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How To Avoid an
Elder Law Train
    Wreck *
             By
Robert A. Mason, JD, CELA,
      Mason Law, PC
  Asheboro, North Carolina
    Savannah, Georgia
           *Maybe




                             2
Setting
The Stage
                  Planning Crisis

• Playing The Odds –


  – By 2025 50% more with Alzheimers
    (Alzheimers Association)


  – By 2025 100% more 65+ with Diabetes
    (American Diabetes Association)




                                          3
Setting
The Stage
            Planning Crisis
• Playing The Odds –

  – 70%
            The Percentage of Those 65+ Who Will Need Some
               Level of Long Term Care Services


  – 30% to 40%
        The Percentage of Those 65+ Who Can Expect
                Nursing Home Level of Care


                                                         4
Setting
The Stage
            Planning Crisis

• Playing The Odds –

  – 50% to 60%
    Percentage of Nursing Home Costs Paid by
    Medicaid

  – Government WILL Tighten Benefit Rules


                                               5
Setting
The Stage

      The Caregiver’s Squeeze
• Almost 10 MM Children 50+
  Care For Parents
• Percentage Has Tripled In
  15 Years (25%)
• Daughters Bear Impact
  Over Sons
  - The MetLife Study of Caregiving Costs to Caregivers (June 2011)

                                                                      6
Setting
The Stage

      The Caregiver’s Squeeze

• Adult Caregivers 50+ More
  Likely To Have Health Problems

• Caregiving Can Jeopardize
  Future Financial Security
- The MetLife Study of Caregiving Costs to Caregivers (June 2011)

                                                                    7
TEN GREAT WAYS TO AVOID AN
 ELDER LAW TRAIN WRECK (maybe)


1. GET A WILL ON TRACK!
2. PUT SOME STEAM IN A POWER OF
   ATTORNEY
3. DON’T SIGN OVER ALL YOUR
   PROPERTY TO THE KIDS

                                  8
TEN GREAT WAYS TO AVOID
AN ELDER LAW TRAIN WRECK
              (maybe)




4. COUPLE UP A HEALTHCARE
   ADVANCE DIRECTIVE
5. FUEL UP LONG TERM CARE
   PLANNING
6. PLAN FOR DISABLED LOVED ONES


                                  9
TEN GREAT WAYS TO AVOID
 AN ELDER LAW TRAIN WRECK
                    (maybe)




7. CARRY ADEQUATE INSURANCE
8. DON’T IGNORE PLANNING AFTER A
   “LATE” MARRIAGE (A CHANGE IN CONDUCTORS!)
9. REVIEW OR UPDATE YOUR ESTATE
   PLAN

                                               10
TEN GREAT WAYS TO AVOID AN
ELDER LAW TRAIN WRECK (maybe)



10. AVOID BAD ADVICE:
          DO NOT LISTEN TO:
          THEY & THEM

                              11
1. GET A WILL ON TRACK

• Common misconception: I don’t need a
  will because . . .
  – Just my spouse and me
  – I don’t have a large enough estate
  – My family knows how I want things




                                         12
2. PUT SOME STEAM IN A
       POWER OF ATTORNEY

•   Often overlooked
•   Absolutely critical
•   Conservatorship may be only option
•   Severe limits on conservator’s planning




                                          13
3. DON’T SIGN OVER ALL YOUR
     PROPERTY TO THE KIDS

• Common Practice
• Exposes to Kids’ Liabilities
• Horrible Tax Planning




                                 14
3. DON’T SIGN OVER ALL YOUR
    PROPERTY TO THE KIDS
                 (Continued)

• Better to Use Irrevocable Trust

• Bank Account Problem (“I Put My Kid’s
  Name on the Account”)




                                          15
4. COUPLE UP A HEALTHCARE
      ADVANCE DIRECTIVE

• Squabbling Children

• May Want to Alter Statutory Priority




                                         16
5. FUEL UP LONG TERM CARE
          PLANNING

• LTC Insurance – insurability issues

• 5 Year Medicaid Lookback; Crisis
  Planning




                                        17
5. FUEL UP LONG TERM CARE
          PLANNING

• Second Marriage Problems

• Many Solutions – esp. for Couples and
  Disabled




                                          18
6. PLAN FOR DISABLED LOVED
           ONES

MUCH can be done

• Tragic to leave to “healthy” kids to “look
  after” sibling
• Special Needs Trusts


