How do I qualify for Medicaid?

Long-term care is expensive

Many people have sufficient income to maintain a regular lifestyle but are unable to afford the high cost of long-term care. With the average cost of long-term care around $7,000.00 a month, it is incredibly difficult for most families to afford it, even more so after retirement. That’s why it’s a good idea to plan for qualifying for TennCare, also known as Medicaid.

Evaluate and restructure your assets to qualify for TennCare

do you know how to qualify for tenncare? Image is of a man in a long-term care facility. He is taking a walk with a nurse and his partner.
It’s worthwhile to know how to qualify for TennCare

As we discussed in our blog last week, there are certain criteria you need to meet to be eligible for TennCare. As an elder law attorney, one of my jobs is to help families get their loved ones qualified for TennCare while maintaining resources available for the rest of the household.

One of the ways that we do this is by restructuring a family’s assets. We do this by turning resources that are countable for TennCare purposes into items that TennCare does not count as part of its eligibility assessment

This process is known in the elder law community as a spend-down. The goal of the spend-down is to make you or your loved one eligible for TennCare as far as your assets are concerned. If you are overqualified for income-based criteria, we can use a special type of trust called a Qualified Income Trust, or a Miller Trust, to reduce your income. The goal of a spend-down is to maintain the quality of life for all family members including those who need long-term care. 

Image of a scooter as a mobility device. Buying a scooter is a good way to spend down your assets to qualify for tenncare
Bob might benefit from purchasing a quality mobility device

What is a “spend-down”?

For example…

Bob needs to go into long-term care. Bob is eligible based on his income. He makes $2,000.00 a month of social security retirement income. Bob also has a house, a car, and $50,000.00 in the bank. Bob is widowed and his children are adults. 

We need to do something with at least $48,000.00 from Bob’s bank account in order to make him eligible for TennCare. His house and his car are not countable for TennCare purposes in most cases. What can we do? 

  • Make improvements to his home that would improve his quality of life and access to the things that he needed in the home. This might include: 
    • Grab bars in the shower or hallway.
    • A ramp into the main entrances.
    • Paving the driveway or expanding it closer to the door 
    • Widening doors 
  • Buy some things for Bob that his Medicare did not cover, such as:
    • Hearing aids
    • Dentures
    • Eyeglasses
    • Top of the line mobility devices 

There may be other things that would improve Bob’s quality of life. There are things we can spend money on or convert into income. I am also going to suggest to everyone that they use the money to make arrangements for end-of-life needs if they have not done so already. Since at some point Bob’s children will need to make arrangements for his burial or cremation, paying for it now from his excess funds is a great way to make those funds unavailable for TennCare purposes and meet a future need. 

image of a smiling older gentleman sitting with his daughter. Do you know how to qualify for medicaid?
Bob has peace of mind because he has plans in place for long-term care

Bob might want a Care and Savings Assessment

It’s not easy getting approved for TennCare / Medicaid, and we know it! That’s why we offer help in planning your steps to qualify. It doesn’t matter what your starting point is, we’re here to help you navigate the process with one goal: get our clients the quality of care that they need. Contact us if you would like to make plans for qualifying for TennCare.

Will TennCare Choices pay for my Mother’s nursing home?

Last week we defined TennCare and how it applies to our clients. This week I want to go more in-depth with how TennCare serves Tennesseans with long-term care. 

Many people believe that Medicare benefits will cover nursing home care once an individual is 65 or older, but this simply isn’t true. While Medicare covers the first 100 days, it doesn’t cover long-term assisted living. Read more about Medicare here

TennCare Choices logo for Tennessee Medicaid Long-Term Services and Support
Choices” is Tennessee’s Medicaid program for long-term care services and support

Back to TennCare/Medicaid…

My Mom doesn’t have long-term healthcare insurance. What are my options? 

