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 Millions of American families are caring for a loved one with Alzheimer's Disease. The Alzheimer's Association, the world leader in Alzheimer's research, care and support, is dedicated to finding prevention methods, treatments and an eventual cure for the disease.
We are gearing up for the Alzheimer's Association Southeast Florida Chapter Memory Walk on April 4th in West Palm Beach. We welcome your support! Please click here to visit our team web page and help in our efforts to support this worthy cause by making a donation.
On March 20, partner Howard S. Krooks, Esq. presented "The Use of Irrevocable Trust Planning for Medicaid and VA Eligibility" at the Elder Law Section of The Florida Bar's 13th Annual Public Benefits CLE held in Tampa.
Mr. Krooks will be attending the National Academy of Elder Law Attorneys (NAELA) Annual Meeting April 1-5, 2009 in Washington, D.C. He serves on the NAELA Board of Directors. On Wednesday, Mr. Krooks will be participating in NAELA's Hill Day by meeting with Senators and Congressional Representatives from Florida to discuss important issues affecting seniors and persons with disabilities.
Partner Ellen S. Morris, Esq. has been active during this legislative session in monitoring legislation which affects seniors and their families. As Legislative Chair of The Florida Bar's Elder Law Section, she has written letters and lobbied in support of pending Annuity bills (S1072, H141 and H981) which protect seniors from improper annuities.
We provide The Elder Law Update to our clients and our colleagues who make up a wide range of service providers for seniors and people with disabilities to facilitate the dissemination of helpful and accurate information. We thank you for letting us share our knowledge with you. We continue to welcome your comments and questions. You may send them to Info@ElderLawAssociates.com. |
Things to Remember at Tax Time
 April 15th is approaching and it is time to begin crossing T's and dotting I's in preparation for paying taxes. As tax time draws near, you want to make sure you file all the proper forms and take all deductions you're entitled to. Following are some things to keep in mind as you prepare your tax form.
- Gifts. Did you give away any money this year? The gift tax can be very confusing. If you gave away more than $12,000 to any one person in 2008, you will have to file a Form 709, the gift tax return. This does not necessarily mean you will owe taxes on the money, however. Click here for more information.
- Medical Expenses. Many types of medical expenses are tax deductible, from hospital stays to hearing aids. To claim the deduction, your medical expenses have to be more than 7.5 percent of your adjusted gross income. This includes all out-of-pocket costs for prescriptions (including deductibles and co-pays) and Medicare Part B and Part C and Part D premiums. (Medicare Part B premiums are usually deducted out of your Social Security benefits, so be sure to check your 1099 for the amount.) You can only deduct medical expenses you paid during the year, regardless of when the services were provided, and medical expenses are not deductible if they are reimbursable by insurance. Click here for more information.
- Parental Deduction. If you are caring for your mother or father, you may be able to claim your parent as a dependent on your income taxes. This would allow you to get an exemption ($3,500 in 2008) for him or her. Click here for more information.
- Long-Term Care Insurance Premiums. Premiums for "qualified" long-term care policies are treated as an unreimbursed medical expense. Long-term care insurance premiums are deductible for the taxpayer, his or her spouse and other dependents. Click here for more information.
- Social Security Benefits. Although Social Security benefits are generally not taxable, people with substantial income in addition to their Social Security may pay taxes on their benefits. If you file a federal tax return as an individual and your "combined income," including one half of your Social Security benefits and nontaxable interest income is between $25,000 and $34,000, 50 percent of your Social Security benefits will be considered taxable. If your combined income is above $34,000, 85 percent of your Social Security benefits is subject to income tax. Click here for more information.
- Real Estate Taxes. If you don't have enough deductions to itemize, you can still increase the amount of your standard deduction by the amount of your real estate taxes up to $500 ($1,000 if filing jointly).
- Home Sale Exclusion. Married couples can exclude from income up to $500,000 in profit on the sale of a home ($250,000 for single individuals). If a surviving spouse sells the home, he or she can still claim the exclusion as long as the house was sold after 2007 and no more than two years after the spouse's death. Click here for more information.
- Elderly or Disabled Tax Credit. Some low-income elderly or disabled individuals are entitled to a special tax credit. To be eligible, you must meet income limits. For more information, click here.
The IRS's Tax Counseling for the Elderly (TCE) Program offers free tax help to taxpayers who are 60 and older. For more information, click here. The IRS also publishes a Tax Guide For Seniors. |
How to Choose a Medigap Policy
 Once you become eligible for Medicare, you will be inundated with offers from insurance companies for Medigap (supplemental insurance) policies. Sorting through these offers can be confusing. Not only are there nine standardized plans, but there can be huge differences in premiums between companies.
