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.
“ 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?
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.
Do a reverse mortgage on her home.
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:
Medical eligibility
Income threshold
Asset threshold
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.
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.
When one spouse wants to disinherit the other, but they are still married, it can be a complicated process. In most cases, disinheriting a spouse is only possible if you have a valid prenuptial agreement or if you are divorced.
Let’s illustrate this with an example:
Jack and Jill have been married for five years, and have one child together. Their house was purchased by Jill before they were married, and Jack’s name was never added to the deed.
Jill recently discovered that Jack is cheating on her with the Instacart shopper. She and Jack are now separated and have started the divorce process, but she wants to make sure that if she dies before the divorce is final that Jack won’t get anything from her.
What can Jill do?
Jill can disinherit her spouse after the divorce
Unfortunately, Jill cannot disinherit Jack until she files for divorce. Tennessee law does not allow you to disinherit your spouse- even if you write a will that says that! My advice is to get divorced as quickly as possible. Unless divorced, Jack is entitled to his share.
The good news is that once divorce papers have been filed, there will be an automatic injunction that specifies that the pair no longer have spousal rights on the property through marriage. This is primarily to protect things like bank accounts, real estate, relationships with the children, and health insurance coverage. However, all that does is prevent money from being spent by either spouse outside of regular expenses. Jill won’t be able to do anything, like estate planning, until after the divorce has been settled or through special permission from a judge.
In the meantime, there are still a few steps Jill can take:
Utilize her prenuptial agreement
Jack and Jill signed a prenuptial agreement prior to their marriage. In it, they waived the right to inherit from each other. All Jill needs to do now is to rewrite her will to specifically omit Jack.
Divide assets into separate trusts
Jill can establish a trust under her name and place the house in it. Since Jack’s name isn’t on the deed or on the trust, he has no right to the house if Jill were to pass before the divorce is finalized.
Rewrite her will
Jill can rewrite her will so that Jack only gets what he is entitled to by law, called his elective share. In Tennessee, spouses are entitled to a homestead allowance, a year of support, and elective share. The elective share amount depends on how long you are married.
Hire a family law attorney
The divorce will go much quicker with the help of a family law attorney.
Jill can get a jump start on planning her estate.
Finally, if Jill is preparing for a divorce, she can take advantage of all the legal documents at her fingertips and get a head start on creating the estate plan she desires. Once her divorce decree is finalized, she can meet with her lawyer and sign the document to make it valid.
Are you getting a divorce and want to start over with your own will and estate plan in Tennessee? Are you looking for a referral to a family law attorney? Let us know! We are happy to help you make plans for your new life. Not sure where to start? Give us a call. We offer a complimentary 15-minute call to see if we are the right fit for you and your situation. You can schedule your call by clicking here.
A Davidson County will and trust lawyer’s job is to make sure that you have all of your ducks in a row so that if you become incapacitated or die, your loved ones will know how to manage your estate and follow your wishes. Laws in Tennessee vary from those found around the country, which is why you want to work with an attorney who is skilled in understanding your specific needs. One area that should be considered is your service providers.
Make a list of your service providers and put it in your estate plan
“Service providers” covers a wide range of individuals involved in your life. Should you be unable to communicate with them, you want to ensure that your trustee, executor, conservator, or other responsible person is able to communicate with them on your behalf. Having them all listed in one place will make this job much more manageable.
Household Providers
This list should include all of the people or companies that you deal with when it comes to the maintenance of your home. In some cases, your home will need to continue to function in your absence, and your representative will need to be able to contact these people to make sure things keep running smoothly. In other cases, whether you are deceased or incapacitated, there are certain services that you may no longer need, and the person in charge needs to be able to contact the service providers and cancel with them.
Some examples of household providers that you will want to list might include:
Computer support
Food or water delivery
Gardening
Pet care
Housekeepers
Heating/Cooling system maintenance
Heating oil delivery
House sitters
Pest control
Pool or spa maintenance
Utilities
Vehicle maintenance
Basically, anything that you have performed on a regular basis should be noted, along with contact and payment information.
Medical Service Providers
You should also provide your representative with contacts for your medical service providers. This information could be very valuable should you need medical attention but be unable to reach out to these providers on your own. Additionally, if you have standing appointments with these providers, it will be helpful to have them canceled so you don’t accrue charges for services you’re not using.
