Long-term care insurance is a specialty type of insurance that helps pay for costs that are typically connected with long-term care. This can include items such as care given in a hospital, nursing home services, medical services provided in your home and treatment for dementia.

WGN’s recent article entitled “10 Crucial Things to Know about Long-Term Care“ looks at these important items.

1. The Biggest Financial Threat. The most significant threat to your financial nest egg is long-term care. About 70% of people over 65 will need some kind of long-term care during their life. The national average for home health care services is $16,743 per month. However, there are ways to manage this without buying a traditional long-term care insurance policy where “you use it or lose it.”
2. Long-Term Care Insurance is Really “Lifestyle” Insurance. It’s NOT nursing home insurance.
3. Reverse Mortgages. These have become a popular and accepted way of paying for expenses, including the cost of long-term care. Reverse mortgages are designed to keep seniors at home longer. A reverse mortgage can pay for in-home care, home repair, home modification and other needs.
4. Using Medicaid to Pay For Long-Term Care. This should be a last resort to pay for long-term care, but it also may be the only way to protect family assets. Medicaid will pay for long-term care, but certain criteria must be satisfied. If you have too many assets, you may not qualify. Talk to an elder law attorney to get qualified amd before applying for Medicaid.
5. Important Considerations When Selecting a Long-Term Care Plan. Four things to consider: (i) go with a company with an AM BEST rating of A+ or better; (ii) the assets of the insurance company should be in the billions; (iii) some long-term care insurers will allow for group discounts through employers, or “affinity” group discounts through a local organization; and (iv) the tax advantages for tax-qualified long-term care insurance plans. At the federal level, premiums for long-term care insurance fall into the “medical expense” category. On the state level, 26 states offer some form of deduction or tax credit for long-term care insurance premiums.
6. The Annuity-Based Long-Term Care & The Pension Protection Act. In 2006, this law was enacted to permit those with annuity contracts to have long-term care riders with special tax advantages. The Act allows the cash value of annuity contracts to be used to pay premiums on long-term care contracts.
7. Asset-Based Long-Term Care Solutions. The best planning approach for those who choose to self-insure is to “invest” some of their legacy assets so the assets can be worth as much as possible whenever they may be needed to pay for care. If unneeded, the money would then pass to the intended heirs, with no “use it or lose it” issues as with conventional long-term care insurance.
8. Long-Term Care Strategy Using IRA Money. Most people use their IRA to supplement retirement. However, sometimes waiting until age 72 when mandatory required minimum distribution rules apply, some people have instead opted to take a portion of their IRA and fund an IRA-based annuity which then systematically funds a 20-pay life insurance plan with long-term care features. This type of IRA-based long-term care policy is unique in the sense that it starts out as an IRA annuity policy, also known as a tax-qualified annuity, and then over a 20-year period makes equal distribution internally to the insurance carrier and funds the life insurance.
9. Important Documents for Long-Term Care Planning. Ask an experienced estate planning attorney about a power of attorney for health care and financial power of attorney, as well as an advance directive or living will.
10. Using Veterans Benefits to Pay For Long-Term Care. The VA offers a special pension: the Aid and Attendance (A&A) Benefit. This is a “pension benefit” and is not dependent upon service-related injuries for compensation.

BOOK A CALL with me, Ted Vicknair, Louisiana Board Certified Estate Planning and Administration Specialist, Louisiana Board Certified Tax Law Specialist, and Louisiana CPA to learn more about estate planning in Louisiana, incapacity planning, and Louisiana asset protection.

If you liked this article, “What Should I Know About Long-Term Care?” read also these additional articles: What Do Seniors Say About Aging in Place? and The Difference between Revocable and Irrevocable Trust and What Is Asset Protection Planning? and Do I Need a Prenup?

Reference: WGN (2022) “10 Crucial Things to Know about Long-Term Care“

About 50% of adults say that assistance for older adults should be funded by Medicare and Medicaid, according to an Associated Press-NORC Center poll.

