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Elder Law

Understanding Medicaid

Federal and state Medicaid programs offer comprehensive health insurance and financial protection to millions of Americans. The program helps low-income families, individuals, and people with disabilities receive adequate health care and provides nursing home or community long-term care services. As of August 2022, more than 90.5 million individuals were part of the Medicaid and Children’s Health Insurance Programs (CHIP).

States Follow Federal Guidelines But Have Some Autonomy

Although Medicaid funding is a federal-state partnership, states administer the programs and have some flexibility in determining who to cover, delivery models, and payment methods for physicians and hospitals. States may apply for a Section 1115 waiver to experiment with different implementation approaches as federal statutes require; however, the Secretary of the US Department of Health & Human Services (HHS) determines advanced program objectives.

Medicaid entitlement has two basic guarantees. First, all Americans who meet Medicaid eligibility requirements are guaranteed healthcare coverage. Second, states receive guarantees for federally matched funds without a cap for enrollees’ qualified services. Under current law, nearly all Medicaid federal funding is open-ended, but this may change for cost containment.

According to the Congressional Budget Office (CBO), the federal government pays anywhere from 54 percent to 79 percent of each state’s annual Medicaid outlays, with the states’ picking up the remainder. Beyond enrollment expansion due to COVID-19 for the fiscal year 2022, nearly one-third of states saw upward pressure on spending due to increasing costs for managed care and provider rate increases.

Medicaid Coverage Continues to Evolve

Medicaid began in 1965 and was a cash assistance program for qualifying individuals or families. In the following years, Congress expanded federal minimum requirements to provide more new coverage types, particularly for children, pregnant women, and people with disabilities. The broader health care coverage of the Affordable Care Act (ACA) in 2010 expanded Medicaid to non-elderly adults with qualifying low incomes and continues to meet changing needs.

A Broad Range of Health and Long-Term Care Services

In addition to the Medicaid federal law service requirements, many states provide optional services. These services include physical therapy, prescription drugs, eyeglasses, and dental care. Medicaid expansion for adults is part of the ACA’s ten “essential health benefits,” which include the following:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity, and newborn care
  • Mental health and substance abuse disorders
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventative and wellness services
  • Pediatric services

Medicaid covers the cost of long-term care, including nursing homes and many community-based long-term services. Over half of all Medicaid long-term care spending is for home and community-based services (HCBS), enabling seniors and those with disabilities to live more independently. Emphasis is shifting away from institutional settings, although intermediate care facilities for adults with intellectual disabilities remain a priority.

Privately Managed Care Plans for Enrollees

More than two-thirds of Medicaid beneficiaries account for privately managed care plan enrollments contracting with states to provide comprehensive services. Other enrollees receive their care in a fee-for-service system.

Most states cover long-term services through risk-based managed care arrangements to contain costs. These managed care organizations (MCOs) are comprised of various entities, as some involve physicians while others combine physicians, hospitals, and other providers.

The blended approach of public and private partnerships to provide Medicaid care allows each participating group to function at their highest level, integrating efforts instead of trying to solve issues outside their expertise.

Medicaid beneficiaries have far better access to healthcare than the uninsured and seek medical care before health problems become severe and more costly. The satisfaction ratings of Medicaid recipients are comparable to those rates for individuals with private health insurance.

Conclusions

Despite experiencing low income, the rate of Medicaid enrollment is similar to those with private coverage. Medicaid covers preventative, rehabilitative, and acute health care in addition to costly long-term care for millions of Americans.

Medicaid services account for one-fifth of healthcare spending and receive a lot of attention regarding:

  • Capacity expansion to address addictions, in particular opioids
  • Refining payment and delivery systems
  • Lowering prescription drug costs
  • Refining eligibility requirements
  • Increasing community-based long-term care services

Medicaid funding is a major financial support for hospitals, doctors, nursing homes, and many other jobs in the healthcare sector. Federal matching funds guarantee an open-ended basis to provide flexibility in supporting each state’s population’s healthcare needs.

Medicaid is an extensive program and varies by state, making it difficult to know what is available to beneficiaries or potential enrollees. Attorneys specializing in Medicaid and disability can help you understand how to benefit from your state’s programs. They can guide your application process, ensuring you receive the necessary benefits.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

Elder Law

Ensuring Health and Safety for Nursing Home Residents

Baby boomers will require more care as they enter their golden years, some will be able to be cared for at home by family members or with hired help. Many will need to move into long-term care facilities, such as nursing homes, to get the level of care they need. This can bring extra costs and concerns. In addition to the growing costs of living in a long-term care facility, there is the concern that your loved one will not get the quality of care you imagined.

Health and Safety

According to a statement released by The White House on February 28, 2022, private equity firms have been buying struggling nursing homes, leading to a general decline in residents’ care. Between 2000 and 2018, investments in nursing homes by private equity firms increased from $5 billion to over $100 billion. Recent research has found that resident care and health are significantly worse in nursing homes owned by private equity firms.