  1. Payout of pocket until you run out of cash – This is an unrealistic option for most families. Nursing home care is expensive. Not a lot of people have an extra $7,000-$11,000 a month in their bank accounts.  
  2. Do a reverse mortgage on her home. 
  3. Qualify for the TennCare / Medicaid program called “CHOICES”

As you can see, options 1 and 2 are very unpleasant and leave nothing left for a loved one’s legacy. However, option 3, CHOICES, is definitely something worth looking into.

What is CHOICES?

CHOICES is the category of TennCare that provides Long-Term Services and Supports (LTSS) such as nursing home care.

What is the process for getting qualified for CHOICES?

In order to be eligible to receive benefits from TennCare/Medicaid your loved one must first qualify within these three categories:  

  1. Medical eligibility 
  2. Income threshold
  3. Asset threshold
Wheelchair bound woman looking up at a nurse in white while at a nursing home for long-term care
Being medically and financially eligible is necessary for TennCare approval

How does someone become medically eligible for TennCare CHOICES?

The state of Tennessee will determine who is medically eligible to receive TennCare Long-Term Services and Support (LTSS) by using a pre-admission evaluation (PAE). This PAE is used to determine if the applicant can do basic life skills on their own without help. The PAE will also determine if the applicant is safe in their current environment. 

The PAE is a strict evaluation and it is performed on a case-by-case basis. An applicant must receive a score of 9 or higher on a 26 point scale in order to be considered medically eligible for TennCare Long-Term Support Services. 

For example, a caregiver or healthcare provider may be asked about a patient’s level of ability to do things and how much assistance is needed. 

The following Activities of Daily Living (ADLs) are covered in the PAE evaluation: 

  • Transfering
  • Mobility
  • Communication
  • Medication
  • Orientation
  • Eating
  • Behavior

If you or your loved one is unlikely to get to a nine or higher on the PAE, it is always appropriate to ask for a “safety determination” evaluation as an alternative route of becoming medically eligible for Choices. 

How can someone become financially eligible to receive CHOICES

You must be able to prove that the applicant has a low income and little assets. As of January 2022, an individual applying for TennCare CHOICES cannot have an income exceeding $2,523.00 per month. Additionally, the applicant cannot have more than $2,000 in assets. This includes any money in the bank and investment accounts but also requires consideration of retirement accounts, life insurance policies, real estate, artwork, jewelry, and any other valuables. When we talk about the assets for a couple of things get a little more complex. The most important thing is that both the applicant and their family are taken care of, both medically and financially. 

Graceful Aging Legal Services, PLLC Logo for the Care and Savings Assessment - It is a graph with lines slowly going down.

My Mom is over the limits for income and assets? What do we do? 

If the applicant is in excess of the amounts we can plan for that! We have a tool to help people who have excess income and assets yet need to qualify for TennCare/Medicaid called the “Care and Savings Assessment”. With this Care and Savings Assessment, we work to determine the best way to structure you or your loved one’s finances, either now or in the future. We plan so that our clients have the peace of mind knowing they can qualify for TennCare if and when they need it! 

In conclusion 

It is often helpful to have an attorney assess your financial situation and offer recommendations on how those finances may be restructured to qualify for TennCare Long-Term Services and Support (LTSS). As an experienced TennCare planning attorney, I can help you evaluate your risk and create a plan that takes care of everyone in the family.

Are you ready for help with TennCare planning? Contact us and we can discuss your plan. Next week we will go over some examples of how we restructure an individual’s finances to meet their needs for long-term care. 

5 Things Every Songwriter Needs to Know About Gifting Copyrights Through Wills

5 Things Every Songwriter Needs to Know About Gifting Copyrights Through Wills

Heading into the month of December, we wanted to focus on the idea of gifting. While in our line of work, we often think of gifting in terms of taxes or inheritance, but there are so many other ways to leave gifts to those in your life.  We asked our colleague Alyssa at Purple Fox Legal to share with us some of the “gifts that keep on giving” through intellectual property law, which is her focus.  If Alyssa’s post helps you or you have questions about your copyrights or trademarks, reach out to her at or 629-248-3310.  -April 

Guest Blogger Alyssa J. Devine, Esq.  at Purple Fox Legal

Image of a street sign called Music Square in Nashville Tennessee.
Owning the copyright to a song is an amazing accomplishment!