MSN’s recent article entitled “Bipartisan support for policies to pay long-term care costs: Poll” says that 75% of adults surveyed say long-term care should be funded through Medicare Advantage or supplemental insurance programs. Close to two-thirds of respondents also said they’d support a government-administered insurance program, government funding for low-income people to receive long-term care at home and Social Security earnings credit or tax breaks for those providing long-term care to a senior.

Overall, 66% of respondents said they think it’s the federal government’s responsibility to make sure all people in the U.S. have health insurance coverage, with 73% of people aged 18-49 likely to support vs. 53% of those aged 50 and older.

Republican and Democratic responses were about the same, according to the poll.

About the same number of Republicans and Democrats favor nontaxable funds to pay for long-term care insurance—about 70%. The largest party difference was about the option for low-income people to receive government-funded, long-term care in their homes. Roughly 84% of Democrats supported this, compared to 55% of Republicans.

Overall public satisfaction with the U.S. healthcare system is low. Just 12% think the government is handling healthcare very or extremely well. When asked about healthcare specifics, 74% of adults said the U.S. handles prescription medication costs or mental healthcare “not too/not at all well,” and 70% said the same about mental healthcare.

The survey found that whites had a more negative view of the U.S. healthcare system compared to black and Hispanic adult respondents. When looking at healthcare for older adults, 56% of white adults think it is not too/not at all handled well, with 49% of Hispanic adults and 44% of black adults responding the same.

The poll consisted of 1,505 interviews between July 28 and August 1, with a 3.6% margin of error.

Under current law, MediCARE will only pay for the first 100 days of long term care.  After that, to pay for long term care, you need to either (a) have long term care insurance, (b) private pay out of your own funds (which will run at least $6,500 per month up to $9,000 per month in Louisiana); or (c) qualify for MediCAID Long Term Care benefits.  MediCAID is different from MediCARE.  MediCAID is a means based program intended for the poor, so to qualify and avoid losing your assets to nursing home poverty, it is best to get your plan in order well before you need to go into the nursing home.  I can help save at least half your assets even with a MediCAID crisis plan, but it is better to save all of your assets rather than merely half.

BOOK A CALL with me, Ted Vicknair, Louisiana Board Certified Estate Planning and Administration Specialist, Louisiana Board Certified Tax Law Specialist, and Louisiana CPA to learn more about estate planning in Louisiana, incapacity planning, and Louisiana asset protection.

If you liked this article, “What Do People Think About Government-Paid Long-Term Care?” read also these additional articles: The Difference between Revocable and Irrevocable Trust and What Is Asset Protection Planning? and Do I Need a Prenup? and Can a 529 Plan Help with Estate Planning?

Reference: MSN (Sep. 12, 2022) “Bipartisan support for policies to pay long-term care costs: Poll”

A Medicaid Planner is a term that encompasses many different types of professionals who may be able to assist you or a loved one with qualifying for Medicaid benefits. Not every Medicaid Planner may be appropriate for your individual needs or situation.

Although Medicaid is a federal program, it is run on a state-by-state basis. This means every state has its own rules and requirements. If you are considering working with a Medicaid Planner, it is important you work with someone who is familiar with your state’s particular requirements to Qualify for Institutional Long-Term Care, which is a needs-based program.

Here is a list of the different types of Medicaid planners:

Elder Law Attorneys — Elder law attorneys are licensed to practice law in a specific state, so they are knowledgeable about their state’s individual Medicaid eligibility requirements. They can help individuals or families protect their assets with a particular type of trust intended to get you qualified. These types of trusts are permitted in Louisiana. If you live in a state other than Louisiana, an elder law attorney can help you explore alternatives to reorganize assets or income so that you can qualify for Medicaid in the future.

Elder law attorneys can also help you appeal a Medicaid denial or adverse Medicaid determination. In addition, where issues become contested with skilled nursing or long-term care facilities, an elder law attorney may be able to help you navigate these issues.

