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Thursday, December 6, 2012

The Importance of Getting Vaccinations

              It is that time of season again! While we fret over  getting gifts for our children or doing more cleaning than we have done all year because the in-laws are coming, we are forgetting one imporatant thing this holiday: our health. I am sure you have seen the advertisements Pharmacies and Drug Stores put out about getting the flu vaccine, but how imporant is it?

              The CDC says that, 'Influenza is a serious disease that can lead to hospitalization and sometimes even death.'  Even I have to admit, I did not think that the Flu was serious enough to cause death, but in reality it does. In fact, over a period of 31 seasons between 1976 and 2007, estimates of flu-associated deaths in the United States range from a low of about 3,000 to a high of about 49,000 people. That is not a small number. It is especially important that our Seniors get the vaccination because during a regular flu season about 90 percent of deaths occur in people 65 years and older.

               The CDC has named this week (December 2-8th) as National Influenza Vaccination Week. It is a national observance that was established to highlight the importance of continuing influenza vaccination, as well as fostering greater use of flu vaccine after the holiday season into January and beyond.

As we prepare for this holiday season, may we give the most imporant gift of all, the gift of good health.

The US Department of Veteran Affairs has some helpful tips and links for our seniors.

http://www.va.gov/health/NewsFeatures/20121203a.asp


Wednesday, November 28, 2012

Social Security COLA to Rise 1.7% in 2013

There’s news abounding for 2012 coming from the Social Security Administration (SSA) including increases to the cost of living adjustment (COLA), a rise in what seniors pay for Medicare Part B, and new wage limits workers must meet before the Social Security tax of 6.2 percent stops as a deduction from paychecks.

Here's how it works: By law, most Medicare enrollees can't be charged a Part B premium that produces a net reduction in Social Security benefits. Assuming the Social Security and Medicare percentages come in as forecast, this "hold harmless" feature would protect seniors with Social Security benefits of $625 or lower, according to SCL.

Seniors with higher benefits would see a small inflation raise. A senior with a $1,000 monthly benefit would see a 0.48 percent net increase after the Part B adjustment; for a $1,500 monthly benefit, the net COLA would be 0.79 percent.

The hold-harmless provision doesn't protect three groups of beneficiaries: high-income seniors, new enrollees in Medicare this year , and low-income seniors who are eligible for Medicare and Medicaid. High-income beneficiaries include individuals with annual income starting at $85,000 (single filers) or $170,000 (joint filers), and move up from there.This group pays full freight on the Part B premium, plus an income-based surcharge. And the surcharges aren't limited to Part B: Extra premiums also are charged for prescription drug plans (Part D) and Medicare Advantage plans (Part C).

For more information follow the link below:

http://money.usnews.com/money/blogs/the-best-life/2012/10/16/social-security-cola-to-rise-17-in-2013

 


Monday, November 26, 2012

IRS Issues Long-Term Care Premium Deductibility Limits for 2013

IRS Issues Long-Term Care Premium Deductibility Limits for 2013

The Internal Revenue Service (IRS) is increasing the amount taxpayers can deduct from their 2013 taxes as a result of buying long-term care insurance.

Premiums for “qualified” long-term care insurance policies (see explanation below) are tax deductible to the extent that they, along with other unreimbursed medical expenses (including Medicare premiums), exceed 7.5 percent of the insured’s adjusted gross income. This threshold is rising to 10 percent on January 1, 2013, although it will remain at 7.5 percent for taxpayers 65 and older through 2016.

These premiums — what the policyholder pays the insurance company to keep the policy in force — are deductible for the taxpayer, his or her spouse and other dependents. (If you are self-employed, the tax-deductibility rules are a little different: You can take the amount of the premium as a deduction as long as you made a net profit; your medical expenses do not have to exceed a certain percentage of your income.)

