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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 alyssa@purplefoxlegal.com 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.


4 Ways Scammers Try To Take Your Money!

4 Ways Scammers Try To Take Your Money!

Last week I defined elder abuse and described who is at risk. This week I want to delve deeper into the topic of financial abuse on older adults.

As we gracefully age, we become targets for some crafty criminals who will entice you to give them your personal information and money. Most of the time we don’t realize it’s happening until it’s too late! Here’s a detailed list of the top scams commonly used on older adults to take their money.

1. Telephone Scams on the Elderly

Grandparent scam

Charity scam

If you receive a phone call asking you to donate to a charity for a recent disaster, it is likely a scam. Do your research and only donate to charities you’ve fully vetted.

Government impersonation

The IRS, Medicare, Social Security or other government offices will never call you! For example, if a fake IRS agent calls you with aggressive threats saying you owe money and must pay immediately, it is a scam! The government does not contact people this way and they don’t work this fast either (we all know this from personal experience). Typically, the government will contact you via USPS mail.

Unexpected prize and lottery scams

These scams bait you into thinking you must pay a “fee” to collect a prize you’ve won. This scam relies on you forgetting that you have entered the competition. These scams can come at you via telephone, email, mail, text message and social media.

Tech support scams

If you receive a phone call from someone claiming to be tech support, hang up! In this scam, someone will contact you via phone, pop-up, or email saying you have a security breach within your computer. They will ask you for your username and password or ask you for permission to remotely take over your computer. The goal of the scammer is to find your confidential information and use it to take your money!

2. Computer Scams on Older Adults

SMS or email phishing scams

Phishing scams come from well-known sources such as your bank or investment company. These messages look legit and prompt you to click on links that redirect to fake websites. Once you enter your username and password into the fake website, the hackers have your credentials and have control over your accounts.

Malware and ransomware

You will see this scam in emails and on social media. The goal of the scammer is to get you to click on a link in an email or an interesting article. Once you are on their website, they will ask you to download some software. Unfortunately the software contains a virus designed to steal your personal information. Sometimes the hacker will hold the information on your computer “hostage” until you pay a ransom. If you pay the ransom, there is no guarantee your computer will be unlocked.

Romance scams

There are a lot of scammers who pretend to be looking for love on social networking and dating apps. These scammers use a fake identity and manipulate you into giving them your money!

3. Fraudulent Business that Target Older Adults

Legitimate services with illegitimate businesses

As an older adult you will be heavily marketed for a reverse mortgage, credit repair, or refinancing. There are a lot of fake businesses that will offer you free homes, investment opportunities, and foreclosure or refinance assistance. If it’s too good to be true, it probably is!

Counterfeit prescription drugs

Not only does this scam hurt your wallet, it hurts your health. There are a lot of fake websites that are more than happy to sell you counterfeit prescriptions.  

Fake Anti-aging products that scam older adults

Online shopping has made it easier for criminals to sell you anti-aging cosmetics. Unfortunately you might be buying a product that contains arsenic, beryllium, cadmium, aluminum, and biological contaminants. These products are unsafe and really gross!

4. Tricky People who “Help” Older Adults

Caregivers who scam the elderly

It’s natural to trust those who are close to you. This includes hired help and family members or friends who provide you with caregiving services. Unfortunately there are tricky people out there who will manipulate or outright steal your money and possessions.

Financial advisors

While most financial advisors are trustworthy, there are a few rotten ones out there that like to scam older adults. These “advisors” might make trades that line their pocket yet empty yours. They might try to involve you in a Ponzi scheme, promise unrealistic returns, or simply walk off with your money because they aren’t who they say they are.

Home repair

Beware the door-to-door salesman offering to repair your roof for cheap because they have leftover material from another job. Also beware the “repairman” who asks to inspect your home without you asking. These scammers want you to pay cash up front and are not bonded and insured. Never prepay for services you might not receive!

Funeral extortion

Another tricky person is the funeral director who tries to sell you something you don’t need such as a casket when your loved one is being cremated. These funeral directors are counting on you being confused because of your grief and loss.

funky lady laughing while on the phone. she is wearing a yellow sweater and bright orange sunglasses

In Conclusion

While this list was fairly detailed, it is not exhaustive! New methods to scam older adults appear every day. Make it a habit to check the federal agency websites to stay up to date about current financial scams. I want you to be aware of what’s out there!

And finally, I want you to think:

  1. What steps are you taking to prevent yourself from becoming a victim of financial fraud?
  2. Do you have a financial inventory? Are you aware of what you could lose?
  3. Do you have a plan for protecting your finances in the future?