Financial Planners — Financial planners can provide a broad range of advice and planning, but by law they cannot draft legal documents. They can help you put together a long-term care plan, discuss and evaluate investment options, and provide other financial advice. However, not every financial planner understands the intricacies of Medicaid or the particular care requirements that a person may have.

Care Managers — Elder care managers are more focused on care planning and coordination, such as resolving issues you may face if you need community or skilled nursing home care, as opposed to handling financial planning or legal matters. Because they are more familiar with day-to-day care issues, they often can serve as very knowledgeable resources on local programs and alternatives to Medicaid.

Counselors — Medicaid counselors are typically volunteers who offer limited services, like assisting with the application process, at no cost. They usually cannot advise a person on how to qualify for Medicaid. They also cannot provide legal or financial advice.

Insurance Agents and Commission-Based Medicaid Planners — These professionals also have a limited ability to assist with Medicaid planning. Only some products they can sell are Medicaid-compliant. For example, only specific insurance policies, such as prepaid burial insurance and certain annuities, are not “counted” in the Medicaid asset limit applicable in your state. These professionals can help sell you one of these options and will receive commissions paid by the insurance company.
Not every type of Medicaid Planner may be suitable for your situation. For those with significant assets or income, a legal professional combined with a financial professional may make the most sense. Others, whose resources are limited, would benefit by a good medicaid “pre-plan” drafted by an elder law attorney.

For more information on Medicaid planning, BOOK A CALL with me, Ted Vicknair, Louisiana Board Certified Estate Planning and Administration Specialist, Louisiana Board Certified Tax Law Specialist, and Louisiana CPA to learn more about estate planning in Louisiana, incapacity planning, and Louisiana asset protection.

If you liked this article, “Is A Medicaid Planner Right for Me?” read also these additional articles: Alert: Scam Targeting Medicare Recipients and CMS Issues Updated Guidance Intended to Improve Quality of Nursing Home Care and What Happens If Couple Divorce and Own Business? and Can Some Foods Help Prevent Alzheimer’s?

A compound that gives strawberries their color, called pelargonidin, is linked with fewer tau tangles in the brain, according to the researchers. These tangles are a key factor in the development of Alzheimer’s disease, reports Money Talks News’ recent article entitled “Can This Berry Help Prevent Alzheimer’s Disease?”

In a press release, Dr. Julie Schneider, the study author and an associate professor and neuropathologist with the Rush Alzheimer’s Disease Center, commented, “We suspect the anti-inflammatory properties of pelargonidin may decrease overall neuroinflammation, which may reduce cytokine production.”

The body’s cells produce cytokines, which are proteins that can regulate various inflammatory responses in the body.

It’s thought that inflammation in the brain triggers the plaques and tangles that lead to Alzheimer’s.

Tau tangles are a hallmark of the disease, which is caused by abnormal changes with tau proteins that accumulate in the brain.

Of all berries, strawberries have the highest concentration of pelargonidin, the researchers found.

They examined data from a long-term study that dates back to 1997 and that included the dietary information of 575 people who have since died.

Brain autopsies were performed on the study participants.

Although the findings are encouraging, the researchers note that the study was observational and thus does not prove that eating strawberries is directly responsible for helping to prevent Alzheimer’s disease.

The work was published in the Journal of Alzheimer’s Disease.

Study co-author Puja Agarwal, a nutritional epidemiologist with the Rush Alzheimer’s Disease Center, says, “While pelargonidin should be examined further for their role in maintaining brain health in older adults, this gives a simple change that anyone can make in their diet.”

According to the Mayo Clinic, Alzheimer’s disease is a progressive neurologic disorder that causes the brain to shrink (atrophy) and brain cells to die. The disease is the most common cause of dementia — a continuous decline in thinking, behavioral and social skills that affects a person’s ability to function independently.

About 5.8 million people in the United States age 65 and older live with Alzheimer’s disease. Of those, 80% are 75 years old and older. Out of the approximately 50 million people worldwide with dementia, between 60% and 70% are estimated to have Alzheimer’s disease.