However, there is a limit on how large a premium can be deducted, depending on the age of the taxpayer at the end of the year. Following are the deductibility limits for 2013. Any premium amounts for the year above these limits are not considered to be a medical expense.

Attained age before the close of the taxable year Maximum deduction for year
40 or less $360
More than 40 but not more than 50 $680
More than 50 but not more than 60 $1,360
More than 60 but not more than 70 $3,640
More than 70 $4,550

Another change announced by the IRS involves benefits from per diem or indemnity policies, which pay a predetermined amount each day.  These benefits are not included in income except amounts that exceed the beneficiary’s total qualified long-term care expenses or $320 per day (for 2013), whichever is greater. (The 2012 limit was $310.)

What Is a “Qualified” Policy?

To be “qualified,” policies issued on or after January 1, 1997, must adhere to certain requirements, among them that the policy must offer the consumer the options of “inflation” and “nonforfeiture” protection, although the consumer can choose not to purchase these features. Policies purchased before January 1, 1997, will be grandfathered and treated as “qualified” as long as they have been approved by the insurance commissioner of the state in which they are sold.

The Georgetown University Long-Term Care Financing Project has a two-page fact sheet, “Tax Code Treatment of Long-Term Care and Long-Term Care Insurance.” To download it in PDF format, go to: http://ltc.georgetown.edu/pdfs/taxcode.pdf


Monday, November 12, 2012

Seniors Beware: How Much Salt are you Eating?

      Just like with most things in life, salt is best in moderation. Salt has been around for thousands of years and has served multiple purposes from being a means to preserve meats to adding flavor to a dish. But did you know that too much salt can create health problems including high blood pressure and heart disease? It is not just the french fries or the potato chips that we have to watch out for, but items that are packadged and heavy card-based.  On National Eating Healthy Day, the American Heart Association developed a list of six items that we should be mindful of consuming because of their above average levels of sodium. Please click the link to find out what are the 'Salty Six'.

 

http://seniorjournal.com/NEWS/Nutrition-Vitamins/2012/20121107-Seniors_Take_Heed.htm


Monday, January 9, 2012

Happy 2012! Make Getting Your Affairs in Order Your Goal for the New Year

 

Each year, I make a list of goals that I want to accomplish for the year.  Some years, the goals have a theme – unfortunately, the theme is almost always the same:  lose weight, exercise more. . .

This year, I’m challenging you to make one of your New Year’s goals to get your estate planning affairs in order.  This is one goal that is easy to accomplish – I promise!

Here are 5 easy steps you can take to accomplish this goal.

1.         Get educated about estate planning.  Attend an estate planning workshop or two.  Estate planning attorneys like me are always giving seminars and workshops to educate people about estate planning.  Yes, these workshops help attorneys attract clients, but the goal of these workshops is really to educate people about the basics of estate planning so clients can have meaningful conversations and can make thoughtful decisions about their own estates. 

2.         Review your old documents.  Do you have a will or trust?  Advanced Directives or Healthcare Powers of Attorney and Living Wills?  Do you have a Durable Financial Power of Attorney?  How old are your documents?  If your wills name guardians for your children who are now 30 years old, your documents are definitely out of date.  Did you name an executor who is now dead or is your ex-wife named as your executor?  Probably time to revise your will. 

            What about your health care documents? If they were done in Georgia before 2007, you may want to update them to the Advance Health Care Directive that went into effect in 2007.  Who have you named to make healthcare decisions for you?  Is that person still the right person to make decisions for you?           

3.         Look at the ownership of all of your accounts.  How is your bank account titled?  Title indicates who owns the account.  Are you the sole owner or is it a joint account?  Who is the joint owner and is this someone who should be a joint owner of your account?  Here’s a link to a blog I wrote last year about the pros and cons of joint ownership of accounts:  http://bit.ly/xm8W5o

4.         Check the beneficiary designations of your accounts.  The beneficiary is the person who would receive the proceeds of the account at your death.  Is the beneficiary your estate?  If so, why did you make your estate the beneficiary?  Having your estate as the beneficiary pretty much ensures that your estate will have to be probated.  Is your beneficiary under the age of 18 or someone with special needs?  It may not be the best thing to give someone under the age of 18 a large inheritance.  Although the court will put protections in place for those under 18, those protections can be expensive and once the beneficiary has their 18th birthday, the money is all theirs – to spend however they wish. Yikes!

             If the beneficiary has special needs, a gift may mean they lose governmental benefits.

            Distributions from IRA’s and 401(k)’s have income tax consequences, so have you considered how your beneficiary designations will affect the tax liability of your beneficiaries?

5.         Make an appointment with an estate planning lawyer, a CPA and your financial advisor.  A good, comprehensive plan involves a group of professionals who can guide  and counsel you in making decisions about your estate. 

Will you accept thechallenge to make getting your New Years Goal getting your affairs in order?

Here's to a great new year!

 


Tuesday, December 20, 2011

Holiday Traditions: Really Check in With Your Neighbors and Relatives

On Friday night, we gathered with neighbors old and new to celebrate a cherished tradition – our annual progressive dinner.  Traditionally, we begin the year.  We find out about the new babies, weddings and graduations to come.  We learn what colleges the children will attend, and where soon-to-be college graduates will start their careers.  We also check in on aging neighbors to find out about their health scares, their difficulties, the loss of their loved ones.  After moving from house to house for salads, and main courses, we end up with more wine and sweet treats to reminisce about dinners past.  How many have we had?  No one can remember.  But by the end of the evening, we’re looking forward to next year’s dinner, and assigning tasks to make it happen.

Continuing this tradition is important to my family and my neighborhood because it allows us to connect with our neighbors, to get to know them when times are good so that we can help each other when times are not so good.  Without our traditional yearly gathering, we might not realize when our neighbors need our help.

In my practice, I see many people who see their aging or ill family members and friends at the holidays and realize that all is not well.  Sometimes, all has not been well for so long that those family members are now in crisis.

If you are visiting family members who are aging or ill, take the time to talk with them to find out about their health.  Are they seeing a doctor?  What medications are they taking?  How do they keep track of their medications on a daily basis?  Ask them if they have a healthcare proxy or advance directive for healthcare?  Who will make healthcare decisions for them if they are not able?

Although it can be difficult to have a conversation with parents about their finances, ask them if they have appointed someone to make financial decisions for them if they are not able.  Look around the house and see if there are stacks of unopened bills.  Find out if they have long-term care insurance.  Ask where their important financial and legal documents can be found.  If they haven’t appointed anyone to make decisions for them, urge them to do that while they still can.

If your aging family members are still driving, ride with them to see if they are still able to drive safely.  Are they stopping at the stop signs?  Do they forget to look before making a turn?  Do they still remember how to get to places they have been to many times before or do they forget where they are going?  If they are having trouble driving, would a driving school help?  Or, can you help them find transportation so they won’t need to drive anymore?

With married couples, try to talk with each one alone.  Sometimes couples get so good at covering for each other, you don’t realize that one of them might be suffering from dementia.  If one of the couple is ailing, find out how the well spouse is coping.  Is he or she eating and sleeping right?  Is he or she getting help in the home so he or she can get out to see friends, or just get some time to rest and recharge?

Look in the refrigerator, freezer and cupboard.  Is the food in the refrigerator or cupboards moldy or out of date?  Are they going to the grocery store on a regular basis?  If you suspect that they are not eating right, is there a meals-on-wheels program that they might qualify for?

I hope that you will enjoy holiday traditions with family, friends, and neighbors this year.  Will you take time to talk with your family and friends to see whether they might need help in the coming year?

Happy Holidays!

Patti Elrod-Hill

 

 

 

 


Sunday, December 4, 2011

Medicare: Treat it as Part of Your Financial Plan

 


Medicare changed things up a bit this year by scheduling open enrollment early.  Because Medicare is in the news, I’ve been getting a lot of calls from clients to ask me about Medicare. While most people understand that they can become eligible for Medicare when they turn 65, they wonder about the types of Medicare plans available, and what plan they should choose.  Today, we’ll talk a little bit about the basics of Medicare, and about how to choose a Medicare Part D prescription drug plan.

Here is the basic Medicare alphabet:

Medicare Part A covers hospital insurance that can help pay for inpatient care at hospitals, skilled nursing facilities, hospice, and home health care.

Medicare Part B covers medically-necessary service such as doctor’s services, outpatient care, home health services, and some other services.  You will pay a premium to be covered by Part B.

Medicare Part C is a Medicare Advantage Plan.

Medicare Part D is the prescription drug coverage.

In order to become eligible for Medicare, you must be age 65, or you must have been receiving Social Security Disability benefits for 24 months.  Most people who are on Social Security or Railroad Retirement benefits will automatically get Medicare Part A and B starting on the first day they turn 65, or when they have completed the full 24 months after beginning to receive Social Security Disability.  One exception is that if you have ALS – Lou Gehrig’s disease- you are eligible for Part A and B in the month your disability begins.

Every year, for those who are qualified for Medicare, there is an open enrollment time when you have the ability to sign up for a new Medicare Part C or Part D plan. 

Normally, the open enrollment period begins in January.  However, this year the open enrollment period began on October 15 and ends on December 7.  If you want to know when to enroll in Social Security Part A and Part B, and when to enroll in Part C and Part D here is a handy chart:  http://www.medicare.gov/Publications/Pubs/pdf/11219.pdf

Medicare Part D is probably the most confusing of the Medicare Alphabet Programs.  Medicare Part D is the program that offers prescription drug coverage to those who are qualified for Medicare.  In order to get the drug coverage, an eligible person must join a plan.  The plans are run by private insurers or other private companies approved by Medicare.

Medicare Part D is available if you are otherwise-eligible for Medicare A & B.  If you don’t enroll in Part D when you become eligible, you might have to pay a slight penalty when you do join at a later date.  You can enroll in two basic types of plans:  Medicare Prescription Plans or Medicare Advantage Plans.  The Medicare Advantage Plans are usually HMO’s or PPO’s that give you all of your Part A and B coverage, and in addition may give you drug coverage.  If you choose another Part D plan while already enrolled in a Medicare Advantage Plan that offers a drug plan, you may become disenrolled from your HMO or PPO plan and returned to regular Medicare.

How can you choose the right Medicare Part D plan?  The plans are run by private insurance plans, or private companies, and the cost of the plan is generally based on the prescriptions you use, the “formulary” of the plan, and whether you go to a pharmacy that is within your plan’s network.  The formulary is the list of drugs that a Medicare plan covers.

The Medicare.gov website is full of information about the plans that are available, and is also full of advice on how to choose a plan.  To choose a plan, you can enter your zip code and your prescriptions in the formulary finder on Medicare’s website.  http://plancompare.medicare.gov/pfdn/PlanFinder/DrugSearch.  The plan finder will then give you a list of providers and will tell you the cost of the plan and the cost of the drugs.  You can then call the providers with any questions you might have.

Erica Dumpel, with Czajkowski Dumpel & Associates, Inc. http://cdainc.net/ an experienced healthcare plan advisor, emphasizes that you should research the plans on a yearly basis.  If you have a number of prescriptions, hunting down the right plan can take a lot of time – but can also save you a significant amount of money each year. 

If you miss this year’s open enrollment period, or if you decide not to change plans, be sure to put a reminder on your calendar to review your plan again next year.  In fact, I recommend that you schedule a yearly financial and legal checkup, which should include a thorough review of all of your insurance premiums, co-pays and prescription costs.

Will you start treating your Medicare Plan as part of your Financial Plan?