Some of the medical service providers you may want to include on your list are:
Chiropractor
Counselor
Dentist
Massage therapist
Ophthalmologist
Physical therapist
Primary care physician
Psychiatrist
Specialists
Personal Service Providers
There are other types of regular services that you may use, and you’ll want to include these as well for the same reasons already mentioned. Some personal service providers to keep in mind for inclusion:
Childcare provider
Hairdresser
Home care provider
Meal preparation
Transportation
Tutors
Additional Information
Along with the contact information for these service providers, it’s a good idea to make notes about when they are expected, and you may even want to include service agreements and contracts. For example, if you have a standing arrangement to have your sprinkler system blown out each fall, make a note of that.
Your estate planning attorney may not include all of this information directly in your estate plan, but they will want to be able to assist your family with where it can be located when the need arises.
If you are seeking estate planning services, please book a call with our office here .
Probate is the name for the legal process of distributing assets after someone passes away. These assets can include bank accounts, real estate, vehicles, retirement accounts, life insurance, and financial investments. Before the assets can be distributed, however, they must first be gathered and used to pay creditors.
After that, the heirs can finally receive their distribution of the estate. However, even then, there are several factors that can still delay the distribution process. In our practice, it is common for probate to last about nine months. In more complex cases, probate can easily last several more months or even years. These delays ultimately mean less money and more headache for the surviving family.
Let’s go through the factors that cause delays in probate, and discuss what steps can be taken to minimize the delay.
1. Passing away without an Estate Plan
If you pass away without an estate plan, your loved ones will have to go to probate court. The court will appoint someone among them to be the “Personal Representative.” The Personal Representative will be responsible for contacting all of the financial institutions about your death. They will also be responsible for using your funds to pay creditors and ultimately make distributions to your heirs.
When there is no estate plan, the process for appointing a Personal Representative can be seriously delayed. The family will have to come to a consensus on who the Personal Representative will be before they present their choice to the court. Moreover, whoever is selected as Personal Representative is often not prepared for the role, as they had not been told to expect it. The process of going through all of your finances and contacting all of your financial institutions might be overwhelming for them, especially if they did not know your finances very well. Moreover, they will be responsible for mediating tension between the family, which is made even more difficult if members of the family do not think you explicitly wanted them to serve as Personal Representative.
Having an estate plan would minimize all of these consequences and delays. By having an estate plan, your family will already know who you want to represent your estate, which will make the process for appointing a representative much smoother. The person you select to represent your estate will also be better prepared for the role, as they are aware that they will one day need to fulfill the role.
The best way to minimize delays in probate is thus to have a clear estate plan in place, and to let your family and loved ones know about your intentions.
2. Family Tension
Even with an estate plan, family dynamics can still play a major role in probate. For example, if the only major asset that you have at the time of your death is your house, and one of your heirs would like to live in it while the other heirs would rather sell it and keep the sale value, tension will ensue and attorneys may need to get involved. All of this will ultimately lead to a delay of the probate process, and may ultimately divide the family in an irreparable way.
Feuds such as the one described happen even in the most loving of families. To avoid these feuds, it is important to not only have an estate plan, but to have one drafted by an experienced estate planning attorney. An experienced estate planning attorney will be familiar with cases such as the one described and will be able to help you think through exactly what you would want to happen if these cases occur. Your estate plan will thus be better able to help your family navigate your precise wishes for your assets, ultimately easing tension and expediting the probate process.
Hiring an estate planning attorney to draft your estate plan is one of the most important steps you can take to minimize probate delays.
3. Financial Complications
If you keep your finances private, it will be difficult for your intended heirs to know what to expect after you pass away. They may not even know where you bank and what financial investments you have. The more difficult it is for them to know your finances, the more difficult it will be for them to notify your financial institutions of your death and gather accounts.
Furthermore, if you are in debt or are not paying your taxes, your Personal Representative will be responsible for using your assets to pay your creditors and the IRS. This can cause serious delays to the probate process, especially if the Personal Representative was unaware. Creditors will ensure they receive their payments by filing claims against the estate through probate court. These claims ultimately slow down the probate process as each claim requires a hearing before a judge.
To save your family time, headache, and grief after your death, it is important that you keep your finances in order. Pay off debt when you can, and keep a clear record of it. File your yearly taxes appropriately. Let your loved ones (especially your Personal Representative) know of your finances and how to contact each financial institution in case something happens.
