medicare premiums, to go toward nursing home costs. So, what if you have more income and other expenses? A Miller Trust may help you resolve this dilemma.A Miller Trust is a Medicaid planning tool that can assist you in meeting the income limits and qualifying for Medicaid. Unlike other planning tools, Miller Trusts don't have specific disability or age requirements. How Does a Miller Trust Work?If your income exceeds Medicaids income limit, you can deposit the amount of your excess income into a Miller Trust also referred to as a qualified income trust. Once it's deposited into this trust, it's not counted as income by Medicaid. However, to qualify, a trust must be irrevocable, which means you cannot cancel or change it. Once you put money into the trust, you cannot get it back directly. However, the trust can pay certain expenses on your behalf.A Miller Trust is a good option for any Medicaid applicant needing long-term care services, whether at home, in their community, or in a skilled nursing care facility. This trust is created by the applicant, a guardian, or a person with a properly drafted power of attorney. A trustee is chosen to manage the trust and the income deposited. Anyone other than the Medicaid applicant can serve as a trustee. Once the trust is set up, the trustee establishes a bank account to receive excess income from the Medicaid applicant. The income can only be used for certain expenses. For example, it may be used to pay the personal needs allowance of an individual in a nursing home, Medicare premiums, bills not covered by Medicaid, or supplement costs of a nursing home.Another requirement of a Miller Trust is that the applicants state Medicaid agency will be the beneficiary of any remaining funds in the trust upon the death of the Medicaid applicant. The amount the state receives is limited to the total value the state paid in long-term care on behalf of the applicant. Any amount remaining after this payment may go to a person the applicant chooses.Medicaid Income CapYou should be aware that not every state allows Miller Trusts as a method to qualify for Medicaid. Currently, only about 25 states, known as income cap states, permit it. Other states don't impose an income limit for nursing home care, and so there's no need for a Miller Trust in these locations. For example, in Massachusetts, you would pay all your income, minus certain deductions, to the facility, and Medicaid would pay the remaining cost.Before creating a trust, it's important to speak with an elder law attorney to ensure this option is right for you. If you live in a state where this isn't allowed, there may be other options, such as pooled income trusts, which serve a similar purpose.For guidance in Medicaid planning, consult a qualified elder law attorney in your area. You can also learn more about how Medicaid treats income on the ElderLawAnswers website.

Assisted living facilities support older adults with daily living while fostering their independence. Individuals who do not require round-the-clock nursing but need help with everyday activities like bathing, housekeeping, medications, and meal preparation can benefit from assisted living. Some seniors choose to move into assisted living following a frightening event, such as a fall. They want to live autonomously but may feel unsafe in their homes. Averaging $4,500 per month, assisted living can be expensive. Those considering assisted living might wonder whether Medicare, a federal health insurance program for qualifying adults aged 65 or over, will cover the cost. Traditional Medicare covers only certain health services to those residing in an assisted living facility. Meanwhile, some Medicare Advantage programs may only pay for services that help people remain in their homes. Does Traditional Medicare Cover Assisted Living?In short, no. While traditional Medicare supports older adults medical needs, it does not apply to most assisted living expenses. Assisted living facilities help residents with everyday, nonmedical tasks, which Medicare typically does not include. Medicare Part A insures people for hospital stays and up to 100 days in a skilled nursing facility. Skilled nursing facilities provide 24-7, short-term nursing care. Because they deliver medical care, they are distinct from assisted living facilities, which offer custodial or daily life care. Medicare Part B pays for medical fees for outpatient care, and Part D covers prescription drug costs. Most assisted living expenses do not fall under Medicare Part A, B, or D. However, traditional Medicare may cover specific medical costs for people in assisted living. Expenses Medicare may cover include:Physical therapySpecific health services like changing sterile dressingsPreventative health services like vaccinationsHealth care transportationDoes Medicare Advantage Pay for Assisted Living? Private insurance companies that contract with traditional Medicare sell Medicare Advantage plans. Like original Medicare, these plans typically do not cover monthly assisted living bills. Certain Medicare Advantage plans may offer supplemental home care benefits that help people continue living independently, albeit in their own homes rather than a designated facility. The services available through select Medicare Advantage programs may include home modifications like wheelchair ramps and bathroom safety grab bars; in-home assistance with daily tasks; and transportation to the hospital and the pharmacy. Adult daycare is also available through some Medicare Advantage plans. Seniors looking to live on their own might consider enrolling in a plan that includes services that support autonomy. Many programs are available, and the coverage that is open to you depends on where you live. The terms of Medicare Advantage plans vary. Review your plan options and speak with an attorney before deciding whether to enroll in a Medicare Advantage program. Does Medicaid Pay for Assisted Living?Unlike Medicare, Medicaid generally will pay for some of the costs of assisted living. Medicaid is a joint federal-state health insurance program for low-income people, including older adults. Although it does not cover room and board for assisted living, it may help pay for personal care services, on-site therapy services, and medication management. Before deciding whether to move into an assisted living facility, speak to us.

Many adult children wonder what their aging parents may need and how can they can help provide it for them. You may constantly worry about your parents or other older loved ones, especially if you live far away from them. You can, however, take some simple steps to ensure your parents are safe as they age.Tip No. 1: Recognize the Risks Older Adults Face Knowing the risks seniors face can help you begin an action plan for your parents. It may be difficult for some older adults to complete tasks they could do before with ease, particularly if they live alone. Examples of those tasks can include:Taking medication correctly and on timeRemembering things, keeping up conversation, or multitasking Getting help in a medical emergency, such as a fallEating healthfullyMoving safely around their home Being aware of these common concerns can be an important first step in doing everything you can to protect your parents as they age.Tip No. 2: Ensure Medication Compliance If your parents have health conditions that require them to take medication regularly, you should take time to make sure they're adhering to their prescription instructions. It may be a good idea to routinely review the medications your parents take, the name of the medications, and any potential side effects. You may consider creating a medication schedule that you can both follow, so that you (or a home care provider) can check in and confirm your loved one is remembering to take medications when necessary.Tip No. 3: Prepare for Cognitive Decline Alzheimers disease and other forms of dementia affect more than 5 million adults aged 65 and older, according to the Centers for Disease Control and Prevention (CDC). Keep your parents safe by understanding their current cognitive abilities and any risks they may face for future decline. Consider setting up a routine for your parents day-to-day lives. This might include social engagement and spending time with you and other family members, which may become even more crucial if their cognitive health has deteriorated.Tip No. 4: Equip Aging Parents for Medical Emergencies Older adults that live alone are vulnerable to falls and other medical emergencies. If you live out of state, you may have concerns about your parents being able to act quickly in ensuring they get emergency medical attention when they need it. To help your parents respond to emergencies, consider using a medical alert system. With a medical alert system, your parents will have emergency assistance at the push of a button. Many different companies offer this type of service. An online search can help you narrow it down.Tip No. 5: Plan for Meals Seniors, especially those that live with memory issues, may not eat regularly. Without adequate nutrition, older adults may fall ill, or any current condition may worsen. Many seniors across the United States are food insecure. Fortunately, there are certain Medicare Advantage grocery benefit programs as well as other free or inexpensive meal delivery services, such as Meals on Wheels, that deliver nutritious meals to seniors. Tip No. 6: Prevent Household Injury Household injury is a major risk for seniors, especially those who live alone. You should do a sweep of your parents home and remove all potential hazards, including unsecured electrical cords, household products and chemicals, or loose rugs. Fix broken handrails on staircases, install grab bars in bathtubs, and ensure there is adequate lighting in their home. Taking each of these steps, and any others you see fit, can help avoid a preventable injury.

Memory care is specialized care for patients living with Alzheimers disease, dementia, or other conditions that cause memory loss. Hospitals and nursing homes may have memory care units or a separate entity dedicated to this service. Memory care provides seniors with meals, opportunities to socialize, mentally stimulating activities, and support for their caregivers. Benefits of Memory Care People living with memory dysfunction need specialized care. Although there's often an expense involved with getting care, the benefits make it worthwhile. Some of the many benefits of memory care may include the following:Round-the-clock supervisionAssistance with medication complianceTransportation to and from doctors appointmentsA secure environment that allows seniors to remain independent while reducing the risk of wanderingAccess to expert and individualized medical careLiving Options for Seniors Living With Alzheimers or DementiaIf your loved one suffers from Alzheimers disease or dementia, you may be seriously considering what the best next step is for securing their long-term care. Several living arrangement options exist for seniors living with memory loss concerns. Your loved ones condition may make one of the following potential housing arrangements a better option than another. Here are some of the choices you may want to explore for memory care:Low-Income HousingLow-income housing may be the most economical option for long-term housing. This option is great for someone with a fixed income. Low-income housing helps seniors whose condition is mild and hasn't diminished to the point where they cannot live unsupervised. Here, they may continue living in their community with their spouse if they don't also need specialized care. Nursing HomeNursing home care is probably the most well-known living arrangement option for seniors who can no longer live independently. Some offer a specific unit or space dedicated to memory care. Nursing home employees can also give residents medication, place an IV, provide wound care, and so on. Other facilities generally don't provide this high level of medical care.This may be a suitable option for seniors who have dementia as well as another chronic medical condition.Memory Care CommunityMemory care facilities specialize in caring for seniors in the more advanced stages of dementia. In addition to 24-hour care and staff who are specifically trained to treat residents with memory loss issues, these communities also may be secure, locked facilities to help your loved one avoid wandering. Memory care communities also assist with activities of daily living and are often designed to mimic the look and feel of a private home.Independent Living CommunityIndependent living communities are a good idea for seniors whose condition is mild to moderate. These communities may include memory care services. This option works best for seniors who can still bathe, dress, and perform other regular maintenance on their own. These facilities provide seniors with a private living space and social and recreational activities to help keep their minds active, which promotes healthy brain function.This service is private-pay, so Medicaid won't cover the expense.Assisted Living Facility An assisted living facility allows seniors who need memory care to continue living independently. Employees can help residents with medical emergencies, but if they need individualized, 24/7 care, this may not be the best option. An assisted living facility can be a good option for seniors who require help with cooking, bathing, dressing, running errands, and getting to and from doctors appointments.Medicaid typically covers some of the costs of assisted living facilities, such as personal care services or on-site therapy. Note, however, that assisted living facility offerings vary by state; not every facility will provide memory care services.Continuing Care Retirement CommunityContinuing care retirement communities help seniors whose conditions may decline over time. Patients can enter a continuing care facility when they are still high-functioning. As their condition worsens, they already have support and a care team to meet their changing needs. The cost of living in a continuing care retirement community isn't covered by Medicaid in most cases, so be sure to budget accordingly if your loved one needs this service in the future. Senior Day Care This option doesn't involve lodging. However, it can be a great way to ensure your loved one has someone to look after them when you need to work, go to school, or have other tasks to complete outside of the home. Adult day cares let seniors socialize and participate in mentally stimulating activities that may help slow the progression of their disease. These programs may include specialized services for those with dementia.Medicaid coverage for these services varies by state. Financial assistance may also be available, such as grants or loans.Contact an Elder Law Attorney Knowing what to do for your family can be challenging. Connecting with an experienced elder law attorney can help point you in the right direction as you decide how to care for your loved one. You can find an elder law attorney in your area here.  

