Find Out More about Home Healthcare Services

Doctor with patient“It should ease your mind to learn that there are many more sources of funding for in-home healthcare than you may think.”

There can be stress, confusion and sadness when a person learns that a loved one needs in-home healthcare services. There are many things to evaluate when it comes to the different types of care and how to pay for home healthcare.

Miami's Community Newspapers’ recent article, “How to Pay for Home Healthcare without Going Broke,” says that many funding resources for in-home services may cost very little or nothing. There are some funding resources for seniors who don’t qualify for government programs. However, bear in mind that some carry financial risks. An experienced Elder Law attorney can help you find the best options for your circumstances.

There are also several different types of caregivers for senior caregiving. You should learn about various roles, since their funding is from different sources.

Personal Care. There are many names for personal care assistants like home care aides, custodial care aides, personal care assistants and companionship aides. They help seniors with hygiene and grooming activities. These caregivers are self-employed and aren’t required to have any certification, licensing, or insurance. They typically charge 20-30% less than workers from home health care agencies and you can usually get one on short notice. Medicare doesn’t cover funding for personal caregiving alone. As a result, most families use personal savings for this service.

Home Healthcare. Home healthcare aides (HHA) or certified nurse aides (CNA), personal care aides (PCA) and geriatric workers are considered skilled care. They perform duties like taking a pulse or monitoring blood pressure and personal care. They help with medication management and medical equipment, and provide a higher level of care. HHAs usually work with home health care agencies that have state certification to bill under Medicare and are bonded, licensed and insured.

Seniors who need these types of care, should look for funding for home healthcare in several areas:

Medicare and Veteran’s Administration. Two primary sources of funding for skilled senior care are Medicare and the Veteran’s Administration, and home health agencies take care of the billing.

Medicaid. Some in-home healthcare services may not be covered under Medicare or Veteran’s Administration coverage, so seniors with Medicaid may need to bill for some medical services separately.

State Programs. The Older Americans Act offers funding to states for Meals on Wheels and meals served in senior centers. It also funds programs for health promotion and family caregiving support.

Personal Funding. Maximize federal and state funding before you use your personal finances. There are several ways to finance uncovered costs like your personal savings, annuities, long term care insurance, a reverse mortgage, life insurance policy conversion, home care loans and a home equity line of credit.

Go with a Pro. Using your personal funds, life insurance and loans will affect the senior’s estate and financial worth, so talk with an Elder Law and estate planning attorney.

Reference: Miami's Community Newspapers (March 21, 2017) “How to Pay for Home Healthcare without Going Broke”


A Checklist for Veterans

US FlagsThe Wadena Pioneer-Journal recently put together a checklist for veterans in the article, “What survivors should know; A veteran/retiree checklist.” This checklist isn’t all-inclusive and should be used with other tools you should discuss with your estate planning attorney. Be sure to create and maintain these files:

  1. Military File. This should include your retirement orders, your DD 214, separation papers and medical records.
  2. Military Retired Pay File. Make sure you have the claim number of any pending VA claims, along with the address of the VA office being used, a list of current deductions from benefits, and the name, relationship and address of the beneficiary for any unpaid retired pay at the time of death.
  3. Annuities File. Be sure to include information about the Survivor Benefit Plan (SBP), the Reserve Component Survivor Benefit Plan (RCSBP), the Retired Serviceman's Family Protection Plan (RSFPP) and your civil service annuity.
  4. Personal Document File. This should have your marriage records, divorce decrees, adoption records and naturalization papers.
  5. Income Tax File. Retain copies of all of your state and federal income tax returns.
  6. Property Tax File. This should include copies of tax bills, deeds and any other related information.
  7. Insurance Policy File. Keep your life insurance, property, accident, liability insurance and hospitalization and medical insurance records here.
  8. Important Contacts. Maintain a list of banking and credit information in a secure location. This should include bank account numbers, the location of all deposit boxes, savings bond information, all stocks, bonds, and any securities, credit card account numbers and mailing addresses and 401(k) accounts.
  9. Memberships. Keep a membership listing of all associations and organizations with their contact and membership fee information.
  10. Family and Business Contacts. Create a list of all friends and business associates and their contact information.

