Transcript The Basic Elements of Estate Planning and Probate in Georgia

Questions and Answers Surrounding
Elder Care Law
Heather Durham Nadler, Esq.
Certified Elder Law Attorney
Heather Durham Nadler, P.C.
2600 Century Parkway, Suite 100
Atlanta, Georgia 30345
(678) 916-5390
[email protected]
What is Elder Law?
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Practice area that is defined by the client
served – seniors
Holistic practice
Estate Planning
Planning for Incapacity
Planning for Long-Term Care
Estate Planning at a Glance
Advance Directive for Health Care
 Durable Financial Power of Attorney
 Last Will and Testaments
 Trusts
 Titling of assets
 Beneficiary designations
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Planning for Incapacity
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Advance Directive for Health Care
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Durable Medical Power of Attorney
Living Will
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Durable Financial Power of Attorney
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Last Will and Testament
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Special Needs Trust for Disabled Beneficiaries
What happens without
Powers of Attorney?
 Guardianship
 Conservatorship
What is Long Term Care?
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In-home care
Independent Living Community
Assisted Living
Personal Care Home
Nursing Home
Continuing Care Retirement Community
Options for Financing Long Term
Care
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Pay privately
Long Term Care Insurance
Limited Medicare benefits
Veteran’s benefits
Medicaid
Private Pay Rates in Georgia
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24 hour/day in-home skilled care can
easily exceed $100,000 per year
Average cost of assisted living is $35,000
per year
Average nursing home cost in Georgia is
$60,000 per year – more in Metro Atlanta
What does Medicare pay?
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Medicare is designed to cover acute illness –
not chronic illness
Limited home care benefit - skilled care
Limited nursing home benefit – only if move to
nursing home follows a 3-day hospital stay
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Days 1-20 in the NH are covered
Days 21-100 potentially covered with a co-pay
Basic Eligibility for VA Aid &
Attendance Benefits
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90 days of active service – one of which was in
wartime
Other than dishonorable discharge
Limited income (after deducting unreimbursed
medical expenses) and assets (<$80,000)
Permanent and total disability at the time of
application (over 65 presumed disabled)
Disability caused without willful misconduct of
claimant
VA Aid and Attendance (cont.)
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Available to a veteran or widow(er) who is
blind OR living in a nursing home OR
unable perform activities of daily living
Amounts
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Veteran with no dependents - $1,644/mo
Veteran with one dependent - $1,949/mo
Widow(er) with no dependents - $1,056/mo
Nursing Home Medicaid
Provides payment for nursing home level
care for the aged, blind or disabled
population who meet the financial eligibility
criteria
Income Eligibility Requirements
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The income of the individual seeking nursing
home Medicaid eligibility must be less than
$2,022 per month (2009 figure)
Income of the spouse of the individual in the
nursing home is not relevant in determining
eligibility
If income exceeds the $2,022 income cap, the
individual must establish a Qualified Income
“Miller” Trust
Nursing Home Payments
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“Member” is required to pay all income toward
the cost of his care at the nursing home
Exceptions:
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$50/month personal needs allowance
Cost of health insurance premiums
Spousal diversion
Incurred medical expenses
Remaining income is paid to the nursing home
Resource Allowances
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A Member may have $2,000 in countable
resources
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The community spouse may have an
additional $104,400 in countable
resources
Countable Resources
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Bank accounts
Investment accounts
Stocks
Bonds
CDs
Cash value of certain life insurance policies
Annuities
Retirement accounts
Real estate other than a homeplace
Exempt Resources
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Homeplace with up to $500,000 in equity
One car
Household goods
Burial Resource Allowance of up to
$10,000
Certain retirement accounts
Certain annuities
Transfer of Assets
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Deficit Reduction Act of 2005
Look-back period expanded from 3 years
to 5 years
Penalty period for making a transfer
begins when the individual is otherwise
eligible for Medicaid (ie, in the nursing
home and assets have been reduced to
allowable levels)
Exempt Transfers
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The following transfers are not subject to a
transfer of asset penalty
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Transfers to a spouse
Transfers to a special needs trust for a
disabled child
Transfer of homeplace to a caregiver child (as
defined by Medicaid), a sibling with an equity
interest in the home, a disabled child or a
child under 21
Estate Recovery
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Effective May 3, 2006
The Department of Community Health
(DCH) is entitled to place a lien against all
property that is owned by a Member at the
time of his death
Property passing by joint tenancy,
beneficiary designation or life estate is
subject to Estate Recovery
Estate Recovery (cont.)
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An estate recovery lien cannot be enforced so long as
there is a spouse, child under 21 or disabled child of the
member living
A lien can be placed at such time as a Member is
deemed “permanently institutionalized” (as defined by
Medicaid) but such a lien cannot be enforced if there is a
spouse, child under 21, disabled child, caregiver child or
sibling with an equity interest living in the home
Any transfers made by a Member within the look-back
period are voidable and may be set aside
Questions and Answers Surrounding
Elder Care Law
Heather Durham Nadler, Esq.
Certified Elder Law Attorney
Heather Durham Nadler, P.C.
2600 Century Parkway, Suite 100
Atlanta, Georgia 30345
(678) 916-5390
[email protected]