All posts by cconboy

Older parents are becoming more common, driven in part by changing cultural mores and surrogate motherhood. Comedian and author Steve Martin had his first child at age 67. Singer Billy Joel just welcomed his third daughter. Janet Jackson had a child at age 50. But later-in-life parents have some special estate planning and retirement considerations.

The first consideration is to make sure you have an estate plan and that the estate plan is up to date. One of the most important functions of an estate plan is to name a guardian for your children in your will, and this goes double for a parent having children late in life. If you don’t name someone to act as guardian, the court will choose the guardian. Because the court doesn’t know your kids like you do, the person they choose may not be ideal.

In addition to naming a guardian, you may also want to set up a trust for your children so that your assets are set aside for them when they get older. If the child is the product of a second marriage, a trust may be particularly important. A trust can give your spouse rights, but allow someone else — the trustee — the power to manage the property and protect it for the next generation. If you have older children, a trust could, for example, provide for a younger child’s college education and then divide the remaining amount among all the children.

Another consideration is retirement savings. Financial advisors generally recommend prioritizing saving for your own retirement over saving for college because students have the ability to borrow money for college while it is tougher to borrow for retirement. One advantage of being an older parent is that you may be more financially stable, making it easier to save for both. Also, if you are retired when your children go to college, they may qualify for more financial aid. Older parents should make sure they have a high level of life insurance and extend term policies to last through the college years.

When to take Social Security is another consideration. Children can receive benefits on a parent’s work record if the parent is receiving benefits too. To be eligible, the child must be under age 18, under age 19 but still in elementary school or high school, or over age 18 but have become mentally or physically disabled prior to age 22. Children generally receive an amount equal to one-half of the parent’s primary insurance amount (PIA), up to a “family maximum” benefit. You will need to calculate whether the child’s benefit makes it worth it to collect benefits early rather than wait to collect at your full retirement age or at age 70.

For more information on Estate Planning, please contact the attorneys at Zacharia Brown. You may schedule an appointment by visiting our website at PittsburghElderLaw.com or by calling 724.942.6200.

 

 

Medicare is supposed to provide up to 35 hours a week of home care to those who qualify, but many Medicare patients with chronic conditions are being wrongly denied such care, according to Kaiser Health News. For a variety of reasons, many home health care agencies are simply telling patients they are not covered.

Medicare is mandated to cover home health benefits indefinitely. In addition, Medicare is required to cover skilled nursing and home care even if a patient has a chronic condition. Unfortunately, many home health providers are not aware of the law and tell home health care patients that they must show improvement in order to receive benefits.

According to a Kaiser Health News article, confusion over whether or not improvement is required (it is not) is one part of the problem. Another issue is that home health care workers are afraid they will not get paid if they take on long-term care patients. In an effort to crack down on fraud, Medicare is more likely to audit providers who provide long-term care. This encourages providers to favor patients who need short-term care.

In addition, Medicare’s Home Health Compare ratings website may be having a negative effect on home health care agencies’ willingness to provide for long-term care patients. One measure of care qualification is whether a patient is improving. Because patients with chronic conditions don’t necessarily improve, they could lower an agency’s rating. Also, under a rule that just went into effect, home health care agencies cannot dismiss a patient without a doctor’s note. This may make agencies even more reluctant to take on long-term care patients.

If you are wrongly denied Medicare home health benefits, you can appeal, although you may have to be persistent to get coverage. To learn more about Medicare coverage for home health care and other elder law issues, please contact the attorneys at Zacharia Brown. You may schedule an appointment by visiting our website at PittsburghElderLaw.com or by calling 724.942.6200.

 

 

With the new year officially underway, we have been busy with lots of exciting developments at Zacharia Brown! We have been working to develop new ways to reach out to our clients, long term care communities, nursing homes, elder care partners and others who are seeking information on Elder Law issues. Here are just some of the things we are rolling out for 2018.

Good LTC
GoodLTC is a ground-breaking communication forum for those who work in and service long term care communities.  It is a place where members of the industry can go to share concerns, collaborate on problems, and seek answers to questions. You can visit the forum to get the latest information in the industry and you will also have the option to send and receive emails on topics relevant to your specific group. We have created GoodLTC as a place to collaborate, share information and ideas, ask and answer questions, work together as a group and help one another. This is a FREE service that Zacharia Brown is sponsoring for our partners in the industry, For more information and to sign up, visit goodltc.com

