Planning for Life

By Harry S. Margolis

Here's a note I recently received from one of the other attorneys in our office:

Was just on the phone with a client who worked with you in 1989. He came back in when his Dad died in 2005 and again now that that his Mom has died at age 102. His Mom had been in a nursing home covered by MassHealth. The house was protected with a life estate deed and $200,000 in savings was protected in an irrevocable trust. Nothing is going through probate and everything will receive a step-up in basis. Thought you would like to know you did a great job in 1989 and despite all of the changes in the law, it still worked. (Also I was in 4^th grade then, just saying, the firm does have longevity.)

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, Last Week Tonight with John Oliver, the host 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 we probably won't know when it's voted on, since Senator Mitch McConnell says his plan is to release it and call a vote before the end of next week.

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.