A recent study of nursing homes that private equity firms acquired found that residents were 11.1% more likely to have preventable emergency department visits and 8.7% more likely to experience a preventable hospitalization than residents of for-profit nursing homes not owned by private equity firms. Additionally, COVID-19 infection rates were 30% above statewide averages, and the death rate was 40% above statewide averages in private equity-owned nursing homes.

The Biden-Harris Administration has tasked the Department of Health & Human Services (HHS) through its Centers for Medicarhealthcared Services (CMS) with improving the quality and safety of nursing homes. This effort is directed at protecting vulnerable residents and the health care professionals who care for them and cracking down on bad actors. CMS is launching new initiatives to help ensure nursing home residents get the quality care they need. These initiatives include establishing a minimum nursing home staffing requirement, reducing resident room crowding, and reinforcing safeguards against unnecessary medications and treatments.

Cost of Long-term Care

Baby boomers will start to enter their 80s in 2025, increasing the number of people needing extra support and services, including long-term care. According to estimates from the CMS, the number of people requiring long-term care will double by 2050.

In a 2019 survey, the insurance company Genworth found that the average annual cost of a private room in a nursing home was $102,000. The Insured Retirement Institute has discovered that 45% of baby boomers have no retirement savings, and more than a quarter of those who have some retirement savings have less than $100,000.

These statistics paint a bleak picture for those who are hoping to live their later years in comfort. Due in part to the high cost of professional health care and support services, most long-term care is provided by close family members, such as spouses and children. Often, though, there comes a point when the person being cared for needs a level of care that their family members are unable to provide.

Paying for Long-term Care

Once someone needs professional care, either in their home or at a long-term care facility, the cost of care increases dramatically. Finding a way to pay for this type of long-term care can be a stressful and confusing process. The earlier the process is started, the better chance one has of preserving assets for their loved ones.

Attorneys who are experienced in estate planning and elder law help clients navigate the often complex process of planning for long-term care. There are many ways to adequately prepare for long-term care while saving assets for heirs.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

Elder Living

Take Advantage of Government Programs for Seniors

Due to current inflationary pressures, many US seniors are experiencing financial insecurity. In addition to cutting back on unnecessary expenses, retirees and those approaching retirement should apply for government assistance programs so they may qualify and alleviate the anxiety many Americans experience with a fixed income.

The National Council on Aging (NCOA) works with thousands of national and local partners to provide tools, resources, advocacy, and best practices for every aging American to have health and financial security. Checking out if you qualify for senior benefits through government programs is easy to do with NCOA’s online BenefitsCheckUp tool.

Wasted Benefits

Every year billions of available dollars in US benefits programs are not claimed because older adults (55 or more) are unsure if they are eligible and, if so, how to apply. No registration is necessary, and requests for information are minimal. Personal data entered into the website will remain confidential, and accessing the database costs nothing. If you hate filling out forms and get confused by all the questions, estate planning and elder law attorneys go through this process every day. Contact them for help. There is rarely an upfront cost for legal help, and you will be in a much better financial position once you begin receiving assistance.

The Online Benefits Check Up

If you complete the benefits check-up online, NCOA will send a confidential report to your mailing address listing the help available to you and how to apply for it. Since 2001 this NCOA program has helped millions of older adults receive help paying for medicine, food, utilities, and more. More than 2,000 benefits programs are in the check-up system, including categories such as:

  • Food and nutrition
  • Health care and medication
  • Housing and utilities
  • Income
  • In-home care and aging in place
  • Disability services
  • Skilled nursing facilities and other long-term care environments
  • Tax help
  • Legal, crisis, and general assistance
  • Veterans’ programs
  • Discounts and activities

The online BenefitsCheckUp site helps older individuals identify the federal and state assistance programs for which they can qualify. This NCOA website is newly revamped and permits error corrections and the addition of information if you feel the need to revise your answers. The resulting online individualized Eligibility Results report can be saved in a PDF format to email to yourself, your lawyer, or a trusted family member.

Providing this eligibility information to your elder law or estate planning attorney is a smart strategy. Suppose you already receive disability benefits through SSDI, SSI, or other programs. In that case, adding other government assistance programs may result in unintended and negative consequences that may render you ineligible for benefits you already receive. Your lawyer will know the strategies already in place and how additional programs may affect your current planning.

The chart above shows how many older adults struggled to manage basic expenses even before the inflationary circumstances of late 2021 – 2022 (and predicted beyond). Participation rates in government assistance programs are at a historic low, with a mere low to mid sixty percent of eligible individuals participating.

Benefit take-up rates are low due to program enrollment barriers. Many older adults lack awareness that these benefits exist, and when they do, the application process for many programs can be cumbersome and complex. Additionally, perceived stigma about receiving government assistance and other program misconceptions contribute to lower participation rates.

