Medicaid – Carrier Law

New David L. Carrier workshop explains Medicaid program’s role in estate planning

Rich Rokicki — Tue, 09 May 2017 12:46:33 +0000

When it comes to estate planning and elder law, you could say the Law Offices of David L. Carrier sets the pace. Or, rather, they set the PACE. The Grand Rapids-based firm, which helps families navigate through complicated issues and laws surrounding estate planning, is making PACE the topic of its latest free workshop.

PACE is an acronym for Program of All-inclusive Care for the Elderly. It’s a comprehensive health program that helps seniors remain at home for as long as possible and is funded by Medicare and Medicaid. Carrier’s workshop on PACE — the next one is scheduled for May 11 from 3 to 4 p.m. in Newaygo – explains how the program works and how Medicaid can play a role in estate planning.

“Nobody wants to go into a nursing home,” Carrier said in a telephone interview, “bBottom of Form

ut how do you stay at home when you have various needs? If you’re safe at home … in other words, you’re not going to burn the place down, but you need additional socialization, medical care, specialist care, pharmacy, etc., and you are physically and financially eligible for Medicaid, PACE might be the solution for you.”

Carrier explained that PACE allows older people in need of long-term care to stay at home and still get the care they need without losing everything.

“Most people go broke not because of the stock market or the casino, but because they need long-term care,” Carrier said. “It can be anywhere from $3,000 a month for Craigslist-type in-home care to $13,000 a month for a skilled nursing at some super-duper nice place. Our goal is to use the Medicaid system to let people hold on to as much of what they have as we can.”

While many people might think of Medicaid as “disadvantaged or poor people’s health care,” Carrier said 20 percent of it is he calls “middle-class Medicaid,” for those who just can’t save enough to pay for long-term care.

“Because, let’s face it, nobody buys the long-term care insurance and nobody has saved enough – you can’t save enough,” Carrier said. “We’ve seen people go from millions [of dollars in assets] to zero.

“The idea (behind using PACE) is not how are you going to pay for it, because you won’t. The question is how do we make sure you get on Medicaid without going broke? The only way that’s going to happen is if you have done all the other things necessary – all the earning and saving and being smart about things — in order to have it there. We focus on making sure your stuff lasts as long as you do. How do I make sure you don’t go broke? We plan for it.”

Carrier’s firm works with people to educate them on how to use PACE and how to qualify for the program without spending all their savings. Because people can have only $2,000 cash on hand to qualify doesn’t necessarily mean they have to spend all their savings.

“There are other ways of doing it,” Carrier said. “When we do a PACE application, we are fully transparent, but it goes beyond the scope … there are a whole range of strategies we use.”

Carrier pointed out that one size does not fit all, and that his firm works with families on a case-by-case basis to get the best results.

“People might have the same asset profile, but given their family situation, some things will make more sense for some than others,” he said. “We try very hard to educate people on what their options are, guide them through the process and make sure it makes sense for their family. It has been hugely successful.”

PACE, a state program, is available on a county-by-county basis. It currently is available in Ottawa, Muskegon, Kent, Allegan and Kalamazoo counties and will soon be available in Newaygo County. The workshop in Newaygo is part of The Law Offices of David L. Carrier’s “hometown series.” The firm does three to four workshops per week at its four locations in Norton Shores, Holland, Portage and Grand Rapids, and reaches out to other communities with its hometown series.

Carrier said many attending workshops often come out of them saying, “I didn’t know it worked like that.” The workshops provide a general overview of programs and how they work, be it probate, PACE, or other programs. The next step is a vision meeting, where points of the workshop are reviewed but potential clients also are introduced to things that are relative to their situation specifically. “Homework” is assigned and the next step is a design conference. Only after that conference, Carrier said, is the firm hired to work with clients.

“There’s a lot of information, and it’s thoughtful and purposeful,” Carrier said. “We have credibility. We have more than 2,000 approved Medicaid applications over the past 10 years. We DO save money for folks.”

