Navigating TennCare/Medicaid: What You Need to Know
What is TennCare? What’s the difference between that and Medicaid? How do you know if you’re eligible for it, and what can you do about it if you aren’t?
Fear not, dear reader, we’ll answer all of those questions and more as we dive into what you need to know about TennCare/Medicaid!
What is TennCare/Medicaid?
Simply put, each state has a name for its own Medicaid program. TennCare is the state of Tennessee’s Medicaid program. It’s a way of saying “Tennessee Medicaid” in fewer syllables.
In terms of what TennCare actually does, it’s a healthcare program that provides medical assistance to low-income individuals, pregnant women, children, and individuals with disabilities. It is funded by both the Tennessee and federal governments, and the primary goal is to ensure that everyone has access to essential healthcare services.
Who is eligible for TennCare?
To be eligible for TennCare, you have to meet specific income requirements and fall into a certain category. If you’re a low-income adult, a child, a pregnant woman, an elderly individual, or an individual with a disability, you’re in an eligible category. However, you still need to qualify based on your specific circumstances and resources available within the program.
Why is it important to understand TennCare?
Understanding TennCare (Medicaid) is crucial because it can provide you and your family with affordable access to healthcare services.
Most seniors are on a fixed income. The median retirement income for Tennesseans is just under $2,000.00-but the cost of a nursing home averages around $7,500 a month. Even if your loved one has savings that can be allocated toward their care, those savings can be depleted quickly. Knowing the eligibility criteria, application process, and coverage options can help ensure that those in need can receive the necessary medical care.
At Graceful Aging Legal Services, we have experience with TennCare applications. We’d be happy to discuss how you can protect your savings and your spouse while still qualifying for TennCare.
Another good resource is Tennesse Justice Center, if you’ve got any questions.
The purpose of TennCare is to make sure that you have access to essential healthcare services that help you to maintain your well-being. With that in mind, there are a wide range of medical services covered under TennCare. However, some services, like nursing home care, require further application.
- Doctor visits, hospital stays, preventative care, and emergency services
- Prescription drugs for managing health conditions
- Counseling, therapy, and other treatments for mental health conditions
- Dental and vision care
Applying for TennCare/Medicaid
Find out about the application process and what documents and identification information you’ll need to apply – and what not to do, so you can avoid delays.
Applications are no one’s idea of a good time, but they are unfortunately necessary for TennCare. Luckily, the process isn’t as grueling as it used to be. You can do it online, by mail, over the phone, or in person, so pick whatever is easiest for you. If you have questions about the process or want someone to help you through it, that’s what we do for some of our clients!
To make the process easier, prepare all of the documents and information that will be needed for your application ahead of time. That will make filling out the actual paperwork go by much faster!
Required documents and information
Documents to prepare:
- Identification documents
- Medical history
- Proof of income
- Health insurance information
Information to have on hand:
- Social security numbers of everyone applying
- Dates of birth for everyone applying
- Current income
- Current address
- Contact information
- Citizenship and immigration status
- Car and property value
- Bank and financial statements (3 months)
- Vehicle title (Kelley Blue book value)
- Life insurance policy information
Common mistakes to avoid
Mistakes mean delays or denials of coverage, so here are major mistakes to avoid:
- Providing incorrect or incomplete information
- Failing to include required documents
- Not reporting changes in income or household size
- Transferring property or making large gifts
- Sharing bank accounts and funds with someone other than a spouse
Renewing and Managing TennCare/Medicaid
Here are the key steps to renew and manage your TennCare plan.
TennCare coverage is not permanent and needs to be renewed periodically. TennCare will try to renew your coverage using the information they already have on file, but they may need further information. Keep an eye out for a renewal packet, and fill out the required information as soon as possible.
Reporting changes in income or household
It is essential to report any changes in income or household size to TennCare. These changes can impact eligibility and may require you to update your information or submit additional documents. Failing to report changes promptly can lead to complications in coverage.
If your TennCare application or renewal is denied, there is an appeals process in place. This allows you to challenge the decision and provide further information or evidence to support your eligibility. If you get to this point we recommend working with an advocate, such as a lawyer or non-profit agency like the Tennessee Justice Center.
