New
Medicaid Qualification Amounts Announced for 2005
Written
By:
Jeffrey
A. Marshall
,
Certified Elder Law Attorney
The
Centers for Medicare and Medicaid Services (CMS) has announced a number of
new qualification and protected resource and income levels for Medicaid
programs beginning
January 1, 2005
.
Community
Spouse Allowances
In
general, when your spouse is in a nursing home, he or she will not qualify
for Medical Assistance (Medicaid) benefits until your combined savings are
reduced to a certain level. That
permitted level of so-called "available resources" varies with each
situation. The general rule
is that the community spouse can keep ½ of the amount of available
resources that were owned by the couple on the date of admission to the
nursing facility. However,
this protected "Community Spouse Resource Allowance" is subject to a
ceiling and a floor.
In
addition to being allowed to keep the resource allowance, the community
spouse is also entitled to have a certain minimum level of income called
the Minimum Monthly Maintenance Needs Allowance. The income allowance is
also subject to a ceiling and a floor.
If the community spouse does not have the required level of income,
the spouse may be allowed to keep additional resources or receive some of
the institutional spouse's income.
These
community spouse resource and income allowances are adjusted annually.
Effective January 1, 2005, the new standards will be as follows:
ü
Minimum
Community Spouse Resource Allowance - $19,020.00.
ü
Maximum
Community Spouse Resource Allowance - $95,100.00.
ü
Maximum
Community Spouse Monthly Income Allowance - $2,377.50.
Note:
The Minimum Monthly Income Allowance remains $1,561.25 - it will be
adjusted on
July 1, 2005
.
Federal
Benefit Rate
CMS
also announced the SSI Federal Benefit Rate Figures for 2005 as follows:
ü
Individual
- $579.00 per month
ü
Couple
- $869.00 per month
PDA
60+ Home Waiver Program
The
Federal Benefit rate is used to determine qualification for many Medicaid
public benefit programs including the Department of Aging Medicaid Home
Waiver program. The income limit the Waiver program is equal to 300% of
the SSI Federal Benefit rate. This means that effective
January 1, 2005
the new income ceiling should be:
ü
$1,737
per month - PDA 60+ Medicaid Waiver Program Income Limit
Attorney
Marshall can be contacted at webmail@paelderlaw.com
or at 1-800-401-4552
Qualifying
for the Homestead & Farmstead Exclusions
Written
By: Attorney
Matthew
J. Parker
Last
month, the application for the
Homestead
and
Farmstead Exclusions was mailed out to property owners within the
Commonwealth
of
Pennsylvania
.
The application was
sent out to permit eligible property owners to qualify for the property
tax relief set forth in the Pennsylvania Homeowner Tax Relief Act.
Property owners who qualify for an Exclusion may eventually see a
reduction in their property taxes in the form of a reduced property
assessment. Any reductions in
property taxes will be made up through increases in local income taxes and
gaming revenues. None of this
proposed property tax relief will take effect until
July
1, 2005
or
as late as
July
1, 2007
.
To
qualify for an Exclusion, you must be the owner of a homestead or
farmstead. A homestead is
principally defined as a dwelling, including the parcel of land on which
the dwelling is located, and other improvements, which is primarily used
as the domicile of the property owner.
It is the primary residence of the property owner that qualifies.
A secondary home, like a vacation home, would not qualify.
If
an applicant has a life estate in the primary residence, the applicant
should be treated as the owner during his or her lifetime and is legally
responsible for all property taxes. However,
an applicant who has transferred title to his or her children without
retaining any right to live in the property will be ineligible.
Farmsteads
are also eligible for an Exclusion. A
farmstead is a farm with at least 10 contiguous acres, owned by the
applicant, and serves as the applicant's domicile.
All buildings and structures on the farm must be primarily used in
commercial agricultural production in one of the following ways; 1) to
produce or store any farm product produced on the farm, 2) to house or
confine any animal raised or maintained on the farm, 3) to store any
agricultural supply to be used on the farm, or 4) to store any machinery
or equipment used on the farm.
In
the event that your primary residence has been deeded to your children and
you have not retained any ownership rights in the property, seek legal
advice as to how you may be granted sufficient ownership in the property
to qualify for the
Homestead
or
Farmstead Exclusion.
A
second notice regarding application for an Exclusion will be sent on
December
31, 2004
to
those who have not yet applied. You
have until
March
1, 2005
to
apply. You will be
notified within 30 days after filing the application as to whether you
have been approved and have the right to appeal the denial of your
application.