While workshops are free, those planning to attend need to register through the firm’s website at davidcarrierlaw.com since seating is limited. For more information, call the Law Offices of David L. Carrier at (616) 361-8400 or (800) 317-2812 or email them at contact@davidcarrierlaw.com.

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The Difference Between Medicaid Pre-Planning and Crisis Planning

Rich Rokicki — Thu, 20 Apr 2017 15:55:41 +0000

Medicaid is designed to help seniors with limited means afford medical care, including long-term nursing home care. Since Michigan’s Medicaid program imposes strict limits on an applicant’s income and assets, some planning may be necessary to help ensure eligibility. Medicaid estate planning generally falls into two categories: pre-planning and crisis planning.

Crisis Planning

Crisis planning is the more common occurrence. A crisis in this context means any sudden or catastrophic healthcare event. For example, an elderly man suffers a stroke. He is no longer able to care for himself and must be moved into a nursing home.

Full-time nursing care is a major financial responsibility. According to a 2015 survey by Genworth Financial, the median annual rate for a nursing home in Grand Rapids-Wyoming is over $93,000 per year. Medicare and private insurance may not fully cover these costs.

Medicaid crisis planning may be necessary to ensure a low-income person has immediate access to care. Medicaid is known for its rules and complexity, and when time is of the essence, immediate action may be necessary. If a person has too many assets to qualify for Medicaid–but not enough to pay for long-term care–an experienced Grand Rapids Medicaid crisis lawyer can present you with options.

Pre-Planning

Ideally, you can avoid the need for crisis planning altogether with pre-planning. If you have some assets and do not face an immediate medical crisis–but fear you will in the years to come–pre-planning can help bring peace of mind. For example, you can establish a special kind of irrevocable trust to protect your assets without affecting your future Medicaid eligibility. You may also be able to purchase long-term care insurance if you are still concerned you may not qualify for Medicaid.

Whether you need crisis planning or pre-planning, Medicaid is not something you should try and figure out on your own. Any slight mistake in a Medicaid application may lead to a denial of benefits–and leave a family member facing a choice between poverty and foregoing necessary medical care.

Do not let this happen. Our qualified Michigan Medicaid crisis attorneys know how to deal with Michigan’s Medicaid system. Let us help you and your family. Contact the Law Offices of David L. Carrier, P.C., to schedule a consultation right away.

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Being Denied Medicaid in Michigan

Rich Rokicki — Thu, 23 Feb 2017 21:48:11 +0000

Medicaid is a government health insurance program for low-income people. It is jointly funded by the federal government and the states, including Michigan.

The Michigan Medicaid plan identifies who is eligible for coverage, what health services plan participants can receive, the state’s reimbursement policy, and other requirements.

Who Is Eligible for Medicaid in Michigan?

You qualify for Medicaid if your household income is below:

195 percent of the federal poverty level for infants under 1-year-old and pregnant women;
160 percent of the federal poverty level for children ages 1 to 18 years old; and
133 percent of the federal poverty level for parents and other adults.

The blind, disabled and other groups may also qualify for Medicaid.

Note that children with household incomes that are 212 percent of the federal poverty level qualify for the Children’s Health Insurance Program (called MIChild in Michigan).

The Michigan Department of Health and Human Services determines whether a family or individual is eligible for Medicaid.

What If My Medicaid Application Is Denied?

There are several reasons your Medicaid application might be denied. The most common reason is that you do not meet the income requirements. In other words, you make too much money. Here’s another example: If you claim eligibility based on disability and the Department of Health and Human Services doesn’t believe that you are disabled, then your application will be denied.

If the department denies your application you will receive a letter that explains why you were denied. The letter will also explain how you can appeal the denial of your Medicaid application. Here is what you need to know about the appeals process:

You have 90 days after receiving the denial letter to request an administrative hearing.
A hearing request form should be included with the letter. You don’t have to use this form to request the hearing, but your request must be in writing and signed by you or your legal guardian.
A notice specifying the time, date and location of your hearing will be mailed to you. Note that most hearings are actually held over the phone.
You may be represented by an attorney, but you must provide the department with the name of your representative, in writing. The department will not provide you with an attorney.
An administrative law judge from the Michigan Administrative Hearing System for the department will hear your case.
The hearing will be recorded, and both you and department officials may ask each other questions.
The judge will not announce his or her decision during the hearing but will send it to you in the mail.

