Texas Estate Planning

What's the Difference Between Medicaid, Medicare, SSI, and SSDI?

If you need assistance paying for long-term care, then you need to look into Medicaid, not Medicare. But if you need health insurance, then it’s a Medicare application you’ll be submitting. And although SSI (Supplemental Security Income) refers to a specific type of program, it’s only a one letter difference from SSDI (Social Security Disability Insurance) which is a completely different benefit program for people with various types of disabilities. 

And when you look into the details of each program, it only gets more complex. So let’s break it down…

There are over one-hundred programs administered under the umbrella of Medicaid out there to help you receive the appropriate health care, insurance, and assistance that you deserve. Because of the sheer number of programs, it can be difficult to find the one best-suited for your needs. Each program has different requirements, guidelines, and limitations. 

Each program is guided by laws that change each year, if not more often, and vary from state to state, depending on the program. It can be quite helpful to get counsel from a licensed attorney in your area who stays up to date on the laws that specifically deal with the program you are applying to. The Attorneys at our Firm stay up to date through consistent continued learning experiences offered specifically for this purpose, and they ensure that every member of the team is made aware of updates and changes in the law so that we can better serve the needs of our community. 

To help you in your search for the program that best fits you and your family’s needs, here is a very quick rundown of 4 common programs that are easy to confuse: 

 

1. Medicaid: 
   • Health coverage (which is legal entitlement to payment or reimbursement for your health care costs)
   • Funded and administered jointly by the state and federal governments. This means that each state has different laws regarding Medicaid.
   • Income and asset limit 
   • Available to low-income: 
     1. Adults
     2. Children
     3. Pregnant women
     4. Elderly adults 
     5. People with disabilities 
   • Can be used for: 
     1. Long-term care 
     2. Inpatient and outpatient hospital services
     3. Physician services
     4. Lab and x-ray services
     5. Home health services 
2. Medicare: 
   • Health insurance 
   • Administered by the federal government 
   • Eligibility is based on: 
     1. Age (65 or older) 
     2. Certain younger people with disabilities 
     3. People with End-Stage Renal Disease 
   • There are various Medicare plans based on your eligibility and needs. 
3. SSI (Supplemental Security Income): 
   • Supplemental monthly income 
   • Eligibility is based on:
     1.  income and asset limits 
     2. disability
     3. Age 
        • Adults: 65+, or blind, or have a disability 
        • Children: under 18 and have physical or mental condition(s) that very seriously limits their daily activities for a period of 12 months
4. SSDI (Social Security Disability Insurance): 
   1. Supplemental monthly income 
   2. Means-tested based on disability and recent work history 
      1. Includes income and asset limits 
   3. Same medical requirements as SSI 

 

Hopefully that helps give you a better picture of where to start in your search for the programs that you or your loved ones might need. Remember that each state has their own set of laws regarding benefit programs and a licensed attorney with an understanding of these programs can be a helpful resource in navigating the application process. 

Ard Law Firm, PLLC is located in the Greater Houston Area, off I-45 south on the way to Galveston, but is able to serve all of Texas. Over the last decade, we’ve focused on Medicaid to help people transition into long-term care without large financial burdens.

We work with our clients to get their information together in order to apply for the benefits they deserve, and if obstacles come up along the way we work together to overcome them. Whether that means drafting legal documents, conducting research, or even arguing appeals, we walk with you on your journey, every step of the way.

Exactly Why Do I Need a Will?

Some people mistakenly think not having a will allows their assets to bypass the time and expense of probate. That’s not true–if you die without a will, your property still must go through probate, says Fed Week’s recent article entitled “The Importance of Having a Will.”

If probate avoidance is an issue, you can create a revocable trust to keep control over the trust assets while you’re alive.

Assets placed in trust during your lifetime can be distributed at your death, under the terms of the trust, without going through probate.

There are many types of trusts, and they all establish a financial arrangement between three parties:

• The Trustor
• The Trustee; and
• The Beneficiaries.

The person creating the trust is known as the trustor or grantor. The trustee manages the trust and disperses income or principal from the trust according to specific terms.

When you draft a will, you shouldn’t forget about it. Any births, deaths, marriages or divorces all may create a need to revisit your so-called “last wishes.”

After each change, make sure your current will is both safe and accessible. You can leave your will with your executor. If you decide to keep your will somewhere else, your executor and other family members should know its location. The estate planning attorney who prepared your will should have a copy, as well as a memo revealing the location of the original.

Regardless of where you put your will, have another document for your funeral and burial instructions. Wills generally aren’t read until days or weeks after death, so that won’t help your family make prompt decisions about a funeral or a memorial service.

As a result, a separate letter should be used to specify your final wishes and your executor should know where these instructions can be found.

Ask an experienced estate planning attorney to help you write your will.

Reference: Fed Week (Nov. 2, 2022) “The Importance of Having a Will”

When Is an Estate Plan Really Finished?

It makes sense: your life changes. Your goals may have changed. You may have been divorced, married, or your children may have gotten married or divorced. Your financial status may have changed. All of these are reasons why the Times Herald-Record advises readers to review their estate plans, as detailed in the article “5 steps to securing your elder estate plan.”

