VA Benefits and Medicaid Eligibility Meeting Complex Requirements for - - PowerPoint PPT Presentation

Presenting a live 90‐minute webinar with interactive Q&A

VA Benefits and Medicaid Eligibility

Meeting Complex Requirements for Benefits Qualification and Application

T d ’ f l f

1pm Eastern | 12pm Central | 11am Mountain | 10am Pacific WEDNES DAY, JANUARY 30, 2013

Today’s faculty features:

Y ale S . Hauptman, Attorney, Hauptman & Hauptman, Livingston, N.J. Laurie A. Hauptman, Attorney, Hauptman & Hauptman, Livingston, N.J.

The audio portion of the conference may be accessed via the telephone or by using your computer's

• speakers. Please refer to the instructions emailed to registrants for additional information. If you

have any questions, please contact Customer Service at 1-800-926-7926 ext. 10.

Tips for Optimal Quality

S d Q lit S

• und Quality

If you are listening via your computer speakers, please note that the quality of your sound will vary depending on the speed and quality of your internet connection. If the sound quality is not satisfactory and you are listening via your computer speakers, you may listen via the phone: dial 1-866-819-0113 and enter your PIN when prompted Otherwise please send us a chat or e mail when prompted. Otherwise, please send us a chat or e-mail sound@ straffordpub.com immediately so we can address the problem. If you dialed in and have any difficulties during the call, press *0 for assistance.

Viewing Qualit y

To maximize your screen, press the F11 key on your keyboard. To exit full screen, press the F11 key again press the F11 key again.

Continuing Education Credits

FOR LIVE EVENT ONLY

For CLE purposes, please let us know how many people are listening at your location by completing each of the following steps:

• In the chat box, type (1) your company name and (2) the number of

attendees at your location attendees at your location

• Click the word balloon button to send

V.A. Aid & Attendance Benefits

4

Yale S. Hauptman Laurie A. Hauptman

4

January 30, 2013

Korean War Korean War World War II World War II

Dec 7, 1941 Dec 7, 1941 — Dec 31, 1946 Dec 31, 1946 June 27, 1950 June 27, 1950 — Jan 31, 1955 Jan 31, 1955

Vietnam War Vietnam War

Aug 5, 1964 Aug 5, 1964 — — May 7, 1975 May 7, 1975 Feb 28, 1961 if served in Vietnam Feb 28, 1961 if served in Vietnam 5

To Qualify for Pension: the Wartime Veteran must ha e the Wartime Veteran must have served in the U.S. Armed Forces and….

Served at least 90 days active duty Served at least one day during wartime y g Was honorably discharged

6

To Qualify for Pension (C

ti d)

Pension: (Continued)

Is over 65 years old Is over 65 years old, blind or disabled Has substantial recurring Has substantial recurring, unreimbursed Medical Expenses Has Limited Household income Has Limited Household income and assets to pay medical expenses expenses Has Expectancy of living and paying future medical expenses

7

paying future medical expenses

7

8

9

Proof of Medical Expenses d d Needed

A Physician must provide a diagnosis A Physician must provide a diagnosis supporting the scope of care and supporting the scope of care and supporting the scope of care and supporting the scope of care and corresponding expenses being corresponding expenses being id d id d

10

provided provided

10

The Net Worth Limitation The Net Worth Limitation

Exempt Assets: Exempt Assets: Exempt Assets: Exempt Assets:

Your house Your car Your household and l d personal goods

11 11

Countable Asset Limitation Countable Asset Limitation

No definite number, but less than No definite number, but less than approximately $80,000 approximately $80,000

12

approximately $80,000 approximately $80,000

12

The Critical Calculation: e C t ca Ca cu at o :

Gross Household Income Gross Household Income Recurring Unreimbursed Medical Expenses(UME) Recurring Unreimbursed Medical Expenses(UME)

Income for Veteran Administration Purposes Income for Veteran Administration Purposes

(IVAP) (IVAP) ( ) ( )

13 13

Maximum Available Pension Resource (MAPR)

MAPR is the maximum available is the maximum available pension per categor

• f need

pension per categor

• f need

pension per category of need pension per category of need

14 14

Special Monthly Pension Rates Paid to Veterans Age 65 or Paid to Veterans Age 65 or Older, Permanently and Totally Disabled, or a Surviving Spouse

For 2013: MAPR *MMC Permanently and totally disabled veteran $20,796 $1,733 Permanently and totally disabled veteran $20,796 $1,733 In need of regular aid and attendance With one dependent $24, 648 $2,054 15 Surviving spouse $13,356 $1,113 15 * Maximum Monthly Check

Case Study 1: Case Study 1: M i d C l V d A&A Married Couple, Vet needs A&A

16 16

Case Study 1: Case Study 1: (continued)

MAPR: $ 24,648 (IVAP): $(12,600)

R d d t $0 Rounded to $0 Couple will receive $2 054 Couple will receive $2,054 monthly Benefit, tax free!

When IVAP is less than MAPR a benefit may be awarded

17

a benefit may be awarded

17

Case Study 2: Case Study 2:

Widow of Veteran

$18,000 Gross Income: UME (home care, prescriptions, co-pays): $15,000 prescriptions, co pays): $3,000 $15,000 $3,000

18 18

Case Study 2: Case Study 2: (continued)

$ MAPR: $ 13,356 (IVAP): $3,000

Wh UME f il t t

Partial Benefit!: $10,356

When UME fails to meet or exceed Gross Income, a partial benefit is available. When IVAP is greater than MAPR

19

When IVAP is greater than MAPR NO benefit is awarded

19

Any VA penalty for gifting assets?