Medicare plans A and B cover only a portion of medical costs. Medigap policies are designed to fill in the "gaps" in coverage. The government created 12 standardized plans (Plans A through L), but Plans H, I, and J, which include prescription drug coverage, are not available to new buyers.
The first step is to figure out what coverage you will need. For information about what each plan covers, click here. Medicare also publishes a guide to Choosing a Medigap Policy that explains the differences in plan coverage. The following are some other things to consider when looking at plans:
- Plans in Massachusetts, Minnesota, and Wisconsin have some extra options, so if you live in those states, check with the state department of insurance to find out the differences.
- If you regularly see doctors who charge above what Medicare pays, Plans F or G, which cover excess charges, may be the right plan for you.
- If you regularly travel outside the United States, Plans C, D, E, F, and G, include coverage for this.
- If you have a chronic condition with high medical bills, Plan K or L may work best. Both pay only a portion of covered expenses, but have a yearly out-of-pocket cap on medical expenses. Once you reach the cap, the policy pays 100 percent of all further medical services.
Once you've decided what type of coverage you need, the next step is to decide which company to buy from. To find a list of companies that sell plans in your state, go to Medicare Options Compare.
Each plan covers the same medical services, but premiums can vary significantly from company to company. The companies use three different methods to set premiums: attained age, issue age, or community.
- Attained-age policies set the premium based on your age, so the premium automatically increases as you get older. Before buying an attained age policy, check with the insurance company to get the premium costs for the next age increments, so you'll know the level of increases to expect each year.
- Issue-age policies set the premium at the age you first buy the policy. The premium will never be higher than the amount the company is charging new buyers at the same age. For example, suppose you buy the policy at age 65. In five years, the premium will be the amount the company is charging new 65-year-old buyers. While your premiums may increase, the increases may not be large because the company will keep premiums lower to attract new buyers.
- Community policies charge the same price to everyone in your area regardless of your age. The premiums go up only when the insurance company raises premiums on all policies of the same type. These increases are regulated by state insurance departments.
While the premiums on an attained-age policy may be lower at first, it is generally better to buy an issue-age or community policy, which may be more expensive at first but doesn't increase as much over time.
Following are some other things to keep in mind when choosing a policy:
- Look for a company that has arranged to file Medigap claims automatically. Companies that offer automatic filing of claims with Medicare can save time and effort.
- It is a good idea to purchase from a financially sound company. 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 or Weiss.
- Contact your state insurance department to find out if the insurance company has any complaints filed against it.
For more information about Medigap, click here. |
Book Review: The Last Goodnights: Assisting My Parents with Their Suicides
 John West. The Last Goodnights: Assisting My Parents with Their Suicides. Counterpoint. 2009. 272 pages.
$16.50 from Amazon (click on book to order)
What would you do if both your parents asked you to assist them with their suicides within the same year? This unthinkable dilemma is exactly what John West faced in 1999 when both his parents became terminally ill almost simultaneously. His book, The Last Goodnights: Assisting My Parents with Their Suicides, explains what he went through as he helped them end their lives.
West's parents were both psychologists and their medical background had led them to agree that if the time ever came, they would help each other die with dignity. They did not imagine that when the time came, they would both be disabled and each unable to help the other. West describes how his father, who was suffering from terminal cancer, came to him for help. At the time, his mother was suffering from Alzheimer's and Parkinson's disease-like symptoms. A few months after his father died, his mother asked him to help her end her own life.
The book unflinchingly describes West's difficulties in coping with his parent's illnesses, his struggles with the health care system, and the stresses of carrying this burden. West wrote the memoir at the request of his mother, but kept it a secret for ten years, waiting to publish until the statute of limitations for assisted suicide in California, where his parents' deaths took place, had expired. But he acknowledges that he could still face prosecution. "I'm hopeful that that won't occur, but there is the possibility," West said in an interview that aired on Good Morning America. "The statute of limitations for assisted suicide has run [out] but the prosecutors can charge you with just about anything. There is no statute of limitation for murder, for manslaughter, probably certain drug offenses."
West doesn't think families should be put in his position, believing instead that when to die should be a decision between patient and doctor. West wants to make it clear that if the laws regarding assisted suicide were changed, no one would have to do what he did.
To listen to a public radio interview with West about his book, click here.
For the interview with West on Good Morning America, click here. |
Retirement Home Can Force Resident to Move to Higher Level of Care
 A federal court has ruled that a continuing care retirement community (CCRC) can force one of its residents to move from her private apartment to an assisted living unit.