Care & Share
In February, Zacharia Brown will begin hosting a brand new Support Group at each of our offices. We envision this group as an intimate, no cost, open forum where individuals can offer support, stories and advice to others who are currently dealing with elder care issues, as well as those who may need assistance in the future. These groups will meet once a month (per office) on Fridays and are designed to help address questions regarding care coordination, ongoing health issues, planning needs and other elder care topics.  Zacharia Brown will provide a meeting space and facilitate these groups each month so that members can share valuable information and personal experiences with one another. Please contact us at 724-942-6200 if you would like to attend a group or for more information.
February’s Care & Share schedule is as follows: Versailles/McKeesport Office:  Friday, February 16th at 1:00pm McMurray Office:  Friday, February 23rd at 1:00pm

Radio Shows and Wednesday’s Weekly Wisdom
In 2018, there are now 6 times a month for you to tune in and hear Zacharia Brown share information and discuss important topics in Elder Care and Long Term Care Planning. First, on KDKA, you can listen to our call-in show on the third Tuesday of every month. We have also started hosting a weekly radio show on 94.5 3WS FM which airs every Sunday morning from 7:30am-8:00am where we share current developments, tools and stories to help you navigate the maze of planning and paying for long-term care. Lastly, we have a new one minute segment on KDKA called Wednesday’s Weekly Wisdom with Zacharia Brown. The segment will air once a week on Wednesdays throughout the month between 3:00pm and 7:00 PM. and will allow us to share helpful tips on Elder issues.

Our Weekly Blog is Back with a Twist!
This year, to supplement the information we share through our weekly blogs, we will be inviting guest bloggers to contribute to the posts on our website, Facebook and Twitter.

Seminars
As always, we will be conducting many seminars throughout the year for the general public and for partner organizations that we work with in the arena of Elder and Long Term Care Planning. Visit our website at PittsburghElderLaw.com to view all of our upcoming seminars and events.

To learn more about Elder Law issues and discuss long term care planning strategies, please contact the attorneys at Zacharia Brown. You may schedule an appointment by visiting our website at PittsburghElderLaw.com or by calling 724.942.6200.

 

 

In 2018, Social Security recipients will get their largest cost of living increase in benefits since 2012, but the additional income will likely be largely eaten up by higher Medicare Part B premiums.

Cost of living increases are tied to the consumer price index, and an upturn in inflation rates and gas prices means recipients get a small boost in 2018, amounting to $27 a month for the typical retiree. The 2 percent increase is higher than last year’s .3 percent rise and the lack of any increase at all in 2016. The cost of living change also affects the maximum amount of earnings subject to the Social Security tax, which will grow from $127,200 to $128,700.

The increase in benefits will likely be consumed by higher Medicare premiums, however. Most elderly and disabled people have their Medicare Part B premiums deducted from their monthly Social Security checks. For these individuals, if Social Security benefits don’t rise, Medicare premiums can’t either. This “hold harmless” provision does not apply to about 30 percent of Medicare beneficiaries: those enrolled in Medicare but who are not yet receiving Social Security, new Medicare beneficiaries, seniors earning more than $85,000 a year, and “dual eligibles” who get both Medicare and Medicaid benefits. In the past few years, Medicare beneficiaries not subject to the hold harmless provision have been paying higher Medicare premiums while Medicare premiums for those in the hold harmless group remained more or less the same. Now that seniors will be getting an increase in Social Security payments, Medicare will likely hike premiums for the seniors in the hold harmless group. And that increase may eat up the entire raise, at least for some beneficiaries.

For 2018, the monthly federal Supplemental Security Income (SSI) payment standard will be $750 for an individual and $1,125 for a couple.

To learn more about Elder Law issues and discuss planning strategies, please contact the attorneys at Zacharia Brown. You may schedule an appointment by visiting our website at PittsburghElderLaw.com or by calling 724.942.6200.

 

 

Are you happy with your current Medicare plan or plans? Now is the time to think about whether you are in the right plan or whether a new plan could save you money. Medicare’s Open Enrollment Period, in which you can enroll in or switch plans, runs from October 15 to December 7.

During this period you may enroll in a Medicare Part D (prescription drug) plan or, if you currently have a plan, you may change plans. In addition, during the seven-week period you can return to traditional Medicare (Parts A and B) from a Medicare Advantage (Part C, managed care) plan, enroll in a Medicare Advantage plan, or change Advantage plans. Beneficiaries can go to www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to make changes in their Medicare prescription drug and health plan coverage.

Even beneficiaries who have been satisfied with their plans in 2017 need to review their choices for 2018. Be sure to carefully look over the plan’s “Annual Notice of Change” letter. Prescription drug plans can change their premiums, deductibles, the list of drugs they cover, and their plan rules for covered drugs, exceptions, and appeals. Medicare Advantage plans can change their benefit packages, as well as their provider networks.