                                               19
7. CARRY ADEQUATE
           INSURANCE

• Long Term Care Costs

• MediGap/Supplemental Policies




                                  20
7. CARRY ADEQUATE
           INSURANCE

The GAP That MediGap Covers:
Part A
      – Hospital
         » $1,156 deductible
         » Days 1 – 60: $0
         » Days 61 – 90: $289/day
         » Days 91 – 150: $578/day
         » Actually only 90 days “per spell of illness” – 60
           days “lifetime reserve”



                                                               21
7. CARRY ADEQUATE
           INSURANCE
The GAP That MediGap Covers:
 Part A (Cont’d)
      – SNF
         » Stringent conditions
         » Days 1 – 20: $0
         » Days 21 – 100: $144.50
         » Days 101+ NO COVERAGE




                                    22
7. CARRY ADEQUATE
            INSURANCE
The GAP That MediGap Covers:

Part B - Mds and other providers
         » $140 deductible
         » 20% coinsurance




                                   23
8. DON’T NEGLECT PLANNING
  AFTER A “LATE” MARRIAGE
               (Change in conductors)



• EVERYTHING Counts Under Medicaid

• Battling “First Families”

• No Prenups; Ignored Prenups


                                        24
9. REVIEW OR UPDATE YOUR
      ESTATE PLANNING

• Exclusion Amount Going Up

• Death of One Spouse

• Testamentary Asset Protection Planning



                                           25
10. AVOID BAD ADVICE – DO
NOT LISTEN TO WHAT “THEY”
            SAY
 “Well, Mr. Mason, THEY say that . . .”




                                          26
Really, Really BAD Idea


11. BONUS SECTION! DON’T
       DO A THING!!



                             27
THREE Things You Can Do
            Today
No. 1:

                         facebook.com/m
                         asonlawpc
  An Open Forum – Ask Questions
  Late Breaking News
  Updates
  Interesting Articles
                                          28
TWO Things You Can Do Today
No. 2:

  Sign Up For Elder Law Update




Interesting Original Articles
News You Can Use

                                 29
THREE Things You Can Do
            Today
No. 3:
Visit Our Website: www.masonlawpc.com


  Packed Full Of Info
  Open Comments (Ask Questions On Articles)




                                              30
Serving Central North Carolina
Elder Law * Wills & Trusts * Advanced Asset Protection
                  Special Needs Law



                                                         31

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How To Avoid An Elder Law Train Wreck