Medicaid is a federal program administered on a state-by-state basis. There are several types of Medicaid including Community Medicaid.Community Medicaid covers care and medical services that enable a recipient to remain in their home or community as long as possible instead of entering a skilled nursing facility or other institution. Community Medicaid can cover home health care, private nursing, personal care, assisted living programs, doctor appointments, wellness visits, hospital care, prescription drugs, laboratory services, occupational therapy, and more.Are You Eligible?Applicants for Community Medicaid must meet specific eligibility criteria. First, they must be disabled or over the age of 65. Second, they must not exceed certain income and asset thresholds to receive benefits. These criteria vary from state to state and adjust year to year. Excess income or assets can disqualify an individual or couple from qualifying for Medicaid benefits. However, there are legal planning mechanisms available to allow people to qualify.Medicaid WaiversAlternatively, there may be a Medicaid waiver program available in your state that allows you or a loved one to qualify for Community Medicaid. Medicaid waivers allow states to waive certain rules so more people can be eligible for specific programs.In the case of Community Medicaid, waivers can offer long-term home and community-based services to more seniors or disabled persons who need help to remain at home or in their community. These waivers may allow them to access home attendants or health aides, adult day care, respite care, accessibility modifications to cars or homes, personal emergency response devices, medical equipment, and homemaker services.Many of these benefits enable the elderly, disabled, or people with Alzheimers disease or dementia to receive long-term care services and live independently in familiar, comforting environments. So, while a person may have to pay for their housing, they can still receive care and support in their home, a relatives home, assisted living facilities, specialized programs, or other home-like environments.For more information on how your loved one may be able to qualify for Community Medicaid, reach out to us.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Assisted living facilities and nursing homes are long-term housing and care options for older adults. Although people sometimes use the terms assisted living and nursing home synonymously, they're distinct. Understanding the differences between assisted living and nursing homes is critical for those considering where to live as they age. This is because assisted living communities and nursing homes provide different types of care. While assisted living is appropriate for active older adults who need support with everyday tasks, nursing homes provide medical care to adults with significant health issues. What Is Assisted Living?Older adults who can no longer live on their own but do not require round-the-clock medical care can benefit from assisted living. While assisted living facilities can have nurses on staff, the primary focus is not on health care, but rather on supporting residents with daily life. Activities of daily living (ADLs) are six basic activities that healthy individuals can carry out on their own on a daily basis. Depending on an individual residents needs, an assisted living facility can provide aid with showering, dressing, preparing meals, completing household chores, and taking medication on time at the correct dose. While giving necessary support, assisted living communities maximize adults independence and autonomy. Residents typically live in private units similar to traditional apartments with kitchens that are part of larger communities offering opportunities to socialize with fellow residents. Units can have safety features tailored to older adults with mobility challenges, such as shower bars, widened doorways, safety rails, and enhanced lighting. Difference Between Assisted Living and Nursing HomeCompared to assisted living, nursing homes may be the right fit for those with significant medical conditions requiring round-the-clock care. Nursing homes can offer more extensive health care services that are unavailable in many assisted living facilities. Therefore, nursing homes can be more appropriate for those with severe health needs. As they provide critical medical support, nursing homes can help people with mobility complications or cognitive challenges that limit their autonomy. For instance, a person diagnosed with severe dementia might do better in a nursing home than in an assisted living facility. Some nursing homes have specialized memory care units for those with dementia. Nursing home staff can also provide medical care and supervision as well as help with the six activities of daily living. Like assisted living facilities, nursing homes also offer help with daily living, such as bathing or help with medication management, and can adapt to individuals needs. For instance, showers and bathtubs may have safety bars, and doors may be wide enough to accommodate wheelchairs. Yet nursing homes offer residents less freedom and independence than assisted living communities. Those receiving care typically don't have their own kitchens and may share a room with another patient. What Are the Costs of Assisted Living Facilities and Nursing Homes?Assisted living facilities and nursing homes can constitute a significant expense for residents and their families. According to SeniorLiving.org, the median cost of assisted living in 2021 was $4,500 per month. Because of the higher level of medical care, nursing homes tend to be more expensive than assisted living. A private room in a nursing home averages $9,034 per month, and a shared room $7,908 per month. Individuals can pay for assisted living or nursing home fees out of pocket or through long-term care insurance. Medicare doesn't cover assisted living or nursing home fees. Medicaid coverage, however, does extend to nursing home fees. Though Medicaid doesn't pay for room and board at assisted living facilities, it includes the skilled nursing care and emergency response services that residents of assisted living facilities receive. Additional Resources Before selecting an assisted living facility or nursing home, research the community and ensure it's a good fit. Find and compare nursing homes with Care Compare. SeniorLiving.Orgs guide explains how to find an assisted living facility. Learn more about the difference between skilled nursing facilities and nursing homes.

A Medicaid Asset Protection Trust (MAPT) is one option a person may consider to protect their assets from Medicaid and nursing homes or long-term care.What Is a MAPT?A MAPT is an irrevocable trust created during your lifetime. The primary goal of a MAPT is to transfer assets to it so that Medicaid won't count these assets toward your resource limit when determining whether you qualify for Medicaid benefits. However, creating an irrevocable trust comes with a certain lack of control over the assets you transfer to this trust. Before making such a significant decision, consider some pros and cons to see if this long-term care strategy is right for you.Benefits of a MAPT 1. You Can Still Benefit From the Assets of a MAPTAlthough transfers of assets to a MAPT cause you to relinquish your ownership and control of them, the finality of the arrangement isn't as harsh as it sounds.In creating a MAPT, you select a person (trustee) who manages the trust assets for your benefit. So, if you transfer investment accounts to the MAPT, you can still receive the income generated from these investments. If you transfer your home, you can still live there. In exchange for giving up control of your assets to a MAPT, your assets no longer count against you for Medicaid eligibility purposes.2. Your Assets Are Safe From Medicaid and Other Long-Term Care CreditorsOnce your assets are in a MAPT and other criteria are met, Medicaid cant seize them or ask you to spend them down to pay for your nursing home or long-term care costs. These assets also aren't subject to Medicaids estate recovery program.As a result, your heirs can benefit from the assets without the interference of Medicaid or liens it could otherwise file against your estate after you pass.3. You Can Choose Your BeneficiariesA MAPT also functions as an estate planning tool. This is because you can designate who receives what remains of the trust upon your passing. The beneficiaries you choose will receive the assets per the terms of the trust agreement, and the chances of a probate court getting involved are diminished.In addition, you may be able to retain what is called a limited power of appointment. This allows you to change who the beneficiaries of the MAPT will be, should your wishes or family circumstances change.4. Assets Are Protected From Your Beneficiaries CreditorsEven though you can designate a MAPTs beneficiaries now, those beneficiaries don't have full access to the trusts assets because of how it's structured. This also means their creditors don't have access to it. And, if your child is a beneficiary and is going through a messy divorce, neither does their spouse. You can also designate how bequests to beneficiaries can be used.5. Protection From Capital Gains TaxesA properly drafted MAPT preserves the full capital gains tax exclusion on the primary residence (currently $250,000 per spouse). Later, when a persons beneficiaries sell the home, it would be valued at the market price at the date of gifting and not at the original purchase price. This can avoid or significantly minimize the capital gains tax that your heirs may owe.Drawbacks of MAPTS 1. Timing Is EverythingFor a MAPT to function as intended, it needs to be created in advance to avoid the Medicaid lookback period. In most states, this is five years for nursing home or institutional care. In some states, there may also be a lookback period for community Medicaid care (home aides, local programs, etc.).If less than five years have elapsed since you created your MAPT, you may still be responsible for some or all of your long-term care costs until sufficient time has passed.2. Income From MAPT Is Countable by MedicaidAlthough assets in a MAPT may not be countable by Medicaid toward your resource limit, these assets may still generate income. If this income is payable to you, it may cause you to exceed the income limit permitted in your state.If this happens to you, you may have other options, such as utilizing a pooled income trust, or may decide you will contribute partially toward your care.3. Giving Up Control Is Non-NegotiableA trust won't qualify as a MAPT if you retain control other than the limited power of appointment that may be permitted in your situation. You must accept that a person you select to act as trustee will manage the trust, distribute funds and income from the trust, and also be the effective owner of the assets.In addition, creating a MAPT but not transferring assets to it is ineffective. You need to fully commit to the concept for it to benefit you.4. Setting Up a MAPT Is CostlyCreating and implementing a MAPT is a complex legal task requiring many hours of work and expenditures made on your behalf. In addition, because MAPTs are tied to individual state and federal laws, the expertise of a qualified Medicaid attorney is essential.You should expect that this expertise comes at the cost of several thousand dollars or more. However, your potential savings could be exponentially greater for you and your family. For this reason, the price is often well worth it.5. Potential Effects on CareIts important to realize that while the MAPT strategy is designed to preserve assets and wealth, it assumes that a person will rely on Medicaid to pay for a portion of their care. However, Medicaid doesn't cover all facilities. For example, many assisted living facilities aren't licensed as assisted living programs and only accept private pay residents. Thus, relying on Medicaid could affect the choice and quality of care a person may receive.The pros and cons discussed above are not exhaustive, and there may be other ones that apply to your situation. Investing in a MAPT is a highly fact-specific process, and MAPTs aren't suitable for everyone.You should speak with us to discuss how a MAPT may affect other benefits you receive, your overall estate plan, its tax consequences, and whether it's right for you.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

If a loved one is experiencing memory loss or suddenly making poor decisions, you may want the court to appoint a guardian, which requires a declaration of incompetence. Determining whether someone is incompetent to make their own decisions is a complicated process. If a loved one is unable to make decisions for him or herself, the court may appoint a substitute decision maker, often called a "guardian," but in some states called a "conservator" or other term. A guardian is only appointed as a last resort if less restrictive alternatives, such as a power of attorney, aren't in place or aren't working.The standard under which a person is deemed to require a guardian differs from state to state. In some states the standards are different depending on whether a complete guardianship or a conservatorship over finances only is being sought. Generally, a person is judged to be in need of guardianship when he or she shows a lack of capacity to make responsible decisions or decisions that are in their best interests. The court usually looks at a number of factors in determining the need for a guardian or conservator, including the following: Comprehension of important medical or financial informationAppreciation of the importance of medical and financial decisions and understanding the effect of those decisions Ability to make reasonable decisions using the information available Capacity to communicate decisions in a consistent mannerAbility to maintain a safe environment A person cannot be declared incompetent simply because he or she makes irresponsible or foolish decisions, but only if the person is shown to lack the capacity to make sound decisions. For example, a person may not be declared incompetent simply because he or she spends money in ways that seem odd to someone else. Also, a developmental disability or mental illness is not, by itself, enough to declare a person incompetent.Keep in mind that the standard for whether someone is legally incompetent to care for themselves is not always the same as whether they have the capacity to make legal decisions. Proper execution of a legal instrument requires that the person signing have sufficient mental "capacity" to understand the implications of the document. 

