FREE FLORIDA MEDICAID AND ESTATE PLANNING SEMINAR - CHOOSE ONE OF THREE LOCATIONS

FREE SEMINAR!

Hear about how you or a loved one may qualify for Florida Medicaid and veterans "aid and attendance" benefits before losing everything to long-term care costs - even if your loved one is already in a nursing home.  

Find out how good estate planning can protect you, your family and your assets from the many other threats we face as we age.

Attendees are eligible to receive a free, one-hour consultation from one of our attorneys (assuming we can assist you).
No reservations necessary. Light refreshments.

PORT ST. LUCIE
Tuesday, June 25
1:30 pm to 4:00 pm 
Port St. Lucie Holiday Inn,10120 S. Federal Highway
  
BOYNTON BEACH
Wednesday, June 26
1:30 pm to 4:00 pm
Courtyard by Marriott, 1600 N. Congress Ave.

PALM BEACH GARDENS
Thursday, June 27
1:30 pm to 4:00 pm
Palm Beach Gardens Marriott, 4000 RCA Blvd.

  More information at The Karp Law Firm website, or call us at  (561) 625-1100

Free Seminar: Medicaid & VA Benefits For Nursing Home Costs, Florida Estate Planning

FREE SEMINAR

Tuesday, April 30
1:30 pm to 4:00 pm
Palm Beach Gardens
Marriott Hotel, 4000 RCA Blvd.

Wednesday, May 1
1:30 pm to 4:00 pm
Boynton Beach
Courtyard by Marriott, 1600 N. Congress Ave.

***

•  Hear about how you or a loved one may qualify for Florida Medicaid and veterans "aid and attendance" benefits before losing everything to long-term care costs - even if your loved one is already in a nursing home. 

• Find out how good estate planning can protect you, your family and your assets from the many other threats we face as we age.

***

No reservations are necessary
 

Attendees are eligible to receive a free, one-hour consultation from one of our attorneys (assuming we can assist you)

Light refreshments

No obligation

  More information at The Karp Law Firm website, or call us at  (561) 625-1100

Boomers More Prepared For Dying Than Living

The values of the Baby Boom generation seem to have have changed over the years. Once it was all about flower power. Now the focus includes financial power - specifically, leaving a financial legacy. 


A March 25, 2019  Financial Advisor Magazine article entitled "Baby Boomers More Prepared For Dying Than Living" reports on a recent survey from the Bankers Life Center for a Secure Retirement. The survey found that Boomers are eager to leave a financial legacy for their loved ones. But at the same time, they are giving short shrift to the challenges of bankrolling their own long-term care. In other words, they are focused on death planning, less so on life planning. 


It's a puzzling finding, because the majority of respondents admit they know someone who needs long term care, and 45% have been caregivers themselves! Moreover, the data shows Boomers face a significant chance of needing long-term care: The U.S. Department of Health and Human Services estimates that there is a 70% chance that someone who is 65 years of age today will need some type of long-term care in the future. Since long-term care costs can easily impoverish a middle class family, neglecting life planning jeopardizes the chances of anything being left over for the children.


Of course, in today's America, there are constraints on what a middle class person can do to prepare for long-term care costs. The "Medicare for All" mantra with long-term care included, remains just a dream at this point. Notwithstanding, there are steps Baby Boomers can and should take to protect their nest eggs:


First, there is long-term care insurance. In the past decades there have been many changes in the industry, giving consumers more flexible insurance opportunities. For more information on these policies, click here.


There is also Medicaid. Like many people, Boomers tend to assume that they need to be impoverished to get long-term care benefits in Florida. But with professional legal guidance, that's not necessarily the case. And the sooner you start planning, the better.


Baby Boomers are well-advised to get a grip on not only what they want to leave behind, but how they are going to cope during their lifetimes if incapacity strikes. To get the ball rolling, meet with our Florida elder law our attorneys to  discuss your options. Don't procrastinate! 

Congress Considering Raising ABLE Account Age Threshold

In prior blog posts I told you about the ABLE (Achieving a Better Life Experience) Act. The 2014 legislation allows individuals with qualifying disabilities to save in tax-advantaged accounts. The main advantage of the account is that it allows eligible individuals to possess over $2,000 in assets, yet still qualify for means-tested federal benefits such as Medicaid and SSDI. Prior to this legislation, individuals dependent on these important federal programs had to keep their assets under $2,000, effectively impoverished, to qualify for these benefits. 

