New Bottom Limit of the Minimum Monthly Maintenance Needs Allowance

Minimum Monthly Maintenance Needs Allowance

Announced by the Department of Health and Human Services 

If a nursing home recipient of Medicaid assistance is married, he or she is called the Institutionalized Spouse (IS) and his or her spouse is the Community Spouse (CS). The income of the CS is not deemed available to the IS at any time for the IS’s care. Although the CS is able to keep all of his or her own income, if the CS has no income or insufficient income, then other rules apply. In such a case, the CS is entitled to receive a Minimum Monthly Maintenance Allowance which is comprised of a basic monthly allowance and a monthly excess shelter allowance.

The Department of Health and Human Services recently announced new poverty income guidelines for 2012. The new guidelines mean that the lower limit of the Minimum Monthly Maintenance Needs Allowance will rise to $1891.25, effective no later than July 1, 2012. The current amount is $1838.75.

Please call our office if you have questions about the Medicaid application process or how the rules might affect you.
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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in Rhode Island who specialize in wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and military family law. 

Call them today at 401-841-5700 or visit them on the web at http://www.CounselFirst.com.

Losing the Forest for the Trees

Can't See the Forest Through the Trees?

This common quote means that if you are so engrossed in looking at individual trees, you might forget that each tree is one of thousands and thus lose sight of the big picture-the forest.

It is much the same in elderlaw. For example, if you focus on the rules of the VA in order to obtain Aid & Attendance Benefits, you can make a mistake and jeopardize your Medicaid eligibility in the future (if you should require assistance to remain in a nursing home).

In elder-law, the trees are Medicaid rules, estate & gift tax laws, income tax laws, VA Aid & Attendance rules, state Probate rules, state statutes and case law. The forest is the comprehensive view of a clients needs, goals, health, and desires or the estate plan of a client.

We saw an example this week. Our client's son and daughter had been advised to spend down their mothers assets by making gifts in the allowed annual amount of $13,000 so that she would qualify for Medicaid nursing home assistance in the future due to lack of assets.

Our clients advisors were confusing one tree (Medicaid allowable spend-down) with another tree (estate & gift tax law). Her gifts would disqualify her from receiving Medicaid assistance for five years from the date of the gifts due to the penalty period imposed by the Medicaid rules. Our client would never have had an estate tax issue because her assets would never reach $900,000, the approximate Rhode Island credit amount.

On the other hand, it was possible that she could run out of funds within the five years and need Medicaid assistance to remain in a nursing home but not be qualified for that assistance due to the penalty.

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in Rhode Island who specialize in wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and military family law. 

Call them today at 401-841-5700 or visit them on the web at http://www.CounselFirst.com.

Short Term Loan Secured By the Equity in Your Home

Short Term Loans Secured by Equity of Home

I was at a meeting this week at Sakonnet Bay Manor, which is an assisted living facility in Tiverton, Rhode Island.

One thing we talked about that I was not familiar with, was a new short term equity line of credit that could be available to home owners, in a couple of days.

Such a loan could be utilized in the following example:

Mom lives alone and she owns a home with no mortgage. She suffers a fall and is likely not to return to the home because she should no longer live on her own. She and the family decide she would be more comfortable in an assisted living facility. She does not have the liquid assets to pay for the facility, but she does have all the equity available in her home. Since the market is not prime for a sale, or repairs need to be made to the house before it could be sold and mom does not have the funds, this type of loan could be helpful. With the funds, mom could get into the facility quickly, and the loan is paid from the equity from the house.

If this sounds tempting, please contact our office 401-841-5700 for more information, and we can put you in touch with a broker. This type of loan may not be for everyone, but it could be an option for you or a family member that should at least be considered.


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The Law Offices of Jeremy W. Howe, LTD. are Elder Law Attorneys in Newport, Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as divorce, child custody and visitation, support, and Military Family Law.

Call them today at 401-841-5700 or visit them on the web at http://www.counselfirst.com

Is a Reverse Mortgage Right for You?

Reverse Mortgages

Attached please find an article that was received by our office as part of an e-newsletter called "Pathways to Independent Living," which is sent to us from a Rhode Island business out of Warwick called Senior Helpers. Senior Helpers provide "companion care" to seniors in their own homes. To reach Senior Helpers, contact Chad Neighbors at (401) 825-7200, or by email at cneighbors@seniorhelpers.com.

Is a Reverse Mortgage Right For You?

If you are a senior who is age 62 or older and you are living in fear that some day, when you need help, you'll have to sell your house to pay for it, there is a solution. You may still be able to stay in your home while paying for home care, home improvements or medical bills.