BOOK A CALL with me, Ted Vicknair, Louisiana Board Certified Estate Planning and Administration Specialist, Louisiana Board Certified Tax Law Specialist, and Louisiana CPA to learn more about estate planning in Louisiana, incapacity planning, and Louisiana asset protection.

If you liked this article, “Can Some Foods Help Prevent Alzheimer’s?” read also these additional articles: Wayward Senior Tracked by Bluetooth Technology and What is the First Sign of Dementia? and Who Is the Best Person for Executor? and What’s the Most Important Step in Farm Succession?

Reference: Money Talks News (Aug. 9, 2022) “Can This Berry Help Prevent Alzheimer’s Disease?”

It’s easy to miss the first signs of cognitive decline. Spotting early dementia symptoms has become more critical than ever: the Alzheimer’s Association projects that 12.7 million people 65 and older will have some form of dementia by 2050. That’s why a lot of research on behavioral changes associated with dementia could help in the early detection of the neurodegenerative condition. However, this subtle action is often ignored by people with dementia and their families.

Yahoo’s recent article entitled “This Is the No. 1 Dementia Symptom People Ignore, Doctors Say” explains that many people believe that memory loss is the only sign of dementia. However, there’s much more to this debilitating condition than forgetfulness. There are a number of other behavioral and psychological symptoms associated with dementia, the most common of which are apathy, depression, irritability, agitation and anxiety. The rarest symptoms are euphoria, hallucinations and lack of inhibition. Many of these are subtle at first. Therefore, understanding what to look for is critical in early detection. It can significantly affect the course of your disease and delay its progression. This behavior change can be seen many years before a dementia diagnosis.

A 2020 study in JAMA Internal Medicine found, when looking at the medical records and consumer credit reports of more than 80,000 people aged 65 and older who were Medicare beneficiaries, people who developed dementia were significantly more likely to have financial problems and poor credit scores. These financial problems became more prevalent following a dementia diagnosis.

Monica Moreno, Senior Director of Care and Support at the Alzheimer’s Association, tells Best Life, “While there are several signs or symptoms of dementia, challenges with problem-solving or planning can cause a person to mismanage their finances. Other dementia-related symptoms that can adversely affect money management or personal finances include poor judgment and difficulty completing familiar tasks.”

The study concluded that missed bill payments lead to higher penalties and interest fees that are detrimental to your financial well-being. Therefore, financial guidance is essential for dementia patients after diagnosis.

“During the early stages of dementia, a person may be able to do simple tasks like paying bills but struggle with more complicated tasks, like managing investments or making a decision on large purchases,” explains Moreno. “Since dementia is often progressive, these challenges will increase over time. Therefore, family members need to identify these potential signs early and intervene as soon as possible.”

It’s important to spot financial behavior changes for early detection of dementia. Common signs include:

• The inability to balance checking accounts
• Consistently making late payments on credit cards; and
• Overspending.

Moreno adds, “People with dementia are susceptible to fraud, including identity theft, insurance scams and get-rich-quick schemes. Allowing these problems or potential threats to go unaddressed can put individuals living with dementia [and their families] at great financial risk.”

Early detection of cognitive decline can help protect older adults and their families from the burden of unnecessary financial stress.

The JAMA Internal Medicine study advises, “Families should be counseled about the potential need to help with financial management following [dementia] diagnosis.”

BOOK A CALL with me, Ted Vicknair, Louisiana Board Certified Estate Planning and Administration Specialist, Louisiana Board Certified Tax Law Specialist, and Louisiana CPA to learn more about estate planning in Louisiana, incapacity planning, and Louisiana asset protection.