 

 

 

 

 

 

 

 


Sunday, November 20, 2011

Paying for Long-term Care: VA Benefits for Surviving Spouses

When she was approaching her 85th birthday, Sarah began to worry.  Until that time, she believed she had plenty of money to last through her lifetime.  Now, she saw her life’s savings slipping away.

Read more . . .


Sunday, July 31, 2011

Caring for Children with Special Needs: Combating Autism Reauthorization Act of 2011

 Caring for Children with Special Needs

Combating Autism Reauthorization Act of 2011

You can’t turn on the television or radio without hearing about the negotiations – or lack of negotiations- in Congress regarding the looming budget crisis.  We are all concerned about whether our elected representatives in Washington can come to a compromise that will help the country out of the current debt crisis.  Of great concern to those of us who work with families who have family members with special needs is whether, and how, the few programs left to support these families will be affected.

Assuming Congress gets through these negotiations and gets back to work on other  important issues, Congress has the opportunity to address a significant issue that the United States faces today.  That issue is that the number of persons diagnosed as being on the Autism spectrum is increasing at an alarming rate.  It is estimated that 1.5 million Americans are currently on the Autism spectrum.  That number is expected to increase by 10-17% annually. 

A growing concern is that the number of autistic children entering adulthood is also increasing rapidly.   By 2023, the number of autistic children entering adulthood is estimated to be 380,000.  The cost of care for these adults is said to be around $27 million, or about the budget of the state of Tennessee. 

On August 3, 2011, the U.S. Senate Committee on Health, Education, Labor and Pensions (HELP) is scheduled to meet for hearings on the Reauthorization of the Combating Autism Act, originally passed in 2006.  The Combating Autism Act allocated $950 million dollars over the five year period for the Centers for Disease Control (CDC), National Institutes of Health (NIH), and other governmental agencies to conduct research on the autism spectrum.  The Act required the Director of NIH to develop and implement a strategic plan for autism research.  If the Act is not reauthorized by September 30, 2011, the federal commitment will disappear.

The current bill, named the Combating Autism Reauthorization Act (CARA), would allocate the federal funding of $1billion and create a National Institute of Spectrum Disorders Research within the NIH.

If CARA is not passed, research on the spectrum will likely be thrown into disorder.  We cannot afford to let this bill die.  Research into the reasons for the disorders on the spectrum, and especially research into treatment and therapies, is crucial. 

If you would like to find out more about CARA, and how you might be able to help make sure this Act is passed, see http://www.autismvotes.org/site/c.frKNI3PCImE/b.6376831/k.ACFC/CARA.htm.

 

 

 

 

 

 

 

 

 

 

 

 


Sunday, July 10, 2011

Planning For a Loved One With Special Needs

 If the last few years have taught us anything, it is that life is not predictable.   The economic crash seemed to come out of nowhere.  The weather appears to be totally weird and unpredictable, with tornadoes and floods occurring with fierce and dangerous intensity.

So, too, our health and physical wellbeing are not entirely predictable.  Despite our best efforts to eat healthy food and exercise regularly, we can have a car accident or suffer a bad reaction to medication and become ill or disabled.

For some of us, our financial resources and health insurance may not be enough to cover our care needs.  When that happens, we sometimes have to seek governmental assistance to provide for our healthcare.

Many of my clients had no idea they would end up depending on Supplemental Security Insurance (SSI) or Medicaid for assistance, but those progams can be a lifeline for those with disabilities and longterm care needs.

How can we plan for our loved ones and family members who are on governmental assistance programs?  How can we provide for their needs without jeopardizing their public benefits programs?

One way is to establish a special needs trust for the benefit of the person with a disability.  A special – or supplemental needs trust, as I’ll call it- is an entity established to hold assets so that those assets are available for  the needs of the person with a disability that are not provided by the governmental benefit.  The person with the disability is not the trustee, does not own the assets, and cannot control the assets, so the assets aren’t counted for purposes of qualifying for benefits.