Although 26% of people in the United States have a disability, only 6% of housing meets basic accessibility requirements. 2 in 5 older adults experience a disability, and 1 in 5 adults are expected to be over 65 by 2030.Many people with disabilities struggle to afford housing that meets their needs. For those receiving Supplemental Security Insurance (SSI), the cost of rent for a modest apartment in many areas can exceed their income, the National Low Income Housing Coalition reports.When accessible residences are unavailable, individuals may feel institutionalized living is their only option. Yet most would prefer to reside in community settings.Features of accessible housing include lowered counters, widened doorways, and zero-step showers. Adaptable housing can be modified to suit the needs of those with disabilities.Location is also important for accessibility. Reasonably priced housing in communities with inexpensive public transportation and walkable or rollable sidewalks promote independence and allow individuals to remain active in their communities. Living and engaging with ones community can also prevent isolation and loneliness.In an effort to address the need for accessible and affordable housing for people with disabilities, Senator Bob Casey (D-PA) introduced the Visitable Inclusive Tax Credits for Accessible Living (VITAL) Act in April 2023. This legislation aims to increase investment in the federal Low-Income Housing Tax Credit (LIHTC) Program to address the housing needs of aging people and individuals with disabilities.The Low-Income Housing Tax Credit (LIHTC) ProgramThe LIHTC program incentivizes developers to build new housing for low-income renters through tax credits. Individuals can obtain LIHTC units when they meet location-specific income requirements.The VITAL Act modifies the LIHTC program to increase the number of accessible homes and residences in navigable communities. This would provide more residential options for adults with disabilities, helping them remain in communities.Highlights of the VITAL ActIf adopted, the VITAL Act would change the LIHTC program in the following ways:It would increase the overall funding for LIHTC for both the 4 percent and the 9 percent tax credits.The 4 percent tax credit, known as the 30 percent subsidy, supports the rehabilitation of existing buildings or new construction financed by tax-exempt bonds. The Act would decrease the tax-exempt bond financing requirement from 50 percent to 25 percent, allowing states to allocate more 4 percent credits for building rehabilitations.The 9 percent tax credit, known as the 70 percent subsidy, which supports new construction and substantial rehabilitation without federal support, would increase 50 percent over the 2021 leveThe Act would make more funding available for developers who build units for those with disabilities in accessible communities. It would give 130 percent more credits to developers who create adaptable and accessible units in areas with good EPA walkability scores. Developers would therefore pay fewer taxes.The legislation would impose requirements on the percentage of accessible units constructed under LIHTC in a three-year period.Forty percent must be adaptable and accessible for residents with disabilities. Or, if these units are located in walkable and rollable areas, states may lower the minimum to 20 percent. This incentivizes creating units in navigable areas, improving residents quality of life. The program would give each state housing finance authority $150,000 annually. The funds would support the creation of LITHC resource centers for new and nonprofit developers. The VITAL Act would establish a housing national advisory council. Comprising community-based organizations, housing developers, state housing finance agencies, investors, and the research community, this council would report on national trends and best practices for the program. The report would be available to states and the Secretary of Housing and Urban Development to review every three years.If the VITAL Act becomes law, it could help support the housing needs of the aging and disabled population. If you have questions, contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call with our staff to learn more about applying for LIHTC housing. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Choosing a nursing home for a loved one is a difficult decision and it can only be made more confusing by the various rating systems. A recent study found that using both Medicares Nursing Home Compare site and user reviews can help with the decision making. The official Medicare website includes a nursing home rating system. Nursing Home Compare offers up to five-star ratings of nursing homes based on health inspections, staffing, and quality measures. However, Medicares rating system is far from perfect. The staff level and quality statistics ratings are based largely on self-reported data that the government doesn't verify. The ratings also don't take into account state fines and enforcement data or consumer complaints to state agencies.  Nursing homes have learned how to game the system to improve their ratings. While Nursing Home Compare doesnt include consumer feedback, Yelp and other online platforms like Facebook, Google, and Caring.com allow users to review individual nursing homes. These user reviews are highly subjective, and it can be difficult to judge their legitimacy. These reviews aren't usually taken seriously--for example, consumer guides to finding a nursing home don't usually suggest that consumers consult online reviews.  (It should be noted, however, that Caring.com goes to great lengths to ensure the integrity of its reviews, including having senior care experts read every submission before publication.). In order to better understand what consumers were saying about nursing homes online, researchers at the University of Southern California evaluated 264 Yelp reviews and grouped them into categories. The researchers found that consumers rate different aspects of nursing home care than does the official rating system. User reviews were more emotional and more likely to focus on staff attitudes and responsiveness rather than on the quality of health care. The researchers concluded that user reviews can be used in conjunction with the Nursing Home Compare site to paint a fuller picture of life at the nursing home because they present complementary information. According to the study, online reviews shouldnt be dismissed because they directly capture the voices of residents and family members, precisely the kind of information [nursing homes] and their consumers need to hear and may want to act on, if resident-directed care is to be achieved. Yelp has gone a step further than other consumer review sites and has teamed up with the investigative news organization, ProPublica, to provide users with additional information. ProPublica's Nursing Home Inspect site, allows users to compare nursing homes based on federal data. Yelp users viewing a nursing home review page see a ProPublica box that provides information on the nursing homes deficiencies and fines.For more on choosing a nursing home, click here.

You spend a large portion of your life and your hard-earned money on the concept of the American dream, buying and living in your forever home. Your home is a special place, filled with memories, love, and laughter. As you age, you might start asking yourself whether your home works with your evolving daily routines and needs.  To ease challenges and simplify living, you may want to consider downsizing. Downsizing can offer many financial and lifestyle benefits for seniors. Why Downsize?Downsizing is the idea that your current space is more than you need and moving to a smaller space may fit your future needs better. Minimizing your living space and the amount of stuff you have can lead to less stress, lower living expenses, and a simpler overall life. The first step is deciding to sell your current home or exit your current lease and look for a new, smaller living space. Seniors might want to downsize to a single-floor residence, to a smaller dwelling after losing a spouse, or to a more community-focused living space. Many couples no longer use certain spaces in their home and could put extra money saved from downsizing toward retirement.What to Look For As a downsizing senior, create a list of your needs and wants in a new home. First and foremost, make sure you're moving to a space where you feel safe and comfortable. If you're going from a single-family home to a condo, consider that you'll now have neighbors and the style of living will be different. Also consider your future health needs. You may no longer want or be able to go up and down the stairs easily, so consider a ranch-style home or a first-floor unit. Ensure you have optimal mobility in your living space to help prevent accidents and falls. Whether you're buying a home or renting an apartment or condo, seek out a supportive community. This could be in the way of a retirement community, a small town, or a top-rated neighborhood. There are many benefits to a retirement community, such as meeting new people who are looking to live a similar lifestyle. This will allow you to foster friendships and stay active with community events. Also, you'll have low maintenance, as lawn and basic home care are typically included. How to Downsize When deciding to downsize, have conversations with your significant other or loved ones about what you envision needing in a living space going forward. Take a look at your health, your care needs, and your finances to understand what your options are. Once you have made the decision to downsize, research your living options. If you plan to buy a new, but smaller home, start with a mortgage preapproval to see what you can afford. Other options are renting, moving in with a loved one if they have the space, or looking into other senior living ideas. Seniors looking to sell their current home and buy one simultaneously will want to hire a real estate attorney to ensure a smooth transition and that their assets are safe. Next, clean out your current living space. This can be tough. Its hard to get rid of items you have accumulated over the years or that have sentimental value. Start by going through and putting together any items that must be kept. This could include family photos, documents, and special jewelry or clothing. Then go through the rest of your home and mark the items you're willing to part with by donating or selling. Moving as a senior cant be done alone. You'll need to get assistance from your friends and family to help. When moving time arrives, you can hire a moving company to assist. When to Downsize There is no right or wrong time to downsize. Its a decision only you and your partner can make. Your family might have differing opinions, but ultimately you have to decide if downsizing is needed to live your best life as you age.