Sally Herriot, 90, is a resident of Channing House, a CCRC in Palo Alto, California, that provides three levels of care -- independent living, assisted living and skilled nursing. Since moving to the facility with her now-deceased husband in 1991, Ms. Herriot has lived in a spacious independent living apartment. After Ms. Herriott returned from a hospital stay in 2006, Channing House determined that it was necessary to transfer her from her apartment to a much smaller, hospital-like assisted-living unit where she could be served by a trained nursing staff. Ms. Herriot, her family and her physician objected to the transfer, arguing that she is able to remain in her apartment with the help of round-the-clock private aides she had hired. Channing House rejected this arrangement.
Ms. Herriot subsequently filed suit in federal court, alleging that Channing House had discriminated against her based on her disabilities by refusing to accept her accommodation of hiring private aides. (See "Retirement Home Resident Fights Move to Increased Level of Care," ElderLawAnswers, 3/3/2007.)
The U.S. District Court for the Northern District of California now rules that Channing House has a duty to provide Ms. Herriot with medical care based on her level of need, and that it cannot delegate that duty to private help hired by Ms. Herriot. The court finds that Channing House would be violating its legal obligations by accepting Ms. Herriot's plan to allow her to remain in her apartment. Herriot v. House (U.S. Distr. Ct., N.D. Cal., No. C 06-6323 JF (RS), Jan. 29, 2009). | |
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Do You have the Right Fiduciary?
 When creating an estate plan, an important decision is who to name as your fiduciary. A fiduciary is a fancy legal term for the person who will take care of your property for you if you are unable to do it yourself, such as the executor of an estate, the trustee of a trust, or an attorney-in-fact under a power of attorney. Your first instinct might be to name one of your children as a fiduciary, but if you want to avoid conflict among your children, this might not be the best option.
When naming a fiduciary, it is important to be able to trust the individual, which is why people often name family members as fiduciaries. However problems can arise when a parent with two or more children names one child as a fiduciary. According to Tim O'Sullivan, an attorney from Wichita, Kansas, who spoke on the issue of family harmony at a recent conference for elder law attorneys, a child is often not the best fiduciary for several reasons:
- It is hard for a child to be completely objective.
- Children often disagree over many things, including how long the estate should take to complete, the selling of assets, and the division of personal property.
- Children often don't communicate with each other well.
O'Sullivan says that, in his experience, when one child is named as fiduciary problems arise between family members about one-quarter to one-third of the time.
An alternative is to hire a professional fiduciary. A professional fiduciary can be a bank with trust powers, a certified public accountant, or a trust company. The attorney who is drafting your estate planning documents can recommend a good one in your area. A professional fiduciary will charge a fee, but the fee should be explained ahead of time. In addition, because a professional is experienced in managing money and property, your assets are more likely to increase under this person's or institution's guidance.
To ensure that your family has some input, you can include a provision that allows one or more family members to discharge the fiduciary if they feel the professional is not doing a good job. This will allow your family to make sure the fiduciary is performing properly without having the burden of acting as fiduciary.
An attorney can help you make sure you have the right fiduciary for your family. Click here to to send us an email if you would like to make an appointment with one of our attorneys. |
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Elder Law Associates PA is a boutique elder law firm that practices exclusively in Medicaid and long term care planning including long term care insurance, Medicaid applications, home and community-based Medicaid waiver services, diversion program benefits, nursing home benefits, spousal refusal applications, and Medicaid fair hearings and appeals; nursing home and assisted living facility residents' rights litigation; asset preservation planning with a special focus on planning in light of the Deficit Reduction Act of 2005, including personal service agreements, the purchase of life estates, income producing real estate and spenddown planning; disability planning, including special needs trusts and guardianship; estate planning, including wills and trusts and advance directives; and probate, which encompasses estate and trust administration as well as litigation.
We assist clients in planning for the possibility of disability, incapacity, home health care, assisted living and/or nursing home placement. Our firm enables clients to avoid impoverishment caused by the escalating cost of long term care, to maintain their right to make health care decisions and to avoid unnecessary medical treatment.
We hope you have enjoyed The Elder Law Update. If you have questions about something you read, elder law matters or issues concerning persons with disabilities, we would be delighted to hear from you. We serve as an elder law resource to many professionals and organizations and want to become your elder law resource as well. You can reach us at Info@ElderLawAssociates.com.
Warm regards,
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Ellen S. Morris, Esq. & Howard S. Krooks, Esq., CELA
Elder Law Associates PA
phone: (561) 750-3850 / (800) 353-3752
fax: (561) 750-4069
This publication is intended for general information purposes only. It is not intended to constitute individual legal advice to any specific client. |
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