Here are steps to make this an easier process:

Step One: gather up all your documents, which may take some time. This includes your will, powers of attorney, health care proxies, living wills, any trusts and any other documents.

For clarity, here are some definitions. A will is the document that states where you want your assets to go when you die. It is reviewed by the court in a proceeding called probate, but only after your death. Assets in a living trust (or other types of trusts, depending on your situation) do not go through this process. Creating a trust results in a legal entity that owns the assets it contains. The trust assets go to the beneficiaries upon death, as directed by you to the trustee. In many instances, trusts save time, money and avoid litigation over inheritances.

Powers of attorney name the person you appoint to make any legal, business or financial decisions for you, should you become incapacitated. A health-care proxy names the person to make your medical decisions, if you are unable to do so. Living wills are used to express your wishes for end-of-life care.

Step Two: review your documents. Make sure that everything is signed. You would be surprised how many important documents aren’t signed. Read the documents to see who was named as the executor of your will and who is the trustee of your trusts. Are those people still able to undertake these responsibilities? Do you still want them making decisions for you? 

Step Three: make a list of all of your assets. Note how they are titled—what names are on the accounts—and what are the values of each? Include retirement accounts like IRAs, 401(k)s, insurance policies and annuities and check to see if you named a beneficiary. Do you still want that person to be the recipient of the asset? Make sure that you have also named a contingency beneficiary.

Step Four: what information would your loved ones need, should you become unable to communicate? They’ll need information about your medications, the name and contact information for your primary care physician, your estate planning attorney, your CPA and your financial advisor. You may want to arrange for a “family meeting” with your healthcare team and your legal and financial team (two separate meetings), so everyone in your family is familiar with your professional teams. A list of where your documents can be found and who you want to receive personal items, may also be helpful.

Step Five: don’t forget to tell your trusted family members, where your important information is located and what lists exist. You don’t have to review everything with them, but if they know where things are at the time of your passing, they will have an easier time of settling your estate.

Reference: Times Herald-Record (Dec. 1, 2018) “5 steps to securing your elder estate plan”

What to Gift

The recently passed tax reform law doubled the lifetime gift tax exemption from previous levels. However, the exemption is scheduled to revert to the previous level in a few years. That means if you want to take advantage of the increased limit, then you need to act quickly. 

It is not always a good idea to gift large amounts of cash that can potentially be wasted and there are many other options. News Max listed some of them in "Gifting Wealth and the Estate Tax Law Under Trump," including:

• You can create an LLC that holds stock or other investments and gift your family members’ interests in the LLC. That allows you to control the investments, while still gifting to your family for their use later.
• If you own a company, you can create a trust and gift stock in the company to that trust for your family's benefit.
• It is a great time to fully fund any special needs trusts your relatives have.
• Now is a great time to create and fund trusts that your family can benefit from later. If you have enough money, you can even create a dynasty trust that will supplement your family for generations to come. An estate attorney can help you determine the best trust for your family.
• You can help younger family members purchase their first homes.
• Consider funding retirement options for younger family members, such as by purchasing annuities for them.

Reference: News Max (June 20, 2018) "Gifting Wealth and the Estate Tax Law Under Trump."

 

Positive Death

Death has typically been something of a taboo subject in our culture. We all know that it will eventually happen to us, but we do not typically like to think about it. Even those people who have strong religious beliefs that they will go to a much better place after they pass away, do not like to dwell too much on their own deaths. 

It is a scary subject for us, since none of us can be absolutely certain what death will be like and what will happen afterwards. A side effect is that elderly people and the terminally ill do not often have people to help them deal with the process. A new movement is trying to change that, as The New York Times reports in "The Positive Death Movement Comes to Life."

The movement is not completely cohesive. It is just various people and groups trying to make the subject of death less taboo and to focus on the personal needs of the dying. In some places, it has taken the form of "death cafes," where anyone interested can come together and talk about the subject. Other people are working on ways for hospice patients to receive personal attention in the same way a midwife helps those giving birth.

One reason why many people do not get estate plans, is they do not want to think about their own death. If this new movement is successful and does result in more people getting estate plans, that will be a very good thing for many families.

Reference: New York Times (June 22, 2018) "The Positive Death Movement Comes to Life."

Stay Issued in California Doctor-Assisted Suicide Case

Several states have passed laws allowing doctors to assist terminally ill patients who want to commit suicide. Whenever these laws are passed, there is always some controversy.  However, it has not been nearly as what has occurred since California passed its law allowing the practice. 

California has seen groups consisting of both doctors and religious-affiliated people fight hard against the law. In May of 2018, the law’s opponents won a major victory, when a district court judge declared that the law violated the state's constitution. 

However, it was not a complete victory. This is because the judge did not rule on the merits of doctor-assisted suicide. Instead, the judge declared the manner in which the law had been passed as unconstitutional. That partial victory is now in doubt, as an appeals court issued an immediate stay of the lower court's order, as KVOA reports in "Court reinstates doctor-assisted suicide in California."