Attorney
Parker can be contacted at webmail@paelderlaw.com
or at 1-800-401-4552
Pennsylvania
Receives
Cash & Counseling Grant
Written
By: Attorney
Jeffrey
A. Marshall
,
CELA*
On
October 7th the Governor's Office of Health Care Reform
announced that
Pennsylvania
has received a $250,000 "cash
and counseling" grant from The Robert Wood Johnson Foundation and the
Administration on Aging.
Pennsylvania
will use the grant to allow
individuals who receive supportive services under the Medicaid waiver the
option of directing and managing their own personal care services.
Traditionally,
Pennsylvania
has contracted directly with home
care agencies to provide Medicaid-financed personal assistance services
such as bathing, dressing, grooming, preparing meals, and housekeeping to
qualified seniors and younger people with disabilities. However, the
perception is that this agency-directed model limits consumers' choice and
control of the services being provided.
Although the consumer may be able to choose among available
agencies, their decision-making power may end at that point.
They may have little or no say or flexibility in how, when, and
what services are provided.
Under
the cash and counseling model, consumers will be given flexible allowances
they can use to design and direct their own services. The hope is that
consumers will remain more independent and more satisfied with their
services when they have more control and direction over those services.
Those providing the personal care services are likely to be far
more responsive to the needs and preferences of the consumer when the
consumer can hire, fire, and train the direct care worker.
"Providing more choice and control to people who are capable of
managing these very personal daily activities makes a tremendous
difference in improving their quality of life," said Kevin Mahoney,
PhD, National Director of the Cash & Counseling program.
Under
cash and counseling, an individual eligible for Medicaid-funded personal
care services will first be assessed.
If approved for the program, the consumer will receive an
individualized monthly budget they can use to choose from a menu of
approved services such as hiring their own care-givers and purchasing
items to help them live independently. There will be flexibility so that
the consumer will be able to purchase more or less services depending on
their particular needs that month. The participant's budget will be
comparable to the value of services that he or she would have received
from an agency.
Counseling
and bookkeeping services will be available to help participants consider
their options and maintain tax and other paperwork. The program is
entirely voluntary and consumers may choose to remain with traditional
Medicaid-funded/ agency-provided services.
Cash
and counseling is part of a national trend toward increasing personal
responsibility and consumer involvement in their own health related
services. It is also intended
to help facilitate the re-balancing of public funding for long term care
towards home and community based care. The program should become available
to participants in several home and community based waiver programs,
including the PDA 60+ Waiver program.
Pennsylvania
will implement cash and
counseling under its existing 1915(c) home and community based waiver
authorization. A new Medicaid
waiver from the federal government to allow the use of Medicaid funds for
the program should not be required. However,
Pennsylvania
's existing waiver may need to
be modified to permit payment for services provided by individuals who
have legal responsibility (such as guardians or agents under power of
attorney) for the consumer.
Implementation
of cash and counseling will begin in 2005.
The program will first be tested in a few counties before becoming
available state wide. By the
end of the three year grant period, the program should be a possible
option for PDA 60+ Waiver eligible seniors in all
Pennsylvania
counties.
The
Office of Health Care Reform, in collaboration with the departments of
Aging and the Public Welfare, will administer the program.
The national press release announcing the grant is available online
at http://www.hcbs.org/files/51/2524/nationalrelease.doc.
The
website for the Governor's Office of Health Care Reform is
http://www.ohcr.state.pa.us/
Attorney
Marshall can be contacted at webmail@paelderlaw.com
or at 1-800-401-4552
Attorney
General Files Lawsuit in Living Trust and Annuity Sales Scams
The
following is drawn from a Press Release issued by
Pennsylvania
Attorney
General Pappert on October 28, 2004.
For the entire press release, please go to the Attorney General's
website at http://www.attorneygeneral.gov/press/release.cfm?p=E019E243-FA9B-5C86-C02C766CF63DE11D
Attorney
General Jerry Pappert has filed a civil lawsuit in Commonwealth Court
accusing 16 defendants of engaging in an elaborate statewide living trust
sales scheme, that deceived older Pennsylvanians into purchasing Revocable
Living Trusts, long term annuities or charitable gift annuities that were
costly, not in their best interest and/or unnecessary. The alleged victims
documented approximate losses that range between $1,800 and $80,000.
Along
with the complaint, Pappert filed a preliminary injunction in
Commonwealth
Court
seeking
to ban the defendants from engaging in the unlawful advertising, promotion
or sale of estate planning products or services in
Pennsylvania
.