Want to Know How We Can Help You Qualify for TennCare?
Graceful Aging Legal Services is here to help! Contact us today to set up an appointment to talk about TennCare and estate planning, or caring for someone who needs advanced care without the resources to pay for it.
Aging often comes with increased healthcare costs and healthcare costs impact everyone—regardless of income level. Miller Trusts are a legal tool that helps individuals with high income qualify for Medicaid long-term care benefits. With a Miller Trust in Tennesee, you can become eligible for TennCare even if you are over the “income cap” set by the state.
What is a Miller Trust?
The Medicaid program (called TennCare here in Tennessee) typically requires limited income to qualify. A Miller Trust is a legal arrangement designed to help those with high income qualify for Medicaid long-term care benefits. By establishing a Miller Trust, also known as a Qualified Income Trust, you can redirect your income into the trust, your income then becomes exempt from Medicaid income calculations.
Why are Miller Trusts Used in Tennessee?
Tennessee is an “income cap” state for Medicaid. That means that those who have income above the cap will not qualify for TennCare. Miller Trusts are used primarily as a tool to create eligibility for Medicaid/TennCare even when you might have too much income. There are times when assets may fall within Medicaid eligibility requirements while income exceeds eligibility limits. In this case, a Miller Trust can help.
Without a Miller Trust even when assets meet eligibility requirements, income may exceed the limits for Medicaid eligibility. By redirecting income into a Miller Trust, you can effectively reduce your income for Medicaid eligibility purposes, ensuring you can receive necessary long-term care benefits.
The Benefits of Miller Trusts
There are several key benefits associated with establishing a Miller Trust.
Qualifying for Medicaid
The primary benefit of a Miller Trust is that it allows individuals with middle to high income to qualify for Medicaid long-term care benefits. A Miller Trust provides a way to legally redirect income into the trust effectively lowering income for Medicaid eligibility purposes.
Miller Trusts also provide a means to preserve income. Instead of having to find a way to reduce your income to meet Medicaid’s income requirements, you can redirect your income into the trust. This ensures you can continue to receive your income while still qualifying for Medicaid long-term care benefits. It provides a way to maintain some financial flexibility while accessing the necessary healthcare coverage.
The Process of Setting Up a Miller Trust
The process of setting up a Miller Trust involves several key steps.
Gathering Financial Information
The first step in setting up a Miller Trust is gathering all relevant financial information. Financial information must be thorough including all income sources and other financial details to create a comprehensive financial report. An effective Miller Trust helps you meet income qualifications for Medicaid. In order for a Miller Trust to work for you it is critical to have an accurate understanding of your current financial situation.
Selecting a Trustee
The next step, in setting up a Miller Trust is to select a trustee. It is important to choose someone who possesses good organizational skills, excellent financial management, and will always prioritize your best interests. Opting for a trustee (typically a family member) who works with a lawyer who has a focus on Medicaid planning to set up the trust ensures they can adeptly navigate the intricacies involved in establishing a Miller Trust. Once the trust is established, it’s usually not too difficult to care for the account.
Creating the Trust Agreement
Once a trustee has been selected the next step is to create the trust agreement outlining the terms and conditions of the trust, including how income will be deposited into the trust and how it will be used for qualified expenses. Consulting an attorney experienced in Medicaid planning is crucial to ensure that the trust agreement is drafted correctly and in compliance with all applicable regulations.
Funding the Trust
After the trust agreement has been created and signed, the next step is to fund the trust. This involves transferring income into the trust, which will then become exempt from Medicaid’s income calculations. This typically involves setting up your Social Security to be direct-deposited to the trust account. You can likely do this online if you have an online account with the Social Security Administration.
It is essential to follow all necessary procedures and guidelines when funding the trust to ensure that it is done correctly and in compliance with Medicaid regulations. Make sure you work with a banker who is familiar with Miller Trusts to be sure that all regulations are followed and ensure that all necessary documentation is provided. Your attorney should be able to provide recommendations for banks they have successfully worked with in the past.