Even in the best of cases, probate takes a while. To minimize delays, we recommend having an experienced estate planning attorney draft your estate plan, clearly telling your loved ones of your intentions, and keeping your finances in order as much as possible. Your loved ones will already be filled with grief after your death. The best gift you can give them is preparation.
Here at Graceful Aging Legal Services, we offer software that can help our clients keep their estate in order. Contact us at 615-846-6201 or hello@galsnashville.com if interested.
Talking to your parents about aging, illness, and death is hard. It’s one of the hardest conversations you can have–but it’s also one of the most important. The feelings that might come up during the conversation, if uncomfortable, are better than the feelings that would otherwise come up when an emergency happens and there is no plan in place for taking care of them (or even a consensus among relatives on how to move forward). As we always say in our office: “it is better to have a plan and not need it than to need it and not have it.”
With that said, directly asking a loved one “hey, what would happen if you died today?” might not be the best way to start the conversation. So let’s consider some better alternatives to open the conversation about estate planning.
1. Tell your loved one what you’re doing for your own estate planning
Telling your loved one about your own estate plan, or your wishes to create your own estate plan, might make them consider making one themselves. Tell them what is in your Last Will and Testament, whether you have a Trust, and who you have chosen to act as your Power of Attorney. Hearing about your concerns for your own aging and death, and hearing how you’ve decided to navigate the future, will give them an idea of where to start, which is often the hardest part. Many people also struggle to decide on an estate planning attorney. It is important that the Nashville attorney they hire aligns with their needs. Hearing about your own process of hiring an attorney, and how you determined which one would be the right fit for you, can help them navigate the difficult world of hiring a Tennessee Wills and Estate Planning lawyer.
2. Talk about other situations that have happened that worried you or made you curious
Many of us know at least one person who has suffered the loss of a loved one and then had to endure the resulting feud among the family. These feuds happen so frequently that a significant number of fictional stories are based on them. Unfortunately, plenty of them could have been avoided if a clear plan had been put in place. And these feuds rarely start right after the death—many of them start much earlier, when the loved one’s health began to decline and someone had to step up to take care of them. Estate planning does not just mean deciding what happens after you die; it also means deciding what happens if your health begins to decline. If there is no plan in place for declining health, it will be up to the family to decide what happens. Even the closest of siblings can begin to resent one another if they feel that their parents’ care is not being handled properly.
Although it is fictional, the feud in This is Us between the siblings regarding their mother’s care is an accurate portrayal of what can happen in these situations. The siblings argued on what kind of medical treatment their mother should receive, and again on where she should live and who should look after her. Although all of the siblings had the best of intentions and loved each other and their mother, the feud nonetheless happened. The mother sensed the feud would escalate once her diagnosis advanced, and so she decided to name her daughter (her most level-headed child) as her healthcare power of attorney. Although the siblings still butted heads with one another, the daughter was able to carry out her mother’s wishes.
There are plenty of other examples in books and TV of families feuding over a loved one’s care or death. Talking about these hypothetical situations might make it easier to begin the conversation about aging and death.
3. Ask what would happen to their children, pets, and home if they were in a medical emergency
While discussions about aging and death might be intimidating, discussions about medical emergencies might be easier to handle. Medical emergencies can happen to anyone at any time. Our office even recommends that eighteen year olds get power of attorney documents in place, as it is important for them to have someone able to speak to medical professionals on their behalf in the event of an emergency. Since medical emergencies can happen to anyone, loved ones who do not like having their age pointed out might be more receptive to the conversation. If you know your loved one is anxious about having a stroke or falling down stairs, and tends to avoid or shut down conversation about either of those scenarios, it might be a good idea to use another medical emergency in your conversation (like a car accident, for example). While it is important for your loved one to confront their anxieties, it is not always our place to force them into a confrontation. Using a more neutral example (like the car accident) instead of one they constantly worry about might be a good way to ease them into the conversation.
4. Ask if they can show you where their estate planning documents are
After signing estate planning documents with our clients, we tell them to please let their family know their wishes and how to find the original documents. After all, the estate planning documents are only as good as the family’s ability to find them. In the event of a medical emergency or death, the signer of the documents will not be able to locate them. If no one else knows where they are or how to find them, the documents become effectively useless. It is therefore of the utmost importance that loved ones know where to locate the original documents. If you know or suspect that your loved one already has a plan in place, ask them where the documents are and how they plan to transfer the documents into the right hands in the event of an emergency or death.
For more information on how to talk to your loved ones about aging, illness, and death, we encourage you to check out The Conversation Project.