Studies show looking after those with special needs exacts a toll on caregivers. As the saying goes, you cant pour from an empty cup. If you've been a caregiver for a loved one with a disability or chronic illness, ensure you're healthy physically and mentally. Here are five tips that can help you prioritize self-care.1. Know Your Limits.It's admirable you're caring for a disabled loved one, but you must keep your abilities and skill set in mind. Even if you're a health care worker, you still may need to contact professional help in some situations.Create and maintain a good relationship with your loved ones medical team, and don't hesitate to contact their doctor when something is beyond your ability.2. Try to Avoid Burnout.The subject of burnout usually centers on stressful jobs that essentially cause workers to lose themselves in their work. Caregivers also face the risk of experiencing burnout, and the chances of burnout may be greater because some caregivers don't think they can stop working.Burnout is mental, physical, and emotional exhaustion, which can come about for many reasons. Causes of burnout include:Trying to live up to unrealistic expectations, whether they're your expectations or those of family or friends.The inability to control your loved ones condition, particularly if their condition worsens over time.Feeling unable to separate your role as your loved ones spouse, partner, parent, child, or friend from the role of their caregiver. Setting boundaries is an essential part of making this distinction.3. Lean Into Your Support System.Part of caring for yourself is learning to delegate responsibility. It's impossible to do everything alone and maintain good mental health. If you have family members willing to take on some of the work and responsibilities of caring for a loved one, let them!Similarly, make an effort to express your concerns and anxieties to your family and friends. Caring for disabled loved ones is very stressful, no matter how rewarding in some respects. Remember you're only human; it's OK to need a shoulder to cry on, a listening ear, and someone else to take charge for a while.4. Create a Support System If You Dont Have One.If you don't have family support, create a support team by reaching out to other caregivers. Various resources are available to help you create a network to lean on when caring for a disabled loved one becomes overwhelming.Among the online and in-person groups that provide emotional support, offer tips about caring for a loved one with special needs, and can point you in the direction of community resources if you need help caring for your loved one are the following:Different DreamMommies of MiraclesThe ArcThe Caregiver Action Network5. Plan for the Future.You cannot hold the reins forever, and you know there's a possibility that you'll need to choose someone to act as your disabled loved ones caretaker in the future. The thought probably causes anxiety and contributes to your overall stress level. To alleviate that anxiety, start planning. One way to plan for the future is by creating a Memorandum of Intent.A Memorandum of Intent guides future caregivers so they know how to care for your disabled loved one properly. You can include any information you think will be helpful for them, including a list of your loved ones medications as well as their likes and dislikes, contact information for health care providers, their schedule of daily activities, and so on.Remember your loved ones are thankful for your care and attention. You owe it to yourself to be easier on yourself. Let your time with your family and loved ones remind you that you're not in this alone and you don't need to do everything on your own. Fill your cup with those around you, and you'll see you can better care for your loved one with special needs.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Life estates can be an excellent tool for Medicaid planning, probate avoidance and tax efficiency, but there are potential problems to look out for. Knowing the implications and risks of a life estate is essential in determining whether it is appropriate for your situation. In a life estate, two or more people each have an ownership interest in a property, but for different periods of time. The person holding the life estate -- the life tenant -- possesses the property during his or her life. The other owner -- the remainderman -- has a current ownership interest but cannot take possession until the death of the life estate holder. The life tenant has full control of the property during his or her lifetime and has the legal responsibility to maintain the property as well as the right to use it, rent it out, and make improvements to it.Life estates are excellent planning techniques in many circumstances. They permit parents to pass ownership in their homes to their children while retaining absolute possession of the property during their lives. By executing a life estate deed, the property avoids probate at the parents' deaths, is protected from a Medicaid lien, and receives a step-up in tax basis.However, there are potential issues that may arise with life estates and its important to fully understand the following risks:As a life tenant, you may not easily sell or mortgage property with a life estate interest. The remaindermen must all agree if you decide to sell or borrow against the property. One thing that can help is a testamentary power of appointment in the deed. This is a mechanism that permits the life tenants to change who ultimately receives the property by directing its disposition in their wills. It wont allow the life tenant to sell the property, but it does give the life tenant more bargaining power with the remaindermen. Another option is a nominee realty trust. This type of trust permits one or more children to act as trustee or trustees for all the children, and provides that they must follow the direction of a majority of the beneficiaries. So, if there are four children and one child objects to the sale or mortgage of the property, but the other three are on board, the majority can direct the trustee to sign the papers necessary to facilitate the sale or borrowing.If the property is sold, the remaindermen are entitled to a share of the proceeds equal to what their interest is determined to be at that time.It is not as easy to remove or change a name once it is on a deed to real estate as it is to change the beneficiary on a life insurance policy or bank account.Once a remainderman is named on the deed to your house, he or she has an interest in the home and his or her legal problems could become yours. For example, if your child, who is a remainderman, is sued or owes taxes, a lien could be filed against your home. Your childs interest in the home is not protected if he or she files for bankruptcy. If your child gets a divorce, his or her spouse could claim all or part of your childs interest in your home. Should your child die before you do, the childs estate would have to go through probate unless at least one other remainderman was listed as a joint tenant. However, while these claims may be made against the property, no one can kick you out of it during your life.Giving away an interest in property could disqualify you from receiving assistance from Medicaid, should you require long-term care within five years of the transfer. In addition, if you and the remaindermen were to sell the property while you were in a nursing home, the state could have a claim against your share of the proceeds for payments it has made on your behalf, but the share of the proceeds allocated to your children would be protected.As with most planning tools, a life estate can be very useful with valuable benefits, but it's not for everyone. In many cases, the potential problems outweigh the benefits. As the law in this area is complex, its important to talk to a lawyer who knows about this in-depth.

The environmental costs of death are significant and constantly rising. With 8 billion people on the planet right nowall of whom have bodies that die and must be disposed ofwe need to start seriously considering alternatives to traditional options for burial and cremation. Fortunately, more and more green options are being developed to reduce these costs, and this article looks at some of the latest innovations.In most conventional burials, the body is pumped with toxic embalming fluid, placed in a steel casket, and buried within a cement-lined vault six-feet underground. According to the Green Burial Council, burials in the U.S. go through roughly 77,000 trees, 100,000 tons of steel, 1.5 million tons of concrete, and 4.3 million gallons of embalming fluid each year.Although cremation is touted as more eco-friendly than burial, it still comes with serious environmental risks. In fact, cremating a single body uses about the same amount of gas as a 500-mile road trip, according to the Natural Death Center. Cremation also releases some 250 lbs. of carbon dioxide into the atmosphere, roughly the same amount an average American home produces in a week.A return to natureWith the death rate expected to spike as Baby Boomers age, the funeral industry is poised to cause even more damage. While green funerals are a recent trend, natural burials were the norm until the Civil War, which coincided with the rise of the industrial age, embalming, and the modern funeral director business.Today, natural burials are making a comeback. Green funerals are designed to not only be more environmentally friendly, but also less expensive overall than conventional burial or cremation. If you want to make your last act on this planet less harmful to the ecosystem, here are 6 green funeral options, along with the best way to include your final wishes in your estate plan.01 Green burialFounded in 2005, the nonprofit Green Burial Council (GBC) establishes environmental standards for green cemeteries, funeral professionals, and funeral-product manufacturers. According to the GBC, a green burial must meet three general criteria:The body cannot be embalmed. The body must be buried without a cement or metal vault or grave liner.Only biodegradable burial containers and shrouds may be used.In green cemeteries, graves are typically marked by GPS or with a simple stone or tree, instead of headstones, metal plaques, and other ornate markers. The grounds are often planted with native species, forgoing pesticides and mechanical landscaping. The graves are shallower than conventional plots, exposing the body to more natural organisms to speed decomposition.Green caskets are constructed from biodegradable materials, such as untreated wood, bamboo, wicker, or cardboard. Burial shrouds should be non-bleached, undyed, and made of natural fabrics like cotton, linen, silk, wool, or hemp. To find funeral providers in your area that offer green burial, use the GBCs list of approved companies.02 AquamationWithout the need for embalming, caskets, or burial vaults, cremation is considered less harmful to the environment than burial. However, a new water-based methodaquamationpromises an even greener alternative. Also called resomation or flameless cremation, the method involves a chemical process in which lye, superheated water, and pressure dissolve the body, rather than burning fossil fuels. The ashes produced by aquamation can be scattered or placed in a biodegradable urn for burial.03 Mushroom burial suitsOne of the latest innovations in green funerals are special burial shrouds containing mushroom spores sewn into the fabric. The suit fits like long-john pajamas, and the mushrooms facilitate decomposition. In addition to absorbing and purifying toxins released by the body, the fungi delivers nutrients to the soil to encourage plant growth. When he died of a stroke at the age of 52, TV and film star Luke Perry was reportedly buried in a mushroom burial suit.04 Eternal reefsEternal Reefs combine ashes from cremated remains with environmentally friendly concrete to create an artificial reef. Submerged on the ocean floor, these hollow reef balls create new habitats for coral, fish, and other marine life. Marked by GPS, your loved ones are encouraged to visit these living memorials by boat, snorkeling, or scuba diving. The company currently has locations in the waters off the following states: Florida, New York, North Carolina, Texas, South Carolina, Maryland, and New Jersey.05 Become a treeIf you arent near the water, but still want to leave a living memorial of yourself, a tree burial might be an attractive alternative. The startup Transcend plans to open forest-based cemeteries across the U.S., where rows of trees, rather than headstones, mark the graves. Heres how it works: the body is wrapped in a biodegradable, linen shroud and placed in a shallow grave thats lined with wood chips or hay. Then, a mixture of soil, wood chips, and fungi is used to fill the grave, and a young tree is planted on top. As the body decomposes, it provides nourishment to feed the tree.Additionally, Transcend has partnered with the nonprofit One Tree Planted, which specializes in planting trees around the world. For every tree burial reserved, Transcend promises to plant an additional 1,000 trees right away. The company expects to launch their first tree burials in 2023. Visit their website to learn more, including how the company plans to ensure your tree will be well-maintained for years to come.06 Human compostingAnother way your death can create new life is by having your remains composted. Known as human composting or recomposting, the process is similar to composting used to fertilize gardens and farms. The body is first placed in a steel cylinder filled with wood chips, straw, and alfalfa, along with bacteria designed to break down organic matter.After roughly a month, your body is transformed into what basically amounts to soil. The end product can either be returned to your family or used to revitalize local conservation areas. Developed in 2020 by the Seattle-based company Recompose, human composting is currently legal in five states: California, Washington, Oregon, Colorado, and Vermont, with legislation pending in Hawaii and Delaware.Put Your Final Wishes In Your Estate PlanRegardless of the method you select, its critical to include your desires, plans, and the money to pay for disposal of your body in your estate plan. While green funerals are typically less expensive than traditional burial and cremation, they can still cost thousands of dollars. To avoid burdening your loved ones, at the very least, your plan should include enough money to pay for your funeral and legally name the person you want to carry out your desired wishes.Moreover, its typically not a good idea to leave money for your funeral in your will. Any money left in your will wont be accessible to your family until your estate goes through the court process of probate, which can last months or even years. Since many funeral providers require full payment upfront, if you leave funds in your will, your loved ones will likely be stuck with the bill.To avoid the necessity for probate, we often advise our clients to leave money and directions for their immediate post-death wishes in a revocable living trust. A living trust doesnt require probate, so the money for your funeral would be available to your loved ones right away. In the terms of your living trust, you can specify how you want your funeral carried out, and the person you designate as trustee is legally bound to use the funds in the exact manner the terms stipulate. This can be especially important for green funerals, which might not be something your loved ones would choose if left to plan things on their own.Finally, you can change the terms of your living trust at any point during your lifetime, and with new alternatives being developed all the time, this flexibility would allow you to use the very latest innovations in green funerals. If youre interested in creating a trust to cover your funeral expenses, meet with us to discuss the options.Help Your Loved Ones And The PlanetWith proper planning, you can ensure that your death is not only significantly easier and less expensive for your family, but that it also has the most beneficial impact on the environment. Well work with you to prepare an estate plan that includes enough funding to have your funeral handled in the exact manner you desirewithout forcing your family to pay for it. Contact us today to learn more.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Once a person becomes a guardian, they should be aware of their responsibilities. Since the ward loses significant rights, guardians must promote their autonomy to the fullest possible extent. Guardians must make decisions, such as moving the ward across states, in the wards best interests.Legal Guardianship for Adults With DisabilitiesThere are several types of guardianship. An adult may require assistance across domains or may only need help in certain areas. In a plenary or total guardianship, a person may have more responsibilities than in a limited guardianship, in which the ward retains more rights.In guardianships of the estate, or conservatorships, responsible individuals handle money for others.Guardianships of the person support personal affairs, such as education, housing, and health care.Plenary guardianships provide total assistance.In limited guardianships, the substitute decision-maker only helps with particular decisions. A court may order a limited guardianship when an adults incapacity may only affect certain decisions. It is the least restrictive arrangement.Effect on the WardIn many cases, those subject to guardianship no longer have significant rights, which can vary depending on how restrictive the guardianship is. In some circumstances, lost rights include:VotingMarriageChoosing where to liveProviding medical consentDeciding whether to extend their lives or die naturallyHolding a drivers licenseControlling, buying, or selling propertyOwning a firearm or weaponEntering into contracts, such as leasesGuardians ResponsibilitiesMaking decisions for those who cannot, guardians must act in the best interests of their charges and fully support their independence. Depending on the terms of the order, responsibilities include arranging appropriate housing, education, and access to medical care. States can also require guardians to take classes.Although the guardians controls can extend across many domains of the wards life, the guardians power stems from the court. Individuals exercising authority may face sanctions if the court has not approved a particular action.Many guardianship orders allow a competent adult to manage the finances of an incapacitated individuals to purchase food and pay bills, for example. In many cases, however, the court does not give custodians complete powers.A guardian may lack the power to sell the adults property, such as a home. To do so, the guardian would need special permission.Caregivers also typically cannot reimburse themselves from the funds of the person with a disability without special permission from the judicial authority.Annual ReportProtectors must file a yearly report. Depending on the guardianship type, this document may update the court on factors such as the following:how the adult with a disability is doingwhere they currently livetheir financial statusIt is crucial that guardians remember to keep good records and submit the report each year. Otherwise, they could face judicial reprimand and removal.Transferring Guardianship Across StatesSometimes, the responsible person may wish to transfer the ward to another state to receive care. Moving must not simply constitute a matter of convenience for the caregiver, but must fulfill the wards best interests. The custodian must have reasonable and adequate plans for the wards care in the new location.Before the majority of states adopted the Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act (UAGPPJA), transferring guardianships was complex. Since state laws govern guardianships, each state had its own rules. Streamlining the process, the Act makes moving those under guardianship easier by honoring the rulings of other jurisdictions. According to Special Needs Alliance, 45 states have enacted the UAGPPJA.Similar to when an individual petitions for guardianship, they must ask the court to transfer the guardianship to a new jurisdiction and give notice of the move to all interested parties. If a person disputes the relocation, the court holds an evidentiary hearing to determine if moving aligns with the wards best interests.Removing GuardiansWhen protectors fail to uphold their duties, the court may strip them of their authority and appoint another guardian. Grounds for removal include:physical abuseemotional abusefinancial abusefailure to meet procedural standards, such as neglecting to file the annual reportTerminating CustodyCapacity can fluctuate over time. In some cases, incapacitated people regain the ability to make decisions. Other times, a ward may dispute guardianship. When a person wishes to end a guardianship, they can ask the court to terminate it.Since wards sometimes face bias in legal proceedings, ending a guardianship can be challenging. Although individuals can represent themselves pro se, or without an attorney, a special needs attorney can help those subject to guardianship restore their rights.Find a Special Needs Planning AttorneySpeak to a special needs planner near you to learn more about transferring or ending guardianship of an adult child with a disability.Additional ReadingLegal Guardianship of an Adult: Becoming a GuardianWhat Are the Wards Rights in a Guardianship?Attorneys Can Help Prevent Bias in Guardianship ProceedingsHow Legal Counsel Can Benefit Ward in Proposed GuardianshipContact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call to learn how we can help. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

