Planning for Life

The Trump-Ryan Plan for Medicaid Moves Towards Block Grants

Posted by Anthony Bushu on March 22, 2017

By Harry S. Margolis

10-donald-trump-paul-ryan.w710.h473.jpgWith the release of the House GOP plan for repealing and replacing the Affordable Care Act, the American Health Care Act, we can now begin moving from conjecture to reality, though much still remains uncertain. This article will focus on the proposed changes to Medicaid and how they could affect seniors and people with disabilities.

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Topics: long-term care planning, MassHealth, Medicaid

Questions & Answers on Protecting the Family Home

Posted by Anthony Bushu on February 1, 2017

By Harry S. Margolis

I recently conducted a webinar surveying the various techniques clients can take to protect their home from the costs of long-term care. These ranged from standing pat and doing nothing to giving their home to their kids, with life estates, irrevocable trusts and purchasing long-term care insurance as in-between strategies, each with its own pros and cons.

Afterwards, I received a number of follow-up questions. Here are some of them with my answers:

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Topics: MassHealth planning, MassHealth

MassHealth Seeking to Limit Use of Pooled Trusts

Posted by Anthony Bushu on January 11, 2017

By Harry S. Margolis

MassHealth has proposed massive changes to its regulations governing long-term care, both in the community and in nursing homes. Many of these are complicated, but could adversely affect many seniors in the state. One that's not so complicated is a proposal to limit transfers to pooled disability trusts.

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Topics: long-term care planning, nursing homes, MassHealth

What Does a Trump Presidency Mean to Estate and Long-Term Care Planning?

Posted by Harry S. Margolis on November 22, 2016

By Harry S. Margolis

The election of Donald Trump along with Republican control of both houses of Congress undoubtedly will impact tax and benefit laws that affect citizens in their personal lives and in their estate and long-term care planning. The question is how? We can't answer for certain since during his campaign the president-elect stayed away from specific policy proposals. But there's still a lot we can glean both from what he has said and from Republican policies, especially those of Speaker of the House Paul Ryan. On the domestic front, Ryan appears much more radical than Trump in many ways.

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Topics: Medicare, social security, MassHealth, capital gains taxes, capital gains, estate taxes, Medicaid

SJC Picks Up Two Irrevocable Trust Cases for Review

Posted by Elizabeth Stepakoff on November 8, 2016

By Sarah Hartline

Earlier this year, we reported on two Superior Court decisions both involving irrevocable trusts created for long-term care planning purposes, Daley and Nadeau. In both cases, the Superior Court sided with MassHealth and upheld their decision to deny the applicant’s MassHealth application due to assets in an irrevocable trust, in both cases created by the applicant more than five years prior to the MassHealth application.

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Topics: MassHealth planning, MassHealth

MassHealth Planning and Real Estate

Posted by Harry S. Margolis on October 11, 2016

I. MassHealth Eligibility and the Family Home

A. Long-Term Care Planning

For all practical purposes, in the United States the only "insurance" plan for long-term institutional care is Medicaid (called “MassHealth” in Massachusetts). Medicare only pays for approximately 20 percent of nursing home care in the United States. Private insurance pays for even less. The result is that most people pay out of their own pockets for long-term care until they become eligible for MassHealth. While Medicare is an entitlement program, MassHealth is a form of welfare -- or at least that's how it began. So to be eligible, you must become "impoverished" under the program's guidelines.

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Topics: long-term care planning, MassHealth

Using Annuities in MassHealth Planning for Nursing Home Residents

Posted by Harry S. Margolis on October 4, 2016

By Harry S. Margolis

Immediate annuities have long been used in long-term care planning as a means of transforming assets that are countable against the limits for MassHealth eligibility into an income stream that does not affect eligibility. This primarily benefits spouses of nursing home residents, but can be used for single nursing home residents as a form of “arbitrage,” in effect to pay the MassHealth rather than the private-pay rates charged by nursing homes. 

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Topics: MassHealth planning, long-term care planning, MassHealth

ABLE Accounts are Open for Business!

Posted by Karen Mariscal on August 4, 2016

This could be life-changing for your disabled loved one

For the first time, many people with disabilities (and their parents) can open special savings accounts in which they can save money (and have the use of more cash) without jeopardizing their government benefits.  Ohio, Florida, Nebraska and Tennessee have all launched ABLE accounts, based on the 2014 ABLE (Achieving a Better Life Experience) Act.

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Topics: MassHealth, Intellectually Disabled, disability

MassHealth Imposing Asset Limit on Community Spouse of Frail Elder Waiver Applicants in Fall 2016

Posted by Patricia C. D'Agostino on July 18, 2016

We anticipate a significant change coming this fall for married elders seeking eligibility for the Home and Community-Based Services (HCBS) waiver in Massachusetts.  The Commonwealth is very likely to begin imposing an asset limit of $119,220 for the community spouse of HCBS waivers.  There is currently no asset limit for the community spouse of applicants for the HCBS waiver.  This will apply to new HCBS applicants and HCBS waiver applicants who started receiving benefits beginning January 1, 2014. 

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Topics: MassHealth

Expanded Estate Recovery NOT included in House Committee on Ways and Means FY 2017 Budget Recommendations

Posted by Elizabeth Stepakoff on April 26, 2016

By Patricia C. D'Agostino

We are happy to report that the House Committee on Ways and Means did not include Governor Baker’s proposal to expand Medicaid estate recovery. As previously reported, the Governor’s proposed provisions would allow MassHealth to make claims against all property in which the deceased MassHealth member had an ownership interest immediately prior to death. This would include property passing by survivorship or beneficiary designation to a spouse or child that was held in joint names, life estate, tenants by the entirety or living trusts. Current law limits estate recovery to the probate estate of a deceased MassHealth member – meaning the Commonwealth could recover if the deceased member owned their home in his or her name alone.

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Topics: Massachusetts, MassHealth

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