Professional creatives, like songwriters and musicians, pour endless amounts of time, energy, and passion into their craft. They spend months perfecting each project, and years carrying the pride of a job well done. And, for many, this hard work continues to live long after they do.

This is where estate planning comes in. Proper estate planning guarantees that your legacy will be managed according to your standards, even when you’re not around to do so. The process names the people and organizations that can lay claim to your assets, and protects your work with red tape and safety nets. It is a critical step in any songwriter’s life.

Knowing the importance of something, and understanding how to do it are two separate matters. In this article, we’re introducing musicians and songwriters (like you!) to the most basic steps of estate planning. We’re covering the top five important tips for songwriters planning their estate.

1. Understand how property is transferred through estate planning

Comprehensive estate planning is crucial for ensuring that all property is transferred to its intended parties. While most estate plans will easily transfer common assets, like cash, vehicles, and real estate, professional songwriters also need to consider protecting their intellectual property. Intellectual property, like copyright, is incredibly important for you to continue providing a stream of income that can flow for generations.

To truly understand estate planning, songwriters must understand what an estate actually is. In layman’s terms, an estate is a portfolio that includes all property (tangible and intangible) accumulated throughout an individual’s lifetime. After your passing, all of your property, assets, and funds will become the property of the estate.

Once you pass on, all of your estate planning goes into action. The executor, or person responsible for carrying out the probate process, will distribute your property through a complex legal procedure. Your final wishes and requests will be followed, typically passed down in the form of a will. A judge will direct your executor to follow state regulations to transfer your assets and distribute your property.

Close up on a row of guitars made in Nashville Tennessee
Create a paper trail! Protect your songs by properly registering them with the Copyright Office.

2. Register your copyrights and maintain copies of every contract associated with them

Copyright registration is paramount in the songwriter’s estate plan. Registering your copyrights will ensure that they are protected for up to 70 years after the author’s death. But, songwriters and musicians should recognize that each song they produce carries two copyrights. It’s not only the sound recording and “master” copyright that matters but the musical composition must also be protected. This includes the lyrics and underlying music.  

To add another layer of complexity, copyright protection doesn’t end with registration. A consistent and cohesive record should be kept of all contracts associated with your copyright. This will help clarify the copyrights owned by the estate itself.

Remember: A notice to the Copyright Office is also required each time a copyright changes ownership. If copyrights are not included in the estate, they cannot be distributed to heirs. Filing with the Copyright Office is so important because it creates a public chain of custody and lowers the likelihood of litigation after your death.  

3. Add beneficiaries to your performance rights organizations and mechanical rights organizations

When it comes to copyright law, registration grants the owner a number of different legal rights. In fact, the US Copyright Act provides six unique and exclusive rights for each copyright. And, each registration lasts long past the life of the author.

Because of this, every songwriter should consider adding potential beneficiaries to transfer control of these six unique protections. Including intended beneficiaries during the estate planning process can prevent expensive litigation after your death. But first, each beneficiary must be added to a musician’s Performance Rights

Organization (PRO) and Mechanical Rights Organization (MRO), in addition to creating a will.

Most musicians are familiar with and registered with both a PRO and MRO. PROs are responsible for administering performance licenses, collecting licensing fees, and distributing these fees. They handle music that is publicly broadcasted on the radio or the Internet, in television shows, or out in public. MROs, on the other hand, collect mechanical royalties. They reserve a fee each time your song is played.

Accurate, updated information is required in both your PRO and MRO accounts. Adding beneficiaries to them cannot be recommended enough.

