How Do I Decide to Retire or Keep Working? – Annapolis and Towson Estate Planning

Fed Week’s article, “Many Factors Affect Choice of Retiring or Continuing to Work,” says that the Congressional Budget Office found that after declining for decades, the share of those ages 55 to 79 who were employed began to go up in the mid-1990s. In 1995, 33% of those in that age range worked, but by 2018, 44% did. The Congressional Budget Office pinpointed some factors that are motivating people to work longer. Let’s look at some of these:

  • Those with a college degree are more apt to be employed at any age than those without one. The percentage of individuals with degrees has been increasing over time, especially among women.
  • From the mid-1990s to 2018, the health of people ages 55 to 79 improved significantly. This shows the gains in self-reported measures and longevity. Improvements in health impact employment, both because healthier people are physically able to work longer and because increased life expectancy may motivate people to spend more years working, in order to pay for their retirement.
  • Job Characteristics. Over time, fewer people worked in blue-collar jobs. Due to the fact that blue-collar jobs typically have greater physical demands than other jobs—and workers in those jobs tend to retire earlier—that decrease impacts some of the rise in employment of people 55 to 79.
  • Increased Employment of Women. Research has shown that the increased employment and delayed retirement of married women over the period, might have contributed to the increased employment of married men because many couples retire at the same time.
  • Employer Policies. The move from defined benefit to defined contribution retirement plans lowers the incentive to retire at a particular age. The added burden for workers to save on their own also creates more motivation to work longer. Private sector companies have also cut back on health insurance coverage for their retirees. Only 37% of workers now have employer-based health insurance that covers retirees between 55 and 64, compared with 69% in 1992. As a result, workers have an incentive to work at least until 65, when they become eligible for Medicare.

Reference: Fed Week (November 7, 2019) “Many Factors Affect Choice of Retiring or Continuing to Work”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Q & A – Medicaid for Nursing Home Care – Annapolis and Towson Estate Planning

As we approach our third act, new terminology comes into our daily lives that we may have heard before, but maybe never gave much thought to. Terms like Medicare, Medicaid, Social Security, Long-Term Care, and so on, can become sources of anxiety, if we don’t truly understand them. Therefore, today we’re answering some of the fundamental questions about Medicaid for nursing home care, in the hopes that we can alleviate at least one source of anxiety for you.

Question #1 – What is Medicaid?

Medicaid is a state and federal government-funded program that provides medical services to financially eligible individuals. Unlike Medicare, you do not have to be elderly to qualify for Medicaid, and many elderly individuals receive Medicaid benefits, including nursing home care. Every state administers its own version of Medicaid. For more information on Medicaid programs in your state, visit the Medicaid website, and select your state.

Question #2 – What are Medicaid’s basic financial eligibility requirements for nursing home care?

To determine your eligibility for nursing home benefits under Medicaid, the government will look at your income and resources in a given month to ensure you are within the legal limits for Medicaid benefits. To qualify for Medicaid, your monthly income must be less than the Medicaid rate for nursing home care, plus your typical monthly healthcare expenses. If you are eligible, you are allowed to keep $70 of your income for personal use. The rest is taken to pay for your care.

Question #3 – What is the Medically Needy Program under Medicaid?

For individuals that may exceed the financial limits to receive Medicaid, they may still qualify to receive Medicaid benefits under the medically needy program. This program allows individuals with medical needs to “spend down” their income to acceptable rates, by paying for medical care for which they have no insurance. For individuals over the age of 65, states are required to allow you to spend down your income regardless of medical necessity.

Question #4 – What resources can we have if my spouse is applying for Medicaid?

When a married couple applies for Medicaid, both spouses’ income and resources are included in the qualifying calculations. You may have all of the “exempt” resources, like an automobile and a house, along with one non-exempt item that does not exceed a set value (currently just over $58,000), such as cash or investments. Once your spouse qualifies for Medicaid, after one year, all excess income and resources must be transferred to the non-Medicaid-benefitted individual. That spouse may also accrue income and resources over and above the limits that Medicaid imposes on the benefitted spouse.

More information can be found on the Medicaid website, including requirements and benefits information for the state in which you reside.