Also, one of the rules is that the beneficiary of an ABLE account must have developed his/her disability before age of 26. Since the introduction of the legislation, public pressure has mounted to raise the age of onset. Raising the age limit would allow those who have developed chronic debilitating medical conditions after that age, or those who have been disabled as a result of accidents sustained after that age, to open an ABLE account.

To remedy this problem, the "ABLE Age Adjustment Act" (Senate Bill 817) has been introduced in Congress. If passed, it will raise the threshold for disability onset from age 26 to age 46. You can read more about the bill and follow its progress by clicking here.


For details on how ABLE accounts work, see my prior blog post here. Read about the Florida ABLE program here.

Film "What They Had" Focuses on Family Coping With Alzheimer's Disease

Update 11/29/18: This film is no longer playing locally.

With Alzheimer's Disease and related dementias on the rise, the new film "What They Had" will resonate with many American families coping with caregiving responsibilities. First-time writer-director Elizabeth Chomko has loosely based the film on her own family. Chomko's grandmother was diagnosed with Alzheimer's seventeen years ago and died just recently.

The film stars Blythe Danner as the family matriarch who has Alzheimer's. The family situation reaches a crisis point when she wanders out in the snow wearing only pajamas. Her daughter, portrayed by Hillary Swank, returns to her hometown to help out, at the urging of her brother, played by Michael Shannon. The siblings clash over caregiving responsibilities, and what is best for their mother and for themselves. Complicating the scenario is their father, played by Robert Forster, who refuses to consider placing his wife in a facility. 

For actors Danner and Swank, the film was particularly meaningful. Both have had personal experience caring for ill family members. Danner cared for her late husband Bruce Paltrow, and Swank, for her father.


This family dynamic will likely ring true for anyone who has faced the challenge of caring for a parent, spouse or other loved one with Alzheimer's. Among those challenges is how to pay for the extraordinary costs of long-term care that many Alzheimer's patients will eventually require. In Florida, the median cost of a private room in a long-term care facility is now over $100,000 (2018 Genworth Financial Cost of Care Survey). The attorneys of The Karp Law Firm counsel many families in this crisis, and can often help them tap into Medicaid benefits and/or Veterans Aid and Attendance benefits before losing everything to nursing home costs. 

Click below to listen to an interview with the actors discussing caregiving challenges, Alzheimer's Disease, and their roles in the film.

Bill Gates Digs Deeper Into Alzheimer's Disease

Bill Gates has taken on a new mission: defeating Alzheimer's Disease. And he's approaching it with the same out-of-the-box thinking that led him to create Microsoft. He recently contributed $50 million of his own money (not his foundation's) to the project.

The philanthropist's father just turned 92 and is doing well, but as Gates notes, he is one of the lucky ones: Statistics show that if one makes it to age 80, the chances of developing the disease are about 50%. And Alzheimer’s is the only one of the top ten causes of death in the U.S. for which there is no effective treatment or cure. That's a fact that does not sit well with Gates' inner innovator.

After studying the tremendous emotional and financial toll the disease takes on families and society, Gates decided to plow $50 million into the Dementia Discovery Fund. The fund is a unique collaboration of industry, charity and government, based in the U.K. While most research into Alzheimer’s focuses on the two proteins which seem to be involved with Alzheimer’s, amyloid and tau, the Dementia Discovery Fund is examining other disease pathways and more unconventional treatments. Writes Gates: “We’ve seen scientific innovation turn once-guaranteed killers like HIV into chronic illnesses that can be held in check with medication. I believe we can do the same (or better) with Alzheimer’s.”

Several of his own family members succumbed to the disease. “I know how awful it is to watch people you love struggle as the disease robs them of their mental capacity,” he notes in his blog, “and there is nothing you can do about it. It feels a lot like you’re experiencing a gradual death of the person that you knew.”

Unlike Gates, most American families lack sufficient financial resources to care for loved ones affected by Alzheimer’s Disease. Many still believe that Medicare covers the cost of long-term care; discovering it does not is a frightening wake-up call for many Americans. Without generous long-term care insurance, middle class families are turning to other solutions, like Medicaid and Veterans benefits, or risking the loss of everything they've worked for.

Kudos to Bill Gates. We hope his efforts will open new “windows” into this dreaded disease, and eventually, lead to an effective cure or treatment. We really need the breakthrough.

Read Bill Gates’ blog post, Why I'm Digging Deeper Into Alzheimer's.

