Planning for Life

By Harry S. Margolis

System Failures in the United States

The coronavirus pandemic and murder of George Floyd have laid bare the failures of public health and policing in the United States. Those failures are not news. We've known that we spend much more per capita on health care than any other nation with uneven results and a system where a health event can bankrupt a family.

By Harry S. Margolis

In an recent article in The Boston Globe, "As costs mount, states scramble for new ways to pay for late-in-life care," reporter Robert Weisman describes initiatives in states around the country to pay for the growing costs of caring for seniors around the country. While the average cost of care for older Americans will be $266,000 according to one projection, only 7% of Americans over age 50 have long-term care insurance. This huge gap falls both on individual families and state Medicaid programs, MassHealth in Massachusetts.

By Harry S. Margolis

In the combined cases of Jean Maas v. Mary Lou Sudders (Suffolk CA No. 18-129-D) and Henry Hirvi and Eva Hirvi v. Mary Lou Sudders (Suffolk CA No. 18-845-D), Superior Court Judge Douglas H. Wilkins finds that in denying applications for MassHealth benefits in cases involving trusts, MassHealth fails to satisfy the requirements of federal regulation 42 C.F.R. sec. 431.210 (b) that it explain the reasons for the denial.

By Harry S. Margolis

On his HBO show, John Oliver , Last Week Tonight with John Oliver, provided a scary and funny explanation of how guardianship works, ending with a public service announcement by William Shatner, Lily Tomlin, and others explaining steps you can take to avoid the guardianship.

By Harry S. Margolis

Everyone who is retired or considering retiring faces the question of whether they have enough money, especially now that few people have pensions that pay for life. This involves a number of unknowns, including how long they'll live, their investment returns, and their living costs. But the biggest uncertainty is whether they'll need long-term care.

The Query

Following are excerpts from an email I recently received from a long-time client:

The only thing that frightens me is that I will run out of funds sooner than later. Let me reassure you first of all. I feel fine, in fact I’m in very good health, active, living independently, driving, traveling, socializing, etc etc. I’m now 88 years old (89 in January) and people “can’t believe how well I look”!

By Harry S. Margolis

In his most recent personal finance column, New York Times reporter Ron Lieber addresses "The Ethics of Adjusting Your Assets to Qualify for Medicaid." As Lieber explains in this and prior articles, Medicaid has become the primary source of payment for long-term care services in the United States. But it is essentially a health care program for the poor and has set asset, and sometimes income, limits for determining if someone is poor enough to qualify for benefits.

By Harry S. Margolis

I generally try to avoid politics in my blog posts, but sometimes politics invade my field of long-term care planning. At this writing, the Republican leadership in the Senate is crafting its own version of Obamacare repeal. We don't know what it will look like, and 

By Harry S. Margolis

I recently received the following inquiry from a colleague:

I’m working with a client whose mother has been self-pay in a nursing home for several months as she spends down her savings. They applied for MassHealth in January and they anticipate she’ll run out of funds by mid-March. There’s the possibility that they will incur a penalty period since in June 2012, their mother gave about $80k to her daughter.

My understanding is that the lookback period is 5 years and that period begins on the date the application was filed, as opposed to when she will become eligible for Medicaid once her money is spent down. Is that understanding correct? The family just needs to know what to expect and is considering asking the sister to recoup the cost but wishes to avoid undue conflict if possible.

By Harry S. Margolis

A life estate is a deed that divides ownership by time. The "life tenant" has full rights to the property during his life, but at his death, full rights pass to the "remaindermen." Both the life tenant and the remaindermen are owners of the property, but their interests are different.

By Harry S. Margolis

Okay, this is somewhat self-serving. As an elder law attorney, my firm and I advise clients on how they can plan to be eligible for MassHealth coverage of their long-term care. But many seniors and their families don't use lawyers, whether for long-term care planning or assistance with the MassHealth application, often because they're afraid of the cost. Some take steps based on what they've heard from others, some do nothing, and others enlist non-lawyers to assist with MassHealth applications, often referred by nursing homes.

Here's a few reasons to use an elder law attorney instead: