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
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.
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.
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.
Quite simply, TennCare is Tennessee’s Medicaid program. While the name “TennCare” has the word “care” in it, it is NOT Medicare. In order to further clarify the difference between the terms “Medicaid” and “Medicare,” you need to remember that we use “Medicare” to “care” for our elders and “Medicaid” to “aid” those, of any age, in need. Essentially TennCare is Tennessee’s brand of Medicaid. Hopefully, that little trick will help you remember the differences between each program.
Who qualifies for TennCare?
Now that you are familiar with the difference between Medicare and Medicaid, let’s discuss who qualifies for TennCare (Medicaid).
There are three qualification criteria that you must meet in order to obtain Medicaid/TennCare.
1. Medical qualification –There is a special medical test that applicants must pass in order to qualify. Usually, a care facility will handle this piece of the Medicaid application.
2. Asset qualification – A TennCare applicant who is single can only have $2,000.00 in assets before they are eligible for TennCare. Vehicles and real estate are usually exempt from the count of assets. A “Care and Savings Assessment” is a good place to start if the applicant needs help with figuring out what they have in assets and what options are available to make excess assets “non-countable” for TennCare purposes.
3. Income qualification – A TennCare applicant can only receive $2,382.00 per month (as of 2021) in order to receive TennCare. If an applicant has more than this amount in income, an attorney can resolve it through what is called a Miller Trust or a Qualified Income Trust.
Long-term care is very expensive
Why should I be concerned about long-term care services?
Unless you are a millionaire or multi-millionaire, TennCare eligibility and designation could have a major impact on your finances and your family. While you may not need TennCare now, you will want to plan as if you will need it in the future. As you may have heard us say before “we hope for the best, and plan for the worst.” Having a plan is an effective way to ensure that you will have long-term care coverage when you need it. This isn’t to say that you won’t find yourself needing TennCare much sooner than expected. When this happens we call it “TennCare Crisis Planning”.
Knowing your options makes all the difference
I don’t know where to start!
The biggest obstacle to TennCare planning is determining what to do with your assets and income; especially if there is excess in any category. There are a lot of rules and potential pitfalls that you need to look out for. Fortunately, we have some great financial planning and legal resources that can help our clients. If you have an immediate need for TennCare or want to plan for TennCare we can supply the client with what we call a “Care and Savings Assessment”. It’s a wonderful tool that helps people effectively navigate through their options.
How do we help our estate planning clients with TennCare planning?
For our estate planning clients, we like to take into consideration the possibility that you may need TennCare in the future.
For example, it is our priority to set up our client estate plans to make sure that TennCare is accessible if it is ever needed. As with many government organizations, Medicaid has lots of rules to follow and many people find that they did not know what rules they were supposed to be following until it was too late! Fortunately for our clients, we know the rules and can help you plan in advance of ever needing to apply for TennCare to cover medical care. Additionally, we create documents that make sure that someone can apply for Tenncare on your behalf. This is useful if you become incapacitated in the future.
How do we help our Conservatorship clients with TennCare?
Many of our conservatorship clients are caregivers for a loved one who requires skilled nursing to keep them safe. The average cost for this type of care is about $7,000.00 per month or more. There is usually a large gap between monthly income and fees. Our firm can navigate the TennCare application process and assure that the appropriate language is in the conservatorship order paperwork with the court so that the client may obtain the appropriate benefits for their loved one.
How do we help clients with TennCare Crisis planning?
For those who have never considered the cost of long-term care until they or a loved one need to enter a nursing facility, the cost of care is likely to come as a shock- and an unaffordable, but necessary, expense. This is when we can step in with what we call “crisis planning,” meaning that you need a plan and you need a plan now.
In these cases, we are able to look at the household financial situation of the person needing skilled care, as well as the family situation overall, and come up with a plan for how to best use existing resources and get them qualified for TennCare benefits to pay for the nursing home bills. This process called our “Care and Savings Assessment”, is one of the most rewarding things that we do! It allows us to help people get the care that they need while still providing a quality of life for themselves and their families.
If you are concerned about accessing TennCare benefits for long-term care, contact our office for a complimentary initial call using our online calendar here.
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.
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.
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.
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.
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.
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.
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.
From a legal standpoint, parents don’t have a lot of rights after you turn eighteen. But we often rely on our families more than we realize, something I was jerked into remembering during my junior year of college when I was rushed to the emergency room and soon told that the surgical team was ready for me. Ummmm….can’t I call my mom first???!!!
Fortunately my situation worked out, but as a lawyer, I can’t help thinking about what if I had not been awake to call my parents. What if I needed more extreme medical treatment and couldn’t tell the doctors what I wanted?
Here’s what you need…
This is where you can learn from my mistakes. Get your legal shit together before you head off to college. Or after. But as soon as you can. I will even help you get everything completed by video call.
As a bona fide adult, you need a minimum of three documents in case of an emergency:
Healthcare Power of Attorney– This document allows you to appoint someone you trust to make decisions if you can’t communicate with your medical providers.
Financial Power of Attorney– A financial power of attorney allows you to give someone else permission to act on your behalf on financial matters. That means paying bills, completing financial aid or loan applications, dealing with insurance companies, and other ways that, well, adulting sucks. You’ll need to choose whether you want this to become effective immediately or only when you are unable to handle your own business.
Signed HIPAA Form– Now that your parents don’t have access to your medical records, you might want to consider authorizing someone to see them. Often family is a good go-to for all things medical (see: hereditary conditions) but you can name anyone-and everyone- you’d like. Mom, Dad, Brother, Best Friend, Fifth Grade Teacher? If you love them enough to share your blood panel results, then a HIPAA waiver is no biggie.
If you wanna get fancy, you can also sign a FERPA waiver to let your trusted adult have access to your educational record. It’s the grown up version of the school sending home your report card to show how smart you are. 🤓
Who should you name?
These are your documents, so you can name any adult you want to act in case you can’t (or don’t want to). In most cases that’s a parent, but let’s be real. Not all parents are created equal. Sometimes your “trusted adult” is your aunt, your neighbor, or your cousin. Whoever you name, it should be someone you trust with your life and your 💵 bank account.
When you’re ready to start getting your adult shit together, just text the word ADULTING to 615-846-6201. The cost for all of these documents together is $500 through our office. Your family might even be willing to foot the bill if you show them how responsible you’re being!
