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.

How many times have you or someone you know said, “I’d rather be dead than in a nursing home.” When the statement is made, it is usually in good fun and easy to laugh about it. Not only is the speaker at the height of his or her mental and physical powers, but those around them, that hear the statement, acknowledge internally that well yes, such and such will not do so well living in a nursing home. From that revelation there is a short line to the conclusion that because of such and such’s personality nursing home residency will not work.

The flaw in these revelations is that most people do not voluntarily choose to enter a nursing home, even those with strong personalities. A medical reason is a prerequisite to admission. Even when medically necessary, many people fight the move. Especially the strong personalities, no sooner are they placed in a nursing home that discussions quickly turn to hatching up an escape plan.

Across the country, individuals living in nursing home facilities close to their homes in small towns are facing the prospect of having to move to another nursing home facility because their current facility is closing.

Following the death of a loved one, most people would rather think of anything else than finances, assets in an estate, or something besides the memories of the person who passed away and left our lives. However, the time will eventually come when the person named as the executor to the deceased’s estate will need to begin the probate process and divide assets among heirs and settle any outstanding taxes and debts.

Sometimes, it may take a family effort to account for assets and pass the estate through the probate court, making cooperation and understanding all the more vital to moving along with a process during and already difficult situation. However, the responsibility to pass the estate through probate will ultimately fall onto whoever was appointed as the executor of the estate in the last will and testament of the person who passed away.

First, any valuable property will need to be secured and accounted for as these items may be listed in the deceased’s last will and testament to be distributed amongst heirs, family, and friends. This should be done as soon as possible as it may be more difficult if surviving relatives help themselves to the deceased’s property while under the impression it may have been promised to them but otherwise not recorded in the will.

For a lot of people, vestin a power of attorney in another individual is one of the most important aspects of estate planning they may have to undertake, possibly even more important than drafting a last will and testament. This is because a power of attorney, sometimes referred to as a durable power of attorney, is charged with making financial and health care decisions on another’s behalf in cases where that individual is unable to do so.

Without a power of attorney, families will need to wait for a judge’s order to appoint a guardian over their loved one’s affairs in the event he or she becomes incapacitated. This can result in increased legal and emotional hardships on family members coping with an already difficult situation. The utility of powers of attorney is that they do not take effect until an individual is incapacitated but when they do, these power take effect right away.

One common question folks have about powers of attorney is whether their rights are diminished in any way by vesting authority in another person to make financial decisions. Granting another person power of attorney over one’s affairs does not limit one’s rights in any way, the authority simply gives the other person the power to act when or where one cannot. That being said, it is extremely important to choose someone you can place your trust in.

Having a well through out, defined estate plan is one of the most important things we can do for ourselves and our families during our life. Without an estate plan, your assets may be thrown into the uncertainty of probate court and legal challenges from interested parties that may feel they are somehow owed part of your estate. Those are just some of the very good reasons to have an estate plan and one that includes more than just a last will and testament.

For starters, an estate plan should include a revocable or “living trust” to pass assets onto friends and family while avoiding probate. Sometimes referred to as an “inter vivos” trust, it is a legal document through which assets are placed into a trust for your benefit during your lifetime and then transferred to designated beneficiaries at your death by your chosen representative, called a “successor trustee.” They are called revocable living trusts because they can be amended at any time and are created during the grantor’s lifetime.

Next, your estate plan will require a last will and testament to pass on any personal or sentimental items not covered by the trust. The will can also give specific instructions for when and how these assets are to be disbursed as well as give surviving family members clear burial instructions and otherwise pass on any other sentiments that are wished to be expressed.

A recent study by Merrill Lynch and Age Wave found that almost half of Americans over 55, have no idea what will happen to their assets when they die because they don’t have an estate plan or will. People often put off planning their estate because they are not ready to contemplate their morality or to make the difficult decisions about their medical care and treatment in the event of incapacity because of a mental or physical disability. The subject is difficult. However, without an estate plan your family is in for a rough ride.

The study identified stumbling blocks that prevent people from creating a will or engaging in estate planning include:

  • Spouses with children cannot agree on who should be appointed guardian in the event of their death.

Marie Kondo, an organizing consultant, has taken the world by storm with her two-step approach to tidying up in her best-selling book, The Life-Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing. First, she encourages people to one-by-one hold in their hands everything they own. Once in their hands, people should ask themselves if the item sparks joy. If it doesn’t, Kondo’s approach thanks the item for its service and then puts it in a trash pile. Second, once people identify which of their possessions gives them joy, they should place it in a visible and accessible place. Only then, will adherents to this method, experience the magic of tidying up once and for all.

We thought about this concept and how it can be used to help plan an estate. Planning an estate is a hard and uncomfortable process. It asks you to contemplate your mortality. At the end of the process you have not thrown anything out, but simply begun a process to transfer one of your possessions to someone else. While your family and friends may have a joyful reaction to receiving your beloved cabin home in Maine, that joy will be sparked by your own death. What follows are lessons we learned when we applied Kondo’s tidying up approach to estate planning.

Step One: A proper estate plan will determine what will happen to your property and how your assets will be distributed in the event of your death. It will also consider how decisions will be made regarding your medical care and treatment and finances in the event of mental or physical incapacitation. With the former, you will need to clearly articulate your wishes about your medical care. With the later, one by one, you will need to consider your property and assets and determine what will happen to it when you die. Gifts can be made to family members, friends, charitable organizations, and other testamentary instruments, like a trust.

Family disputes often arise in the estate administration process. Especially if there is money at stake, a disgruntled family member or other interested person may be unhappy with his or her inheritance, or lack thereof. A personal representative of an estate or trust may be forced to deal with a challenge brought by one of them.

When the estate itself is illiquid, difficulties arise that when challenged often mean less is available for distribution when the dispute is ultimately resolved because of the simple fact that the asset cannot be divided but instead must be sold to be distributed. The sale and challenge are an additional cost that gets paid by the estate before an asset can be distributed. When an estate plan (a will or a trust) is challenged, the three most common reasons are listed below.

A challenge to the validity of the estate planning documents is often initiated by a disinherited family member or someone who believes, rightly or wrongly, that they are receiving less than what was gifted. A challenge to the administration of the estate or trust is really a complaint against how the personal representative is handling the administration of the estate. Usually in these scenarios, an interested party alleges that the personal representative is not doing his or her job, is using the estate or trust assets for the personal representative’s own benefit, or is acting against the beneficiaries’ best interests. The third scenario is a challenge to both the validity and the administration of the estate or trust.

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