A group home is a living accommodation option for people with disabilities. Living in a group home may be a good option for those individuals who do not need advanced medical care but cannot safely live alone. The care in a group home setting allows residents to receive extra support in a community setting without sacrificing their independence.The size of group homes varies, but generally they tend to be smaller than most long-term care facilities. They may offer shared spaces for residents, and bedrooms may be private or shared with a roommate.How Can the Staff of an Adult Group Home Help My Loved One?People living in group homes may have significant difficulties performing activities of daily living (ADLs).Examples of these essential daily activities include:EatingBathingToiletingDressingStaff at group homes may assist with these activities in addition to others, such as housekeeping, transportation, and monitoring prescription medications. Some group homes also offer rehabilitative services and employ specialists, including speech therapists, physical therapists, and counselors, to support residents with disabilities.Group homes also help residents stay active socially. Living with a disability can bring feelings of loneliness and bouts of isolation. Group homes provide socially stimulating activities that keep residents engaged. Many group homes provide residents with activities like field trips, shopping, games, and other entertainment.What to Look for in Group Homes for Adults With DisabilitiesChoosing the right place is important. This will be your loved ones home, so you will want a facility that is safe, can cater to their needs, and meets your basic standards. Some things to consider when evaluating a group home include:The level of training provided for and completed by employees.The cleanliness of the facility and how well-groomed the residents appear.How the facility handles medical emergencies.Whether there is professional medical care on-site or immediately available.How easily residents can contact family members and others outside the facility.Whether there is a waiting list and how long the wait for admission may be.Remember that it is OK to ask questions. You should gather all the information available to ensure you and your loved one feel comfortable living in the space you all choose.How Can I Pay for a Group Home?Paying for ongoing medical care can quickly become expensive. Private group homes can range from tens of thousands of dollars to more than $100,000 per year for full service. Group homes can be beneficial to many families, but they may prove too expensive for some.Medicaid is a federally funded health insurance program that provides low-income Americans with health care coverage if they qualify. Each state decides how to allocate the federal funds they receive. Some states allow Medicaid to pay for a group home or adult foster care services through a waiver program. To learn more about your options, and to find out whether you qualify for coverage, check with your states Medicaid office.Military veterans with disabilities who qualify for Aid and Assistance benefits may also be able to receive financial support that can help pay for care in certain types of accommodations, such as group homes.Certain nonprofits help cover expenses for group home care. A special needs planner may be able to assist you in finding a program that will fit the needs of your loved one. Find a qualified special needs planner in your area.Beyond Institutional CareGroup homes are set up to provide a homelike setting. For decades, many individuals with disabilities were placed in large institutions where they lacked autonomy, privacy, and interaction with the larger community.In the 1960s and 1970s, a movement toward deinstitutionalization emerged, with the late 1990s marking a major shift in policy. For individuals in the disability community who qualify for government benefits, a 1999 landmark Supreme Court decision secured the legal right to live in the least restrictive setting possible. As a result of this ruling, many individuals who had been confined to institutional settings like nursing homes and psychiatric facilities had the choice to live their lives as more integrated members of their community.Additional Resources on Group Homes for Disabled AdultsWe all feel compelled to protect those we love who have disabilities. Providing them with quality of life as well as a sense of dignity and independence requires learning what is best for their care. The following organizations in your state may be a good place to start if you and your family believe that finding a group home is the best next step for your loved ones care:Centers for Independent Living.State affiliates of the National Alliance on Mental Illness.State agencies supporting people with intellectual/developmental disabilities.If you have questions about health care or housing options for a loved one living with disabilities, call Sharek Law Office at 412-347-1731 or click here to schedule your free 15-minute phone call consultation. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

You might think that only the super wealthy need to worry about asset protection planning. But the truth is that if you dont have millions, you may be at even greater risk. For instance, if you are a multi-millionaire, a $50,000 judgment against you might not be that big of a deal. But for a family with a modest income, savings, and home, it could be devastating.Furthermore, asset protection planning isnt something you can put off until something happens. Once you are under threat of a lawsuit, its likely too late to protect your assets. Like all types of planning, to be effective, you must have your asset protection strategies in place well before something happens. And your asset protection plan isnt a one-and-done deal: it must be regularly updated to accommodate changes to your assets, family dynamics, and the law.While you should meet with us, your Personal Family Lawyer to determine the asset protection strategies that are best suited for your particular asset profile and family situation, here are four essential strategies to consider for safeguarding your familys most valuable assets. 1. Invest In InsuranceInsurance is always the first line of defense when it comes to asset protection. Anyone can file a lawsuit against you at any timeand basically for any reason. And whether you are ultimately found at fault or not, defending yourself in court can be extremely costly.The insurance coverage you purchase should not only pay damages if a lawsuit against you is successful, the policy should also cover the cost of hiring a lawyer to defend you in court, whether you win or lose your case. And because a large judgment could exceed your policies coverage limits, you should also seriously consider buying umbrella insurance.Should your underlying insurance policy max out, an umbrella policy will help cover any remaining damages and legal expenses. As your Personal Family Lawyer, we will evaluate your current insurance policies and advise you about the types and amounts of insurance you should have for maximum protection of your assets.2. Take Advantage Of Statutory ExemptionsAnother way to protect your familys assets is by taking full advantage of federal and state laws that make certain types of assets exempt from creditor claims and judgments. Depending on the state, the availability and amount of protection offered by these exemptions can vary.For example, many states offer a homestead exemption, which protects a certain amountor even the full valueof the equity you have in your primary residence from creditors. If your state provides a generous homestead exemption, paying down your mortgage could protect funds that would otherwise be vulnerable.Similarly, federal and state laws also classify many retirement plans, such as 401(k)s and IRAs, as exempt assets. Additionally, some states offer significant, or complete, exemptions for life insurance policies and annuities, as well.Even though such exemptions wont offer you total protection, they can provide significant shelter for certain assets. Plus, using statutory exemptions is something that can be accomplished without investing anythingall thats required is for you to understand how best to structure your investments to take advantage of these protections. Meet with us, your local Personal Family Lawyer to learn what types and amounts of exemptions are available in your area, and how to make the best use of each one.3. Use The Right Business EntityOwning a business can be a major wealth-generating asset for your family, but it can also be a serious liability. In fact, without the proper protection, your personal assets are at serious risk if your company ever runs into trouble. For example, if your business is currently a sole proprietorship or general partnership, you are personally liable for any debts or lawsuits incurred by your business.However, structuring your business as a limited liability company (LLC) or corporation is typically the best move for most small businesses. When properly set up and maintained, both entities create an impenetrable barrier between your personal assets and your business activities. Creditors, clients, and other potentially litigious individuals can go after assets owned by your company, but not your personal assets. Additionally, having the right business insurance in place can help shield your business assets from such claims.If you own any kind of business, even just a side gig to earn extra income, you should consider setting up a protective entity to ensure any liabilities incurred by your company wont affect your personal assets. We can help you select, put in place, and maintain the proper entity structure for your particular business operation. If you havent done this already, contact us right away to ensure your business doesnt put your personal assets in jeopardy.4. Put The Proper Estate Planning In PlaceAlthough each of the above scenarios are mere possibilities, there is one certainty in lifedeath. Its coming for all of us, and given this fact, your eventual deathor your potential incapacity from a serious accident or illness before you pass awayis the biggest risk to your familys assets. If you become incapacitated or die without proper estate planning in place, your assets and family will face a number of potentially tragic outcomes. Without the proper planning, your assets will get stuck in the court system, which could result in those assets passing to family members you would never want inheriting them, or if the assets eventually do pass to the loved ones you would want inheriting them, those assets could be seriously depleted or even lost. To this end, planning in advance for the inevitability of death is one of the greatest gifts you can give those you love most. You work way too hard to leave your familys assets at risk. If youve been putting off creating your estate planor if you havent updated your existing plan recentlynow is the time to get it handled. As your Personal Family Lawyer firm, weve made estate planning incredibly easy, and we start with a Life and Legacy Planning Session, which is the first step in our Life & Legacy Planning process.Life & Legacy Planning: Do Right By Those You Love Most During this process, well walk you through an analysis of your assets, whats most important to you, and what will happen to your loved ones when you die or if you become incapacitated. From there, well work together with you to put in place the right combination of estate planning solutions to fit with your unique asset profile, family dynamics, budget, as well as your overall goals and desires. As your Personal Family Lawyer, we arent like most estate planning firmswe see estate planning as far more than simply planning for your death and passing on your estate and assets to your loved onesits about planning for a life you love and a legacy worth leaving by the choices you make today. And this is why we call our services Life & Legacy Planning. Contact us today to schedule your visit to ensure that your assets and loved ones are safeguarded from all potential threats.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge.

