For families and friends of individuals with special needs, the primary concern is sustaining the individual financially. Not only do we want to ensure that their requirements for daily care are met, but we also want to make every effort to provide the best quality of life possible. One of the best ways to meet both goals is to establish either a Special Needs Trust or a Supplemental Needs Trust which allows a person with special needs to continue receiving government assistance for standard care while the trust money can be used for supplemental benefits such as advanced medical treatment, education, entertainment, and even vacations.
A key to success is knowing whether a Special Needs Trust or a Supplemental Needs Trust is right for the situation at hand, and this series is intended to inform readers about some of the basics and benefits of each. Because the laws and terminology involving trusts vary from state to state, it is helpful to consult with a local attorney who specializes in this area. If the Beneficiary lives outside the state of Minnesota, the special needs trust attorney will inform you about the options available for your loved one and help you take the steps necessary to safeguard their well-being.
1. Memory loss that disrupts daily life.
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks at home, work or leisure.
4. Confusion with time or place.
5. Trouble understanding visual images and spatial relationships.
6. New problems with words in speaking and writing.
7. Misplacing thinks and losing the ability to retrace one’s steps.
8. Increase in poor judgment.
9. Withdrawal from work or social activities.
10. Changes in one’s mood or personality.
With the current cost of long-term care services, may people choose to purchase long-term care (LTC) insurance policies to help subsidize these costs. While LTC policies are integral to many life care plans, LTC claims are often denied, leaving the insured in the difficult position of paying significant out-of-pocket expenses that should have been covered by the LTC policy.
When LTC claims are denied, the insurer has an obligation to specify the exact basis for its denial. Typically, this is done in what is called a denial letter. If the specific reason for denial is not given, you should immediately seek the basis for the denial from the insurer.
Once you know the basis for the denial, many policies allow the insured to provide the insurer with additional information to support the claim. If you have additional information that you believe supports the LTC claim, you may want to provide the insurer with this information.
Most policies also provide for an internal appeal of the denial. The time by which you must appeal a denial of LTC benefits is usually found in the policy; however, if it is not, you should clarify the appeal time with the representative who sent the denial letter. An appeal is typically a written statement outlining the basis for the claim and the LTC policy covers the claim.
Once all appeals allowed under the policy have been exhausted and the insurer continues to deny benefits, you may file a lawsuit against the LTC insurer for breaching its LTC insurance contract.
Strategies for dealing with a denial of LTC benefits vary depending on the basis for the denial, but you do not have to accept a denial of LTC benefits. If you believe that benefits should be paid under the policy, you should not let the insurer simply deny benefits. Doing so could have a significant negative impact, both financially and emotionally.
Isaac I. Tyroler
Maser Amundson, P.A.
Effective January 1, 2013, the annual exclusion rate for gifts will increase to $14,000, up from $13,000 in 2012. What does this mean?
This means that a person can gift $14,000 per year to any individual without having to file a gift tax return. So I could gift $14,0000 to each of my children and my husband could also gift $14,000 to each child. So effectively a couple could transfer $28,000 to each child without having to file a gift tax return. Assuming the children are stable and can handle money appropriately, this may be a means, among others, to reduce the Minnesota estate tax that would be imposed on estates in excess of $1,000,000.
Kris L. Maser
Attorney at Law
The GP recently modified a prescription given by the nephrologist and changed the dosage of Sophie’s blood pressure medication. Even though Sophie’s grandson knows what medications she has, he is not sure that she is actually taking them.
Sophie and her grandson live together. Grandson works during the day and is frequently out in the evening. Grandson cooks dinner for Sophie when he is home in the evening.
It took the combination of Sophie’s grandson, two daughters and daughter-in-law to piece together information about Sophie as to what was happening at home and with her care providers. In the end, Sophie was fine and her medications were adjusted to avoid this situation happening again.
What my friend learned from this event is as follows:
1. Perhaps more than one person should be on the health care directive, either acting together or as an alternate.
2. The health care directive should be reviewed more frequently and discussion should include Sophie and her family. (Sophie’s health care directive was executed 20 years old.)