Ramsey Alwin, NCOA CEO and President, admits, “In today’s economy, inflation is taking a bigger and bigger bite out of people’s incomes.” He adds, “We completely redesigned BenefitsCheckUp to make it even easier … no one should have to choose between paying for medications or food.”

To worry less and age better with more resources at your disposal, explore the NCOA’s BenefitsCheckUp website and learn what is available to you. Before you use the contact information to take the next step to apply, be certain to consult with your elder law or estate planning attorney. All assistance you receive should not interfere with existing plans and help you age successfully. More than 2,000 government benefits programs are available to help you, and it can make the difference between thriving or just surviving.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

Estate Planning

Probate’s Timeline

A will must go through probate before it is acknowledged, a personal representative (executor) is named, and assets are distributed according to the will. It also requires paying the decedent’s outstanding debts and federal and state taxes. Each state has different laws determining if probate is necessary or can be expedited, whether the fiduciary requires bonding, and what reports must be prepared. The probate experience is unique, as no two wills are the same.

In general, the timeline of the probate procedure moves quickly if the estate has minimal assets and little debt. Larger estates can expect a process lasting anywhere from nine months to a few years, especially with problematic family dynamics. An estate planning attorney or probate lawyer can help guide efforts in these more complex or contentious circumstances. During a time of grief, it is reassuring to have a general probate timeline to help manage expectations and deadlines as you move through the process.

Prepare and File the Probate Petition (1-4 months)

Filing a probate petition requires a valid will and the decedent’s death certificate, usually provided by the funeral home. The personal representative or executor sends an official notice of probate to beneficiaries or interested parties, with each state having specific requirements regarding the notification process. To speed the process, when there is agreement among beneficiaries, each party signs the “waiver of process consent to probate.” This consent form advises the court there are no issues with the will, and beneficiaries forfeit the right to challenge the will or its executor.

Usually, an executor sends a notice of probate within the first two months of the decedent’s passing. Some states require a notice of death published by the executor in the newspaper. The executor provides the funeral home with the decedent’s Social Security number, and they create a legal death certificate. An executor may prefer to purchase several death certificates for larger estates. It is a responsibility to report the person’s death to the Social Security Administration. If the decedent received medical benefits, a notice of death to the Department of Health and Human Services (HHS) is a requirement.

Provide Notice to Creditors (3-6 months)

Like all beneficiaries, all creditors must be aware of the decedent’s will. The estate’s personal representative notifies appropriate claim holders via a formal notice to creditors and other firms, companies, or people to whom the decedent owed money. It is important to follow court rules for notifying creditors. Discovery regarding the deceased’s outstanding debts is most easily achieved by gathering the remaining bills or requesting a copy of the decedent’s credit report.

Payment of Debts and Fees (6-12 months)

The decedent’s creditors receive notification of the individual’s death with a formal notice of death and notice to creditors. The executor must pay all professional and personal debts from the estate with estate funds. The estate is also responsible for payment of the decedent’s state and federal income taxes before the probate process can conclude.

Additionally, the process of probate itself costs the estate money. All fees and administration costs relating to probate are to be paid by the estate via the personal representative’s actions. The fee structure can increase based on the length of time a will is in probate, so the executor benefits by moving quickly and carefully.

Asset Inventory (6-12 months)

An inventory of the estate’s assets is a crucial part of the will since it becomes part of the official estate record. The task can be time-consuming, particularly if the estate’s records are in disarray. Most asset inventory will include:

  • Bank accounts, including savings and checking accounts
  • Property and real estate
  • Stocks and bonds
  • Retirement accounts
  • Life insurance and annuities
  • Luxury items of significant value, like jewelry, watches, art, and other collectibles
  • Intellectual property, including patents, trademarks, copyrights, software databases, and design rights
  • Online line business ventures that produce income or have stand-alone value

Jointly owned real estate, property, vehicles, and financial accounts transfer to the surviving owner. Probate is also not required for IRAs with a beneficiary or other accounts with a pay-on-death designation.

Asset Distribution (9-18 months)

Before asset distribution, the estate’s executor should make every effort to pay all outstanding debts. When all creditor bills are paid, and the remaining assets are accounted for, some state probate law dictates the distribution of assets occur only after the probate hearing. Concluding the probate hearing first prevents the opportunity for an ungrateful or disgruntled beneficiary to threaten the will’s validity.

The Estate Closing (9-24 months)

Probate can conclude when all creditors are paid, taxes are filed, and assets are sold or distributed. After finalizing the executor’s duties, the probate court judge then issues the final order of discharge of the personal representative. This court action officially closes the estate.

All wills go through probate proceedings; however, it is not the only available option. Larger estate owners may prefer to protect the futures of their loved ones using trusts. There are advantages to avoiding probate as it can be lengthy, complex, expensive, and is always a matter of public record.

