1. MEDICAID, MEDICARE, VETERANS
BENEFITS, AND ESTATE PLANNING:
HOW TO DEVELOP A PEACE OF
MIND IN UNCERTAIN TIMES
Alzheimer's Association-West Michigan
P. Haans Mulder, JD, MST, CFP®
Cunningham Dalman, P.C.
321 Settlers Road
Holland, MI 49423
(616) 392-1821
phmulder@holland-law.com

2. Background
• Partner at Cunningham Dalman, P.C.
• Masters in Tax, CFP®, and specialize in
estates/elder law and business planning
• Cunningham Dalman, P.C. has been
serving the greater Holland/Zeeland since
1900
Serving the Holland area since 1900

3. Overview
• Medicaid process and eligibility rules
• Example of how Medicaid planning works
• Medicare Parts A-D
• Transition from Medicare to Medicaid
Serving the Holland area since 1900

4. Overview
• Veteran’s Aid & Attendance benefit and
eligibility rules
• Elements of an estate plan and what the
process involves
• Most common types of estate plans
Serving the Holland area since 1900

5. Did you know?
• 40% of people 65 years and older will
stay in a nursing home
• Average cost to stay in a local nursing
home is $6,500-7,500/month
Serving the Holland area since 1900

6. What is Medicaid?
• State and federal program that pays
for medical treatment (including
nursing home care)
• Oftentimes confused with Medicare
Serving the Holland area since 1900

7. When does Medicaid apply?
• Applies principally in a nursing home
(could apply in your home or an
assisted living facility)
• Applies to people who are 65 years or
older, blind, or disabled
• Must pass the income
and asset tests
Serving the Holland area since 1900

8. Who does Medicaid apply to?
• Under income test, you cannot have
enough income to pay the monthly
cost of staying in a nursing home
($6,500-7,500 in this area)
Serving the Holland area since 1900

9. Who does Medicaid apply to?
• Under assets test, a single person can
only have $2,000 in countable assets
• Can keep your home (if it’s not in your
trust) and a vehicle
• All other assets are countable
Serving the Holland area since 1900

10. Who does Medicaid apply to?
• Asset test allows a married couple to
keep their home (again, if it’s not in a
trust), a vehicle, and one-half of their
other assets
Serving the Holland area since 1900

11. Example
• Clients were husband and wife
• Wife had to go to a nursing home
• Didn’t stay in a hospital for three days
so Medicare didn’t cover stay
• Had house, vehicle, and investments
Serving the Holland area since 1900

12. Example
• Could keep the house (because it was
properly owned) and their vehicle
• Without any Medicaid planning, they
would have had to spend down one-half
of their investments
Serving the Holland area since 1900

13. Example
• Drafted a trust that allowed them to
protect all of their investments (as
opposed to just half)
• This provided peace of mind to the
husband
Serving the Holland area since 1900

14. Medicare and Parts A-D
• Medicare is a government insurance
program that has many aspects and is
divided into parts
• Have to be 65 years old, be disabled, or
fit specific criteria
• Part A covers hospital
expenses
Serving the Holland area since 1900

15. Medicare Parts A-D
• Part B deals with doctor’s and out-patient
expenses
• Part C is a private insurance plan that
covers your medical expense in general
• Part D is your prescription drug coverage
Serving the Holland area since 1900

16. Transition to Medicaid
• Many people who are eventually
approved for Medicaid start on Medicare
• Must have a three day hospital stay
• Medicare will cover up to 100 days, but
there can be a co-pay after the 20th day
Serving the Holland area since 1900

17. Veteran’s A&A Benefit
• Veteran is eligible for up to $1,632 per
month (expenses must exceed income)
• Surviving spouse is eligible for up to
$1,055 per month
• Veteran with a spouse is eligible for up to
$1,949 per month
Serving the Holland area since 1900

18. Veteran’s A&A Benefit
• Will cover in-home, assisted living, and
nursing home care
• Financial eligibility is based in general on
$40,000 of countable assets for a single
person and $80,000 for a couple
Serving the Holland area since 1900

19. Did you know?
• You could save approximately $6,000
by having an estate plan that will cost
you $850
Serving the Holland area since 1900

20. What is estate planning?
• Process of planning for the future
management and distribution of your
assets and your future medical care
• Includes documents such as
wills, trusts, and powers of attorney

21. Why is it important?
• Reduces the cost of administration
• Minimizes stress for family and friends
• Determines who will receive your assets
• Authorizes who will make your medical
decisions

22. What is probate?
• Probate is a court process to administer
a deceased person’s financial affairs
• Required when someone passes away
with assets in his or her own name or
fails to name a beneficiary

23. Why avoid probate?
• It is a public process
• Can exacerbate family situations
• Can be costly to administer ($5,000)
• Takes time to complete (6-9 months)

24. What are the most common
estate plans?
• Basic plan includes wills (potentially with
a trust) and powers of attorney
• For clients who do not have a house or
are not concerned with avoiding probate

25. What are the most common
estate plans?
• More comprehensive plan includes a living
trust, pour-over wills, and powers of
attorney
• Designed for clients who want to avoid
probate

26. What does the estate planning
process look like?
• Complete estate planning questionnaire
• Attend a meeting that we discuss your
goals and the types of estate plans

27. What does the estate planning
process look like?
• Review draft of documents
• Attend a signing conference
• Change beneficiaries or/and fund your
trust

28. Questions……
Serving the Holland area since 1900

29. Thank You
P. Haans Mulder
Cunningham Dalman, P.C.
321 Settlers Road
Holland, MI 49423
(616) 392-1821
phmulder@holland-law.com
www.holland-law.com
Serving the Holland area since 1900