If the judge upholds the denial, you have 30 days to file an appeal with the Circuit Court, typically in the county in which you reside. You could also choose to file a motion for rehearing or reconsideration with the administrative law judge.

Contact Us Today

The appeals process can be complicated, and you shouldn’t have to navigate it alone. Contact our experienced Grand Rapids Medicaid lawyers today if your Medical application is denied. We will help you receive the health insurance coverage that you deserve.

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Best Life Insurance Plan Options

Rich Rokicki — Wed, 18 Jan 2017 19:33:19 +0000

If you are currently thinking about estate planning and are considering purchasing life insurance, it is important to consider a number of different options. As an article in Consumer Affairs explains, while many Americans decide not to purchase life insurance (some simply because they do not recognize its value), a life insurance policy “can provide financial help to your family by covering final expenses in the event of a death.” Life insurance is extremely important for any family to consider regardless of the family size, but as that article points out, “many people are underinsured or have the wrong policy, especially women who are the primary breadwinners for their family.” As you may already know, there are a number of different life insurance options that can be particularly valuable for seniors, although no single insurance policy can be best for all persons in a specific age group.

What should you know when choosing a life insurance policy? First, we will discuss tips for choosing a life insurance company. Then we will discuss life insurance policy options.

How Should I Choose My Life Insurance Company?

When you are deciding between and among different types of life insurance policies, how can you know which is best to suit your individual needs? There are many different kinds of life insurance products, and as you age, your specific life insurance needs probably will shift. As such, from the start, you should be sure to consider the following issues:

Whether your insurer has options for upgrading or downgrading your policy: given that needs to indeed change over time, particularly as Michigan residents age, it is important to work with an insurer on a policy that can be upgraded or downgraded, according to the Consumer Affairs article, as your individual needs change.
Whether your insurance company is stable: as the article points out, since purchasing a life-insurance policy is a “very long-term proposition,” it is essential that you pay for a policy that will be able to provide for your family years down the road. To be sure, according to Consumer Affairs, the “need for company strength and stability cannot be overemphasized.” As such, you should check ratings for your insurer through AM Best, S&P 500, Weiss, and Moody’s. In addition, you should explore the rating history of the insurer and whether there have been significant changes in the ratings over the years (particularly a decline). And finally, you should investigate the company’s financial statements to ensure its stability.

What Life Insurance Options Are Available?

What are some of the different policy options you can choose? The following are examples of a wide variety of insurance products:

Term life insurance: this type of life insurance policy is a structured policy that provides a benefit for a particular number of years. Typically, this is among the least insurance, or most affordable options.
Universal life insurance (UL): this policy is a cash value life insurance policy. It is also one type of permanent policy, which means that it is designed to last for the entirety of your life (in other words, it will not expire). It accumulates cash over time, which means that you may be able to borrow against the life insurance policy. Since insureds can borrow, tax-free, against a UL policy, the premiums often are higher than or other types of policies.
Whole life insurance: this policy also is a cash value policy and is the another type of permanent policy. But, unlike a UL policy, the premiums are fixed.
Variable life insurance: this type of policy is also a permanent policy, but it is different from the others in that there is more risk. This policy “invests in mutual funds providing potential greater returns (and losses),” according to the Consumer Affairs article.
Survivorship life insurance: this type of policy is another form of permanent insurance, and couples purchase this type of policy most often. It pays a benefit after both persons pass away.

Contact a West Michigan Estate Planning Attorney

If you have questions about life insurance policies and the options that are best for you, do not hesitate to speak with an experienced Michigan family trust lawyer. An advocate at our firm can speak with you today. Contact the Law Offices of David L. Carrier, P.C. to learn more.