Your estate attorney can customize an estate plan for your family situation. Our estate planning firm can advise trusts and other legal mechanisms to lessen the probate process or let you know if your estate is a candidate for an expedited process. There is a general timeline for the probate process, yet, all wills and state laws are different.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

Elder Law

2023 Brings Changes to Social Security Benefits

More than seventy million people who rely on Social Security’s benefit programs will undergo significant changes in the coming year.Inflation continues to increase daily living costs with higher costs for gasoline, food, utility, rent, and mortgages. Yet real wages have been stagnant for decades to all but the highest-earning households, making basic living costs untenable for an increasing number of workers. Additionally, supply chain problems also increase the prices of available goods. The five changes to Social Security benefits in 2023 will relieve some of the current challenges that inflationary pressures present.

Cost of Living Adjustment (COLA)

Before 1975, Social Security benefit increases were set by legislation. In 1972, congress enacted the COLA provision, and automatic annual COLAs began in 1975. Since then, the COLA has set all SS public benefits increases. This adjustment figure is tied to the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). The COLA ensures that the purchasing power of Social Security benefits programs does not erode due to inflation.

The COLA for 2023 is 8.7 percent and will appear as an increase in benefits payments. According to Bankrate, this adjustment will amount to a $146 increase for the average retired worker receiving Social Security benefits, increasing the average check from $1,681 to $1827. Couples, where both partners receive benefits, will receive an estimated payment increase of $238, increasing the average check from $2,734 to $2,972.

Maximum Taxable Earnings Increase

The Contribution and Benefit Base limit changes annually according to the national average wage index. Usually referred to as the taxable maximum for earnings, the base is $160,200 for 2023. This tax is a funding mechanism for Social Security benefits via the Old Age, Survivors, and Disability Insurance (OASDI), more readily known as the Federal Insurance Contributions Act (FICA).

W-2 workers have this tax deducted from their paychecks, and 1099 employees pay through the self-employment tax upon federal tax filing. The tax revenue supports the ASI Trust Fund for retirement and the DI Trust Fund for disability. The tax amount typically increases at a 6.2 percent rate meaning more of a worker’s income is subject to tax.

Maximum Social Security Benefit Increase

The maximum Social Security receivable benefit for workers retiring at full retirement age will increase from $3,345 to $3,627 in 2023. This maximum only applies to those who take their benefit at full retirement age, which is 67 for people born after 1960.

Maximum amounts will vary depending on those who retire before full retirement age as benefits reduce in that situation. The situation also applies to those who retire after the full retirement age, a strategy known as maxing out your benefit check. Bankrate cites three main levers to max out your Social Security income: working longer, earning more, and delaying your benefit. All of these strategies will provide you with the maximum retirement benefits.

Increase in Average Benefit for Spouses and Workers with a Disability

In 2023 beneficiaries’ average benefit amounts will increase across the board. This increase includes benefits for widows and widowers, and people with disabilities. According to Bankrate, the figures break out accordingly:

  • The SSA will increase the average widowed mother with two children from $3,238 to $3,520.
  • Widows and widowers, aged and living alone, will receive an average increase from $1,567 to $1,704.
  • A worker with a disability and a spouse with one or more children will receive an average benefit increase from $2,407 to $2,616.

These increases are averages, and individual circumstances will vary. The SSA has a Fact Sheet that can help narrow down your specific situation and describe your benefit change amounts. The SSA will mail COLA notices throughout December to retirement, survivors, and disability beneficiaries, as well as SSI recipients and representative payees. To learn about your increases online, in early December, you can log into your personal My Social Security account in the Message Center under COLA notices. You can read more about the process here.

Social Security Adjusts Earnings Test Exempt Amounts

If you claim retirement benefits before full retirement age and are still producing income, Social Security will withhold some benefits from your check at a certain earned income threshold. The program calls this the retirement earnings test exempt amount, and it can claim a significant chunk of your benefits if you are still working.

In 2023, if you begin collecting Social Security before full retirement age, it is permissible to earn up to $1,770 per month ($21,240 annually) before the SSA will begin to withhold benefits. This withholding is $1 in benefits for every $2 above the limit. This rule applies even when you reach full retirement age but with much more forgiving terms. In 2023 at full retirement age, you can earn up to $4,710 per month ($56,520 annually) before the SSA withholds benefits at a rate of $1 in benefits for every $3 earned above the limit.

These five Social Security benefit increases for the year 2023 can help all beneficiaries, especially those living on fixed incomes, to combat rising prices brought about by increasing inflation and supply chain problems. The cost of living projections for 2023 may increase 2024’s COLA by around ten percent. Uncertainty in the world and financial markets will continue to affect retirement accounts and the lifestyles of aging Americans. The law enacted by Congress in 1972 for automatic increases to Social Security benefits using a COLA helps retirees, survivors, and people with disabilities live financially better lives.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

Estate Planning

Estate Planning to Reduce Probate

The probate process occurs after someone passes away. Probate can be lengthy, complex, and expensive, but good estate planning can mitigate unwanted risks by anticipating and preventing problems before they arise. Sound estate planning can make the probate process run efficiently and smoothly, protecting your estate’s value and legacy, and preserving your family’s well-being.