Meeting Medicaid Requirements
Finally, meeting all Medicaid requirements is essential. Income limits, reporting, documentation and any other Medicaid requirements must be met for a Miller trust to be effective. Consulting with an attorney with experience in Medicaid planning can help ensure all requirements are met.
Managing a Miller Trust
Once a Miller Trust has been established, proper management is essential. Here are a few key considerations.
Using Trust Funds for Qualified Expenses
The funds in a Miller Trust should be used exclusively for qualified expenses. This includes medical and long-term care costs that are not covered by Medicaid/TennCare. For example, if Medicaid covers one set of dentures every two years but you lose yours before it’s time to get a new set, you can use it to cover another set of dentures. It is important to keep accurate records of all expenses paid from the trust to ensure compliance with Medicaid regulations.
A trust can also be used for professional expenses. For example, a Miller Trust can be used to pay for legal fees.
Keeping Accurate Records
Record keeping is a vital aspect of managing a Miller Trust. Accurate records of all income deposits, expenses paid and other trust related financial transactions are necessary for proper trust management. The records are required for ongoing compliance as well as the TennCare redetermination period when you will need to submit proof that you still financially qualify for TennCare/Medicaid.
Reporting to TennCare/Medicaid
As a Miller Trust beneficiary it is important to report any changes in income or financial circumstances to TennCare/Medicaid if there is a significant increase. This includes significant increases in income sources, the amount of income deposited into the trust, and any other relevant financial changes. By keeping Medicaid informed – and by getting in touch with an experienced Medicaid attorney – beneficiaries can maintain their eligibility and continue to receive the necessary healthcare coverage.
For example, if you get a Miller Trust and then get an inheritance, you may no longer be eligible for TennCare/Medicaid. However, at that point, it would be wise to talk to an experienced Medicaid attorney, because they may be able to help you if you notify them quickly and before the inheritance is received.
Potential Challenges and Considerations
While Miller Trusts can be a valuable tool for Medicaid planning, there are some challenges and considerations to keep in mind.
Legal and Financial Implications
When establishing a Miller Trust there are serious legal and financial considerations making it vital to consult with an attorney who has Medicaid planning experience. An experienced attorney will help ensure all legal requirements are met and help you fully understand the implications of a Miller Trust.
In all cases, Medicaid will seek to recover expenses paid on behalf of a Miller Trust beneficiary from the beneficiary’s estate after their passing. In other words, anything in the Miller Trust at the end of life will go to the TennCare/Medicaid office This is known as estate recovery. It is important to understand the potential implications of estate recovery and to plan accordingly when establishing a Miller Trust.
Monitoring Eligibility Requirements
Medicaid eligibility requirements can change over time and it is important to monitor these changes to ensure ongoing eligibility. It’s in your best interest to stay informed about updates and changes to Medicaid requirements.
Consult Graceful Aging Legal Services for Your Miller Trust
Miller Trusts provide an option for individuals who have significant income and want to qualify for Medicaid long term care benefits. If you or someone you love falls into this category, a Miller Trust is an option to divert your income.
In addition to the often difficult conversations surrounding estate planning, establishing and managing a Miller Trust can be quite complex and challenging. It is advisable to seek assistance from a lawyer who focuses on Medicaid planning to navigate the process of establishing and managing a Miller Trust.
If you have more questions about Miller Trusts and would like to know if it’s a good option for you or your family, click here to schedule an initial call with our office. We’d love to work with you!
Did Michael Oher need a conservatorship? The real question behind the recent news that Oher requested (and has been granted) a termination of his conservatorship is whether or not he needed one in the first place.
Today we’ll go over the necessary criteria for a conservatorship, and what information courts need in order to grant one. We’ll cover the usual processes for putting a conservatorship in place, and look at how Oher’s conservatorship was different, based on public records available.
Who is Michael Oher?
Michael Oher’s football success began long before his rise to fame. Born in Memphis, Tennessee, Oher grew up in a disadvantaged neighborhood. Through the guidance of the adults in his life, he was able to show his football skills to the right people and become a successful NFL player. This eventually led to the publication of The Blind Side: Evolution of a Game by Michael Lewis, which was adapted into the movie “The Blind Side”.