How? If your home is paid off or you have only a small mortgage left, you can get a reverse mortgage to tap the equity in your home without selling or moving. These mortgages are called reverse mortgages because the lender makes payments to you, the homeowner, not the other way around.

The money you will receive is tax-free and will not affect Social Security payments or Medicare benefits. You do not have to pay off the loan until you move out of the house or the home is sold. You will never owe more than the value of the home at the time of repayment, even if the loan balance is higher than the value of your property. No debt will be passed on to your heirs. Reverse mortgage funds are available to spend any way you choose.

Who Is Eligible?

To be eligible, you must be 62 years or older. (If you are a married couple the youngest partner must be age 62.) You must also either own the home outright or have a low mortgage balance that can be paid off with the proceeds from the reverse loan. You must also live in the home. Like all homeowners, you still are required to pay your real estate taxes and other conventional payments like utilities.

Cautions and Things To Remember

Be sure to work with a reputable lender, consult with your financial advisor if you have one, and do your homework before you make any commitments or sign any documents.

Investigate the costs involved in a reverse mortgage before making the decision.

Closing costs and fees may amount to more than 5% of your home's value. If you plan to live in your home for more than three years, a reverse mortgage can make good financial sense. However, if you know you won't stay in your home that long, then the cost of the loan plus interest may make seeking a reverse mortgage an unwise choice.

Using the equity in your home will reduce the amount of money you leave to your family as inheritance.

If you live alone and need to stay in a nursing facility for more than a year, your loan will come due.

It takes 45 to 90 days to apply for and receive a reverse mortgage. It may be better to receive one when you do not urgently need the money for immediate home repairs or in-home care.

For More Information the AARP offers information about reverse mortgages, including an online calculator you can use to find out how much money you may get from a reverse mortgage. The National Reverse Mortgage Lenders Association (NRMLA) includes information for consumers interested in learning more about reverse mortgages.

You can also call our office for a referral for someone to speak with about Reverse Mortgages if you think this could be an option for you. We can also accompany you to a meeting with your reverse mortgage broker, or review the documents before you sign, or answer any questions you might have.


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The Law Offices of Jeremy W. Howe, LTD. are Elder Law Attorneys in Newport, Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as divorce, child custody and visitation, support, and Military Family Law.

Call them today at 401-841-5700 or visit them on the web at http://www.counselfirst.com

Eligibility Verification Reports (EVRs) are DUE Soon!

Eligibility Verification Reports

We thought our clients and friends may find this information useful. It was provided to us by the Veterans Advocate Group of America (VAGA), and written by Victoria L. Collier, of Collier & St. Clair, LLP. She is a co-founder of VAGA, co-author of VisPro, author of 47 Secret Veterans Benefits for Seniors...Benefits You Have Earned but Don't Know About, and a national speaker and educator of VA Improved Pension benefits. Learn more about Victoria at www.elderlawgeorgia.com

Article:

It is that time of year to reach out to your veteran clients and either remind them or guide them in completing their annual EVR.

What is an EVR? The Eligibility Verification Report is an annual report due no later than March 1st of each year for beneficiaries who are receiving the Improved Pension. Because eligibility for this program is based on disability status and financial criteria, the VA must ensure that the beneficiary remains eligible from year to year. The EVR provides a report of actual income and dependency status in order to verify that the payment the beneficiary is receiving is correct.

What are the required forms to complete and return to the VA? The VA will send the required forms to the beneficiary in late December or early January. One of the following forms should be completed, based on the type of beneficiary:

21-0510 EVR Instructions
21-0516-1 Improved Pension EVR (veteran without children)
21-0517-1 Improved Pension EVR (veteran with children)
21-0518-1 Improved Pension EVR (surviving spouse without children)
21-0519s-1 Improved Pension EVR (surviving spouse with children)

In addition to the aforementioned forms, the beneficiary must also complete a Medical Expense Report on VA Form 21P-8416 (NOTE: THIS FORM WAS UPDATED DECEMBER 2011). This form must be completed twice. The first one is to report actual medical expenses paid out of pocket by the beneficiary during the EVR reporting period. The second one is for the beneficiary to report the next 12 month's projected medical expenses. This form must also be signed by the beneficiary or the fiduciary if one has been appointed.

Where are EVRs Processed? There are three Pension Management Centers (PMC), Philadelphia, Milwaukee, and St. Paul. Whichever PMC adjudicated the initial application for pension benefits will be the same PMC to process the EVR.