Probate includes:

  • Validating a deceased person’s will
  • Identifying and inventorying the property of the decedent
  • Getting property appraisals
  • Paying valid outstanding debts and taxes
  • Distributing the remaining assets and property according to the will
  • Applying state intestacy laws if there is no will

Avoiding Probate

An estate planning attorney can structure your estate to minimize or avoid probate entirely. Circumventing probate reduces legal fees for your surviving heirs, protects privacy as probate is part of the public record, and avoids estate tax which can significantly reduce inheritable assets.

Popular Alternatives to Probate

A revocable living trust transfers assets to the trust but allows access to them during your lifetime. This probate-avoidance technique can protect any property you own, including:

  • Bank accounts
  • Real estate
  • Jewelry
  • Art collections and heirlooms
  • Vehicles

A revocable living trust

This trust functions like a will by leaving your property to heirs, but you can change the terms of your trust and the beneficiaries or revoke it while you are still alive. After your death, the property in the trust is in the control of your named successor trustee. They distribute the property to inheritors according to the trust’s instructions without involving probate court.

Life insurance and annuity policies

Death benefits are paid directly to a designated beneficiary upon the death of the insured or annuitant and pass outside of probate. And in some states, for example, Texas, death benefits are exempt from creditor claims for either the insured or beneficiary.

Payable-on-Death (POD) accounts or Transfer-on-Death (TOD)

A simple, no-cost strategy to keep money, even large sums, out of probate by designating a beneficiary via the financial institution’s POD paperwork process for all types of bank accounts. A TOD transfer applies to stocks, bonds, and brokerage accounts in the same way. These accounts are not accessible to the beneficiary while you are alive. You can designate beneficiaries on various accounts types, such as:

As the testamentary deposit account owner, you can withdraw money, close the account, or name a different beneficiary at any time. There may be a short waiting period after the designator’s death before the bank or credit union releases funds, but probate is not a requirement.

Depending on where you live, a POD account can also be a:

  • Totten Trust
  • Tentative trust
  • Informal trust
  • Revocable bank account trust
  • ITF, short for “in trust for”

In most cases, you cannot name an alternate beneficiary, so staying current with the paperwork designating your choice is important. No matter what information is in your will, it can’t override a properly established beneficiary designation.

Joint tenants or joint tenants by the entirety designate real estate

This property designation type has two owners. When one owner dies, the surviving owner automatically owns the property. This ownership is commonly referred to as the right of survivorship and also applies to community property in community property states.

Streamlining the Probate Process

Many states have simplified probate procedures for smaller estates, meaning they are under a certain dollar valuation. Depending on your state’s rules, even if your estate exceeds the definition of a small estate, there may be an avenue to exclude large chunks of assets to lower its size and value.

Many states don’t consider the value of certain properties when evaluating an estate. These property types may include real estate, real estate located in another state, and even motor vehicles. Additionally, many states won’t count the value of a property that doesn’t pass through probate. In essence, probate avoidance can pay double dividends after your death.

When trying to minimize an estate’s value to streamline probate, some states permit you to subtract any amounts owed on a property you don’t fully own. This can make a huge difference. Knowing your state’s definition of a small estate is crucial when creating probate-avoidance strategies. Staying under a certain threshold can simplify probate.

Probate Takeaway

A sound estate plan can circumvent many issues that arise from probate, which may cause a lengthy process and reduce your estate’s value and legacy. Avoid the additional costs of probate, both monetarily and to your family’s well-being.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

Elder Law

Married Couple’s Medicaid- Compliant Annuity

In general, an annuity pays a fixed amount annually to the owner for the remainder of his or her life. Most annuities are deferred, meaning the payout doesn’t occur until a later date. However, you can receive immediate payouts if you purchase a Medicaid-Compliant Annuity (MCA). When you buy a Medicaid annuity, you give a company a lump sum of cash in exchange for a guaranteed income stream. While only private insurance companies can issue annuities, you may purchase them through banks, financial planners, insurance agents, and brokerage firms.

The Benefits of a Medicaid Annuity

In what circumstances is a Medicaid annuity beneficial? Many Medicaid applicants are denied coverage for long-term care because they have too much money or too many assets. However, Medicaid applicants applying with insufficient funds to pay their nursing home bills can leave a healthy spouse destitute in the short term if paying out of pocket. A Medicaid-compliant annuity can accelerate eligibility for the joint state and federal Medicaid health insurance program, which pays for a person’s medical bills and nursing home care while providing reliable income for the healthy at-home spouse.

