Planning for Life

What is Settlement Planning?

Posted by Harry S. Margolis on April 1, 2020

 
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A settlement or award of damages in a personal injury case means the end of litigation. It’s the biggest step – but only the first step – in assuring your financial future. You need to make sure that the award is maximized, that the funds are safeguarded, and that you preserve your eligibility for public benefits. This involves a number of issues, including:
 

Resolving Liens – Personal injury settlements and awards to minor or disabled plaintiffs are often subject to claims by Medicare, Medicaid (MassHealth), or private insurers. These must be resolved prior to any distribution of funds. It's often best that this be done as part of settlement negotiations, because a lien holder—the state, federal government, or insurance company—has an incentive to help the case settle. Your personal injury attorney will resolve any of these liens as part of the litigation.

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Topics: Medicare, special needs planning, MassHealth, personal injury settlement

Attorney Sarah Hartline Gets MassHealth Transfer Penalty Overturned

Posted by Estey Silva on March 24, 2020

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The MassHealth Board of Hearings ruled in favor of Attorney Sarah Hartline’s client last week in a case involving a transfer of assets from a nursing home resident to her son and a question of whether the transfer was done with the intent to qualify for MassHealth benefits, which would result in a significant disqualification period.

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Topics: nursing homes, Massachusetts, MassHealth, elder law, Medicaid, disqualifying transfer

5 Common MassHealth Myths & Misconceptions

Posted by Patricia C. D'Agostino on February 18, 2020

 

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With so much at stake, planning — and paying — for long-term care services such as assisted living or nursing home stays can be a confusing and anxiety-ridden process. Medicaid (known as MassHealth in Massachusetts) provides coverage for long-term care costs, including comprehensive coverage for skilled nursing home care and supplemental coverage for the cost of assisted living and home health care, but there are some common misconceptions about what MassHeath does and does not cover and who is eligible.

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Topics: nursing homes, MassHealth, Estate Planning, financial planning, Medicaid, MassHealth lien

Court Rules MassHealth Must Return Annuity Payments

Posted by Harry S. Margolis on February 4, 2020

By Harry S. Margolis

Annuity-MassHealth-long-term-planning-attorney-Wellesley-MA

A common MassHealth planning technique for spouses of nursing home residents to protect assets is to purchase a qualifying annuity to shelter their assets above the spousal asset limit of approximately $130,000. (Read our legal guide Using Annuities for MassHealth Planning for Nursing Home Residents.) In order for such purchases not to be treated as disqualifying transfers, they must be "actuarially sound" and must name the Commonwealth as the remainder beneficiary "for at least the total amount of medical assistance, paid on behalf of the institutionalized individual."

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Topics: MassHealth planning, MassHealth, annuities

How Does MassHealth Calculate Life Estates?

Posted by Harry S. Margolis on November 12, 2019

By Harry S. Margolis

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Life estates have long been a prime long-term care planning device for protecting the home from MassHealth estate recovery because they're quite simple to create. MassHealth recently changed its rules in terms of how it measures life estates when they are created or when property held in a life estate is sold.

What is a Life Estate?

A life estate is a form of joint ownership of real estate where ownership interests are divided by time. The so-called "life tenant" has the right to occupy the property during his or her life and to collect any rental income earned from the property. The life tenant also has the obligation of maintaining the property.

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Topics: MassHealth planning, MassHealth, life estate

Now or Never, MassHealth to Close Door on Pooled Disability Trusts

Posted by Harry S. Margolis on September 17, 2019

By Harry S. Margolis

pooled-disability-trusts-elder-law-attorney-Wellesley-MA

Nursing home residents and their families have long used pooled disability trusts to shelter funds for their future needs that are not covered by MassHealth. These may include extra therapies or medical care, entertainment, hiring geriatric care managers, or the costs of maintaining a home. The funds can also be used to pay nursing homes for any gaps in coverage by MassHealth that sometimes occur.

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Topics: MassHealth, disqualifying transfer, pooled disability trust

Is MassHealth Really a State Budget Buster?

Posted by Harry S. Margolis on July 16, 2019

By Harry S. Margolis

Masshealth-elder-law-attorney-Wellesley-MA

At a cost to the Commonwealth of almost $17 billion in fiscal year 2019, MassHealth makes up 36% of the total state budget. But according to a recent report from the Massachusetts Budget and Policy Center (MassBudget), about half this expense is reimbursed by the federal government, bringing net MassHealth costs down to $8.4 billion, just under a quarter of the state budget net of federal contributions.

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Topics: MassHealth

D'Agostino Wins MassHealth Trust Case

Posted by Harry S. Margolis on June 10, 2019

By Harry S. Margolis

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The MassHealth Board of Appeals recently decided a case involving real estate held by a trust in favor of Patricia D'Agostino's client, a current nursing home resident who had sought coverage beginning in December 2017. The trust had been created by the client's now-deceased husband back in 1995 and held two vacation rental properties.

The Trust in Question

At issue were two provisions in the trust. The first gave the client the right to use and occupy the vacation properties and to receive the net rental income. The second permitted the dissolution of the trust upon agreement of all the beneficiaries and the sale of the trust property with the proceeds being paid to the beneficiaries listed on "the then current schedule of beneficiaries," the couple's children.

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Topics: trusts, MassHealth, vacation house

The Facts on Alzheimer's Disease and Other Forms of Dementia

Posted by Harry S. Margolis on April 2, 2019

By Harry S. Margolis

The Alzheimer's Association has released its annual report, Alzheimer's Disease Facts and Figures, which as usual contains some daunting figures, especially as Baby Boomers age and we hear the latest news story of an unsuccessful drug trial. Here are some of the results:

  • 5.8 million Americans have been diagnosed with Alzheimer's disease, which is projected to increase to 14 million by 2050.
  • The annual cost of the illness is $290 billion, which is projected to rise to $1 trillion by 2050 (in current dollars). Medicare and Medicaid currently pay $195 billion of this cost.
  • More than 16 million Americans provide unpaid care to family members with Alzheimer's or other forms of dementia providing an estimated 18.5 billion hours of care valued at $234 billion.
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Topics: dementia, MassHealth, Alzheimer's disease

Court Faults 'Arbitrary and Capricious' MassHealth Hearing Decision

Posted by Harry S. Margolis on December 26, 2018

By Harry S. Margolis

MassHealth-asset-transfers-elder-law-attorney-Wellesley-MA

In the case of Pauline Coko vs. Daniel Tsai, Director of the Office of Medicaid (Essex Sup. Ct. CA No. 2018-00071-A, December 13, 2018), Judge Timothy Q. Feeley faults the arbitrary and capricious conduct of a MassHealth hearing officer in imposing a 193-day transfer penalty for four transfers by Pauline Coko totaling $68,632 in value.

Disqualifying Transfers

The transfers in question included a deed of Mrs. Coko's life interest in her home to her daughter, two disbursements from Mrs. Coko's bank account, and the gift of her 2003 Mitsubishi valued at $1,365 to a granddaughter.

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Topics: MassHealth, disqualifying transfer

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