In my next blog I will discuss several methods you can use to protect yourself and your money!

You’re almost 65. Congrats on your Medicare Milestone!

We’ve been talking about Medicare for a few weeks now, but we haven’t gotten to the how-tos yet.  That’s about to change. Today we dig into how you actually enroll in Medicare. 

Your first Medicare enrollment period begins three months before you turn 65 and runs until three months after.  Even if you don’t sign up for any other coverage, we recommend that you sign up for Medicare Part A during this first enrollment period. 

To sign up for Part A, go to the Social Security Administration’s Medicare portal here.  It will be helpful to set up an account for when you come back to sign up for Part B or when you are ready to begin receiving retirement benefits. 

If you are signing up for Parts A and B, the process is the same. You’ll sign up through the Social Security Administration’s website. Remember that if you enroll for Part B, your premiums will either be deducted from your Social Security retirement payment or you will receive a bill. The 2021 Part B premium is $148.50 for most people.

If you are looking for a Medicare Advantage plan, Part D, or a Supplement (Medigap) plan, you will want to compare plan options using a plan comparison service.  There are insurance brokers like Kendall Chanley and Harry Perret here in town who can help you compare options and narrow things down. Once done, they will get you signed up. These services are free to you and it’s nice to have one agent who can help you each year. 

If you prefer to do things yourself or just want to do some exploring, Medicare.gov will allow you to find plans in your area and narrow them down based on what you are looking for and price ranges. I recommend filtering plans by the star ratings (four or above) and then whether you are looking for dental, vision, and prescription medicine access. 

Once you make it through your first enrollment period at age 65 (ideally), you’ll be eligible for open enrollment each year from October 15th through December 7th.  You may also have options to select coverage during a special enrollment period if you lose other coverage. 

Applying for Medicare isn’t nearly as scary as it sounds, but it does require advanced planning and research. You don’t want any deadlines sneaking up on you! Personally, I love using reminders on my calendar well in advance of any deadlines that I have. Maybe one to begin research, one to call an expert, one to compare plans, one to sign up….all before your birthday or November. 

What’s your plan for Medicare enrollment?  Head to our Facebook page to share your plans in the comments!

3 Common Mistakes People Make by Waiting to Sign Up for Medicare

I don’t know about you, but I don’t plan to retire at 65. I mean, that’s only 25 years away. And I like my job. Maybe that’s you.

Even still, don’t put off signing up for Medicare when you turn 65. Here’s Why.

Mistake #1: Waiting until after you retire to sign up for Part A. 

Why it’s a mistake: Medicare is basically free money. You paid for it with your taxes for the past forty-some years…but still.

Ultimately here’s the deal–you CAN wait. But since it’s no skin off your back, wouldn’t you rather set it and forget it?  Think about that time you set up automatic payments into your savings account or 401k. You may not have missed the money, but when you got your tax forms, you saw the benefit of making a small change. It’s the same here. Signing up for Part A is easy, and makes the process of signing up for Part B or a Medicare Advantage plan much easier. 

Mistake #2: Staying on private health insurance coverage instead of signing up for Part B, without doing further research.

Why it’s a mistake: The plan you are currently on may not provide enough coverage.

If you plan to stay on your current coverage instead of signing up for Part B as soon as you turn 65, you want to make sure that your health plan provides appropriate coverage. We’re talking about a qualified group health plan (as defined by the IRS). If you’ve ever had to provide proof of “creditable coverage” for plan enrollment, this is similar.  Otherwise, you will pay a penalty when you sign up for Part B coverage.  This penalty is paid with each premium payment and never goes away. The longer you are eligible for Part B without signing up, the more the penalty costs. Do your future self a favor and get HR to confirm (in writing) that your current coverage meets the requirements. 

Mistake #3: Assuming that your current insurance plan will continue to be available after you become eligible for Medicare

Why it’s a mistake:  Believe it or not, some insurance plans and employers will not cover you (or your spouse) if there is other coverage available elsewhere. That includes Medicare.  Medicare enrollment begins three months before you turn 65 and lasts three months after.  Start looking at your options early to make sure you don’t get left without insurance unexpectedly. 

Whatever you decide about retirement, make sure that you have the information you need to make good, informed decisions. 

Next week we’ll be getting into the nitty-gritty of how to actually sign up for Medicare. Make sure to follow us on Facebook or Instagram to see when the blog gets posted!