To properly plan for a Medicaid-compliant annuity, seek the advice of an elder law attorney who understands your state’s Medicaid rules. There are ordinary immediate payout annuities that are not Medicaid-compliant, so it is critical to receive the correct advice before your purchase. The goal for married couples is for the healthy spouse (the annuity owner) to collect the annuity income while the spouse needing medical benefits from Medicaid-funded extended care and nursing home benefits remains eligible.

Medicaid-Compliant Annuity Requirements

  • The MCA is for an individual and must be non-assignable and irrevocable
  • The annuity income payout must be based on the life expectancy table equivalent to the Social Security life expectancy tables Medicaid uses
  • The annuity terms can’t extend beyond the annuity owner’s life expectancy
  • All premiums will return to the client by the end of their life expectancy
  • The immediate irrevocable annuity must not have a cash value
  • The restricted annuity may not have balloon payments, and the distribution of annuity payments to the owner must be equal and actuarially sound
  • The Medicaid beneficiary structure must comply with the state’s Medicaid recovery rules
  • Guidelines and recovery rules vary by state law, often asking the State Medicaid Agency to be named as beneficiary

Drawbacks for Medicaid-Compliant Annuities

These Medicaid-compliant annuities are challenging to set up, may not cover all of your assets, and preclude you from accessing them if you require them for future needs. However, because of long-term care’s prohibitive costs, many married couples are willing to accept these potential risks because Medicare does not cover long-term care. The national average for long-term care insurance for a couple both 60 years old is $3,400, and approximately 30 percent of applicants between 60 and 69 are declined coverage.

While that may seem like a lot of money to pay in premiums, if you qualify for the insurance, it pales in comparison to the national estimates of long-term care costs out of pocket. According to Genworth, the cost of long-term care in a 2021 survey cites the following monthly average costs:

annuity.org

Non-Countable Income Stream

Purchasing a Medicaid annuity converts an asset into a monthly income stream for the healthy spouse, and this income does not count toward Medicaid eligibility. Purchasing this annuity type means the couple’s assets do not have to be “spent down” for one to be Medicaid eligible. However, the annuity payments must be completed before the end of the healthy spouse’s life expectancy so that the annuity purchase does not become giftable to heirs.

A Medicaid-compliant annuity will convert liquid assets into a lifelong income stream that helps a healthy spouse maintain their quality of life while the spouse in need of long-term care can still qualify for Medicaid. The Medicaid-friendly annuity requires that it be irrevocable (unchangeable) and non-transferrable to heirs upon your death. Since this purchase must be irrevocable to achieve the goals, it is crucial to meet with an elder law attorney to ensure your selection is the right financial product for your circumstances. A Medicaid-compliant annuity can help both spouses in a marriage to get the resources they need should one require long-term care.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

Estate Planning

Probate with No Will

When a loved one dies without making a will, or intestate, a probate court will oversee the distribution of the estate according to your state’s intestacy laws. Also known as intestate succession, it has similarities to the probate process when a will is present. Still, the terms are not interchangeable—any adult who dies intestate triggers a somewhat different process than a will going through probate.

Do You Have a Will?

Many Americans will face the challenges of their loved one dying without a will. According to Think Advisor, a recent survey finds that 59 percent of men and 72 percent of women do not have a will or estate plan. In another survey, CNBC finds a mere 33 percent of Americans have properly established estate plans. Many individuals feel they do not own enough to necessitate writing a will or negatively perceive estate planning as too complex and expensive. They leave their grieving loved ones to accept the court’s decisions regarding their loved one’s inheritable assets and possessions.

Resolving the Estate

The probate court judge’s primary duty is to oversee the lawful resolution of the decedent’s financial affairs. They will follow state law to select a personal representative as the estate administrator. There is technically no executor as no will was left to execute, yet the estate still must be legally resolved. A loved one can begin the intestacy process by going to the decedent’s county probate court, filing a death certificate, and petitioning to begin probate. They will typically nominate themselves as the administrator, but the probate court judge has the authority to name the estate administrator.

Assets Falling Outside of Probate and the Role of Administrator

Like dying with a will, dying intestate does not affect jointly held accounts and those assets with a designated beneficiary or payable-upon-death status. These may include money market, savings and checking accounts, IRAs, retirement accounts, certificates of deposit (CD), life insurance, and annuity policies. The estate administrator, as appointed by the probate court judge, will perform the functions as required by state law, including:

  • Identify and give notice to estate beneficiaries and other interested parties
  • Give notice to creditors
  • Give notice to all government agencies from which the decedent received benefits
  • Pay debts and fees, including state and federal taxes
  • Inventory assets
  • Distribute assets
  • Close the estate

Under the law, family members may inherit the remaining assets after payment of the estate’s final debts through the estate administration process. The handlers of the administration process may be one person, two or more individuals, a bank, or a law firm. In cases of estates under a certain dollar amount, the administrator may petition the probate court for a simplified version of the probate proceeding.