  • 1.
  • 2. How To Avoid an Elder Law Train Wreck * By Robert A. Mason, JD, CELA, Mason Law, PC Asheboro, North Carolina Savannah, Georgia *Maybe 2
  • 3. Setting The Stage Planning Crisis • Playing The Odds – – By 2025 50% more with Alzheimers (Alzheimers Association) – By 2025 100% more 65+ with Diabetes (American Diabetes Association) 3
  • 4. Setting The Stage Planning Crisis • Playing The Odds – – 70% The Percentage of Those 65+ Who Will Need Some Level of Long Term Care Services – 30% to 40% The Percentage of Those 65+ Who Can Expect Nursing Home Level of Care 4
  • 5. Setting The Stage Planning Crisis • Playing The Odds – – 50% to 60% Percentage of Nursing Home Costs Paid by Medicaid – Government WILL Tighten Benefit Rules 5
  • 6. Setting The Stage The Caregiver’s Squeeze • Almost 10 MM Children 50+ Care For Parents • Percentage Has Tripled In 15 Years (25%) • Daughters Bear Impact Over Sons - The MetLife Study of Caregiving Costs to Caregivers (June 2011) 6
  • 7. Setting The Stage The Caregiver’s Squeeze • Adult Caregivers 50+ More Likely To Have Health Problems • Caregiving Can Jeopardize Future Financial Security - The MetLife Study of Caregiving Costs to Caregivers (June 2011) 7
  • 8. TEN GREAT WAYS TO AVOID AN ELDER LAW TRAIN WRECK (maybe) 1. GET A WILL ON TRACK! 2. PUT SOME STEAM IN A POWER OF ATTORNEY 3. DON’T SIGN OVER ALL YOUR PROPERTY TO THE KIDS 8
  • 9. TEN GREAT WAYS TO AVOID AN ELDER LAW TRAIN WRECK (maybe) 4. COUPLE UP A HEALTHCARE ADVANCE DIRECTIVE 5. FUEL UP LONG TERM CARE PLANNING 6. PLAN FOR DISABLED LOVED ONES 9
  • 10. TEN GREAT WAYS TO AVOID AN ELDER LAW TRAIN WRECK (maybe) 7. CARRY ADEQUATE INSURANCE 8. DON’T IGNORE PLANNING AFTER A “LATE” MARRIAGE (A CHANGE IN CONDUCTORS!) 9. REVIEW OR UPDATE YOUR ESTATE PLAN 10
  • 11. TEN GREAT WAYS TO AVOID AN ELDER LAW TRAIN WRECK (maybe) 10. AVOID BAD ADVICE: DO NOT LISTEN TO: THEY & THEM 11
  • 12. 1. GET A WILL ON TRACK • Common misconception: I don’t need a will because . . . – Just my spouse and me – I don’t have a large enough estate – My family knows how I want things 12
  • 13. 2. PUT SOME STEAM IN A POWER OF ATTORNEY • Often overlooked • Absolutely critical • Conservatorship may be only option • Severe limits on conservator’s planning 13
  • 14. 3. DON’T SIGN OVER ALL YOUR PROPERTY TO THE KIDS • Common Practice • Exposes to Kids’ Liabilities • Horrible Tax Planning 14
  • 15. 3. DON’T SIGN OVER ALL YOUR PROPERTY TO THE KIDS (Continued) • Better to Use Irrevocable Trust • Bank Account Problem (“I Put My Kid’s Name on the Account”) 15
  • 16. 4. COUPLE UP A HEALTHCARE ADVANCE DIRECTIVE • Squabbling Children • May Want to Alter Statutory Priority 16
  • 17. 5. FUEL UP LONG TERM CARE PLANNING • LTC Insurance – insurability issues • 5 Year Medicaid Lookback; Crisis Planning 17
  • 18. 5. FUEL UP LONG TERM CARE PLANNING • Second Marriage Problems • Many Solutions – esp. for Couples and Disabled 18
  • 19. 6. PLAN FOR DISABLED LOVED ONES MUCH can be done • Tragic to leave to “healthy” kids to “look after” sibling • Special Needs Trusts 19
  • 20. 7. CARRY ADEQUATE INSURANCE • Long Term Care Costs • MediGap/Supplemental Policies 20
  • 21. 7. CARRY ADEQUATE INSURANCE The GAP That MediGap Covers: Part A – Hospital » $1,156 deductible » Days 1 – 60: $0 » Days 61 – 90: $289/day » Days 91 – 150: $578/day » Actually only 90 days “per spell of illness” – 60 days “lifetime reserve” 21
  • 22. 7. CARRY ADEQUATE INSURANCE The GAP That MediGap Covers: Part A (Cont’d) – SNF » Stringent conditions » Days 1 – 20: $0 » Days 21 – 100: $144.50 » Days 101+ NO COVERAGE 22
  • 23. 7. CARRY ADEQUATE INSURANCE The GAP That MediGap Covers: Part B - Mds and other providers » $140 deductible » 20% coinsurance 23
  • 24. 8. DON’T NEGLECT PLANNING AFTER A “LATE” MARRIAGE (Change in conductors) • EVERYTHING Counts Under Medicaid • Battling “First Families” • No Prenups; Ignored Prenups 24
  • 25. 9. REVIEW OR UPDATE YOUR ESTATE PLANNING • Exclusion Amount Going Up • Death of One Spouse • Testamentary Asset Protection Planning 25
  • 26. 10. AVOID BAD ADVICE – DO NOT LISTEN TO WHAT “THEY” SAY “Well, Mr. Mason, THEY say that . . .” 26
  • 27. Really, Really BAD Idea 11. BONUS SECTION! DON’T DO A THING!! 27
  • 28. THREE Things You Can Do Today No. 1: facebook.com/m asonlawpc An Open Forum – Ask Questions Late Breaking News Updates Interesting Articles 28
  • 29. TWO Things You Can Do Today No. 2: Sign Up For Elder Law Update Interesting Original Articles News You Can Use 29
  • 30. THREE Things You Can Do Today No. 3: Visit Our Website: www.masonlawpc.com Packed Full Of Info Open Comments (Ask Questions On Articles) 30
  • 31. Serving Central North Carolina Elder Law * Wills & Trusts * Advanced Asset Protection Special Needs Law 31