The U.S. Department of Health and Human Services (HHS) has recently started to focus on finding ways to support family caregivers by assisting them with resources to maintain their health, well-being, and financial security while they act as caregivers. As part of this, it has announced the implementation of a National Strategy to Support Family Caregivers.HHS estimates that approximately 53 million people provide a broad range of assistance to their aging, health-compromised, or disabled loved ones each year. Millions more open their homes to grandparents as well as children who cannot live with their parents.Burdens of CaregivingMany caregivers put their needs last, often giving up income to step into a caregiving role. As a result, they may suffer quality of life and financial and health issues. When these scenarios become untenable, their loved ones are forced to enter nursing homes or other facilities, and taxpayers bear this cost. In response to these issues, HHS has proposed its National Strategy to Support Family Caregivers, a collaboration between the federal government and the private sector. HHS plans to update this strategy every two years and seek input from the public, and from local and state councils and agencies that work with family caregivers. The strategys primary goal is to provide caregivers with training, support, and opportunities for rest and self-care. Two main categories of caregivers are the focus of the strategy family caregivers and kin and/ or grandparent caregivers. Family caregivers usually assist a loved one with a chronic or other health condition, disability, or functional limitation. A kin and/ or grandparent caregiver refers to a grandparent or adult relative who takes on responsibility for grandchildren or other children who cannot remain with their parents.The National Strategy outlines five main goals:To increase awareness of and outreach to family caregiversTo advance partnerships and engagement with family caregiversTo strengthen services and support for family caregiversTo improve financial and workplace security for family caregivers through the proposed implementation of various national paid leave programs and/or refundable tax creditsTo expand infrastructure that will enable data collection about the prevalence of caregiving, the context in which care is provided, and the financial, emotional, and physical impacts of caregivingLearn more about the National Strategy to Support Family Caregivers and the coordinated approach to supporting caregivers it hopes to achieve.

Many options are available for those planning where to live and receive care during their retirement years. Independent living communities are for healthy, active older adults. Assisted living facilities suit those who need help with activities of daily living, such as bathing, dressing, preparing meals, and medication management. Skilled nursing facilities provide care to individuals with significant medical conditions. Yet, as people age, the type and level of care they need often change. Older adults who start in one kind of community often must move to another facility that can support their evolving needs. Relocating can be stressful, as individuals leave their friends to start over in an unfamiliar environment, often while their autonomy and access to recreation diminishes. Continuing Care Retirement Communities Provide Consistent CareContinuing care retirement communities (CCRCs) present a solution for people who wish to avoid the strain of moving and remain in one senior living community that meets their evolving needs. Also called life plan communities, these establishments typically offer independent living, assisted living, memory care, and skilled nursing in one centralized location. Residents can choose from different housing options, such as cottages, condos, and studio apartments. Far from appearing like institutions, CCRCs resemble neighborhoods. As elders needs change, such a community can provide progressively appropriate care. For instance, a resident may begin living unassisted before transitioning to receiving aid with activities of daily living or nursing care. A person who develops dementia can move into a memory unit within the grounds. Additional Benefits of Continuing Care As well as allowing residents to remain in a single, familiar community as their health and abilities change, CCRCs have many advantages compared with other residential senior living establishments. Live With Your Spouse  In CCRCs, individuals with different needs can live in the same community. So, spouses can remain together even if only one requires nursing care or help with activities of daily living. Remain in a Community  Elders can also stay connected with their friends in the community and enjoy a social environment. Maintenance and Meals  Residents don't have to worry about maintaining their homes, cooking, or cleaning.Rely on Convenient Services  Similar to a small town, life plan communities provide commercial services like banks, beauty salons, barber shops, coffee shops, and shopping.Access Health Care  Professional health services, such as physician and nursing care, physical therapy, dental services, nutrition counseling, and mental health assistance, are also available. Enjoy Other Amenities  Amenities, such as walking trails, swimming pools, and fitness centers, as well as game, craft, and music rooms, help residents stay active and engaged. Selecting a Life Plan Community With over 2,000 across the United States, many areas have continuing care retirement communities, SeniorLiving.org reports. Since these facilities typically resemble ordinary housing developments, people may not know there is a CCRC in their town. Choosing a life plan community near your family, friends, and hometown can maximize social support. Most people seeking continuing care options intend to remain there for the rest of their lives. In fact, this is continuing cares primary advantage so location is an essential consideration. In addition to location, AARP.org recommends assessing several other components before choosing a life plan community. It's a good idea to tour the CCRC before signing an agreement. Also, consider the following.Review Housing Options  How are the floor plans? Are the common areas clean?Investigate the Staffs Credentials  Are they professional and friendly? What hours do they keep? Consider Available Services  Does the staff take care of laundry? What kind of commercial services does the development have? What type of transportation does the organization offer? Learn About Social Activities  Is there a schedule of activities with off-site trips? How are the exercise facilities? Are there fitness classes? What kind of entertainment does the place offer? Evaluate Meals  Examine recent menus. How many entrees do they offer? Can the facility accommodate dietary restrictions? Speak to Residents  How do they feel about the community? Do they think it's worth the cost? What do they think of the staff and services available? Affording Care in a Continuing Care Retirement CommunityCCRCs require a one-time entry fee in addition to monthly payments. According to AARP.org, the price can range from $20,000 to more than $2 million, with an average of $402,000. Entry payments can be especially high for those who enter into extensive life-care contracts. Still, they receive assisted living, medical treatment, and skilled nursing care for little or no additional cost for the duration of their lives. They can avoid later costs by paying in advance for assisted living and nursing services. For many, life plan communities are worth the cost. Residents can have peace of mind knowing they will remain in a familiar location with consistent support should their health decline. While maintaining maximum independence, they can prepare for future mobility or health complications. Consult a LawyerJoining a CCRC requires signing a complex contract. Those exploring continuing care should consider working with an elder law attorney. An advocate can help them weigh the pros and cons of continuing care, determine payment options, and explain contracts before you sign them.

Per an announcement from the United States Department of Health and Human Services (DHHS), the federal Public Health Emergency created in response to the COVID-19 pandemic ended in May 2023. With the end of this Public Health Emergency (PHE) comes a number of shifts in policy that may specifically impact U.S. military veterans.The Public Health Emergency for COVID-19The federal government may declare a public health emergency in the face of a disorder, significant outbreak of an infectious disease, or other emergency or disaster that is determined to present a threat to the public.Declaration of a public health emergency allows the federal government to release resources to handle a public health crisis. The COVID-19 Public Health Emergency has left a legacy in response to the COVID-19 pandemic. Some of the effects of the Order include the following:The country now has tools to detect and respond to COVID-19 variants.The Public Health Emergency helped the country prepare for a potential surge of COVID-19 cases.The experts issued guidance on mitigation measures, including testing and masking.How Will Veterans Be Affected by the End of the Public Health Emergency?The end of the Public Health Emergency will impact many different groups of Americans, including veterans. Veterans and their families can expect the following changes as the country transitions away from the guidelines put into place during the COVID-19 PHE:Veterans experiencing homelessness will no longer receive the direct support they did under the Public Health Emergency. The assistance veterans received included food, clothing, hygiene products, and help with finding housing and completing housing assistance forms.Flexibility in prescribing controlled medications to veterans through telemedicine has not ended with the Public Health Emergencys expiration. Doctors may continue prescribing controlled medications for veterans without having to complete an in-person physical examination first. (Note that the Drug Enforcement Agency has also proposed rules to make permanent the use of some telemedicine flexibilities for certain prescriptions.)During the Public Health Emergency, Veterans Affairs (VA) relaxed rules regarding telemedicine appointments, allowing the use of various video platforms for these appointments. With the PHEs end, the VA returns to primarily using VA Video Connect for Telehealth in order to comply with HIPAA and protect patient privacy; Webex will be used only on a restricted basis.The Veterans Family Caregivers program will resume in-person visits for initial home care assessments, reassessments, and wellness checks.After the Public Health Emergency expired, the VA lost the authority to provide COVID-19 vaccinations to spouses and caregivers not enrolled in VA health care.After June 9, 2023, the VA is reinstating the pre-pandemic, 30-day deadline to submit for travel reimbursement. Veterans and caregivers will no longer have an extended deadline to apply for travel reimbursement for mileage and other travel expenses related to eligible veterans health care appointments.As the country transitions out of the shadows of the COVID-19 pandemic, many populations will feel vulnerable, especially if they lose benefits that had been provided through the Public Health Emergency regulations. If you are a veteran impacted by these changes, consider researching the following resources:Contact Your Local VAHUD-VA Supportive Housing Program and the National Call Center for Homeless Veterans (for veterans experiencing homelessness)VA travel pay reimbursement (for caregivers of veterans)If you have questions, contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute Call with our staff to learn how we can help you. This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

When it comes to retirement planning, many Americans find themselves underprepared. A majority of baby boomers (born between 1946 and 1964) and Generation Xers (born between 1965 and 1978) often end up without retirement savings or dont have realistic expectations about post-retirement costs. According to the Insured Retirement Institute, only 25 percent of boomers are confident of having sufficient savings in retirement. If you're in your 50s and nearing retirement without substantial savings or a plan, dont despair -- it's never too late to start planning.Although every working professional should contribute towards retirement from their early days, for various reasons they often delay the process. If you're nearing your 50s without a post-retirement plan and see yourself working for another 10 to 15 years, this is an opportunity to plan judiciously and save for your retirement right away.Here are five strategic steps for achieving the best retirement plan:1. Set Specific and Practical GoalsProper retirement planning begins with setting specific goals. Calculate your current income, total savings, and ongoing investments to understand how much you could save, and be sure to set realistic goals.While providing for emergency expenses and paying off a mortgage can be your short-term and intermediate goals, saving up for retirement should be your long-term goal. An annual financial review is helpful in evaluating your past goals and understanding your earnings as well as liabilities.2. Plan a Realistic Budget Focusing on RetirementReview your monthly and yearly expenses and list the factors that are likely to remain constant for the next few years. Now allocate funds to each category in a way that will allow you to save more for your retirement.According to financial experts, if you're saving for retirement after 50, it's best to contribute 30 percent of your salary towards this end. If you find that goal difficult to meet, look at your budget list and reduce optional expenses.3. Pay Off DebtsPaying off debts early will help you meet your retirement budgets and ease the financial burden. According to an AARP report, 44 percent of Americans continue to pay for their home after they retire.Clearing off outstanding debts, credit card bills, loans, and mortgages will make it much easier to prioritize retirement funds.4. Invest in Retirement Plans401(k)s, 403(b)s and IRAs are some of the retirement plans available in the U.S.  While 401(k)s are one of the most popular plans, not all companies offer them and those that do have their own, often restrictive, investment rules. Then there are two types of IRAs: traditional and Roth IRAs.To make the best choice among the many retirement plan options, it's essential to have a thorough understanding of IRA vs. 401 (k), Roth IRA vs 401(k) and other investment alternatives, as well as  contribution limits.5. Diversify Your InvestmentsInvestment diversification will help keep you on a firm financial footing. Don't stash all your money in banks; instead, create an investment portfolio and explore your options.It's important to diversify and distribute your money among multiple sectors. Considering the volatility of markets, diversification of your investment portfolio safeguards your capital and helps it grow.Its Time to Step Up a GearA concrete retirement plan with emphasis on savings is essential to ensure a comfortable and healthy post-retirement life. Saving for your retirement is the first priority and the sooner you start, the better your chances of achieving your retirement goals.