Standard Probate Proceedings

Though some of the filings and processes are different than probate with a will, the probate court is still actively involved if your loved one dies intestate. The probate court processes may:

Resolve or prevent conflicts – A probate court judge will decide how to answer any legal questions that may arise related to state law. When someone dies without a will, family members often claim certain assets or possessions of the decedent, citing a verbal promise. The estate administrator can avoid becoming the lightning rod of controversy for decision-making since the probate judge makes the final decision. Although this is no guarantee heirs won’t fight things out in court, in most cases, intestate succession laws prevent these disputes.

Legally Transfer Title – Real property like a house, car, truck, or boat, without joint tenancy with right of survivorship or held in trust, requires the probate court to transfer the name on the title. In cases of real estate owned by a couple or shared personal property in a community property state, titles may transfer automatically to the surviving spouse.

Cut off claims by creditors – Once the probate court process starts, creditors have a certain amount of time to bring a claim against the estate. Estate administration can reduce this timeframe in some states to as little as three months so that a creditor can’t approach a family member looking for money months or even a year into the future.

Take money from accounts – If the decedent’s financial accounts are not jointly held or do not have named beneficiaries, or payable-on-death status, a family can’t access the funds in the accounts without the probate process and approval.

Probate Laws Vary by State

In cases of dying intestate, the probate process is similar among all states, but state laws still vary. If you are administering an estate without a will, an estate planning attorney or probate lawyer can help you understand the differences in the probate process. Getting professional legal advice can be well worth the money spent to distribute the decedent’s assets according to state law and properly close the estate.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

Estate Planning

Estate Planning for Farm and Ranch Properties

In succession and estate planning, farm and ranch real estate, livestock, equipment, and other personal property face unique challenges. There is a common misconception that federal estate taxes threaten farm or ranch property, preventing assets from getting to rightful heirs. Over the past twenty years, legislation has managed to ease the estate tax burden.

According to the current Tax Cuts and Jobs Act (TCJA), tax exemptions will remain at $12.06 million per inheritor until 2026. Although farm assets may require filing a federal estate tax return, debts against assets will lower the final estate value. Depreciation will protect the estate from excessive valuation and taxation.

Assets and Reinvestment Strategies

Farm or ranch assets typically fall into three categories: 

  • Business 
  • Retirement 
  • Inheritance 

Much of the tangible assets come from reinvesting a majority of farm profits back into the business to build capacity and maintain or modernize buildings and equipment. Reinvestment can also expand the operation’s size to capitalize on economies of scale. However, too much reinvestment may unbalance other asset categories, particularly retirement.

Succession Planning

If there is a successor already working in the business, a family farm hand in training to one day run the operation, they might assume there is planning to make business assets affordable and accessible when they take over the farm. Yet, there may also be off-farm heirs, and the owner may include farm assets to serve as an inheritance. So what happens to inheritances if the focus is on the business and retirement assets? Early and careful succession planning is required to determine how best to balance the farm’s business, retirement, and inheritance goals.

Property inheritance is common within farm and ranch families. There is an emotional symbolism attachment to the property transfer from generation to generation. Throughout the years, the farm or ranch may come to symbolize love, trust, power, history, and family rituals. Identifying the right course of action and making estate planning decisions can be a daunting task with so much legacy investment. Because of these emotional attachments and complexities, many farm owners mistakenly do not create a plan.

Why Estate Planning is Important for Farmers and Ranchers

Without estate planning, owners leave the farm subject to the state’s succession plan, where the assets are typically divided equally among the heirs. This equal distribution of farm assets increases the chance that the on-farm successor will not have all the farm assets required for business operation. In time, this situation will impede the farm’s ability to grow or put the business at risk of failing as the on-farm successor must buy sibling inherited farm assets back at near full market value. Most farms do not generate enough cash flow for the successor to purchase the farm assets outright. This situation puts the farm business in the position of having to pay for its assets twice to cash out off-farm heirs’ inheritance.

Statistics Regarding Heirs and Asset Division

Oklahoma State University developed a statistical model comparing probabilities of success rates of various farm inheritance transfer strategies. The lowest success rates and farm failure most often occur when farm assets are divided equally among heirs. As an owner, if you want your farm or ranch legacy to continue as a working business, your estate planning strategy needs to be more creative.

Three guiding principles can help an owner think through fair and practical distribution decisions:

  • Equality principle – Regardless of contribution by each heir, assets will divide equally
  • Proportional equality principle – Asset distribution is contingent upon individual heir contributions in maintaining or growing the asset
  • Need-based principle – Those heirs with more need receive primary consideration

Making the Right Decision

Farm families generally incorporate all three principles to varying degrees. Updating the estate plan may change the decision-making emphasis dependent on fortunes outside the farm, goodwill, and necessity. Like many decisions in life, timing is everything, and your estate planning attorney can readily amend your plan to meet changing challenges and fortunes.