References:

Medicaid.gov. (Accessed November 28, 2019) https://www.medicaid.gov/medicaid/index.html

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

The Medicaid Medically Needy “Spend-Down Program” – What You Need to Know – Annapolis and Towson Estate Planning

If you’ve been denied Medicaid benefits because you have too many assets or too high an income, don’t give up. There are available programs that may enable you to qualify for Medicaid benefits, despite this setback. Each state may offer different programs, and the Affordable Care Act (ACA) has added new ways to obtain coverage. This article addresses the “spend down program” offered in every state.

Medicaid Spend-Down Program – The Basics

To qualify for Medicaid benefits, your income and assets may not exceed a certain amount set by law. If these items do exceed the legal limits, you may still qualify after a spend-down period. The medically needy spend-down program helps individuals over the age of 65, and some younger individuals with disabilities. To be eligible for this program, you must not be receiving public financial assistance.

Exempt & Non-Exempt Assets

It is not necessary to sell off everything you own to qualify for the spend-down program. You may keep a certain amount of “exempt assets,” such as the home you live in, your car (used for transportation), household furniture, clothes, jewelry and other personal items. None of these assets affect your eligibility, regardless of their value (unless you have high equity, say $1 million in an asset, in which case you may need to spend that down).

Non-exempt assets, on the other hand, do affect your eligibility for the spend-down program. These assets include bank accounts, stocks, investments, and cash over $2,000 for an individual or $3,000 for a married couple.

Amount of Income You Can Have to Apply

It does not matter how much income you have when you apply. The more income you have, though, the more medical expenses you must incur before your coverage can start. The way you spend down this income is by spending it on medical expenses, until you reach the income requirements for Medicaid. Interestingly, you just need to incur medical costs. You don’t have to actually pay them.

In addition, you can pay down accrued debt to spend down your income. Therefore, paying down credit card bills, car payments, or mortgage debt can count towards your spend down. Another tactic you can use, is to pay excess monthly amounts on old medical bills.

Seeking Professional Assistance

Medicaid programs are different in each state, and the laws change frequently. If done wrong, you could end up incurring penalties instead of obtaining benefits. It may be a good idea to enlist the help of a Medicaid specialist or elder law attorney to walk you through the process in a way that will avoid these types of penalties.

Resources:

National Council on Aging. “Benefits Checkup” (Accessed November 28, 2019) https://www.benefitscheckup.org/fact-sheets/factsheet_medicaid_la_medicaid_spend_down/#/

U.S. News and World Report. “How a Medicaid Spend Down Works.” (Accessed 28, 2019) https://money.usnews.com/money/retirement/baby-boomers/articles/how-a-medicaid-spend-down-works

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Alternatives to Medicaid – A Short Primer on Long-Term Care Insurance – Annapolis and Towson Estate Planning

Medicaid is a state-run program that caters to those surviving on less than 125% of the official poverty level. Many elderly individuals forego purchasing long-term care insurance, in favor of relying on Medicaid to cover their expenses. Unfortunately, after bankrupting themselves to qualify for Medicaid nursing home coverage, many of these same individuals find themselves dismayed at the lack of choice and care options.

Qualifying for Medicaid Long-Term Care

To obtain long-term care benefits through Medicaid, you must meet the income and asset requirements. In addition, you must be unable to perform at least two of the following six activities of daily living:

  • Feeding
  • Bathing
  • Walking
  • Transferring
  • Toilet Use
  • Dressing

If you qualify, you may be able to get all or most of your care covered, but you don’t have as many options when it comes to choice of facility. Medicaid also doesn’t typically cover adult daycare, assisted living, respite care, or in-home care.

Alternatives for Medicaid Long-Term Care – Not Medicare

With Medicare covering about 1/5th of nursing home care in the U.S., elderly individuals are forced to look at alternative means to cover skilled nursing and other long-term care needs. As it stands, Medicare Part A covers up to 100 days of skilled nursing care. Requirements to qualify are stringent, and few people have the time or understanding to correctly navigate the Medicare system.

Long-Term Care Insurance

If you’re insurable and can afford the premiums, long-term care insurance may be the best option for your long-term care needs. Coverage will vary based on your insurance company and plan options. Be sure to get coverage for all you anticipate you’ll need.