If you liked this article, “What is the First Sign of Dementia?” read also these additional articles: Who Is the Best Person for Executor? and What’s the Most Important Step in Farm Succession? and Is ABLE Account the Same as Special Needs Trust? and Pay Attention to Income Tax when Creating Estate Plans

Reference: Yahoo! (Aug. 8, 2022) “This Is the No. 1 Dementia Symptom People Ignore, Doctors Say”

Many families help their disabled loved ones with whatever resources they have, if they can, but this must be done carefully to protect eligibility for government aid, reports a recent article titled “Here’s how ABLE accounts, special needs trust differ…and how they can work together” from CNBC. An ABLE account—named for the Achieving a Better Life Experience Act—can be paired with Special Needs Trusts to improve the quality of life for the disabled family member.

How do Special Needs Trusts work?

The two types of Special Needs Trusts are known as First-Party Special Needs Trusts and Third Party Special Needs Trusts.

A First Party Trust is created with the disabled individual’s own funds and is used to shelter any income, earned or inherited, to maintain their eligibility for Medicaid, which has both income and asset limits. Any distributions from the First Party Trust must be approved by the trustee. After the death of the disabled individual, Medicaid will make a claim against any funds in the First Party Trust to the extent of funds expended by Medicaid on behalf of the disabled individual.

In contrast, the Third-Party Trust is funded by parents or others and are only for the disabled person’s needs (not the disabled person’s own funds). After the disabled person passes, the funds are allowed to go to someone else in the family (not Medicaid).  Obviously, a Third Party Trust is preferred to a First Party Trust.  That is why parents who have disabled persons on Medicaid should think twice about bequests directly to the disabled person.  Doning that will either (1) kick the disabled person off of Medicaid; or (2) Medicaid will allow the disabled person to stay on Medicaid at the cost of putting the disabled person’s property in a First Party Trust (over which Medicaid is the remainder beneficiary).

Special Needs Trusts (SNTs) may not be used for certain expenses paid for by government programs, including groceries, medical expenses covered by Medicaid and housing expenses, which are covered by Supplemental Security Income (SSI).

Expenses not covered by government programs can also be paid from ABLE Accounts. The ABLE account is a tax-advantaged saving account similar to the 529 accounts used for college savings. Funds may be used for expenses that maintain or improve the individual’s health, independence, or quality of life. Funds can be used for education, recreation, personal technology and more.  They are treated much like First Party Trusts in that Medicaid can clawback funds from the ABLE account after the death of the recipient.

There are requirements and limitations to the ABLE account. In 2022, only $16,000 may be contributed per year. Most parents leave more than this amount for their disabled children, so a different vehicle is needed for inheritance.

Here’s where it gets interesting: A trustee for a SNT can make a distribution to the ABLE account to help cover expenses not permitted to be paid from the Trust.

An estate planning attorney can help the family plan for the present and the future to use these and other strategic planning tools for a disabled individual.

BOOK A CALL with me, Ted Vicknair, Louisiana Board Certified Estate Planning and Administration Specialist, Louisiana Board Certified Tax Law Specialist, and Louisiana CPA to learn more about estate planning in Louisiana, incapacity planning, and Louisiana asset protection.

If you liked this article, “Is ABLE Account the Same as Special Needs Trust?” read also these additional articles: Pay Attention to Income Tax when Creating Estate Plans and How Changes to Portability of the Estate Tax Exemption May Impact You and What Healthy Snack Is Best for My Long-Term Health? and Who will Receive Naomi Judd’s Estate?

Reference: CNBC (June 30, 2022) “Here’s how ABLE accounts, special needs trust differ…and how they can work together”

To the estate planning attorney, the situation is known as “crisis planning.” It almost always involves two things happening at once: the immediate need for additional healthcare and for a family’s assets to be protected. The end goal of crisis planning is to protect assets for both spouses, while ensuring that the sick spouse receives the care they need, as explained in the article “Crisis planning for couples focuses on asset protection” from The News-Enterprise.

What is Medicaid Crisis Planning?

Crisis planning for married couples requires a three-step process. First, does the spouse in crisis have the documents in place to allow another person to act on their behalf? This includes a financial power of attorney and a healthcare power of attorney.

Powers of Attorney need to be checked to ensure that they include specific powers needed to take action on the person’s behalf. These documents are “state specific,” meaning each state has laws determining what the POA must contain and how it must be prepared. Crisis planning requires a POA providing a broad set of powers, so agents can access and change documents like deeds, bank and investment accounts.