4. Be aware of the deadline for recapturing copyrights

When a copyright is created and then assigned to someone else, the original author is afforded an opportunity for a second bite of the apple. This means that original authors can elect to recapture copyright ownership by filing a specific notice with the US Copyright Office. It’s important to know that there is a limited period of time before the termination goes into effect.

For many songwriters, recapture is available as early as 35 years after publication.

Close up of two hands giving a gift box with a red bow on it.
Not all gifts come from a store! What will you do with your art?

5. Write down how you want your property to be transferred before creating a will

A valid and effective will is just one step in the estate planning process, but it may be the most important one. A will dictates exactly where your assets will go after your death, including the methods of transfer and the terms you expect. Anything in a will is subject to probate court though, which is why it shouldn’t be the only document in your estate plan. Wills serve best when used as a safety net for any assets not covered in your other estate planning documents.

Final Thoughts

When it comes to estate planning and managing your assets, age should never be a factor. Songwriters with assets should always be protected. Just look at Kurt Cobain and Selena Quintanilla, who didn’t have wills when they died. Their lack of an estate plan created a whirlwind of legal problems for their families.

Creating a will can be overwhelming The process to get there can be overwhelming though, but having help from an experienced attorney can make the process seamless for you and your family.

Medicare 101: Mastering the ABCs of Medicare Planning

As if choosing health insurance under an employer’s plan wasn’t difficult enough, figuring out which type of Medicare plan is best for you is even more confusing. I call Medicare an alphabet because there are 4 parts- A, B, C, and D. Oh, and you might want to consider a supplement too!  

Don’t worry. With a little time and some guidance, you can master the Medicare alphabet just like you mastered your ABCs! 

First, let’s go through the four types and what they cover. 

  • Part A only covers emergency care, such as if you need to stay at the hospital. 
  • Part B covers regular care like doctors visits, bloodwork, and any other testing or treatment that your doctor recommends. 
  • Part C is often referred to as an “Advantage Plan”. It is administered by private insurance companies, just like an employer’s plan.  It includes Part A and B coverage and may include other benefits as well, such as dental, vision, and prescription drugs. 
  • Part D covers prescription drugs. That’s it. 

When you approach age 65, ask yourself what your current health needs are, what family history might impact future healthcare needs, and what type of coverage you are used to receiving.  Then look at your budget. 

Part A is free for those who are eligible through their tax contributions. In 2021, most individuals will pay $148.50 per month for Part B, although the amount can be higher depending on your income.  

If you anticipate that you will need something more than just emergency and regular doctor’s visits, there is another alternative. Consider a Part C “Advantage” plan or a Medicare Supplement (or “Medigap” plan), instead. This plan will provide coverage for those things that Parts A and B don’t, like such as prescription medications, dental, or vision care.  Keep in mind that you still pay co-pays and deductibles on Medicare, so you will want to look at those amounts and not just your premium when considering your budget. 

When thinking about the Medicare alphabet, I have a little way to help me remember what each part covers: 

A is for an Accident that lands you in the hospital 

B is for Bloodwork they do at the doctor’s office

C is for Comprehensive coverage you can get with an Advantage plan

D is for Drugs (They made that one easy!)

Now you know your ABCs….next week I hope you’ll join us when I share my favorite FREE resources to learn about Medicare before you sign up. 

Nashville Wills and Trusts Lawyer: How to Handle Underage Beneficiaries

Many grandparents wish to leave a legacy behind for their grandchildren; however, they may run into some issues if those children are underage. A Nashville Wills and Trusts lawyer can help you determine what the best options are for leaving assets to underage beneficiaries, whether those assets are held in a Will or Trust, financial accounts, or as part of a life insurance benefit. 

Underage Beneficiaries in a Will or Trust

As a Nashville Will and Trust lawyer, I always ask my clients if any of their beneficiaries are underage, or even if they would like to keep younger beneficiaries from accessing their full inheritance until they’ve reached a certain age, which is usually 25 or even 30. If the children are underage, an adult guardian must be named since minors are not allowed to own property. If a significant amount of property is left to the minor, a Trust is usually a good idea to manage the property until the child comes of age. In fact, Trusts can be used to ensure the minor only receives their full inheritance once they reach a certain age or milestone, such as graduating from college, while at the same time providing assets to make sure the child can achieve that milestone. I can speak with you about leaving an inheritance to an underage child and will help you choose the best option for administering the distributions.