Understanding Michael Oher’s early years is crucial to grasp the circumstances that led to his conservatorship.
Growing up in a disadvantaged environment, Oher faced numerous challenges. However, he was not without adult guidance. He moved in with the Tuohy family before his senior year of high school with the understanding that they were adopting him.
Recent news articles have made it clear that the adoption didn’t happen. Michael Oher was not adopted, even though he could have been; the state of Tennessee has laws in place that permit adult adoption, which 18-year-old Oher would have been eligible for.
Instead, Michael Oher was placed into a conservatorship run by the Tuohys.
A Quick Look at Conservatorship
There are a few finer points to conservatorship in Tennessee that are important to know.
The Purpose of Conservatorship
Conservatorship is a legal arrangement where an appointed conservator assumes the responsibility of managing the personal and/or financial affairs of an individual who is unable to do so themselves.
This legal process exists to protect vulnerable individuals, ensuring their well-being and safeguarding their interests. There have been ongoing updates to conservatorship law in Tennessee in order to guarantee that a conservatorship is in the best interests of the individual.
The conservator’s job is to manage the personal and/or financial affairs of the individual under conservatorship because they cannot perform those duties themselves. Most commonly, conservatorships are a way for adult children to take care of aging parents when they can no longer take care of themselves.
The Conservator’s Role
A conservator is tasked with making important decisions related to the individual’s well-being, which could include medical care, housing, and financial management. Their responsibilities extend to ensuring the individual’s safety, providing necessary support, and advocating for their best interests.
With the authority granted by the court, the conservator has the power to make significant decisions on behalf of the individual under conservatorship. This often includes medical decisions, which means that taking on a conservatorship requires careful consideration of the individual’s needs and preferences while adhering to legal and ethical guidelines.
Michael Oher’s Conservatorship
Since the court granted a conservatorship over Oher in 2004, the Tuohy’s have been responsible for his important decisions for the past two decades, despite Oher being a legal adult. Now he’s filed a petition to end the conservatorship, which places the motivations and processes behind the original decision under heavy scrutiny.
The big question: did the Tuohys place Oher under conservatorship to protect his best interests, or did they use it to take advantage of him? Could the guidance they provided him have been given without a conservatorship?
Initiation of Conservatorship
In order to be granted a conservatorship in Tennessee, one of two criteria must be met:
One, there has to be an emergency situation, or two, the person under conservatorship has to live with a medically evaluated disability that affects their ability to take care of themselves.
There was no emergency, urgent or otherwise, when Oher was placed under conservatorship, and there was no qualifying disability. In fact, Oher’s order specifically states that he doesn’t have a disability, which raises more questions than it answers.
Without either of those criteria being met, it seems odd that the Court found a conservatorship to be in his best interest. In addition, there was only one court hearing to review the conservatorship, and it did not involve the input of any medical experts.
They also waived the guardian ad litem, which is unusual. The guardian ad litem is an attorney appointed by the court to make a recommendation following an investigation into whether someone needs a conservatorship. They’re the safeguard on behalf of the individual, and the guardian ad litem is hardly ever waived. In the cases where it is waived, it’s typically because the person filing for conservatorship is a biological parent of a disabled adult child who has been cared for by their parents their whole life.
The fact that the guardian ad litem was waived means that there was one less person to look out for Oher’s best interests.
Problems with Oher’s Conservatorship
The main problem with Oher’s conservatorship is that he didn’t know he was under one. He’d been told it was an adoption equivalent, which it was not. When he discovered this in 2023, he started to take steps to end the conservatorship.
While it’s important for young adults to have the guidance of trusted adults, there appears to be no logical reason why Oher couldn’t have made his own medical and financial decisions, which is why this conservatorship is under so much scrutiny. Oher alleges that the Tuohy family has made money from the selling of Oher’s image and life story, which raises questions about the intention of the conservatorship.
The level of guidance and support that Oher received from the Tuohys was not a result of conservatorship. Adult adoption and even just mentoring are two common ways to provide the same level of guidance and support provided by the Tuohys without legal oversight by the courts.