Once the documents and POAs are in hand, the next step is to get a detailed breakdown of the couple’s financial position and the cost of care. This becomes easier if the couple is organized and has information readily available for each income stream and asset.

What Information Will the Agent Need?

The agent must find several different types of financial documents. Proof of income for each income stream is needed. The actual proof of income will show taxes withdrawn or other deductions taken from income, such as health insurance.

The agent will also need access to several months of statements for each account, including bank statements, investment accounts, retirement accounts and deeds and titles for property. Proof of other assets, including insurance policies, burial plot deeds and other assets must also be included.

Some types of income and assets are countable, and some are non-countable. However, the non-countable income and assets may need to be considered, so the estate planning attorney will need to have all the information.

Medicaid Resource Assessment Request

Step three is to determine eligibility for programs and make the necessary applications. This will depend on the type of care needed. However, a typical crisis case is for nursing home care, which almost always means Medicaid eligibility. All income and assets are reported to Medicaid through a Resource Assessment request. The Medicaid office creates a breakdown of what will be counted against the applicant.

The remaining amount is what must be “spent down” for a person to be eligible for Medicaid coverage.

The most common way to do this is through a Medicaid Annuity. This annuity takes the spend down amount and returns the full amount as income to the spouse at home, effectively preserving the couple’s assets.

Crisis planning is stressful but does not have to be hopeless. By working with an experienced estate planning attorney and providing documentation as quickly as possible, health care needs can be met without the well spouse being impoverished.

BOOK A CALL with me, Ted Vicknair, Louisiana Board Certified Estate Planning and Administration Specialist, Louisiana Board Certified Tax Law Specialist, and Louisiana CPA to learn more about estate planning in Louisiana, incapacity planning, and Louisiana asset protection.

If you liked this article, “Medicaid Crisis Plans for Long Term Care Costs” read also these additional articles: Is Now a Good Time for a Roth Conversion? and What Does a Funeral Cost These Days? and Will Drinking Milk Prevent Dementia? and What are Mistakes to Avoid with Beneficiary Designations?

Reference: The News-Enterprise (July 23, 2022) “Crisis planning for couples focuses on asset protection”

The legal needs of many older Americans go beyond basic legal services. They are also all intertwined. In addition to understanding the legal issues and complications that older Americans face, elder law attorneys must also understand the surrounding personal concerns of their clients, such as health, financial and family issues, and how those affect their clients’ legal issues.

Recently Heard’s article entitled “What You Need to Know About Elder Law” explains that other specific areas of expertise include the following:

• End of life planning could extend to planning your health care support system as you age, signing a general power of attorney, establishing a medical power of attorney and other issues surrounding end of life care.
• Financial issues frequently entails questions about retirement and financial planning, housing financing, income and estate tax planning and gift tax issues.
• Long term care can include planning for asset protection, insurance for in-home care or assistance with activities of daily living, Medicaid long-term care planning, insurance, veterans’ benefits and other issues.
• Residents’ rights issues may include claims or complaints you bring while a patient in a nursing home or long term care facility.
• Workplace discrimination issues stem from the fact that older Americans sometimes face age and disability discrimination in the workplace.
• Interdiction (called Guardianship in states other than Louisiana) issues might include interdiction avoidance, planning wills and trusts, planning for the future of a special needs child, probate court and other issues surrounding minor or adult children.
• Landlord-tenant law may mean handling disputes with landlords, contesting an eviction, dealing with foreclosure issues, rent increases and more.
• Abuse, neglect, and fraud. These elder law attorneys specialize in cases where an older client is being victimized.

An elder law attorney can be a great partner for you as you plan out the legal and financial aspects of the next stage of your life-or the life of a loved one. Speak to one today.