In 2019, the average cost of a semi-private room in a nursing home was $7,513 per month. Private rooms average over $8,000 per month. Even if you don’t anticipate needing that level of care, you should be aware that a one-bedroom apartment in an assisted-living facility costs over $4,000 a month. With inflation, this will likely increase. You don’t want to come up short on coverage.

If long-term care insurance is an option for you, be sure to start planning early. Insurance companies are known to reject more applicants, the older they get. Review your plans each year to ensure your policy still meets your anticipated needs. Make changes if necessary, and never stop paying your premiums, unless you want your insurance to lapse.

Resources:

ElderLawAnswers. “Alternatives to Medicaid: A Long-Term Care Insurance Primer” (Accessed November 28, 2019)  https://www.elderlawanswers.com/elder-law-guides/5/a-long-term-care-insurance-primer

Investopedia. “Medicaid vs. Long-Term Care Insurance: What to Know” (Accessed November 28, 2019)  https://www.investopedia.com/articles/05/031005.asp

Investopedia. “Strategies to Help Pay for Eldercare” (Accessed November 28, 2019)  https://www.investopedia.com/articles/personal-finance/102014/top-5-elder-care-strategies.asp

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

What is a Special Needs Trust? – Annapolis and Towson Estate Planning

Supplemental Security Income and Medicaid are critical sources of support for those with disabilities, both in benefits and services.

To be eligible, a disabled person must satisfy restrictive income and resource limitations.

That’s why many families ask elder law and estate planning attorneys about the two types of special needs trusts.

Moberly Monitor’s recent article, “Things to know, things to do when considering a special needs trust,” explains that with planning and opening a special needs trust, family members can hold assets for the benefit of a family member without risking critical benefits and services.

If properly thought out, families can continue to support their loved one with a disability long after they’ve passed away.

After meeting the needs of their disabled family member, the resources are kept for further distribution within the family. Distributions from a special needs trust can be made to help with living and health care needs.

To establish a special needs trust, meet with an attorney with experience in this area of law. They work with clients to set up individualized special needs trusts frequently.

Pooled trust organizations can provide another option, especially in serving lower to more moderate-income families, where assets may be less and yet still affect eligibility for vital governmental benefits and services.

Talk to an elder law attorney to discuss what public benefits are being received, how a special needs trust works and other tax and financial considerations. With your attorney’s counsel, you can make the best decision on whether a special needs trust is needed or if another option is better based on your family’s circumstances.

Reference: Moberly Monitor (October 27, 2019) “Things to know, things to do when considering a special needs trust”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

How Much Will I Really Spend in Retirement? – Annapolis and Towson Estate Planning

People are living longer today compared to previous generations. This means that their retirement savings need to last longer. As a result, you’ll need to be certain that you’re calculating your retirement spending accurately.

Kiplinger’s recent article, “Planning for Retirement? You’re Probably Underestimating Your Spending,” explains that general figures and trends don’t consider a person’s health and many other factors. Still, you should anticipate a lengthy retirement, which makes it even more critical to understand your cash flow and break out your expenses.

It’s not uncommon for people to totally underestimate their post-retirement spending. They don’t see the many additional expenses they’ll incur after ending their employment or selling their business. The common notion is that as you get older, you spend less. However, there are new expenses that come with retirement and current costs that you may not be accounting for.

Let’s look at the four main types of expenses that prospective or new retirees need to plan when creating a budget. Educating yourself in these areas will help to have a comfortable retirement.