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How to Plan for a Medicaid Crisis

Rich Rokicki — Wed, 30 Nov 2016 15:52:12 +0000

Nobody wants to face a Medicaid crisis in which an elderly loved one unexpectedly requires expensive, long-term care but is ineligible for government assistance. However, all too often, residents of Grand Rapids suddenly require nursing home care and are told that they have too many assets and thus cannot qualify for Medicaid. As a fact sheet from the U.S. Department of Health and Human Services (HHS) explains, Medicaid provides free or low-cost healthcare for a variety of different people, including the elderly.

When a Medicaid crisis happens, however, patients in need of immediate care may be forced to sell or liquidate assets if they are ineligible for Medicaid assistance. As an article from AARP makes clear, the average cost for a private room in a nursing home in 2016 was more than $92,000. Even if you decide to stay at home and pay for an in-home health aide, the cost still averages more than $46,000. The ultimate goal for families should be avoiding this kind of Medicaid crisis. While Medicaid crises do happen much too often, the good news is that it is possible to take steps to prevent this from happening.

From thinking about long-term care insurance to understanding Medicaid eligibility, you can be ready for a medical crisis. An experienced Michigan elder law attorney can assist you.

When Should I Start Preparing for the Possibility of a Medicaid Crisis?

Many Michigan residents want to know when they should start planning for the possibility of a Medicaid crisis. Although many older adults may need Medicaid to pay for nursing home care, particularly given the high costs associated with many facilities, the difficulty of the Medicaid process can be minimized with some early planning. To be sure, when you plan ahead of time, you can protect certain assets, and at the same time you take steps to help ensure that you will be able to receive quality care.

As we mentioned above, the best time to begin planning is while you are still healthy and do not need long-term care. Generally speaking, we refer to this as “Medicaid pre-planning.” When you engage in Medicaid pre-planning, you can take steps to protect valuable assets from being used to pay for nursing home costs and to safeguard your eligibility for Medicaid assistance.

While it is best to begin planning before you become ill, it is still possible to work with an experienced elder law attorney on Medicaid crisis planning. You should not have to use all of your hard-earned savings to pay for a stay in a nursing home. You may still be able to protect your property.

Different Steps You Can Take to Plan for Long-Term Care in a Nursing Home

What steps can you take to plan for long-term care in a nursing home? The following are some important tips that can help to minimize the financial impact of nursing home expenses:

Determine your eligibility for Medicaid: before you need Medicaid assistance, you can complete a Michigan Medicaid application to determine your eligibility. It is important to work with an experienced elder law attorney in Grand Rapids since these applications can be complicated.
Long-term care insurance: While you are still healthy, you should consider investing in a long-term care insurance policy. The AARP article emphasizes that long-term care insurance can seem pricey—often around $3,100 per year—but it can pay off in the long run.
Medicaid trust: if you transfer your assets improperly right before entering into a nursing home, you can incur substantial penalties that can make you ineligible for Medicaid. However, there may still be ways to protect your valuable assets so that you do not have to use them to pay for your long-term care.

Contact a Michigan Medicaid Crisis Attorney

If you have questions about determining your Medicaid eligibility or planning for a Medicaid crisis, an experienced Holland elder law attorney can help. Contact the Law Offices of David L. Carrier, P.C. today for more information.

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The Dos and Don’ts of Choosing a Medicare Plan

Christine Flodin — Mon, 29 Aug 2016 18:02:25 +0000

When it comes time to choosing a Medicare plan, it can be difficult to know which type of coverage is best for you. We understand how complicated insurance plans can be, especially when you are an older adult in need of frequent medical care and prescription drugs. The important thing to remember is that different plans can be better or worse for your needs, and you can always seek advice from an experienced Grand Rapids Medicare planning lawyer.

According to a fact sheet from Medicare.gov and a pamphlet from the AARP Foundation, there are a number of questions that you should ask before choosing or changing your Medicare coverage. To better understand some of the questions you should be asking (and the types of answers you should be seeking), we would like to discuss some helpful “Dos and Don’ts” when it comes to selecting or changing your Medicare coverage.