Underage Beneficiaries of Financial Accounts

Many people choose to make beneficiary designations directly on their financial accounts, such as savings accounts, annuities, and retirement plans.  Nashville Wills and Trusts lawyers urge their clients to carefully examine the details surrounding these beneficiary designations, as minor beneficiaries often cannot directly inherit assets after your passing. It is important to consult with a Nashville Wills and Trusts lawyer to determine the best way for your underage beneficiaries to receive the inheritance you leave for them at a time when they can make informed financial decisions on their own. Directing the assets to Trust is often the best bet in these situations, but consulting with an attorney will give you a much better idea of how this should be done. 

Underage Beneficiaries on Life Insurance

Many parents and grandparents name their children or grandchildren as beneficiaries on their life insurance policies. As with the cases above though, an adult guardian or a Trust must be named in order to hold the life insurance proceeds until the minors come of age. It is generally not advised to name minors as beneficiaries to life insurance policies, as courts will often appoint an adult to look after the proceeds until the child comes of age – and that adult may not be someone you would have wanted to be appointed to such a role. Speaking with a Nashville Wills and Trusts lawyer may help you determine the best way to handle your life insurance beneficiary designations.

If you have any questions about the best ways to leave an inheritance to underage beneficiaries, please contact us at 615-846-6201 to set up a consultation.

Davidson County Will Attorney: 5 Considerations When Choosing a Legal Guardian for Your Kids

Choosing a legal guardian who can raise your kids if you are unexpectedly incapacitated or pass away can be a daunting and difficult challenge.  There are many things to take into account such as parenting styles and the potential guardian’s ability to love and take care of your children. 

These are just some of the questions we believe every parent should answer before naming a guardian. 

  1. Where will your children live? Many parents desire to keep their children in a familiar environment if something unfortunate happens. It’s not unusual for parents to put instructions in their estate plans regarding the cities or states they want their kids to be raised in if mom or dad passes away. If the geographical location of where your kids will be placed is important to you, be sure to make this known to your Davidson County will attorney when creating your plan.
  2. Are your children familiar with the potential guardian? It is important that your children are comfortable with the guardian you are about to choose for them. If you are selecting a guardian that lives far away, you may want to consider ways to begin cultivating a relationship between your children and the potential guardian before it’s needed. Naming a temporary guardian is also important in such situations. This will ideally be a person that lives close by and can help ease the transition to your kids relocating to their permanent guardian’s home.
  3. Is your potential guardian prepared to care for your children? There are many factors that could fall under this category, but it is important to make sure that your guardian is emotionally, physically, and financially prepared to care for your child/ren. For example, you may want a grandparent to become guardian, but their age and their own financial and/or medical needs may make serving in this role difficult for them. Don’t forget to take their point of view into account when making your selection.
  1. Do any of your children need special care? If you have a child with a mental or physical disability, it could take special knowledge and resources to care for your child. It is important to make sure that the named guardian would not be overwhelmed by this responsibility and that they are prepared to care for your child in whatever way that your child may need.
  2. Have you discussed this choice with your potential guardian? It is very important that you ask your potential guardian if this is a responsibility that they can take on. You will also want to talk about your desired path for raising your child/ren to make sure that you are in agreement and that your wishes will be followed. 

As parents, you spend a lot of time planning the best future for your children. Make sure that your planning includes naming a legal guardian should you become unexpectedly incapacitated or pass away. You should be the one making that decision – not the courts. Schedule a call with our Davidson County will law firm today, so you can have the peace of mind knowing your children will be cared for by the person you want, in the way you want if anything happens to you.