  1. Formerly business-subsidized expenses. For many, the job provides more than a salary. It can include health benefits, cell phones and health club memberships. To avoid some surprise when you retire, make a list of the expenses that are now covered by your employer or business. Some you might be able to do without, while others may be a necessity in retirement.
  2. Overlooked expenses. Many people do the majority of their primary spending on one credit card. However, when they estimate their spending for retirement, they forget about spending on other credit cards and regular services and charges that may be paid for by cash or check, such as landscaping, housekeeping and real estate taxes. Prior to retirement, go through all your expenses and how they’re being paid. This should help flesh out a thorough understanding of your spending.
  3. Health care expenses. Even if you hit retirement without a major accident or illness, you’re still probably going to spend a good portion of your income to stay that way. A recent study found that a healthy male-female couple retiring at 65 in 2019 can expect to spend $285,000 on health care over their retirement years. Medicare begins at 65 and covers many expenses, but there are many common health care costs that are not covered, such as dental and vision services, prescription drugs (unless you buy a supplemental plan, such as Part D), and long-term care. Out-of-pocket costs can also shoot up if a senior has a serious or chronic disease, like a heart condition.
  4. Recurring non-recurring expenses. You may get a new car or need a major repair in your house. These are considered non-recurring expenses you commit to sparingly or just once in your life. However, big purchases and unexpected costs occur more often than you’d imagine. It’s a good practice to plan for at least one “one-time purchase” each year to cover these unanticipated bills.

Reference: Kiplinger (October 3, 2019) “Planning for Retirement? You’re Probably Underestimating Your Spending”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

How Can I Plan for Medical Expenses in Retirement? – Annapolis and Towson Estate Planning

Healthcare can be one of the biggest expenses in retirement.

Fidelity Investments found that a 65-year-old newly retired couple will need $285,000 for medical expenses in retirement. That doesn’t include the annual cost of long-term care. In 2018, that expense ran from $18,720 for adult day care services to $100,375 for a private room in a nursing home, according to Investopedia’s recent article, “How to Plan for Medical Expenses in Retirement.”

Despite saving and preparing for retirement their entire lives, many retirees aren’t mentally or financially prepared for these types of expenses. A survey by HSA Bank found that 67% of adults 65 and older thought that they’d need less than $100,000 for healthcare. However, Fidelity calculated that males 65 and older will need $133,000—and females, $147,000—to pay for healthcare in retirement.

There are two important numbers for healthcare expenses in retirement: how much money is coming in and how much is going out. A typical person in their 60s has an estimated median savings of $172,000. On average, those 65 and older spend $3,800 per month, but Social Security only replaces about 40% of their working-life income.

Medicare can pay for some healthcare spending in retirement. However, there are some limitations. If a senior doesn’t have a Part D prescription drug policy, Medicare won’t cover medications. Medicare Parts A and B won’t cover dental and vision care, but Medicare Advantage plans typically do. Medicare also doesn’t offer coverage for long-term care. Medicare Advantage plans are offered through private insurers.

There are two ways pre-retirees can create a safety net for healthcare spending when they retire. One way is with a Health Savings Account (HSA). HSAs are available with high-deductible health plans and offer three tax advantages: (i) deductible contributions; (ii) tax-deferred growth; and (iii) tax-free withdrawals for qualified medical expenses. HSA funds can be used to pay for certain medical premiums, like Medicare premiums and long-term care insurance premiums. If you’re in your 50s, you can still maximize these plans by taking advantage of catch-up contributions and employer contributions. However, those already enrolled in Medicare can’t make new contributions to an HSA.

You can also buy long-term care insurance to fill the gap left by Medicare. This policy can pay a monthly benefit toward long-term care for a two-to three-year period.

Healthcare spending can easily take a big bite out of a retirement budget. Estimate your costs and design a strategy for spending to help preserve more retirement assets for other expenses.

Reference: Investopedia (June 25, 2019) “How to Plan for Medical Expenses in Retirement”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Are You Prepared to Age in Place? – Annapolis and Towson Estate Planning

If aging in place is your goal, then long-term planning needs to be considered, including how the house will function as you age, accommodations for the people who will care for you and how to pay for care, says the Record Online in the article “Start planning now so you can ‘age in place.’”

Many homes will need to be remodeled for aging in place and those changes may be big or small. Typical changes include installing ramps and adding a bathroom and bedroom on the first floor. Smaller changes include installing properly anchored grab bars in the shower, improving lighting and changing floor covering to avoid problems with walkers, wheelchairs or unsteady seniors.

Choosing a caregiver and paying for care are intertwined issues. Many adult children become caregivers for aging parents and for the most part they are unpaid. Family caregivers suffer enormous losses, including lost work, career advancement, income and savings. Stress and neglect of their own health and family is a common byproduct.