SSI and Medicaid generally restrict the recipient of those programs from having more than about $2,000 in assets, but the assets in the trust aren’t calculated in that $2,000.  Most of the time, the trust is established by a parent or grandparent, but If the assets did not belong to the person with a disability to begin with, anyone can establish the supplemental needs trust and anyone can contribute assets to that trust.  The trust can be the recipient of gifts or inheritance.

We’ve discussed how to choose a trustee in previous blogposts,

http://bit.ly/rfPKWc  but for a supplemental needs trust I usually recommend appointing a professional trustee to manage the assets in the trust.  The intricacies of public benefits programs can be daunting for most people, so even though they charge for the management,  professionals with experience with supplemental needs trusts can save money in the long run.

So, even though life seems unpredictable, you can at least plan for some of the supplemental needs of your loved one with a disability.

 


Sunday, July 3, 2011

When Bridget Came To Visit: On Being Prepared

 When Bridget came to visit, she wanted to take my blue and white teacups home with her.  They were shiny and pretty, and fit in her hand just perfectly.  Dick promised they would go to the mall and buy some teacups just like them.

Bridget was in the mid to late stages of Alzheimer’s disease when she and Dick first visited my office.  Dick, a wonderful, patient husband and caregiver to Bridget, was determined to be prepared for whatever legal and financial zingers might hit the couple.  Years before, after Bridget was first diagnosed with Cognitive Memory Impairment, Dick and Bridget had prepared living trusts, powers of attorneys, and healthcare directives.  They came to me to make a few changes to Dick’s living trust and financial power of attorney.   I always recommend that clients update advance directives and powers of attorney to avoid having someone decide that the documents are “stale” and, therefore, not valid.  We prepared new advance directives for Bridget and Dick.  On the day Bridget came to sign, she could not remember that the children whom she had nominated as agents were adults.  In fact, I’m really not sure she could remember who her children were.

With sadness, I told Dick that Bridget could not sign any documents that day.  We agreed to try another day, since those with dementia often have times when they are very alert, and other times when they are not.  Bridget never was able to sign her new advance directive, and soon went to stay in a wonderful memory care facility.   The health care and financial proxies she had already signed worked fine for her, and Dick was able to make her healthcare and financial decisions without any challenges.

Susan, on the other hand, had never executed advance directives for healthcare, financial powers of attorney, or any wills or trusts.  She didn’t think she needed to, since her husband made most of the financial decisions for the couple.  Her family did not push her to do any planning, since they thought it would upset her.  When I visited Susan at the nursing home after her husband died, she told me the nurses were stealing her underwear, she no longer recognized her family members, and she wondered why I was visiting her at work.   Susan swore like a sailor, and insisted that she would not sign “any g. . d. . . papers”, believing that I was trying to steal from her, too.

As a result, her family had to spend months and thousands of dollars to seek guardianship and conservatorship of Susan, a court proceeding which is expensive financially and emotionally for all involved. 

Many folks with Alzheimer’s and other dementias become paranoid and distrustful.  When they hit that stage, it is extremely difficult to get them to agree to do advance directives, financial powers of attorney, or wills.  Why would they agree to sign something that they believe allows folks to steal from them?

As an attorney, I preach that every adult needs to have an advance directive for healthcare, a financial power of attorney, and at least a basic will.   In Susan’s case, her fear of planning led to heartache and hardship for her family.   Could all of this expense and difficulty have been avoided by visiting an attorney’s office while Susan was able to plan for her and her family’s future?

As a footnote, I want to tell you all about Dick, Richard J. Farrell, whom I mentioned above.  Dick has written a book Alzheimer’s Caregiving about his life with Bridget, joys and trials of caregiving, and about his grief when Bridget died after living with Alzheimer’s for nearly 20 years.  Check out his website at www.alzheimerscaregivingbook.com to see how you can order a copy.

 


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