BOOK A CALL with me, Ted Vicknair, Louisiana Board Certified Estate Planning and Administration Specialist, Louisiana Board Certified Tax Law Specialist, and Louisiana CPA to learn more about estate planning in Louisiana, incapacity planning, and Louisiana asset protection.

If you liked this article, “Understanding the Issues of Elder Law” read also these additional articles: What are the Advantages of a Business Trust? and What Is the Best Asset Protection? and What Happens If My Partner Dies and We’re Not Married? and What Does a Blended Family Need to Know about Finances?

Reference: Recently Heard (June 23, 2022) “What You Need to Know About Elder Law”

If you are injured due to another person’s negligence and receive Medicaid benefits to pay for care, the state has a legal right to recover the funds it spends on your care from a personal injury settlement or award. Yet in a legal case involving a Floridian teen who was catastrophically injured more than a decade ago, the U.S. Supreme Court has ruled that state Medicaid programs may be repaid from settlement funds reserved for future medical expenses as well.

The decision affects anyone who receives medical care through Medicaid after suffering a disabling injury that results in a lawsuit.

In 2008, a truck struck 13-year-old Gianinna Gallardo, leaving her in a vegetative state. The state’s Medicaid agency provided $862,688.77 in medical payments on Gallardo’s behalf. Her parents sued the parties responsible, and the case eventually settled for $800,000, of which about $35,000 represented payment for past medical expenses. The settlement also included funds for Gallardo’s future medical expenses, lost wages, and other damages.

The state Medicaid agency claimed it was entitled to more than $300,000 in medical payments from this settlement, including money that had been specifically allocated for Gianinna’s future medical expenses.

Gianinna’s parents then sued the agency in federal court, arguing that the state of Florida should be able to recover monies only from that portion of the settlement allocated for past medical expenses.

When a U.S. district court ruled in favor of Gianinna, the Medicaid agency appealed. A court of appeals reversed the lower court’s decision. Ultimately, the U.S. Supreme Court agreed to hear the case in order to resolve the conflict.

In a 7-2 decision, the Supreme Court agreed that the state is allowed to recover benefits for Gianinna’s past — as well as future — medical care. Justice Clarence Thomas, who wrote the majority opinion, noted that Medicaid law “distinguishes only between medical and nonmedical care, not between past (paid) medical care payments and future (un-paid) medical care payments.”

Justices Sonia Sotomayor and Stephen Breyer dissented. They argued that accepting Medicaid shouldn’t leave a beneficiary indebted to the state for future care that may or may not be needed.

The important takeaway here from the perspective of the attorney who is planning for his or her client, is that any settlement or judgment should, if possible, be weighted less toward reimbursment of medical expenses (past and future) and loss of wages for the injured person, and more toward pain and suffering for the injured person and her family, as well as punitive damages.  Good medicaid planning ahead of time in drafting the judgment will be critical in determining whether the family – or the state – will be awarded more or less of the judgment.

To read the full decision, click here.

BOOK A CALL with me, Ted Vicknair, Louisiana Board Certified Estate Planning and Administration Specialist, Louisiana Board Certified Tax Law Specialist, and Louisiana CPA to learn more about estate planning in Louisiana, incapacity planning, and Louisiana asset protection.

If you liked this article, “SCOTUS Rules States Can Recoup a Larger Share of Injury Settlements” read also these additional articles: Three Estate Planning Options for Your Art Collection and What Common Mistakes are Made with Living Trusts? and How Do I Maximize My IRA? and Can My Pet Help Me in Old Age?

It’s a common series of events: an elderly parent is rushed to the hospital in the middle of the afternoon and once children are notified, the search for the Power of Attorney, Living Will and Health Care Power of Attorney begins. It’s easily avoided with planning and communication, according to an article from The News-Enterprise titled “Give thought to storing your estate papers.” However, just because the solution is simple doesn’t mean most people address it.

As a general rule, estate planning documents should be kept together in a fire and waterproof container in a location known to fiduciaries.