To read about Medicaid benefits and Veterans benefit for long-term care, click here.
 

Find out more about the Dementia Discovery Fund.

Long-Term Care Costs Increase Sharply

Genworth Financial has released its 2017 survey of long-term care costs. The picture is not encouraging. Although the cost of care has always been shockingly expensive, and increased annually without fail, the rate of increase seems to be picking up.

Nationally, the median cost of a private room in a long-term care facility is now $97,455, a 5.5% increase over 2016. This is three times the national inflation rate. Compare this to the 1.24% increase from 2015 to 2016. In South Florida, the cost is even higher than the national median: $116,800 annually for a private room.

It’s not just nursing homes that cost more. So do other long-term care services. The national median cost of a home health aide rose even more sharply than nursing home costs, up 6.17% from last year, to $21.50 per hour. Homemaker services rose 4.75%, to $21 per hour. Even adult day care services costs rose, up 2.94% to $70 per day.

Despite these daunting numbers, two thirds of Americans still believe that government programs will cover all or some of their care if they ever need it! Every day my office receives panicked calls from family members who have discovered that assumption isn't so. Unless you are very poor or very wealthy, you are on your own.

With no coherent national policy to address the growing crisis, each of us has to take steps in anticipation that we will need long-term care at some point in our lives. For some, that means securing long-term care insurance. Contact our office and we can put you in touch with someone who can discuss your insurance options. Alternatively, make proactive plans to secure Medicaid benefits for long-term care. Contact a Florida Bar Certified Elder Law Attorney to discuss how you can protect all or some of your assets from the cost of long-term care.

Check out the costs of long-term care services in your state  here.

Penn Treaty fails: What does this mean for you if you want long-term care coverage?

Thousands of people across the nation hold long-term care policies from Penn Treaty Insurance Company. The company and its American Network Insurance subsidiary have been in dire financial straits since at least 2001. With the company short the $4 billion necessary to cover claims, a Pennsylvania court in March gave the go-ahead for Penn to liquidate. The court reasoned that liquidation provided the best outcome for policyholders in a bad situation. 

What happens to policyholders now? 

State insurance guaranty associations will now pick up the benefits for policyholders. According to estimates from the Long Term Care Group of the Guaranty Association, Florida is on the hook for about $354 million. However, in most states there is a cap on payouts. In Florida, the limit on individual payouts is $300,000. Some states have higher limits; in Connecticut and California, for example, it is $500,000. Note: To be covered, you must continue to pay your premiums. Read Penn Treaty's information for existing policyholders here. 

How could this happen? 
The long-term care insurance industry emerged about two decades ago in response to the needs of an aging population. Many companies underestimated the cost of coverage, however. Actuarial projections and premium structures failed to anticipate the number of policyholders who would claim benefits or let policies lapse. Penn Treaty had particularly lax underwriting standards; some of my clients who were turned down by other carriers were often able to secure Penn Treaty policies. A low-interest-rate environment also affected insurance companies' projected return on assets. As profits faltered, several carriers left the market, and those that remained raised premiums. The good news is, the insurers that survived are now doing a better job of underwriting.

Should You Get Long-Term Care Insurance? 
As with any form of insurance, there are no certainties, only  probabilities, risks and rewards to be weighed. Peace of mind should be figured into your calculations, too. In general, I am in favor of it. First, as noted above, traditional policies are now better underwritten and the companies in the market are more solid. Also, as I will explain later, new kinds of policies are available today that were not available just a few short years ago. 

Here are a few facts and figures to consider: 

• A 2015 report from The Centers for Medicare and Medicaid Services notes that at least 70% of those over 65 will need long-term care services at some point in their lives. 

• A 2014 report from the Centers for Disease Control and Prevention finds that the average stay in a long-term care facility is 845 days. 

• According to a 2015 Genworth Financial report, the average cost for a nursing home in a private room in Florida statewide is $265 per day. Based on an average stay of 845 days, the total cost is $223,925. (In some parts of the state, a private room can cost far more - as much as $505 daily.).

• Medicare does not cover long-term care. 

• Medicaid, which has been the saving grace for many of my clients, may continue to be available for those who do the proper planning. Even so, the fate of the Medicaid program is uncertain in the current political climate.

• In Florida, it is very difficult to get Medicaid assistance for at-home care. The waiting list is near interminable. If one is able to qualify and secure assistance, it is usually only for 4 hours per day.