You’ll want to speak with an estate planning elder care attorney about how or if the parent may compensate the child for their caregiving. If the payment is deemed to be a gift, it will cause a penalty period when Medicaid won’t pay for care. A caregiver agreement drafted by an elder law estate planning attorney will allow the parents to pay without a penalty period. The child will need to report this income on their tax returns.

The best way to plan ahead for aging in place is with the purchase of a long-term care insurance policy. If you qualify for a policy and can afford to pay for it, it is good way to protect assets and income from going towards caregiver costs. You can also relieve the family caregiver from duties or pay them for caregiving out of the insurance proceeds.

Without long-term care insurance, the next option is to apply for community Medicaid to pay for care in the home if available in your state. To qualify, a single applicant can keep $15,450 in assets plus the house, up to an equity limit of $878,000 and only $878 per month of income. For a married couple, when one spouse applies for community Medicaid, the couple may keep $22,800 in assets plus the house and $1,287 per month of income. If the applicant or spouse are on a managed care plan, the couple may keep more assets and income.

Another option is spousal refusal, which may allow the couple to keep more assets and income. When an applicant has too much income, a pooled income trust may be used to shelter income from going towards the cost of care. This is a complicated process that requires working with an estate planning attorney to ensure that it is set up correctly.

Self-paying for home care is another option, but it is expensive. The average cost of home health care in some areas is $25 per hour, or $600 per day. When you get to these costs, they are the same as an expensive nursing home.

Planning in advance with careful analysis of the different choices will give the individual and the family the best picture of what may come with aging in place. A better decision can be made once all the information is clearly assessed.

Reference: Record Online (Aug. 31, 2019) “Start planning now so you can ‘age in place’”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

Can You Protect Your Home If You Need Medicaid? – Annapolis and Towson Estate Planning

Anyone who owns a home, whether a magnificent mansion or a modest ranch, worries about the possibility of losing the home because of long-term care. How can they keep the home for their spouse or even for their family, if they need to apply to Medicaid for long-term nursing care costs?

The problem, reports The Mercury in a recent article “Protecting your house and Medicaid” is often the strategies that people come up with on their own. They usually don’t work.

The first thought of someone who is confronted with the need to qualify for Medicaid is to immediately transfer ownership of the family home to another person. The idea is to take the home out of their countable assets. But unless the person who receives the house is an adult child, that transfer only leads to problems.

Medicaid’s basic premise is that if you can afford to pay for your own care, you should. Transfer of a home, let’s say one with a value of $400,000, means that a $400,000 gift has been given to someone. There is a five-year lookback period. Any assets given away or transferred in that five-year period means that you had the asset under your control. Medicaid will not pay for your care in that case.

There are some exceptions to the gifting rules, but this is not something to be navigated without the help of an experienced elder law estate planning attorney. Here are the exceptions:

Your spouse. It’s understood that your spouse needs a place to live and a transfer of the home to your spouse does not result in penalties under Medicaid rules. This usually means transfer from title as joint tenants with rights of survivorship or tenants by the entireties to the healthier wife or husband. It is also understood that a transfer to your spouse at home is not a disqualifying transfer. This is a common practice and part of Medicaid planning.

A disabled child. A parent may transfer a house to their disabled child on the theory that it is needed for self-support. It is not necessary for a child to lose a home because a parent will be on Medicaid. This is a common mistake, and completely avoidable. Talk with an elder law attorney to learn more.

If a child is a caretaker. An adult child who moves in with the parents for a period of at least two years to care for them so they could stay at home and avoid going to a nursing home, or if the child has lived with their parents for longer than that and they need this care at home, under federal law the home can be transferred to the child without penalty and the parent can go to a nursing home and receive care under Medicaid. This is another very common mistake that causes adult children to be left without a home.

For a person who is single or a widow or widower who will never move home after moving into a Medicaid certified nursing home, the house may be sold and planning can be done with the proceeds of the sale. Paying bills to maintain a vacant home for no reason and having the government take the home as a creditor through the estate recovery program does not make sense. An elder lawyer estate planning attorney can help navigate this complex and often overwhelming process.