Remember that fraud perpetrators will inevitably use the Open Enrollment Period to try to gain access to individuals’ personal financial information. Medicare beneficiaries should never give their personal information out to anyone making unsolicited phone calls to sell Medicare-related products and services or to someone who shows up on their doorstep uninvited. If you think you’ve been a victim of fraud or identity theft, contact Medicare. For more information on Medicare fraud, click here.

Here are more resources for navigating the Open Enrollment Period:

To learn more about Medicare Open Enrollment and discuss Elder Law planning options, please contact the attorneys at Zacharia Brown. You may schedule an appointment by visiting our website at PittsburghElderLaw.com or by calling 724.942.6200.

 

 

The median cost of a private nursing home room in the United States has increased to $97,455 a year, up 5.5 percent from 2016, according to Genworth’s 2017 Cost of Care survey, which the insurer conducts annually. Genworth reports that the median cost of a semi-private room in a nursing home is $85,775, up 4.44 percent from 2016. The rise in prices is much larger than the 1.24 percent and 2.27 percent gains, respectively, in 2016.

The price rise was slightly less for assisted living facilities, where the median rate rose 3.36 percent, to $3,750 a month. The national median rate for the services of a home health aide was $22 an hour, up from $20 in 2016, and the cost of adult day care, which provides support services in a protective setting during part of the day, rose from $68 to $70 a day.

Alaska continues to be the costliest state for nursing home care, with the median annual cost of a private nursing home room totaling $292,000. Oklahoma again was found to be the most affordable state, with a median annual cost of a private room of $63,510.

In Pennsylvania, the the median cost of a semi-private room in a nursing home in 2017 is $9,277 a month or $111.324 annually, That figure increases to $10,007 a month or $120,084 a year for a resident in a private room.  As for other types of care, the statewide average cost for an Assisted Living community in Pennsylvania is $3,650 a month or $43,800 per year. Pennsylvania residents can also expect to pay an average rate of $22/hr for Home Care Services and an average of $62 per day for Adult Day Care at a health facility.

The 2017 survey was based on responses from more than 15,000 nursing homes, assisted living facilities, adult day health facilities and home care providers. The survey was conducted by phone during May and June of 2017.

As the survey indicates, nursing home and other elder care options continue to increase annually, with care becoming more and more expensive. Because of this, it is extremely important to consult with the experienced and knowledgeable attorneys of Zacharia Brown to learn more about protecting your assets, available benefits and all planning options that may be available to you or a loved one. You may schedule an appointment by visiting our website at PittsburghElderLaw.com or by calling 724.942.6200.

For more information regarding specific state by state costs in Genworth’s 2017 Cost of Care Survey, click here.

 

 

No one truly wants to think about his or her own death, however, a little preparation in the form of a prepaid funeral contract can end up being very useful. In addition to easing the burden on your family after your death, a prepaid funeral contract can also be a good way to spend down assets in order to qualify for Medicaid.

A prepaid or pre-need funeral contract allows you to purchase funeral goods and services before you die. The contract can be entered into with a funeral home or cemetery. Prepaid funeral contracts can include payments for: embalming and restoration, room for the funeral service, casket, vault or grave liner, cremation, transportation, permits, headstones, death certificates, and obituaries, among other things.

One benefit of a prepaid funeral contract is that you are paying now for a service that may increase in price, and therefore possibly saving your family money. You are also alleviating the burden on your family of having to make arrangements after you have passed on, which can often be difficult emotionally as well as time-consuming. Finally, if you are planning on applying for Medicaid, a prepaid funeral contract can be a way to spend down your assets when used correctly.

In Pennsylvania, Medicaid applicants must spend down their available assets until they reach the qualifying level (either $2,400 or $8000, depending on your gross monthly income). By purchasing a prepaid funeral contract, you can turn available assets into an exempt asset that won’t affect your eligibility. In order for a prepaid funeral contract to be exempt from Medicaid asset rules, the contract must be irrevocable. That means you can’t change it or cancel it once it is signed. Additionally, the dollar amount of the contract that will be considered exempt differs from county to county throughout the state, so it is important to consult with an experienced elder law attorney to make sure you are taking full advantage of this exemption.

Finally, before purchasing a prepaid funeral and signing a contract, you should shop around and compare prices to make sure it is the right contract for you. Buyers need to be careful that they are buying from a reputable company and need to ask for a price list to make sure they are not overpaying.

For help in understanding the benefits of prepaid funeral planning, as well as the complex Medicaid rules that apply to spending down your assets, contact the knowledgeable attorneys at Zacharia Brown. You may schedule an appointment by visiting our website at PittsburghElderLaw.com or by calling 724.942.6200.