Most people think of a bank safe deposit box as a protected place. However, this is not necessarily a good location for several reasons. Individuals may not have access to the contents of the safe deposit box, unless they are named on the account. Even with their names on the account, emergencies don’t follow bankers’ hours. If the Power of Attorney giving the person the ability to access the safe deposit box is inside the safe deposit box, bank officials are not likely to be willing to open the box to an unknown person.

A well-organized binder of documents in a fire and waterproof container at home makes the most sense.  But not always.  Here are some guidelines that I suggest to my clients in my law practice to answer the question”How Do I Store Estate Planning Documents?”:

Health-Care Power of Attorney.  The powerholder (your agent) should have a stamped “True Copy” of you Health-Care Power of Attorney.  I make “True Copies” regularly available to my clients.  In addition, the powerholder should have a printable electroinc copy of the document.  In the event that it needs to be “True Copied” my firm will provide this at no extra charge.  Each of your health care providers should also have a copy of this document.  I provide as many “True Copies” to my clients as they request without an additional charge.  If “True Copies” are distributed to your powerholder, it becomes less important what happens with the original, which may be kept safe in a fireproof container.

General Power of Attorney.  Like the Health-Care Power of Attorney, your powerholder (your agent) should have a stamped “True Copy” of your General Power of Attorney.  Also, advance delvery to banks or other institutions is usually a good idea so that it is ready to use if the time comes.  But it is not as important to give your bank your General Power of Attorney as it is to give your health care provider your Health-Care Power of Attorney.  Your powerholder should have electronic copies.

Last Will and Testament.  Keep in mind that court rules generally require that the original of the will be filed with the court.  Although a copy of the will could be filed, this is not the first best choice. What I recommend you do with your Last Will and Testament depends on the circumstances.  If you are disinheriting an heir (partially or fully) and that heir would have access to your house after you pass away, that heir would have an incentive to destroy the will.  If there is any chance of this happening, you don’t want to keep your will at home, whether in a fireproof container or not.  In some cases, it may not even be best to keep it in a safe deposit box.  If this is a concern, you have two options.  Your first option is to file the original at the Clerk of Court.  Generally this will cost between $100 and $200 depending on the number of pages of the will.  Your second option is to leave the orginal will with your attorney.  I generally offer my clients the opportunity to keep the original will in my firm safe deposit box without an additional charge.  If you are not too concerned about your will being destroyed by an angry heir, then you can keep it in your home, but I suggest that it be kept in a fireproof lockbox.

If your Health Care Power of Attorney is provided to each healthcare provider, they would be able to make it part of your medical record and  it would be are accessible 24/7 to health care providers.

Power of Attorney documents may be given to each financial institution or agency in preparation for use, if and when the time comes.

It may feel like an overwhelming task to contact banks and brokerage houses in advance to make sure they accept a Power of Attorney form in advance. However, imagine the same hours plus the immense stress if this has to be done when a parent is incapacitated or has died. Banks, in particular, require POAs to be reviewed by their own attorneys before the document can be approved, which could take weeks to complete.

Durable General Powers of Attorney may also be filed at the parish clerk’s office. If a POA is filed but is later revoked and a new document created, or if a fiduciary needs to convey real estate property with the powers conferred by a POA, the document at the county clerk’s office should be updated.

Each fiduciary listed in the documents should be given a copy of the documents. This will be helpful when it’s time to show proof they are a decision maker.

Having estate planning documents properly prepared by an experienced estate planning attorney is the first step. Step two is ensuring they are safely and properly stored, so they are ready for use when needed.

BOOK A CALL with me, Ted Vicknair, Board Certified Estate Planning and Administration Specialist, Board Certified Tax Law Specialist, and CPA to learn more about estate planning, incapacity planning, and asset protection.

If you liked this article, “How Do I Store Estate Planning Documents?” read also these additional articles: Are Vitamin D and Dementia Connected? and Using Estate Planning to Prepare for Medicaid and What Is a TOD Beneficiary? and Can My Gun Collection Be Part of Estate Plan?

Reference: The Times-Enterprise (June 11, 2022) “Give thought to storing your estate papers”