Take the Following Questions Into Account When Choosing Medicare Coverage

What should you absolutely do before you select or change your Medicare coverage? The following tips from Medicare.gov and the AARP Foundation can help:

Inquire about how your specific medical needs will be covered by different plans;
If you visit your doctors’ offices with some frequency, do choose a plan that is most economically efficient in terms of monthly premiums and deductibles (keep in mind that lower monthly premiums usually mean higher deductibles, but if you go to the doctor enough, it might make sense to pay a higher monthly premium for a lower deductible amount);
Choose a plan with coverage that your doctors already accept, as you likely will not want to change physicians simply because you have selected a new insurance plan;
Find out if the plan you are considering will require you to get a referral in order to visit a specialist;
Ask about whether your current prescriptions are on the drug list of the plan you are considering (this is also known as a “formulary”);
Inquire about whether you will need to join a Medicare Prescription Drug Plan;
If you already have prescription drug coverage, do learn more about whether you will have to pay a penalty if you join a Medicare Prescription Drug Plan later on;
Find out how much your prescription drugs will cost under the plans you are considering;
Choose a plan that allows you to visit doctor’s offices and pharmacies that are nearby;
Ask if your plan’s coverage will continue if you travel outside of Michigan, including within the U.S. and outside the country; and
Last but not least, do seek help from an experienced Grand Rapids Medicare planning law firm.

Do Not Enter into a Plan Without Understanding Its Costs and Benefits

What should you avoid when choosing a Medicare plan? Based on the “Dos” we listed above, you might be able to guess as some of the “Don’ts,” but in brief, do not do any of the following when selecting a Medicare plan:

Do not choose a plan that will cost you more money in the long run;
Do not choose a plan that will prevent you from seeing your doctors or visiting your regular pharmacy;
Do not choose a plan that has a poor rating; and
Do not make a decision without consulting with an experienced elder law attorney.

Contact a Medicare Planning Attorney in Grand Rapids, MI

At The Law Offices Of David L. Carrier P.C., we know that a person’s choice in Medicare plan can have a significant impact on the type and quality of care they end up receiving. If you have questions about choosing the Medicare plan that is best for you, one of our dedicated Grand Rapids Medicare planning attorneys can help. Contact us today to discuss your options.

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Nursing Facility Transition (NFT)

Christine Flodin — Tue, 11 Aug 2015 01:39:19 +0000

Do you have a loved one in a nursing facility who would like to return home?

The Nursing Facility Transition (NFT) helps those currently living in a nursing home move into a house, apartment, or assisted living and helps put necessary services in place.

Individuals work with a Transition Specialist who will explain the process and conduct an assessment to determine what services would be needed in order to transition out of the nursing home. They will then work together to develop a plan centered around the individual’s needs and choices (if desired, family and friends may also be included in the process).

Each situation and plan of care is individualized but examples of services provide include bathing, dressing, home delivered meals, assistance with medication and housekeeping.

Qualifications:

Residing in a nursing facility
Currently on, or eligible for, Medicaid
Desire to return to the community (house, apartment or assisted living)
Has barriers to living independently such as needing in-home care and/or housing

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Deed Protection and Medicaid Eligibility

Christine Flodin — Tue, 14 Jul 2015 01:43:58 +0000

Medicaid imposes stringent limits on income and assets of recipients, consistent with its mission to provide a health care safety net for the poor and for those whose personal resources are insufficient to pay the full cost of care. In order to fulfill this mission, Medicaid also recovers expenses paid on behalf of recipients from their estates under certain circumstances. Medicaid is the largest source of funds for institutional long-term care expenses. It pays nearly half of the total amount spent on nursing homes, followed, respectively, by out-of-pocket funds of long-term care consumers, Medicare, private long-term care insurance, and other public and private funding sources.