According
to the lawsuit, the defendants encouraged consumers to meet with their
"Estate Planning Advisors" or "Certified Senior
Advisors" to explain "What Everyone Should Know About Estate
Planning Techniques, Financial Planning Strategies" and "Estate
Preservation." The promotional materials from the defendants' estate
planning advisor companies led consumers to believe that they were
receiving impartial estate planning advice.
The
complaint claims that consumers who attended the presentations or allowed
the defendants into their homes were advised to purchase a Revocable
Living Trust. The trust was presented as an estate planning document that
was in the consumers' best interest, regardless of their individual
financial holdings. Many were sold living trust kits for approximately
$1,800 whether they needed them or not. Consumers said they were unaware
that the sales representatives were insurance agents who received sales
commissions.
The
alleged victims said they fully trusted the representatives and followed
their advice because they were led to believe that they were lawyers or
estate planners.
"In
reality, the individuals advising consumers about estate planning products
are not unbiased legal professionals but sales or insurance agents working
on commissions," Pappert said. "These older citizens were given
legal advice from non-attorneys who intentionally steered them toward
purchasing living trusts as a way to find out the contents of their
financial portfolios. After profiling the portfolios, the defendants
deceptively convinced consumers to convert their stocks or other non-real
estate investments into charitable gift annuities or long-term deferred
annuities that paid the agents even higher commissions."
To
encourage the sale of living trusts, the suit claims that the defendants
used scare tactics and deceived consumers by falsely claiming that living
trusts are superior to wills because:
-
The probate process will result in significant delays and court costs.
-
The probate process will greatly reduce the size of the decedent's estate
because of attorney and executor fees.
-
The probate process will require court intervention to supervise the
administration of the estate.
-
The probate process will expose private matters to the public.
-
The probate process will expose the decedent's estate to litigation.
-
Living Trusts will lessen or eliminate taxes.
Other
alleged deceptions included claims that the defendants failed to disclose
that:
-
The rate of return would be less than promised on some annuity contracts.
-
There were penalties for early withdrawal of annuity contracts.
-
The sale of investment portfolios would result in losses due to capital
gains taxes.
-
Living Trusts may not be appropriate in all instances.
-
Moving marital, residential real estate property into a living trust could
have a possible negative impact on Medicaid eligibility. - Consumers had
three days to cancel their transactions without paying a fee.
-
They could not provide legal advice because they were not licensed
attorneys.
"In
my view, these actions are unconscionable. Consumers were lied to and
deceived into purchasing long-term annuities based on what the defendants
would make in commissions. The sales commission rate was higher if the
pay-out period to consumers was longer. I am proceeding against these
defendants with every appropriate remedy available under the law,"
said Pappert.
Pappert
said several consumers told his office that they lost thousands of dollars
in their life savings due to the failure to realize the promised returns,
extra fees or costs, additional tax expenses and the inability to have
access to their investments without paying huge penalties.
Pappert
urged consumers who suspect that they were victimized in the alleged
scheme to contact his office immediately by calling 1-800-441-2555 to
obtain a complaint form. Consumers may also download a complaint form or
electronically file a complaint by visiting www.attorneygeneral.gov.
Marshall
& Associates Now Offering FREE In-Office Workshops
Marshall
& Associates is now offering free workshops for seniors, their
families and professionals who want to know more about paying and planning
for long term care. The
workshops are held in our
Williamsport
and
Wilkes-Barre
offices and last about an hour.
These informal discussions with our planning experts are a great
opportunity to learn about the options available to pay for care.
Reservations
are suggested, but not required. SIGN
UP ONLINE
or call 1-800-401-4552 for more information or to reserve your spot.
November
is National Alzheimer's Awareness Month
In
1983 former President Ronald Reagan declared November as National
Alzheimer's Awareness month. This
year to commemorate, our local Alzheimer's Association has some great
activities planned. For more
information, please call 822-9915 or e-mail
Regional Director, Estella Killian at estella.killian@alz.org.
Candlelight
Vigils
Tuesday,
November 16th at
Luzerne
County
Courthouse,
Wilkes-Barre
5:30PM
Tuesday,
November 16th at
Heritage
Hill Adult Day Care,
Hazleton
7:00PM
Wednesday,
November 17th at
Lackawanna
County Courthouse Square
,
Scranton
at
6:00PM
Wednesday,
November 17th at
Hazleton
City
Hall
at
6:00
PM
Wednesday,
November 17th at
St.
Luke's Lutheran Church,
Williamsport
at
7:00PM
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*Attorney
Marshall
is
certified as an Elder Law Attorney by the National Elder Law Foundation
under authorization from the Pennsylvania Supreme Court
© 2000-2005
Marshall & Associates www.paelderlaw.com