Is Anyone Exempt from Filing an EVR? Annual EVRs are not required for Improved Pension recipients who have no countable income, or whose only countable income is from VA or Social Security. However, filing an EVR may be helpful even in this situation if the beneficiary is not receiving the maximum VA pension due to the amount of medical expenses projected at the beginning of the year. If the medical expenses increased throughout the year, or if the beneficiary paid out of pocket for medical expenses that are not considered "recurring" (i.e. doctor co-pays, prescriptions, travel expenses, hearing aids, expenses related to burial of spouse or dependent child, etc.), then these expenses can be reported on the EVR and the VA will recalculate what the monthly pension should have been. If the pension amount for prior months should have been higher based on the medical expenses reported in the EVR, the VA will pay a lump sum payment to the beneficiary for the appropriate amount.

Termination of Benefits. If a person does not return the EVR, benefits will be terminated as of the beginning of the EVR reporting period. Because of that, the beneficiary will receive notice that the VA overpaid them and, thus, they will owe the money they received back to the VA. Clients are usually not able to return the money because it has been spent on their high cost of medical care. It is essential that the EVR is returned by March 1st, that it is completed accurately, and that it is signed by either the beneficiary of the benefits or by the fiduciary if one has been appointed (neither a 21-22a representative, a power of attorney agent, nor a guardian can sign the EVR).

For more information, refer to M21-1MR, Part V, Subpart iii, Chapter 7 and 38 CFR 3.277.

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The Law Offices of Jeremy W. Howe, LTD. are Elder Law Attorneys in Newport, Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as divorce, child custody and visitation, support, and Military Family Law.

Call them today at 401-841-5700 or visit them on the web at http://www.counselfirst.com

Insurance and Medical Bill Advocacy

Insurance and Medical Bill Advocacy

I received this article as part of a monthly newsletter this week, and I thought it could be useful to our clients and friends. The contact person is Robin at Robin G Smith Consulting. Call her at 888-363-3914 or go to her website at is www.robingsmith.com for more information, or call us!

As 2012 begins, many people will find themselves with new health benefits and higher deductibles, or, increasingly, with no health insurance at all, particularly in the 50—64 year old age category. Additionally, the latest focus of healthcare reform has become prevention, or wellness, vs “sickness” care. Companies are struggling to find solutions to health cost inflation, and new paradigms are emerging that feature “worksite” clinics, and direct, af?fordable pre-paid primary care (another story here). I offer one such program, Medical Membership Plans (MMP).

A MMP is a prepaid primary care plan for companies and individuals ($84/month individual, $99/family), where care is delivered by a national network of urgent care centers. There are no copays, no deductibles, no pre-existing conditions, and care generally includes all services that can be delivered at the urgent care center (x-rays, injections, labs, etc.) This plan is open to all, and is a membership plan, not health insurance. Many clinics are available, al?though, geographically, some areas are better covered than others— e.g. Worcester and Boston area, MA, great, Cape Cod, not so good. RI has many clinics available, and CT has good coverage in the urban areas. Call me (Robin) for more information, or a list of participating providers in your area. The MMP model may help drive down health costs.

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The Law Offices of Jeremy W. Howe, LTD. are Elder Law Attorneys in Newport, Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as divorce, child custody and visitation, support, and Military Family Law.

Call them today at 401-841-5700 or visit them on the web at http://www.counselfirst.com

Recognizing the Need for Outside Help in Caregiving

Article: Recognizing the Need for Outside Help in Caregiving

Caregivers often don’t recognize when they are in over their heads, and often get to a breaking point. After a prolonged period of time, caregiving can become too difficult to endure any longer. Short-term, the caregiver can handle it. Long-term, support is needed. Outside help at this point is often necessary.

A typical pattern with an overloaded caregiver may unfold as follows:

· 1 to 18 months--the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.

· 20 to 36 months--the caregiver may be taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.

· 38 to 50 months--Besides needing tranquilizers or antidepressants, the caregiver's physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.

It is often at this stage that family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled loved one in a facility. Without intervention, the caregiver may become a candidate for long term care as well...

Please read the entire article and previous articles: Either click on the link http://www.planforcare.org or copy and paste the following into your browser: http://www.planforcare.org.

Please note: This article is provided for informational purposes only, and the resources provided when you follow the applicable "link" may or may not be recommended by our office. .

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The Law Offices of Jeremy W. Howe, LTD. are Elder Law Attorneys in Newport, Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as divorce, child custody and visitation, support, and Military Family Law.

Call them today at 401-841-5700 or visit them on the web at http://www.counselfirst.com