Reference: The Mercury (July 31, 2019) “Protecting your house and Medicaid”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

What Should I Know About a Special Needs Trust? – Annapolis and Towson Estate Planning

Your disabled family member may be eligible for a number of government programs. However, Pauls Valley (OK) Democrat’s recent article asks “Can your family benefit from a special needs trust?” The article reminds us that these programs don’t cover everything. You may need to close the gaps.

A few government programs have eligibility restrictions based on the level of financial assets that are available to the recipient. This means the financial help you’re wanting to provide may do more harm than good unless you establish a special needs trust.

As the donor, you supply the funds. A trustee holds and administers them according to your instructions. The beneficiary typically can’t use the trust for basic support or to receive benefits that can be provided by the government. The special needs trust can be used to provide specialized therapy, special equipment, recreational outings and other expenses.

When considering a special needs trust, you’ll need to look at several issues with your attorney.  However, there are two that are critical. The first is designating a trustee. You could name a family member or close friend as a trustee. While this works well for many, it has the potential to cause family conflicts. You could also name a trust company. This company can provide professional management, expertise and continuity of administration. A third option is to name an individual and a trust company as co-trustees.

The second critical issue with a special needs trust is funding the trust. You can fund the trust during your lifetime or have it activated when you die.

Note that you don’t have to be the sole donor. A special needs trust can be created so other family members can also contribute to it. The trust can be funded with securities (stocks and bonds), IRA proceeds, insurance death benefits and other assets.

You’ll need to understand the requirements of various federal, state and local benefit programs for people with disabilities, so that your loved one’s benefits are not at risk.

Speak with an experienced elder law or estate planning attorney about how you can to make life better for a disabled child or family member with a special needs trust.

Reference: Pauls Valley (OK) Democrat (August 1, 2019) “Can your family benefit from a special needs trust?”

Sims & Campbell, LLC – Annapolis and Towson Estate Planning Attorneys

For Immediate Release

Contact: Jane Frankel Sims

410-828-7775

Contact: Frank Campbell

410-263-1667

Sims & Campbell Estates and Trusts

Frankel Sims Law and Holden & Campbell
Merge to Form Sims & Campbell

Firm will offer comprehensive Trusts & Estates services through offices in Towson and Annapolis

TOWSON, Md. (April 26,2019)  Frankel Sims Law and Holden & Campbell have jointly announced the merger of their firms to create a boutique Trusts & Estates law firm providing comprehensive services in the fields of Estate Planning, Estate Administration, Trust Administration and Charitable Giving. The combined firm will be named Sims & Campbell and have offices in Towson, Md. and Annapolis, Md.  Jane Frankel Sims and Frank Campbell will lead and hold equal ownership stakes in the firm.

Sims & Campbell will have 9 attorneys and 15 legal professionals that handle every facet of estate and wealth transfer planning, including wills, revocable living trusts, irrevocable trusts, estate and gift tax advice, and charitable giving strategies.  The firm will focus solely on Trusts & Estates but will serve a wide range of clients, from young families with modest resources to ultra-high net worth individuals.  This allows clients to remain with the firm as their level of wealth and the complexity of related estate and tax implications change over time. 

“By joining forces, we have expanded our footprint to conveniently serve clients in Maryland, D.C. and Virginia” said Jane Frankel Sims.  We are seeing some of the greatest wealth transfer in our country’s history, and we want to continue to be on the leading edge of helping our clients maintain and enhance their family’s wealth.  In addition, we aim to serve our clients for years to come, and the new firm structure will allow Sims & Campbell to thrive even after Frank and I have retired.”    

“Jane and I have always admired each other’s firms and recognized the need to provide even greater depth and breadth of focused expertise to help families amass and protect their wealth from generation to generation,” said Frank Campbell.  “Now we have even greater capabilities to make a real difference for our clients.” 

The Sims & Campbell Towson office is located at 500 York Road, on the corner of York Road and Pennsylvania Avenue in the heart of Towson.  The Annapolis office is currently located at 716 Melvin Avenue, and is moving to 181 Truman Parkway in August, 2019.  For more information, visit www.simscampbell.law.