The California law is being closely monitored by interest groups on both sides of the debate over doctor-assisted suicide.

Interest groups are also following the law, because it included several provisions mandating that the state collect data about how the law was working and to issue regular reports about it. Both sides hope what the data reveals will be helpful for them, as other states consider similar laws.

Reference: KVOA (June 16, 2018) "Court reinstates doctor-assisted suicide in California."

Stan Lee Involved in Elder Abuse Investigation

It seems that 95-year-old Stan Lee is at the height of his fame. The characters he created for Marvel Comics currently make the film industry millions of dollars annually in film after film. Lee himself appears in a cameo role in every film. 

To most people Lee is known as a friendly, beloved creator of the superheroes that they love. However, there is another side to Lee's life right now, as police are investigating whether he is the victim of elder abuse, as Time reports in "L.A. Police Investigate Reports That Marvel Comics' Stan Lee Is a Victim of Elder Abuse."

After Lee's wife passed away, a man named Keya Morgan stepped in to assist Lee with his affairs. Morgan is on probation for an unrelated matter. It is claimed that Morgan moved Lee out of his home and will not let friends and family visit Lee. 

Police and a social worker were sent to Morgan's home to conduct a welfare check on Lee.  However, Morgan called 911 on them and falsely reported that he was being burglarized. Morgan now faces criminal charges for filing a false police report. A restraining order against Morgan has also been issued by a court prohibiting him from contacting Lee.

While it is not yet known whether Lee is a victim of elder abuse, a common sign is when a caretaker isolates an elderly person from other friends and family.

Reference: Time (June 14, 2018) "L.A. Police Investigate Reports That Marvel Comics' Stan Lee Is a Victim of Elder Abuse."

Where to Move in Retirement

Traditionally, when Americans move after they retire, they choose to go to a state with a warm climate. Arizona and Florida are popular options. They have both developed the infrastructure and industries for elderly Americans to live comfortably and to get the services they need. 

However, more and more retired people are choosing to move to other states. One trend is for people to move closer to their adult children, as The New York Times reports in "The New Retirement: Near the Kids."

One reason for the trend is that people are more likely to move further away from their hometowns when they grow up, than ever before. Young people today often find they need to move to far away cities for job opportunities in their chosen fields. 

As much as parents would like to be closer to their children and grandchildren, they often cannot move closer since they have jobs of their own. That all changes when the parents retire.

A positive result of this trend is that it helps to combat the growing incidence of elderly Americans who are lonely and isolated.

There are many options for moving when you are retired. One thing to keep in mind if you do want to move closer to your children, is that living in large cities is usually more expensive than living elsewhere. Plan accordingly, before you move.

Reference: New York Times (May 4, 2018) "The New Retirement: Near the Kids."

Plan Ahead to Be a Caregiver

If you know you were going to have increased expenses in the future, you would be wise to plan ahead for how you will meet those expenses. This is something people do all the time. Someone who would like to buy a house, plans ahead to save the money needed for a down payment. 

One future expense many Americans will face is the cost of acting as the primary caregivers for their elderly parents. Older Americans are living longer than ever before, and nursing homes continue to get more expensive. Being the caregiver for an elderly parent is also increasingly common. Americans need to plan for how they will meet the future caregiving expenses, as Kiplinger's Personal Finance discusses in "Why Families Need a Plan for Caregiving."

Beyond just having another mouth to feed, caregiving can often come with other expenses, such as helping an elderly parent pay for expensive co-pays for medicine and expensive insurance deductibles. Other expenses can come from making sure that a home is a safe environment for an elderly person who needs caregiving. People should also speak with an elder law attorney to find out what programs might be available for their parents.

It is not possible to know ahead of time, how much money you might need to help an elderly parent or even if you will have to be a caregiver at all. Nevertheless, you can get a better idea of what might be coming up, by talking to your parents ahead of time and making plans.

Reference: Kiplinger's Personal Finance (May 9, 2018) "Why Families Need a Plan for Caregiving."

Do You Understand Social Security?

On the surface, Social Security is a fairly simple concept to grasp. People pay into it, while they are working. When they retire, they then get paid benefits that are based on their income, when they were working. This seems simple enough.  However, what the federal government does is often not that simple.  

Social Security is actually a very complex system with all sorts of different rules people can use to get the most out of it. People need to understand what those rules are, as Financial Advisor discusses in "Nearly Half of Americans Still Don't Understand Social Security."

In a recent survey, 47% percent of respondents over the age of 50 were unable to correctly answer a series of true/false questions about Social Security benefits. This could be a potential problem, because it means that they might not get what they need out of the system, when they retire. The Social Security Administration is supposed to assist people with this.  However, it can do little more than tell people what their options are when asked.

A good way to learn how to get the most out of Social Security for yourself, is to visit an elder law attorney. The attorney can help you understand how to get the maximum amount of benefits per month and how to weigh that against getting the maximum amount of total benefits in your lifetime.

Reference: Financial Advisor (May 18, 2018) "Nearly Half of Americans Still Don't Understand Social Security."