However the farm or ranch owner decides to split assets, one of the most important aspects of estate planning is an honest appraisal of the farm’s financial capacity to continue as a family business and achieve its goals. If the goal is the continuation of the family farm for subsequent generations, then the equal distribution of farm assets is not a tenable solution.

Communication is Critical

The owner generation must communicate expectations to family members, presenting clear goals to ensure a smooth future transition. The more off-farm heirs understand the decision-making process, the better their expectations are managed to reduce the possibility of family conflict after the owner passes. Identifying and documenting near and long-term goals for a farm or ranch business owner and how they affect family heirs often make clearer pathways to success.

An estate planning attorney can take the owner’s goals and financial information and structure an estate plan that will preserve the business without unnecessary family conflict for those heirs who are not in the farm or ranch business. The sooner you begin planning with your lawyer, the easier it will be to accommodate all heirs while preserving the family legacy. Life insurance policies and other techniques can provide inheritable money to off-farm heirs while permitting the farm to continue operation, keeping your legacy intact.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.

Estate Planning

The Six Biggest Estate Planning Mistakes

Unfortunately, many individuals make costly mistakes without the proper advice and guidance of a qualified estate planning attorney. Beyond undermining your intent and diminishing your financial legacy, poor planning can create additional stress to your heirs in their time of grief.

Six common errors frequently happen during the estate planning process. These mistakes often occur because the complete financial picture was not fully considered. It is easiest to avoid estate planning mishaps by knowing what they are before you begin or looking for these errors when reviewing and updating your plan.

Financial procrastination causes problems. While examining your mortality and making end-of-life preparations is not a particularly fun activity, try viewing it as helping and enhancing your loved ones’ future lives while creating a sense of peace during your own. 

The need to protect your finances using wills, trusts, and power of attorney (POA) documents is not solely the domain of the elderly. Putting off the drafting of legal documents necessary to protect yourself and your inheritors can lead to disastrous outcomes.

By far, failing to create an estate plan is the most common mistake. Even if you do not have a lot of money, you need a will to protect any minor children you have by naming their guardians. Your will also ensures your asset distribution to heirs is carried out according to your intentions when you die and names a representative to handle debt obligations, final taxes, and other estate administrative duties. Dying without a will or “intestate” can lead to dire consequences.

Outdated wills, forms, and POAs create problems. If you made a will twenty years ago and have not reviewed and updated its contents, chances are many of the details no longer reflect current assets or beneficiaries. Estate planning is not a “set it and forget it” proposition. Reviewing estate planning documents and beneficiary forms every two years is generally adequate, barring a major life change such as divorce, birth, death, remarriage, or relocation to another state.

Beneficiaries without coordination can create expensive oversight. Beneficiary forms for retirement accounts like 401(k)s and IRAs, annuities, and life insurance policies may constitute a significant portion of your estate’s assets. These beneficiary forms are legally binding and will supersede the contents of your will. Failure to update beneficiary forms can lead to an ex-spouse receiving assets that preferably would go to your heirs. Routine checks of all beneficiary designations are best practices for estate planning.

Failing to title trust assets properly can lead to probate. While not everyone requires a trust, those who do must carefully retitle their assets into the name of the trust. Forgetting to add more recently purchased property or opening a new account requires you to title them into the trust to receive trust benefits. Whether real estate, cash, mutual funds, or stocks, if you fail to move the asset into the trust, they become subject to the probate court, possible tax consequences (depending on the trust type), and a public record of these assets.

Life insurance can trigger estate tax. Life insurance can provide heirs with liquidity without the sale of assets and tax consequences when handled correctly. However, if a wealthy individual dies while maintaining ownership of their life insurance policy, they may inadvertently create a tax event for their heirs. Although life insurance death benefits are not subject to state or federal income taxes, any “incident” of ownership by the decedent can create an inheritance tax.

An estate planning attorney can help shelter life insurance proceeds from high-value estates by gifting the policy to an Irrevocable Life Insurance Trust (ILIT) or draft a new trust to purchase a new policy where the trust is the owner and beneficiary. A policy owned by the trust does not create a taxable situation to death benefits. Your attorney’s careful structuring of this trust type is complex but can provide proper protection.

Joint ownership of assets with your children can lead to disastrous consequences. Naming your children as co-owners of assets, even digital, permits their creditors to access your money. The better way to address the situation is to give your adult child power of attorney and assign them as a beneficiary to a payable on death bank or brokerage account. This tactic permits them to access your funds if required during your lifetime. However, it keeps your assets from your child’s estate and away from their potential creditors.

Ultimately the biggest error you can make is not finding the right estate planning attorney to guide you. This specialized attorney receives training on avoiding probate, tax implications, and asset protection if you require long-term care. Proper planning with the right guidance will help you avoid costly estate planning mistakes and protect your family’s future financial well-being.

We hope you found this article helpful. If you have questions or would like to discuss your personal situation, please don’t hesitate to contact our Reno office by calling us at (775) 853-5700.