• Veterans Benefits may be available to certain elderly and aged veterans or their widows, but it is widely expected that the Veterans Administration will tighten its eligibility requirements in the near future.

• You are more likely to qualify for and get better prices on long-term care insurance if you apply when you are younger and healthier.

• Many of my clients say they do not want to spend their children's inheritances on long-term care. Understood - but without long-term care insurance, they may end up depleting their nest egg anyway, all the while having deprived themselves and their family of the peace of mind that comes from knowing there is coverage if the worst comes to pass. 

Types of Policies Available
Traditional: As noted above, traditional long-term care policies still are available from certain carriers. You should always investigate the ratings for these companies before you buy. Moodys, Standard & Poors and other organizations rate these companies for financial soundness.

Hybrid policies: There are both life insurance policies and annuities which may be purchased with a long-term care rider. Also, if you have an existing life insurance policy or annuity, you may be able to use the policy to purchase a new policy with a long-term care rider. If you want to cancel the policy or never file a claim, you may be entitled to a return of premium on an annuity policy, or for a life-insurance type policy, to a death benefit.

Here is a chart I originally posted in 2014 that will help you understand the differences between traditional and hybrid policies. If you would like to investigate purchasing long-term care insurance, contact my office and we can put you in touch with someone who can assist you.   

	Traditional Policy	Hybrid Policy
Premiums	You pay the premium annually or in periodic installments.	Annuities and most life insurance policies: you pay a lump sum at the inception of the policy. No additional premiums thereafter. Some life insurance policies may offer annual premiums.
Policy Lapse	Policy will lapse if you fail to keep up with the premiums. No refunds. No benefits from premiums paid to date.	Policy remains in force after initial payment, except life insurance policies with annual premiums, which must be paid.
Premium Increases	Premium increases may occur if company gets approval for increase from State Insurance Commissioner.	No increases.
Filing a Claim	When you file a claim and if your policy has a waiver of premium clause, you will not have to continue to pay premiums.	With a lump sum annuity or life insurance policy, you may owe no additional premiums. With the life insurance policies that have additional premiums, you will have to make payments even after you have filed a claim, unless you have a waiver of premium clause in your policy.
If You Never File a Claim	No return on what you’ve paid in.	On an annuity type policy, you will be entitled to a lump-sum payment when you cash in the policy, or upon your death. With a life insurance policy, you will be entitled to a death benefit as scheduled.

Six years post diagnosis, Glen Campbell's wife reports on the Rhinestone Cowboy

As I reported in my post in 2013, acclaimed country music singer-songwriter Glen Campbell was diagnosed with Alzheimer's Disease in 2011. This was not entirely a shock to his fans, who had noticed the Rhinestone Cowboy forgetting lyrics during performances. At home, he had begun getting lost while driving well-known routes he'd traveled for years.

Campbell, his wife Kim and children never hid the diagnosis. On the contrary, they leveraged Campbell's high profile to bring attention to the disease.  In 2013 the Grammy Award-winning musician and his daughter testified in front of a U.S. Senate Subcommittee, explaining how the disease was impacting them and urging legislators to support research.

Kim, Cambell's wife of 34 years, cared for her husband at home until she found her strength rapidly decreasing and her worries about his safety increasing. She was always on alert to make sure he didn't fall down the stairs in their home. Eventually, he would no longer allow himself to be bathed. So, in 2014, the family decided that Campbell would be better cared for at long-term care facility in Nashville.

Now, six years after diagnosis, Kim has provided USA Today with an update on both of them. Unsurprisingly, Kim suffers from depression, but tries to remain socially and physically active. She writes a blog that provides information and support for caregivers. She visits Campbell, now 80 years old, nearly every day. He has declined significantly and is in the last phase of the disease. (The average life span after an Alzheimer's diagnosis is 2 to 8 years.) He is no longer able to play the guitar or sing. He is aphasic and can only utter a few words. When his daughter Ashley visits, she plays the guitar and sings for him. "You Are My Sunshine" seems to be one of his favorites. Kim credits her husband's musical mind for holding off the worst of his symptoms for a longer time than is usual, since music "sparks the brain." 

According to the Alzheimer's Association's 2017 report, Alzheimer's is the most expensive disease in America. Our Florida elder law attorneys meet regularly with families struggling to stay afloat financially while shouldering the cost of a loved one's long-term nursing care. According to the Alzheimer's Association, spending on Alzheimer's and other dementias will be $259 billion this year, and $1.1 trillion by 2050 if no cure or treatment is found. Every 66 seconds, someone in America develops the disease. If we had a treatment that could delay the onset by just five years - not cure it, just delay it - Medicare spending could be reduced by almost half in 2050.