Conservatorships are Intended to Improve Quality of Life
The purpose of conservatorship in the state of Tennessee is to improve the quality of life for the person under conservatorship. Since the time that Michael Oher’s conservatorship was granted, there have been some changes to the process of obtaining a conservatorship, but it is generally the same as in 2004 when Oher’s conservatorship was granted.
Today, a judge has to find that conservatorship is the least restrictive alternative for the individual. If the individual has the ability to understand and sign a power of attorney that would fulfill the same intentions of those filing for conservatorship, the conservatorship is unlikely to be granted.
Get Help Understanding Conservatorship Today
Though there are plenty of questions surrounding Michael Oher’s conservatorship, there are laws in place to prevent a situation like this from happening.
Used properly, a conservatorship can be a helpful legal process to improve the quality of life and care for your loved ones. If you want to discuss whether conservatorship may be right for your situation, Graceful Aging Legal Services is here to help. Schedule a call with us today to start the conversation about what’s best for your loved ones.
Knowing a few common terms can go a long way in understanding estate planning. For example, if you’re unsure what a trustee and an executor are, you won’t know who to choose for each (very important) role.
Let’s dive into some estate planning basics!
Common Estate Planning Terms
Planning for your estate after death helps secure the future of your assets and helps you figure out what you want and how to accomplish it. Creating an estate plan gives you peace of mind that your wishes will be respected upon your passing – even if your loved ones may be unhappy about it.
An estate plan can also reduce tax obligations for your family and prevent or minimize family conflicts. A will is a significant part of the estate planning process. Wills outline how you want your assets to be distributed, who should take care of any dependents, and who will carry out your wishes.
When learning about estate planning, there are some terms you’ll need to know, including:
- Probate – the court process that validates wills and administers the estate
- Executor/Executrix – the person named in a will to manage estate assets
- Trust – a legal tool used for managing assets, often in order to avoid probate
- Trustee – the person named in a trust to manage trust assets
- Intestate succession – a situation where no will exists, and heirs are determined by state law
- Personal Representative – the person who administers an estate (this is the umbrella term used in Tennessee for executors, etc.)
- Guardian – a person who is named to oversee the needs of a minor child
- Beneficiary – someone who is specifically named to inherit
- Heir – someone who inherits based on their family relationship
Understanding these terms will help you make decisions that protect your legacy.
Creating a Will and Trust
Creating an estate plan can involve the use of wills and trusts.
A will outlines how you want your assets to be distributed after death, who should take care of your children, and who will handle the administration of your estate. However, the purpose of a will is to go to probate. When drafting a will it’s crucial to consider factors such as family dynamics, non-probate assets, and the potential for disputes.
On the other hand, trusts provide added benefits like privacy and flexibility. When well-funded, it bypasses the need for probate proceedings. Even without lots of funding, trusts enable you to better control how your assets are managed during your lifetime and after you pass away.
Whether you choose to have a will or trust is a personal decision, but setting up a trust can offer advantages such as increased control over asset distribution, continuity in managing your estate affairs, and potential tax benefits. Sometimes, it’s a good idea to have both!
Appointing Executors and Trustees
If your estate plan involves a will or trust, it is crucial to appoint executors and trustees.
An executor (or personal representative) is responsible for carrying out the terms of the will. For example, an executor must distribute assets and handle obligations during the probate process. It is important to choose someone with integrity, conflict-resolution skills, and financial knowledge. Since you won’t be there to smooth out any disputes that arise, choosing a capable peacemaker is a must.
Trustees, on the other hand, oversee trusts. They ensure that assets are managed according to your instructions for the benefit of beneficiaries. It is advisable to select a trustee with expertise in finance who’s committed to fulfilling your wishes. In other words, pick someone you can trust as your trustee.
Good options for executors or trustees may include attorneys or financial institutions, since they are generally impartial and have specialized knowledge. By ensuring reliable individuals or entities fill these roles, you can safeguard your intentions for properly managing your estate.
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We’re just scratching the surface of what estate planning is. If you’d like to learn more about planning your estate and aging gracefully, sign up for the Graceful Aging Legal Services newsletter. We’ll send you regular updates and insights into estate planning, conservatorship, and more!