After preparing all of this, make sure to address the following:

  1. Burial. Have a discussion with your next of kin about your wishes for burial and funeral services. Include the cemetery location and type of burial. You should also consider pre-arranging your funeral services at your local funeral home.
  2. Will. Once your decisions have been made and you’re comfortable with them, have a will prepared outlining specifics by an estate planning attorney.
  3. Notifications. Be sure that your will and all other important documents are kept in a secure place, and let your family know where the documents are located. Some of the organizations to be notified in the event of a retiree death include:
  • Defense Finance and Accounting Service;
  • Social Security Administration (for death benefits);
  • Department of Veterans Affairs (if applicable);
  • Office of Personnel Management (OPM);
  • Any fraternal groups of which you are a member; and
  • Any previous employers that provide pension or benefits.

Reference: Wadena (MN) Pioneer-Journal (January 21, 2017) “What survivors should know; A veteran/retiree checklist”


Tips on Downsizing

HouseDownsizing your home can have a financial effect, especially for your pension and your estate planning. This was the advice in a Starts at 60 article, “8 things you need to know before you downsize in 2017. Here are a few important things to consider when downsizing.
1. Allow yourself plenty of time. Start the downsizing process early. Plan the move several years in advance, so you have time to see where you’d like to move and to crunch the numbers.
2. Ask for advice. Buying and selling a home can be a real emotional event, so ask a family member, friend, or financial adviser for a second opinion or a fresh pair of eyes to review the situation.
3. Review any impacts on your pension. You should determine what effect your move will have on your pension.
4. If you’re headed to a retirement community, figure out what would be left were you to move again. Many retirement communities charge what is called a Deferred Management Fee for each year you live there. For every year you live in the retirement village, you’re charged a fee, which is taken out of the proceeds when you choose to sell your home. It’s possible the amount you leave that retirement village with when you sell, will be less than what you paid.
5. Consider regular fees the facility may charge. There may be a monthly fee to defray some of the expense of running the village.
Here are a few “Don’ts” to remember:
1. Don’t purchase a new home before selling your old one. Don’t sign a contract on a new home until you sell your old home. If you sell your home first, you eliminate extra stress, and you’ll know your financial status. This makes it easier to buy the next home.
2. Don’t be overly itchy to move when you’re not ready. If you have doubts that a move will make sense financially, there’s no harm in staying put. If you stay a little longer, you can avoid a stressful move.
3. Don’t sign any contracts until you get unbiased advice. It’s a busy time and contracts can be complex. Ask an attorney to review them before you sign anything. You should also check with your estate planning attorney to make sure that the numbers work with your estate plan.
Reference: Starts at 60 (December 28, 2016) “8 things you need to know before you downsize in 2017”


Elder Law Attorneys Help Seniors and Their Families

Bigstock-Extended-Family-Relaxing-On-So-13907567The (Fort Worth TX) Star-Telegram recently published an article, “Elder care attorneys can help with long-term care, Medicaid.” The article explained that this segment of the legal profession focuses on the needs of older and disabled adults. Elder law attorneys focus on issues of guardianship, estate planning, probate, veteran’s benefits and Medicaid.

One thing that most seniors don’t plan for is long-term care. Many people are trying to pay for long-term nursing care. A focus of elder law is how an elderly person can pay for it. With this in mind, the majority of long-term care is paid for by Medicaid, so understanding how that program integrates with estate planning is important. For example, you wouldn’t want a bequest in someone’s estate planning to adversely impact your Medicaid planning. A family member may be ineligible for Medicaid if they inherit something.

Completing the Medicaid application can also be a challenge. Elder law attorneys see many of their clients’ applications initially denied. An experienced attorney may be successful on appeal. It might be a mistake at Health and Human Services (HHS). The best way to do this is to ask for the assistance of an elder law attorney. People who apply on their own may be denied and won’t question it—or even realize that they can question it.

Some people worry that their parent will go broke before they need costly end-of-life care and they’re afraid that Medicaid patients received substandard care. However, they should receive the exact same care as a private pay or short-term disability in the nursing home. Even so, you should look at several facilities, speak with residents and staff, and observe the conditions before making a choice.

There is also a lot of bad information floating around about Medicaid eligibility. Some folks believe they won’t qualify. However, some assets, like a house and vehicles, are exempt when qualifying for Medicaid. This allows the community spouse — the one remaining at home — to continue to support themselves.

Also, there are a few elder law attorneys who receive an extra certification called a Certified Elder Law Attorney, or CELA. It’s a national certification program that requires five years of practice in elder law and a written exam.

Reference: The (Fort Worth TX) Star-Telegram (October 14, 2016) “Elder care attorneys can help with long-term care, Medicaid”

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