Unless they are among the minority who have long-term care insurance, individuals contemplating paying thousands of dollars out-of-pocket every month for long-term nursing home care face the possibility of exhausting all available assets and using up their lifetime savings before being able to qualify for Medicaid. Not surprisingly, a web search on “Medicaid estate planning” yields thousands of results offering advice on a variety of strategies to qualify for Medicaid while preserving assets and savings for heirs.

Federal guidance implies that states can recover when the surviving spouse dies, or a child’s protected status is lost, or when a protected relative moves out of the home. However, a number of states waive their future right to recovery altogether, others defer it, and yet others use a mix of approaches based on the specifics of each case.

It is up to each state to develop and disseminate information to help the public understand the rationale and necessity for Medicaid estate recovery, as well as the rights of both the State and the recipient. For this reason, considerable variation exists in the level of resources each state commits to this process. The state Medicaid agency must decide how to keep it understandable, while providing all the essential points, and how to accommodate the variety of individual circumstances. Decisions must also be made regarding what level of detail beneficiaries and their families can absorb or when is the best time to provide information about estate recovery — an event that may occur long after the application process. Even when a state provides comprehensive estate recovery information at the most suitable time, people may be overwhelmed by the complexity of the decisions they must make during the application process, which may take place over a fairly short and emotionally difficult period of time.

At a minimum, states must recover amounts spent by Medicaid for long-term care and related drug and hospital benefits, including Medicaid payments for Medicare cost sharing related to these services. However, they have the option of recovering the costs of all Medicaid services paid on the recipient’s behalf. The majority of states recover spending for more than the minimum of long-term care and related expenses.

Recoveries may only be made from the estates of deceased recipients who were 55 or older when they received Medicaid benefits or who, regardless of age, were permanently institutionalized. However, states may exempt recipients if their only Medicaid benefit is payment of Medicare cost sharing (i.e., Medicare Part B premiums).

http://aspe.hhs.gov/

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Medicaid Myths

Christine Flodin — Thu, 14 May 2015 02:42:34 +0000

The overwhelming majority of nursing home residents receive Medicaid. That’s right! Over 70% of nursing home residents right now are getting Medicaid. What about the rest? They’ll be on Medicaid too… in 6-18 months! Think about it… can we all afford $7000-$9000 per month, every month? Most folks can’t and Medicaid is the solution!

MYTH: I have to sell all my stuff and spend all the money on long term care before Medicaid will help!

FACT: You are allowed to keep several kinds of “exempt” assets, including your car, your family home and the stuff inside! Not to mention other items.

MYTH: If I gave anything away in the last 3 years (or 5 years or whatever the time limit is now), my spouse and I are disqualified.

FACT: Not so fast. Some assets can be transferred without penalty under certain circumstances. Find out which legal loopholes do you qualify for!

MYTH: There’s nothing we can do! Now that my spouse needs skilled nursing care, we may as well sign over our life savings, family cottage, homestead and give up!

FACT: There is NO reason for ANY married couple to be paying “private pay rates” for skilled nursing. Using LifePlan™ Crisis techniques, I’ve helped thousands of married couples save millions… almost all of their life savings… not just the small “protected amount”. I can do the same for you.

MYTH: As usual, married folks get all the breaks… I’m single so there’s nothing I can do… I’m the one who has to give up!

FACT: Different LifePlan™ Crisis techniques are available for single people. There is always something we can do to get you the care that you or your loved one needs – without losing your life savings!

MYTH: Today’s LifePlan™ Crisis techniques solve everything! We don’t have to do anything until it’s time for long term care!

FACT: Medicaid rules change all the time and they’re not getting any easier. As Medicaid gets more and more difficult we respond with more advanced Crisis LifePlanning™ strategies, but the best approach is to plan ahead and avoid the crisis altogether. Find our how at the next LifePlan™ Essentials Workshop… click on the button or call us and sign up!

MYTH: My spouse will qualify for Medicaid right away because our prenuptial agreement says that my stuff is mine!

FACT: Pre-nuptial agreements, post-nuptial agreements, and legal separations are all irrelevant for Medicaid purposes.

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