When individuals cannot manage their finances, courts can appoint guardians. Financial guardianship is for those who need help handling money. Depending on the jurisdiction, financial guardianship may also be called guardianship of the estate or conservatorship.In cases where individuals need help with personal and financial decisions, the court can order guardianship of the person and estate. The guardian makes both personal and financial decisions for the protected person.What Financial Guardianship EntailsFinancial guardianship gives the guardian the authority to oversee the protected persons finances and access money to pay bills. In many cases, the terms of the arrangement require the guardian to seek court approval before making financial actions on behalf of the ward, such as spending money and selling assets.The wards money goes into a blocked account. The guardian can only access such an account with a court order, according to the Family Law Self Help Center.When Do Courts Order Financial Guardianship of an Adult?Courts appoint financial guardians when people demonstrate that they cannot handle their finances on their own.Individuals who frequently forget to pay bills might need help with finances. For instance, a person might need help remembering to pay bills and handling money.Those who are vulnerable to financial exploitation might also need guardians. For example, suppose a person makes significant payments to an online scammer. In that case, a loved one might petition the court to become the persons guardian to protect them.Individuals with diseases and disabilities that prevent them from understanding money may also need the help of a trusted person. For instance, dementia can cause people to have executive functioning difficulties that impact their ability to handle money.When a person has significant assets but needs help managing them, courts will order financial guardianship. Individuals with limited income and assets might not need financial guardians.Alternatives to Financial GuardianshipWhile providing protection and support, guardianship limits autonomy. Many states require courts to explore less restrictive alternatives to guardianship before appointing a guardian. Those facing challenges with financial decisions should, along with their loved ones, first consider other options.Financial Power of AttorneyGuardianship is appropriate when a person is impaired and cannot make their own decisions. Suppose an individual still can make decisions and understand the consequences of their choices. In that case, the person can execute a power of attorney for property. This gives a trusted individual the ability to handle their assets.Compared to financial guardianship, an economic power of attorney can protect individuals rights while allowing someone to step in and help with monetary decisions. Under financial guardianship, it is more difficult for the protected person to change the arrangement if disagreements with the guardian arise. The person subject to the arrangement must petition the court to terminate it.Revoking a power of attorney is, by comparison, straightforward. As long as the individual who made a power of attorney retains capacity, they can withdraw their power of attorney at any time for any reason. They can also appoint a new agent without judicial oversight.Supported Decision MakingAnother option for those with money difficulties is supported decision-making. Under a supportive decision-making arrangement, a person can have a trusted individual or multiple people help with financial decisions.Supportive decision-making is less restrictive than guardianship, as individuals get help with decisions while retaining autonomy. Unlike a ward in a guardianship, the individual keeps the final decision-making power.Those wondering whether they need someone to help with finances should speak with an elder law attorney. Contact Sharek Law Firm today at 412-347-1731 or schedule a free 15-minute introductory call today for all of your elder law needs. Additional Reading on Legal GuardianshipThe Ins and Outs of Guardianship and ConservatorshipBritney Spears Case Puts Renewed Focus on Guardianships and Less Restrictive AlternativesHow Do I File for a Guardianship?New Yorker Article Highlights Abuses in the Guardianship System This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Older people may need a trusted individual to step in and manage their affairs, should they ever suffer debilitating health problems like dementia, Alzheimers disease, and strokes. Guardianship can provide protection and assistance with certain decisions for an incapacitated individual known as a ward who may become unable to make decisions or advocate for themselves. In appointing guardians, courts can restrict a wards rights in some circumstances. Wards may lose the right to:VoteDecide where to liveProvide medical consentMake decisions about whether to prolong their life with medical interventionsHave a drivers licenseControl, buy, or sell propertyPossess a firearm or weaponMake contractsA guardian should make decisions that benefit the ward. Some guardians fail to act in their wards best interests, preventing them from seeing family and friends, making unsound healthcare decisions, and neglecting to protect them from harm. Although the guardian becomes the primary decision maker, the person under guardianship also retains many essential freedoms. Elders with guardians and their family members should know these rights so that they can respond if control becomes overly restrictive. State Laws Governing GuardianshipsState laws govern guardianships, and many states have acted to protect the rights of wards. The American Bar Association reported that, since 2015, 18 states have passed laws protecting the rights of people in the custody of guardians, while other states have strengthened their laws. Many states have passed versions of a Guardianship or Ward's Bill of Rights, with rights including:Access to an attorney and the power to petition the court for reliefFair treatmentThe ability to see and communicate with friends, family, community members, and othersRespect for the wards religious beliefs and wishesPrivacyThe most significant attainable level of control over their circumstancesNursing Homes and the Rights of People with Guardians Special considerations arise for wards residing in nursing homes. The federal Nursing Home Reform Law governs skilled nursing facilities receiving federal funding and establishes the rights of nursing home residents, including the rights to:Visit with other residents and family members in the establishmentSelect a physician Medical privacyPrivate communications from family Confidential recordsReceive accommodations for their needsExpress complaints about the home and other residents without retaliation Engage in social and religious activitiesReview the results of nursing home surveys done by the Secretary of StateRefuse room transfers and moves out of a skilled nursing room Whether nursing home residents with legal guardians retain these freedoms or whether these rights transfer to the guardian depends on state law. The liberty to visit with family and others and participate in social groups is of particular concern for wards who receive care in skilled nursing facilities, as nursing homes may rely on guardians authority to prevent residents from accessing friends and family. Petitioning the Court Even after a court has ruled a person disabled and assigned a guardian, the person retains the right to petition the court to terminate the guardianship. For example, an individual may recover from illnesses that once rendered them unable to handle their affairs and opt to end the guardianship arrangement. What to Do When a Guardian Is Abusive Abuse by a guardian is illegal. Those suffering abuse by a guardian and their family should understand their rights and take action to protect themselves or their loved ones. Nursing home residents who suffer abuse under guardianship may contact their local ombudsman, an official who advocates for people in nursing homes. Elders who experience abuse may reach out to Adult Protective Services. Individuals may ask the court to remove the guardian. For guidance on guardianship, consult with a qualified elder law attorney in your area.

In an effort to cut back on overuse of antipsychotic medications in nursing homes, the Centers for Medicare and Medicaid (CMS) is launching an investigation ultimately focused on helping families more accurately assess the safety, quality, and transparency of these types of facilities nationwide. The CMS has raised the concern is that nursing homes may be misdiagnosing residents as having schizophrenia. As a result, these residents are then needlessly prescribed antipsychotic drugs. Misuse of these types of medication can pose potential health risks for older patients. Such risks include loss of cognitive function and even death. Experts also worry that such drugs are being prescribed merely to sedate residents when, for example, facilities face staff shortages.To identify facilities that are improperly prescribing these drugs to residents, the CMS will be conducting audits.No nursing home resident should be improperly diagnosed with schizophrenia or given an inappropriate antipsychotic, Xavier Becerra, secretary of the U.S. Department of Health and Health Services said in a news release. The steps we're taking today will help prevent these errors and give families peace of mind.If a nursing home is mistakenly coding residents for schizophrenia, CMS will lower the facilitys quality rating in its public five-star rating system. These ratings appear on the Medicare websites online Care Compare tool. Care Compare seeks to help consumers compare the quality of nursing home facilities and other types of health care service providers. In addition to its quality measure, the tool rates different nursing homes fare on staff turnover, vaccination rates, health inspections, and more.CMS will also track whether facilities found to have violated are making improvements if needed.Residents of nursing homes have the right to be free of unnecessary physical or chemical restraints, which include antipsychotic drugs. If you believe your loved one in a nursing home is taking a needless antipsychotic, contact your local nursing home ombudsperson. Or, get in touch with a qualified elder law attorney in your area.Learn more about how to choose the right nursing home for your situation.