 

Many seniors and their families don’t use a lawyer to plan for long-term care or Medicaid, often because they are afraid of the cost. But an attorney can help you save money in the long run, as well as make sure you are getting the best care possible for your loved one.

Instead of taking steps based on what you’ve heard from others, doing nothing, or enlisting a non-lawyer referred by a nursing home, you can and should hire an elder law attorney. Here are a few reasons why you should strongly consider this option:

  1.  No conflict of interest.

When nursing homes refer the families of residents to non-lawyers to assist in preparing the Medicaid application, the preparer has dual loyalties, both to the facility that provides the referrals and to the client applying for benefits. To the extent everyone wants the Medicaid application to be successful, there’s no conflict of interest. However, while it is in the nursing home’s interest that the resident pay privately for as long as possible before going on Medicaid, it is instead in the resident’s best interest to protect assets for his or her own care or for the care of the resident’s spouse or family. An attorney hired to assist with Medicaid planning and the application process has a duty of loyalty only to the client and will do his or her best to achieve their client’s goals.

2.  Saving money.

The average cost of Nursing Home care in Pennsylvania is between $9.000 and $10,000 a month. So when assessing the legal fees that may be charged by an attorney, one should keep in mind the substantial savings that can be achieved by preserving assets and avoiding an extended private pay stay at a nursing home.

3.  Deep knowledge and experience.

Professionals who work in any field on a daily basis over many years develop both the depth and breadth of experience and expertise to advise clients on how they might achieve their goals, whether those are maintaining independence and dignity, preserving funds for children and grandchildren, or staying at home rather than moving to an assisted living facility or a nursing home. Less experienced advisers, however well intentioned, can’t advise on what they don’t know.

4.  Malpractice insurance.

While we should expect that every professional we work with will provide outstanding service and representation, sometimes things don’t work out. Fortunately, there is a remedy if an attorney makes a mistake because almost all attorneys carry malpractice insurance. This is probably not the case with other advisers in the Medicaid arena, where mistakes can be costly.

5.  Peace of mind.

It is possible that when you consult with an elder law attorney, the attorney may advise you that in your situation there is not much you can do to preserve assets or achieve Medicaid eligibility more quickly. Even if this is the case, a consultation will provide peace of mind that you have not missed an important opportunity. In addition, if obstacles arise during the process, the attorney will be there to work with you to find the optimal solution.

Medicaid rules provide multiple opportunities for nursing home residents to preserve assets for themselves, their spouses and children and grandchildren, especially those with special needs. There are more opportunities for those who plan ahead, but even at the last minute, there are almost always still steps available to preserve some assets. Consequently, it is always worth investigating whether these are steps you would like to take.

For help in understanding the complex Medicaid rules and assistance with asset protection planning and applying for benefits,  contact the knowledgeable attorneys at Zacharia Brown. You may schedule an appointment by visiting our website at PittsburghElderLaw.com or by calling 724.942.6200.

 

A new report finds that states have made incremental improvements in providing long-term care, but need to make more improvements in order to meet the needs of the growing number of people who require long-term care services. According to the 2017 Long-Term Services and Supports State Scorecard, while long-term care remains unaffordable for middle class families, there has been some progress in other areas.

The scorecard, a collaboration between the AARP, The Commonwealth Fund, and The SCAN Foundation, measures states’ long-term care system performance in five areas: affordability and access, choice of setting and provider, quality of life and quality of care, support for family caregivers, and effective transitions between care settings.

The 2017 scorecard found that states showed progress since the previous scorecard in 2014 in reducing inappropriate antipsychotic drug use for nursing home residents, helping family caregivers, reducing long-term nursing home stays, increasing the number of Medicaid recipients receiving care at home or in the community rather than in an institution, and reducing potentially burdensome hospitalizations for people who die in a nursing home. However, the scorecard concludes that overall improvements are not keeping up with the demand. For example, there are not enough home care workers to meet the needs of individuals with disabilities living in the community. In addition, while states have made improvements in providing home health care, progress is moving too slowly to keep up with growing needs.

According to the scorecard, the top five states for long-term care are Washington, Minnesota, Vermont, Oregon, and Alaska. The bottom five states are Tennessee, Mississippi, Alabama, Kentucky, and Indiana. Tennessee and New York made the most progress since the previous scorecard in 2014.

To see where your state ranks, go here:
http://www.longtermscorecard.org/2017-scorecard

For help in navigating the maze of long term care options and the planning required to pay for care, contact the knowledgeable attorneys at Zacharia Brown. You may schedule an appointment by visiting our website at PittsburghElderLaw.com or by calling 724.942.6200.

