Articles Posted in Caregiving

The best time to plan for long-term care is when you are mentally and physically well. While it is a task often avoided, thinking about how you wish to be cared for when you become older or are suffering from an illness or incapacitation is important for you and your loved ones. The only way to ensure that your wishes are followed is to write them down and communicate them to others.

People live longer these days even with serious illnesses and various stages of incapacity. There are steps you should take to plan for any potential future period of incapacitation to protect your finances and the ability for your family or loved ones to afford to care for you as you get older and in need of assistance to care for yourself. A catastrophic accident or medical emergency may alter the course of your life forever. Once these acts occur, you may or may not be in the position to make decisions for yourself. Having a plan will help your family and you focus on healing and living again.

To guide your thoughts, begin by thinking about the answers to the following questions:

The popular adage that the only two things that are certain in life are death and taxes is a good starting point as we begin our discussions on the topic of the possibility of the claw back of gift transfers under the 2017 Tax Cuts and Jobs Act.

According to the Internal Revenue Service (IRS), an estate tax is a tax on an individual’s right to transfer property (cash, real estate interests, or other holdings) at his or her death. An accounting of everything owned on the date of death is made and a tax is levied. This tax can greatly reduce the value of the overall estate, cutting the value of the gifts bequeathed in the will, because the tax must be paid before the gifts made in the will can be disposed.

A method people use to reduce the imposition of the estate tax is to make a gift of money or property to someone during an individual’s lifetime. This gift however may subject the person giving the gift called a donor to federal gift tax. Each year, donors are permitted to make gift transfers that are tax free if they are made under the threshold limit. For example, in 2019, the gift tax exemption amount is $11.4 million. By making a transfer by gift under the threshold limit, the donor and estate avoid paying taxes on that portion of the estate.

We are examining proposals at various stages of the legislative process to expand Medicare and Medicaid healthcare coverage to either provide universal healthcare coverage to all Americans or expand eligibility of individuals currently not covered by the Affordable Health Care Act.

Our last post examined two proposals to expand Medicare and Medicaid by introducing universal health care coverage or allowing individuals to buy a private plan using Medicare and Medicaid efficiencies and cost-savings to Americans.

Elimination of employment-sponsored healthcare plans

Medicare at 50 is a bill currently making its way through Congress that would allow anyone over 50 to buy into Medicare. Proponents of the bill want people between the ages of 50 and 65 to be able to purchase a private Medicare health insurance plan and obtain the same tax credits and cost-sharing subsidies as those offered under the Affordable Healthcare Act.

Medicare is a national health insurance program for Americans 65 and older that helps individuals pay for medical care and treatment, including hospitalizations, nursing home care, prescription drugs, and medical supplies and equipment, among others, as they age and retire. Medicare is not free. Seniors pay an annual deductible and are responsible for co-payments and part of their prescription bill.

By and large Americans, of all ages and political denominations, are worried about the availability and affordability of healthcare services. Individuals able to retire are postponing retirement in order to maintain employer sponsored healthcare. Especially if there is a spouse suffering from a chronic illness, the working spouse may need to maintain an employer-sponsored health insurance plan to keep a younger spouse insured.

More so than any physical transformation, memory loss is one of the most severe consequences of aging. Aging at its core, affects how information is processed in the brain. Older people are often told that they are slow – in thought and in movement. While it is true that it may be more difficult to move, see, or hear as people age, people are surprised to learn that their senses are also slower and continue to slow down as they age.

Changes in memory storage and retrieval

According to Dr. Mark E. Williams, changes in memory storage and retrieval of information occur for all age groups as human beings mature and age. Over time however, recall gets worse. Recall involves the searching and retrieving of factual information.

Entering into a nursing home or other residential skilled care facility can be hard enough on a beloved older family member without having to worry about having to leave that facility and moved into another one. Unfortunately, this is a reality all too many seniors face these days as nursing homes do not always make guarantees about being able to offer the type of care the individual needs to live a comfortable, dignified life.

Fortunately, Continuing Care Retirement Communities (CCRC) are able to guarantee residents a lifelong place to live without having to worry about transfering to a new and unfamiliar environment due to factors outside of his or her control. CCRCs offer the entire residential continuum, from independent housing to assisted living to round-the-clock nursing services, under one roof to allow residents to remain in place and create a stable living environment.