VA currently has VA currently has No Penalty No Penalty Period Period of ineligibility for gifting

• f ineligibility for gifting

Period Period of ineligibility for gifting

• f ineligibility for gifting

“excess” assets to other “excess” assets to other family members family members family members family members

20 20

Should one give assets away l f to qualify?

Th d d Th d d The answer depends on: The answer depends on:

 Family dynamics  Life expectancy  Likelihood of increased future medical expenses  Likelihood of increased future medical expenses  Tax consequences  Financial benefit vs. financial loss Financial benefit vs. financial loss  The “Medicaid Trap” caused by gifts within 5 years to nursing home need

21 21

“Beware “Beware the Medicaid Trap!” the Medicaid Trap!” If one needs If one needs If one needs If one needs Medicaid within Medicaid within 5 f t f f l 5 f t f f l 5 years of any transfer for less 5 years of any transfer for less than fair value, than fair value, he or she he or she will be penalized by penalized by a period of Medicaid benefit a period of Medicaid benefit

22

a pe od o ed ca d be e t a pe od o ed ca d be e t ineligibility! ineligibility!

22

How Does Medicaid Work?

For A Single Person Exempt Assets Exempt Assets Countable Assets Countable Assets

 House  Car  Almost Everything Else  Funeral  Life Insurance  Household Goods 23 23

A Single Person Example A Single Person Example

$100 000 $100,000

$2 000

24

$2,000

24

Married Couple (Example)

$500,000

$231,840

(John)

115 920

(Sally)

115 920

$ 3 ,8 0 $115,920 $115,920 John & Sally Smith 25 $2 000 John & Sally Smith 25 $2,000

Look Back Period 5 Years Penalty Starts When: Penalty Starts When: Penalty Starts When: Penalty Starts When: In Nursing Home (or need nursing g ( g home level of care) “Otherwise Eligible” $2,000 in assets

26 26

All Trusts Are Not Created Equal All Trusts Are Not Created Equal

Revocable Living Trust Credit Shelter Trust Irrevocable Life Insurance Trust Spend Thrift Trust Income Only Type Trust Income Only Type Trust V t Eli ibilit T t V t Eli ibilit T t Veterans Eligibility Trust Veterans Eligibility Trust

27 27

Trust to Qualify for Medicaid

• Irrevocable
• Principal cannot be distributed
• Income typically can be distributed
• Income typically can be distributed
• This is a problem for qualification for VA

b fi d h “ li i h ” l benefits under the “relinquishment” rule

• VA will count the trust assets under VA

asset rules

28 28

Veterans Eligibility Trust

• Can be grantor

trust or not trust or not

• Income payable

to lifetime beneficiaries and not to grantor and not to grantor

• Assets in trust not countable

f VA for VA purposes

29 29

Veterans Eligibility Trust

(Continued) (Continued)

• Home can be placed

Home can be placed in trust and qualify for Section 121 exclusion Section 121 exclusion

• Limited testamentary power

y p

• f appointment to allow for

step up in basis upon death step up in basis upon death

30 30

How is VA benefit treated by M di id Medicaid

• Aid and Attendance is NOT treated as
• Aid and Attendance is NOT treated as

income for Medicaid eligibility purposes

• Other VA benefits are treated as income
• Check your state’s
• Check your state s

Medicaid regulations

31 31

How is VA benefit treated by M di id (

i d)

Medicaid (continued)

• However VA benefit

i il bl t b d is available to be used towards care when on Medicaid

• Once VA knows you are receiving

Medicaid they will reduce pension to $90 Medicaid they will reduce pension to $90 per month

32 32

V.A. Aid & Attendance Tips F VA A li ti Fax VA Applications Dementia issues are a red flag Dementia issues are a red flag Waive 60 day due process y p period Involve local Congressman

33 33

V.A. Aid & Attendance Tips

(C ti d) (Continued)

Healthy veteran with Healthy veteran with sick spouse can collect Expediting a claim if claimant is on hospice hospice Veterans that received honors may get f ti l t t t preferential treatment

34 34

Be Nice T Be Nice To Me – Me – I Pick I Pick Your Nursing Home! ur Nursing Home!

How How to Provide rovide For For Your

• ur Parent

arent’s Care are How How to to Provide Provide For For Yo Your Parent Parent s Care Care Without Going to thout Going to the Poorhou the Poorhouse or e or Nuthou Nuthouse se

“O f h h ll i f ld l i l i i h “One of the most challenging parts of elder law is explaining what we do and how we can make a real difference in our clients’ lives”  Grow your practice

$23.97

(Plus Shipping and Handling)

 Grow your practice  New way to communicate what we do to prospects, clients, and our network of referral sources  An amazing tool to educate the uncommitted prospect 35 www www.BeNiceT .BeNiceToMeBook.com

• MeBook.com

To Order Your Copy Today Go To

35

Yale S. Hauptman Laurie A Hauptman Laurie A. Hauptman HAUPTMAN & HAUPTMAN, P.C. HAUPTMAN & HAUPTMAN, P.C. 570 West Mt. Pleasant Avenue, Suite 101 Livingston, NJ 07039 (973) 994-2287 contact@hauptmanlaw.com

36 36