Making important decisions for aging parents can be a challenging task, but power of attorney (POA) can provide peace of mind and clarity in times of need. POA enables individuals to make crucial decisions on behalf of their parents, such as managing their finances or making medical decisions, when theyre unable to do so themselves due to age or illness.While it may be difficult to approach this topic with your parents, having these discussions early on can help ensure that you follow their wishes if their health changes over time. Starting the conversation with empathy and understanding can make all the difference.In this article, well explore how to obtain power of attorney for elderly parents and provide helpful tips on how to approach these discussions with warmth and care. After all, our ultimate goal is to ensure that your aging parents receive the best possible care and support.Whats a POA?According to the American Bar Association, POAs are legal documents, which vary between states, that provide a person, or several individuals, with the power to perform actions on behalf of someone else. The individual with a POA is an agent, whereas the principal refers to the person who is having their affairs managed by other individuals. Agents can only perform actions outlined within the POA document. Moreover, if someone agrees to a POA, they can still make their own decisions, providing they can still do so coherently. This means the agent cannot make exclusive decisions on behalf of the principal.POA TypesBelow is more information regarding the different POA types:General: For this POA, the agent can manage the principals affairs for a specific period, and the principal may revoke this at any point. These automatically finish if the principal becomes incapacitated and are common when an individual can still see to their affairs but prefers that someone else does this for them.Durable: These POAs continue after the principal becomes incapacitated and are more common when someone cannot manage their affairs. They can conclude in many ways, including once the principal dies or if the agent completes the conditions within the POA document.Springing: The terms in this POA dont take effect unless the principal becomes incapacitated. For this POA, the principal remains in control of their affairs until they lose capacity.Medical: These POAs allow agents to make the principals medical decisions. They last until the principal is competent and might also expire after a certain period mentioned in the document.Limited: These limit the agents ability to make decisions regarding certain tasks as outlined in the POA document, such as paying bills or selling a house. Limited POAs are usually temporary and end when the principal loses capacity.Why and When to Consider a POA For Your Aging ParentsHere are the common reasons why individuals may consider getting a POA:Finance issues: POAs enable individuals to continue paying their parents bills and manage their finances when their parents struggle to fulfill these obligations.Serious illness: Having a POA for an elderly parent can be helpful as it allows them to focus on getting better and reduces the stresses associated with managing their affairs.Memory issues: Individuals commonly obtain a POA to manage their parents affairs if they develop dementia. Its helpful to note that its necessary to obtain the POA before the parent loses their capacity.Surgery: When an elderly parent is undergoing surgery, it might be a good idea to obtain a POA so individuals can make decisions on their parents behalf and manage their affairs until theyve fully recovered.Frequent travel: Some elderly parents like to travel frequently, so POAs can be useful here for ensuring their affairs remain in order while theyre away.How Do I Choose a POA For My Parents?When considering a POA for your aging parents, there are several things to keep in mind. The most crucial factor is trust you must choose someone you can rely on to make decisions in your parents best interests and follow their wishes.While family members are often chosen for this role, its important to consider whether theyre the best fit. If you think an objective outsider may be better suited to the task, such as a lawyer, accountant, or financial institution, this is also an option, although it may come with additional costs.Before agreeing to be a POA for your parents, its essential to have a thorough discussion with them to understand their needs and preferences. Different types of POAs have different levels of responsibility, and its important to clarify what your parents expect from you. If your parents need help with medical decisions, for example, this will require more involvement than if they only need assistance with financial decisions.Finally, its essential to understand the financial implications of becoming a POA. Youll need to keep your finances separate from your parents and be prepared to justify any decisions you make to avoid legal issues.Choosing a POA for your aging parents is a significant decision, and its essential to approach it with care and sensitivity. By having open and honest discussions and seeking objective advice, you can ensure that your parents receive the best possible care and support.Contact Us To Learn More About Obtaining A Power Of Attorney For Your Elderly ParentsIf you have elderly parents, its understandable that discussing power of attorney (POA) may be a sensitive topic. However, starting these discussions as early as possible can bring peace of mind and clarity in the future.When approaching these conversations, its important to consider your parents health and well-being. Let them know that youre there to support them and that you will only use the POA powers if its absolutely necessary. Its a promise that can help reassure your parents that you have their best interests at heart.Additionally, it may be helpful to seek the guidance of an experienced estate planning attorney. They can provide objective advice and alleviate any concerns that your parents may have. We understand that this is a difficult process, but we're happy to help. Please feel free to contact us to learn more about how we can assist you and your family.This article is a service of Sharek Law Office, LLC. We dont just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than youve ever been before, and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Are you a taxpayer who has purchased long-term care insurance (LTCI)? Take note of your policy details and your premium amount, as you may be able to deduct the cost or at least part of it from your 2023 income.If your total eligible medical expenses (including your LTCI policy premium) for the year exceed 7.5 percent of your adjusted gross income, you may be able to take the amount of your LTCI policy premium as a deduction on your federal income tax return.However, note that only certain LTCI policies qualify.What Is Long-Term Care Insurance, and Do I Need It?Long-term care insurance helps you cover costs for services you'll likely need as you grow older, such as nursing home care or home health care.According to LongTermCare.gov, U.S. seniors aged 65 today face a nearly 70 percent chance of requiring some form of long-term care later in life. In fact, almost a fifth of them will need it for more than five years.Policies for this type of insurance can vary dramatically. Most will provide you with between $2,000 and $10,000 in funds each month, with premiums costing up to $5,000 a year. The younger you are when you purchase LTCI, the less pricey your annual premiums will generally be.Keep in mind, too, that the average prices for long-term care have skyrocketed over time. For example, a private room in a nursing home will currently cost you more than $9,000 a month on average.Unless you have very significant wealth, paying for LTCI may be well worth the cost, given how quickly long-term care can drain your retirement savings.Can I Deduct My Long-Term Care Insurance Premium?As mentioned above, only certain LTCI policies are tax-deductible. If your LTCI policy is considered qualified for tax deductibility, your total eligible medical expenses (including your LTCI policy premium) for the year also need to exceed 7.5 percent of your adjusted gross income in order for you to be able to deduct your premium.In addition, you're limited in how large a premium you can deduct. Read more about these caveats below:1. Tax-Qualified Policies  To qualify for tax deductibility, your LTCI policy is required to meet specific rules, as outlined by the National Association of Insurance Commissioners (NAIC).If you purchased your policy before January 1, 1997, it's likely qualified. (Double-check with your insurance broker or their states insurance commission.)Policies purchased on or after January 1, 1997, have to meet a number of federal standards. Learn more about these standards on Page 9 of the NAICs Shoppers Guide to Long-Term Care Insurance, available in PDF format.2. Deduction Limits  The limit on your deduction depends on your age at years end. The IRS annually issues adjustments to these limits; it increased the 2023 tax-deductible limits by about 6 percent since 2022.Note that if your annual premium amount for 2023 exceeds the limit provided in the table that follows, it won't be considered a medical expense:Attained age before the close of the taxable yearMaximum deductionAge 40 or under$480 (up from $450)Age 41 to 50$890 (up from $850)Age 51 to 60$1,790 (up from $1,690)Age 61 to 70$4,770 (up from $4,510)Age 71 and over$5,960 (up from $5,640) 3. Other CaveatsIf you're self-employed, you can take the amount of the policy premium as a deduction if you made a net profit. Your medical expenses don't necessarily need to have exceeded 7.5 percent of your income.Most hybrid life insurance policies are typically ineligible for tax deductions.Note as well that benefits from per diem or indemnity policies, which pay a predetermined amount each day, aren't included in income except amounts that exceed the beneficiarys total qualified long-term care expenses or $420 per day (for 2023), whichever is greater.For further details on these and other inflation adjustments, access the complete PDF from the IRS website.Additional ResourcesTo get an idea of how much long-term care may cost you, visit Genworths Cost of Care online tool to calculate the cost of care where you live.Be sure to seek out information from a professional when it comes to evaluating your long-term care insurance needs as well as protecting your loved ones assets in the event that you do require long-term care. Find a qualified elder attorney near you.

No one wants to think about our death or the death of a loved one. The reality is that death is inevitable, so preparing for end-of-life decisions is essential. Over the past few years, especially with the COVID-19 pandemic, we've all been reminded about lifes fragility. When you're faced with addressing end-of-life care, knowing where to turn for the answers your family needs can be overwhelming. For guidance in getting started, continue reading.Hospice Care Hospice care is medical treatment for patients close to the end of their lives. Their conditions are unlikely to improve. Hospice care focuses on patient comfort and family support.If you choose to place a family member in hospice care, you'll have a team of medical professionals surrounding you during a difficult time. Examples of the care your loved one may receive include medications to reduce pain, periodic visits to the patient by a care team, and respite for family members and caretakers.To learn more about the availability of hospice care and how to get connected to resources in your area, visit the Hospice Foundation of America online. End-of-Life Planning In addition to making your loved one as comfortable as possible, ensure their legal interests are protected, too. If you have a loved one with a terminal illness, it may be wise to have them complete estate planning documents if they haven't already done so. For guidance in drafting these important legal documents, consult with us.Last Will and TestamentThis document aims to set up how your affairs will be handled after your death. A loved one diagnosed with a terminal disease or who is elderly should have a valid last will and testament to help family who is left behind to avoid the stress of dividing their deceased loved ones assets and property.Living Will A living will, also known as an advance directive, is a document that directs your family about your health care before you lose the capacity to make your own decisions. The purpose of a living will is to include your choices regarding emergency care and life-saving medical treatment. Having a living will helps your family avoid the stress and guilt associated with making end-of-life decisions regarding medical care.Grief Support Groups It's as essential to take care of yourself as it is to take care of your loved one as their life ends. You may feel alone during this time of grief. Build a support network around yourself to aid in navigating the grieving process. If you have family members to lean on, take advantage of that. It's possible to find support groups filled with people who understand your situation if you dont have family or close friends. If you're looking for a place to start, visit findhelp.org. You can search for bereavement groups, counseling services, and workshops that fit your needs in your area. Whether you're looking for a group that understands the loss of a parent or spouse, a veterans group, or any other unique group of people, know you aren't alone.

Receiving a denial at the pharmacy for a drug you need can be a stressful experience. When Medicare declines to cover a prescription, some might worry that they cannot afford the medicine out of pocket. Others might also need the treatment immediately and become concerned that the lack of coverage will adversely affect their health. Medicare can initially refuse to cover prescriptions for a variety of reasons, such as when your plan doesn't typically include your medication on its roster of covered drugs. Still, you have the right to ask your plan to cover the treatment you need and request an appeal if you disagree with your plans decision not to include your medication. Steps to Take Following a Prescription Denial If your plan doesn't cover a drug, inform the health care professional who prescribed it. Your prescriber might be able to find an alternative medication that your plan includes. For instance, you might be able to switch from a name-brand medicine to a generic one. In the event that there's no viable replacement for the medication or you aren't satisfied, you have the right to ask Medicare for an exception so that your plan covers the medicine. Your prescriber can also advocate for you and reach out to Medicare on your behalf. As a Medicare beneficiary, you have the right to receive a coverage determination outlining the reasons for the rejection, and you have the right to ask for an exception. While asking for an exception, it's helpful to have the support of your doctor or the person who prescribed the medicine. For instance, your doctor may help your case by writing a letter explaining why you need the medication. If, following your request, Medicare refuses to cover the medicine, you can appeal or appoint a trusted medical professional as your representative to appeal on your behalf. There are five levels to the appeals process. To begin this process, you can have Medicare issue a redetermination of your plan and then ask an Independent Review Entity to revisit it. The Office of Medicare Hearings and Appeals (OMHA) examines coverage decisions for drugs that meet a minimum value, and the Medicare Appeals Council reviews the judgments of OMHA. The medicine must cost at least $180 for an OMHA assessment. To reach this amount, appellants can combine the values of multiple drugs. When coverage denial persists, beneficiaries can appeal to the federal district court. To reach the federal district court, the minimum value of the treatments must be $1,760 as of 2022. How to Respond If You Need the Medication Immediately Those who need the medication urgently can request an expedited appeal and receive a decision on the exception request within 72 hours. Medicares failure to cover your treatment must compromise your life, health, or ability to regain maximum function. For assistance with appealing a coverage denial, speak with an attorney who understands Medicares appeal process.