These types of arrangements allow residents to age in place and typically work by having the individual pay a an entry fee and an adjustable monthly rent in return for the guarantee of care for the rest of their life. CCRCs also maintain an assortment of on site medical and social services which allow residents to live in one part of the community while in good health and then transfer to another part of the community better equipped to handle lifestyle and health changes.

The Internal Revenue Service recently issued a notice to people with disabilities who are employed that for the first time they can now deposit extra money into their ABLE accounts without losing Social Security, Medicaid, or other government benefits. Annual contributions to ABLE accounts are currently capped at $15,000 but under new legislation passed in late 2017 individuals with disabilities who are employed may now accrue at least some of their wages as well.

This year, Americans living in the lower 48 states may now deposit an additional $12,140 from their income which means workers with disabilities are allowed to save up to $27,140 in their ABLE account in 2018. Hawaii residents can save an additional $13,390 and Alaska residents can save an additional $15,180, according to the release put out by the IRS this month.

Additionally, the IRS has announced that workers with disabilities and an ABLE account may now qualify for a Saver’s Credit to help reduce their federal tax bill. Formerly known as the Retirement Savings Contributions Credit, the Saver’s Credit gives special tax breaks to low and moderate income taxpayers saving for retirement. The Saver’s Credit can be taken for contributions to a traditional or Roth IRA, a 401(k), SIMPLE IRA, SARSEP, 403(b), 501(c)(18) or governmental 457(b) plan.

Having a last will and testament is something that every single person needs to have, regardless of how substantial or modest they feel their estate may be. This because a last will and testament does much more than spell out who receives what part of an estate. A last will and testament can and should go on to set out contingencies for many practical scenarios and life events that the average person can find himself or herself in.

First and foremost, a last will and testament allows individuals to direct portions of their estate to whomever they choose. When individuals pass away without a will it is known as intestacy and will be distributed according to the laws of the state where that person resides. Generally, this means that the deceased’s property will be distributed among his or her immediate family, regardless of what his or her final wishes would have been.

Once a person passes away, his or her estate will generally need to pass through probate court, known in New York as Surrogate’s Court. Without a last will and testament, this process can be more costly and time consuming than if the deceased had clearly expressed to the court his or her final wishes on how to divide the estate in question.

Medicare helps seniors pay for a whole host of mental health treatment services, including both inpatient and outpatient treatment services to help diagnose and treat mental health conditions. Depending on the type of care needed, beneficiaries may incur some out of pocket costs, including deductibles, and are subject to some limitations on the length of treatment you can receive at in patient centers.

Medicare Part A will cover inpatient mental health services at either a psychiatric hospital or a general hospital, depending on the type of care determined by the primary care doctor. Medicare will cover up to 190-days of treatment at a psychiatric hospital during a person’s lifetime and may cover additional inpatient care at a general hospital if necessary.

When receiving inpatient care with Medicare Part A, beneficiaries will need to pay an out of pocket deductible before they enter the facility. As of 2018, that cost is estimated to be $1,340. After paying the deductible, Medicare Part A will pay the first 60-days of inpatient treatment in full. The next 30-days require the patient pay a daily co-insurance of $355 and the remaining 90-days require a daily co-insurance of $670.

If you have a beloved elder who currently needs or will eventually need long term, in-home health care, you need to know about new changes to federal labor laws that may not only raise the cost of these services but potentially alter quality aspects. In addition to federal labor and wage laws, state and even local laws may impact what you pay for in home health care and who provides it.

When a person suffers from dementia, alzheimer’s, or or another cognitive health condition, he or she will likely need the aid of a home health care aide to provide even the most basic of care needs. For many years, home health care providers who also lived in the patient’s home were subject to different portions of the federal Fair Labor Standards Act (FLSA) which made them exempt from overtime and would essentially earn less than minimum wage because the individual was expected to be on call even during the evening.

However, a recent legal decision determined these in-home health care workers were not overtime exempt and must be paid one and a half times their average hourly wage when working more than 40-hours per week. This meant that it became economically feasible for many families to maintain constant care to their loved one from a familiar person that could be counted on to provide attentive, individualized service to the patient.

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