 

When we’re young we believe that we’re invincible, which makes it harder to admit as we age that our bodies naturally need more care. Normal aging affects the heart, bones and joints, so preventive care is key to avoiding aging that could be harmful to your health.

Medicare-eligible Americans who are signed up for Medicare Part B as part of Original Medicare or Medicare Advantage (Medicare Part C) can take advantage of the preventive services that are included. Preventive care can help save you from serious illnesses entirely or detect health conditions early enough to treat.

What are Medicare preventive services?

Preventive services include fully and partially covered screenings, vaccinations, and counseling services.

If your doctor accepts assignment, meaning your doctor agrees to accept Medicare’s fee for covered services, you can benefit from the many preventive care services that are available at no cost to you. Free preventive care services are readily available to adults age 50 or older, so it’s surprising to learn that less than 50 percent of adults age 65 and older are up to date on preventive services, according the Centers for Disease Control and Prevention. If your provider does not accept payment in full — or Medicare at all — you may pay for the services out of pocket.

Below is a breakdown of which Medicare preventive services are free and which aren’t.

Fully covered Medicare preventive services:

Screenings

    • Abdominal Aortic Aneurysm Screening
      A one-time ultrasound is covered.
    • Bone Mass Measurement
      One test every 24 months or more if medically necessary.
    • Breast Cancer Screenings
      Annual screenings, including breast exams and mammograms, are covered.
    • Cardiovascular Screenings
      Blood tests to check cholesterol, lipid and triglyceride levels every five years.
    • Cervical and Vaginal Cancer Screenings
      Pap tests and pelvic exams once every 24 months or once every 12 months if at risk for cancer.
    • Colorectal Cancer Screenings
      Sigmoidoscopy every 48 months or every 24 months if at high risk, screening every 120 months if not at high risk and fecal occult blood test every 12 months.
    • Depression Screening
      One yearly screening with your primary care physician.
    • Diabetes Screening
      Two fasting blood glucose tests are covered if you are at risk for diabetes.
    • Hepatitis C Screening Test
      One test is covered. However, if you are at high risk, yearly screenings are covered.
    • HIV Screening
      One test every 12 months is covered.
    • Lung Cancer Screening
      One yearly screening is covered for current or former smokers.
    • Obesity Screening
      The screening is covered for individuals whose body mass index (BMI) is 30 or more.
    • Prostate Cancer Screenings
      One prostate specific antigen test is covered every 12 months.
    • Sexually Transmitted Infections Screening
      Screenings for Hepatitis B, chlamydia, gonorrhea, and syphilis are covered once every 12 months.

Vaccinations

    • Flu Shots
      One flu shot every flu season
    • Pneumonia Shots
      One shot in a lifetime is typical, but a second shot is also covered one year later.
    • Hepatitis B
      Three shots for full protection

Counseling

    • Alcohol Misuse
      Four yearly sessions are covered.
    • Cardiovascular Behavioral Therapy
      One yearly session with your primary care physician is covered.
    • Medical Nutrition Therapy
      The first year includes three hours of therapy. Each year after that includes two hours of therapy.
    • Obesity
      Behavioral counseling to help you lose weight is covered.
    • Tobacco Use Cessation
      Eight sessions in 12 months are covered.

Partially covered Medicare preventive services:

Screenings

    • Colorectal Cancer Screenings
      Barium enemas require you to pay 20 percent of the Medicare-approved amount for the service.
    • Diagnostic Mammogram
      You will pay 20 percent of the Medicare-approved amount. However, this can be applied to your Part B deductible.
    • Glaucoma Tests
      You will pay 20 percent of the Medicare-approved amount. However, this can be applied to your Part B deductible.
    • Prostate Cancer Screenings
      Digital rectal exams require you to pay 20 percent of the Medicare-approved amount. However, this can be applied to your Part B deductible.

Counseling

    • Diabetes Self-Management Training
      You will pay 20 percent of the Medicare-approved amount. However, this can be applied to your Part B deductible.

If a free service leads to other non-preventive services based on the results, you may have to pay. However, Medicare plans could help cover those costs. Not all Medicare beneficiaries are eligible for all Medicare preventive services. For example, mammograms are a free service to female Medicare beneficiaries only. You may want to check your Medicare policy if you have questions about which preventive services are covered.

For more information about Medicare benefits and preventative services, contact the knowledgeable attorneys at Zacharia Brown. You may schedule an appointment by visiting our website at PittsburghElderLaw.com or by calling 724.942.6200.