3. The health care proxy should be able to be contacted and available. The proxy was unavailable for some time.
4. The family needs to develop a plan for Sophie’s care.
5. Someone needs to monitor Sophie’s medications and set up the medical alert bracelet.
6. The family needs to discuss the role of the grandson in living with Sophie.
7. Communication among family members and organization of Sophie’s care is an ongoing responsibility.
Kris L. Maser
Attorney at Law
Another uneventful Sunday was planned by a friend of mine. She was to meet Sophie, her 90 year old mother-in-law, at church for the Sunday service. But this Sunday didn’t go as
Kris Maser Attorney at Law
planned. Sophie arrived late and found her daughter-in-law already in the pew. The church service began with the call to prayer and as the congregation stood, Sophie collapsed in the pew.
911 was called, the paramedics arrived and Sophie was taken to the hospital. A decision was made to keep Sophie overnight in the hospital for observation and further tests. At the hospital, the daughter-in-law discovered that although she thought her cell phone was up to date on all the family’s contacts, it wasn’t. A call was placed to a family member to locate other family members and the health care proxy.
The grandson arrived at the hospital, then one daughter, then much later a second daughter (the health care proxy). In the interim, daughter-in-law is asked a number of questions about Sophie’s health status. The daughter-in-law couldn’t answer most of the questions.
In the course of this hospitalization they learned that daughter #1 takes Sophie to her general practitioner, daughter #2 takes Sophie to her nephrologist. Daughters are often mad at each other and don’t always communicate with each other.
To be continued…
Kris Maser Attorney at Law
The Financial Industry Regulatory Authority Inc., (FINRA) the brokerage industry’s largest regulator, has issued a warning against financial advisors using authoritative-sounding titles like “certified senior advisor” or “certified retirement counselor” because the use of these misleading designations has become so wide spread. Sometimes these designations are no more than “weekend” designations obtained by attending a hotel seminar. Some of these designations don’t require a high school education or a college diploma.
Go to FINRA Regulatory Notice 11-52 for more information.
When working with a financial advisor please do your homework: ask for references, review the financial planner’s background including the time she/he has been in business as well as his or her education history.
If the current health care trend continues, more than 35% of the state’s budget will be needed for Medicaid by 2030. Of this amount, ½ will be needed for Long-term care services.
This information comes from the Article by Deloitte Development LLC “Medicaid Long-term Care: the ticking time bomb.”
So what if you think you don’t have the funds to purchase a long term care insurance policy? Perhaps you could consider a limited duration long term care insurance policy. Typically these policies can be used to keep the cost of long term care insurance affordable. According to the American Association of Long Term Care insurance in 2009 almost 1/3 of people buying individual policies purchased a 3 year benefit period policy.
Men with a 3 year policy who begin a claim on their policy at age 82 have a 12.4 % likelihood of outliving their benefits. Women who begin using their policy at age 82 have a 23.5% chance of outliving their benefits according to a consumer guide published by the industry trade association.
A policy that pays benefits for 3 years costs somewhere between 42% to 54% less than a policy that will pay for an unlimited number of years. It appears that the risk is smaller for men than for women. When considering a long term care insurance purchase perhaps less insurance can provide benefits sufficient to cover some, if not all of one’s health care costs.
An experienced insurance person should be able to discuss with you the cost benefit analysis of any policy of interest to you.
What was true for obtaining Medicare coverage overseas is not true for receiving one’s Social Security benefits. People who decide to retire to another country or who travel outside the United States for more than 30 days in a row must comply with Social Security’s rules for collecting their benefits.
Thankfully the Social Security Administration (SSA) will send checks to anyone who is eligible for benefits and chooses to live abroad. There are a few countries where the SSA is not allowed to send checks. If you retire in Cuba or North Korea, the SSA will not send checks into these two countries. You can receive your checks if you go to a country where the Social Security checks can be sent.
You could have your Social Security check directly deposited into a bank account in the United Sates or check to see if your check could be directly deposited in an account in the country in which you choose to live. But be careful, some countries may tax your Social Security benefits. To find out whether a country imposes a tax on your Social Security benefits, you can contact the country’s embassy in the United States.
For more information go to the Social Security website.