alzheimer's association presentation 2012

ESTATE PLANNING, VETERANS BENEFITS, MEDICARE, AND MEDICAID: HELPING A LOVED ONE WITH ALZHEIMER’S

P. Haans Mulder, JD, MST, CFP®

Cunningham Dalman, P.C.321 Settlers RoadHolland, MI 49423(616) 392-1821phmulder@holland-law.com

Alzheimer's Association-West Michigan

Background• Partner at Cunningham Dalman, P.C.• Has a Masters in Tax, CFP®, and

specialize in estates/elder law and business planning

Serving the Holland area since 1900

Overview• Elements of an estate plan and what the

process involves• Most common types of estate plans• Veteran’s Aid & Attendance benefits and

eligibility rules

Serving the Holland area since 1900

Overview• Medicare Parts A-D• Transition from Medicare to Medicaid• Medicaid process and eligibility rules• Example of how Medicaid planning works

Serving the Holland area since 1900

What is estate planning?• Process of planning for the future

management and distribution of your assets and your future medical care

• Includes documents such as wills, trusts, and powers of attorney (financial and health care)

Why is it important?• Reduces the cost of administration• Minimizes stress for family and friends• Determines who will receive your assets• Authorizes who will make your medical

decisions

What is probate?• Probate is a court process to administer

a deceased person’s financial affairs• Required when someone passes away

with assets in his or her own name or fails to name a beneficiary

Why avoid probate?• It is a public process • Can exacerbate family situations• Can be costly to administer ($5,000)• Takes time to complete (6-9 months)

What are the most common estate plans?

• Basic plan includes wills (potentially with a trust) and powers of attorney

• For clients who do not have a house or are not concerned with avoiding probate

What are the most common estate plans?

• More comprehensive plan includes a living trust, pour-over wills, and powers of attorney

• Designed for clients who want to avoid probate

Veteran’s A&A Benefit• Veteran is eligible for up to $1,704 per

month (expenses must exceed income)• Surviving spouse is eligible for up to

$1,094 per month • Veteran with a spouse is eligible for up to

$2,020 per month

Serving the Holland area since 1900

Veteran’s A&A Benefit• Will cover in-home, assisted living, and

nursing home care• Can either have low monthly income or

medical expenses that exceed income• Must have not more than $80,000 of

countable assets

Serving the Holland area since 1900

Medicare and Medicaid• 40% of people 65 years and older will

stay in a nursing home• Average cost to stay in a local nursing

home is $7,500-9,000/month

Serving the Holland area since 1900

Medicare and Parts A-D• Medicare is a government insurance

program that has many aspects and is divided into parts

• Have to be 65 years old, be disabled, or fit specific criteria

• Part A covers hospital expenses

Serving the Holland area since 1900

Medicare Parts A-D• Part B deals with doctor’s and out-

patient expenses• Part C is a private insurance plan that

covers your medical expense in general• Part D is your prescription drug coverage

Serving the Holland area since 1900

Transition to Medicaid• Many people who are eventually

approved for Medicaid start on Medicare• Must have a three day hospital stay • Medicare will cover up to 100 days, but

there can be a co-pay after the 20th day

Serving the Holland area since 1900

What is Medicaid?• State and federal program that pays

for medical treatment (including nursing home care)

• Oftentimes confused with Medicare

Serving the Holland area since 1900

When does Medicaid apply?• Applies principally in a nursing home

(could apply in your home or an assisted living facility)

• Applies to people who are 65 years or older, blind, or disabled

• Must pass the income and asset tests

Serving the Holland area since 1900

Who does Medicaid apply to?

• Under income test, you cannot have enough income to pay the monthly cost of staying in a nursing home ($7,500-9,000 in this area)

Serving the Holland area since 1900

Who does Medicaid apply to?

• Under assets test, a single person can only have $2,000 in countable assets

• Can keep your home (if it’s not in your trust) and a vehicle

• All other assets are countable

Serving the Holland area since 1900

Who does Medicaid apply to?

• Asset test allows a married couple to keep their home (again, if it’s not in a trust), a vehicle, and one-half of their other assets

Serving the Holland area since 1900

Example• Clients were husband and wife• Wife had to go to a nursing home• Didn’t stay in a hospital for three days

so Medicare didn’t cover stay• Had house, vehicle, and investments

Serving the Holland area since 1900

Example• Could keep the house (because it was

properly owned) and their vehicle• Without any Medicaid planning, they

would have had to spend down one-half of their investments

Serving the Holland area since 1900

Example• Drafted a trust that allowed them to

protect all of their investments (as opposed to just half)

• This provided peace of mind to the husband

Serving the Holland area since 1900

Questions……

Serving the Holland area since 1900

Thank YouP. Haans Mulder, JD, MST, CFP®

Cunningham Dalman, P.C.321 Settlers RoadHolland, MI 49423(616) 392-1821phmulder@holland-law.comwww.holland-law.com

Serving the Holland area since 1900