The Campbell family's journey is especially timely now, as funding for the research they championed may be in the crosshairs. The National Institutes of Health (NIH), responsible for conducting and coordinating Alzheimer's research with other organizations, is facing a $5.8 billion cut under the White House's proposed budget, America First: A Budget Blueprint to Make America Great Again. While there was bipartisan support for a 2017 congressional appropriations bill to increase funds for Alzheimer's research, there is no guarantee that this area of research will be insulated from the proposed cuts. Any cuts could certainly slow progress toward the goal of having a cure or treatment by 2025, says Bruce Lamb of the Indiana School of Medicine. And the organization USAgainstAlzheimer's notes that starving Alzheimer's research could spell disaster for America's fiscal future. If you support robust funding to find a cure or treatment, be sure to let your representatives and senators know!

If you have a loved one with Alzheimer’s, consult our lawyers about how you may be able to tap into Medicaid and/or VA benefits before you lose everything to a nursing home. Even if you are healthy now, we can help you prepare in case disability strikes in the future.

Let's all keep working toward a world without Alzheimer's!

Services a Florida Elder Law Attorney provide you and your family

Just what does an elder law attorney do? What are our services? Why would you want to consult with an elder law attorney? Can younger people use our services? Are our services different from those that an estate planning lawyer provides? You may not know the answers to the above, because elder law is a relatively new field. Let me clarify how we can help you and your family. 

As the term implies, elder law helps people with the legal concerns they have as they grow older. And today in America, there’s a lot of concern! According to the census bureau, 40.3 million Americans were age 65 or older in 2010. That number is expected to rise to 89 million by the year 2050.

One area of concern is making sure loved ones inherit one's assets as efficiently, inexpensively, and stress-free as possible. This is estate planning, and it’s one of the services my law firm provides. We help clients set up wills and trusts and determine how to best structure these plans. Many clients want to keep their estates out of Florida probate. Others with taxable estates seek my help to minimize or eliminate the tax bite.

Some clients have additional planning concerns. They may have children who do not get along and cannot serve as co-trustees or co-beneficiaries. Or a child may have a disability, making a special needs trust and additional legal and financial planning advisable. A parent may be estranged from a child and wish to disinherit him/her, or include the child in an estate plan in a manner that does not jeopardize the other beneficiaries. Or a client may be so concerned about a child’s reckless spending habits that it is prudent to install certain controls in the plan.

Retirement plans like IRA's and 401K's often require special treatment in an estate plan. And for clients who own rental property and are concerned about potential liability, we can assist by setting up a limited liability company for the property.

Blended families, so common these days, can present particularly thorny estate planning challenges. A person in a second marriage who has children from a prior marriage often wants to ensure the spouse is taken care of, while still protecting his/her own children’s inheritance. The couple may have their own children together, too. It can get complicated!

Of course, when someone dies, my law firm helps the family with probate or trust administration. 

Even younger people need our services, making the term “elder law” unrealistically restrictive. For example, my clients include many first-time parents who recognize that they need to set up a will in order to name a guardian for their children. If they have a special needs child who will likely never be self-sufficient, they need to start planning accordingly. Younger couples come to us to ensure that the spouse is protected should one of them become ill or pass away. We even prepare health care surrogates and durable powers of attorney for young adults, since once a child achieves majority, parents are no longer able to automatically make decisions for the child. 

As you can see, elder law attorneys do what estate planning attorneys do. But they do more - because elder law is not just about death. It’s also about life. We help clients remain in control of their medical destiny and their financial affairs while they are alive. Today's longer life spans mean we have a greater risk of becoming incapacitated at some point. If you are like most people, you will probably want your health care decisions and financial decisions to be made by someone you have so authorized, not a court-appointed guardian who may not know your values or priorities. To make this happen, we will help you create a durable power of attorney, and a health care surrogate. We will also help you fashion a living will to ensure that your wishes are honored at the end of life. Of course, all of these “life plans” need to be consistent with your “estate plans.”

Another area of practice unique to elder law is long-term care planning. The incidence of incapacity is growing dramatically, especially diseases like Alzheimer’s. Alzheimer’s and other dementias are hugely expensive diseases; if a loved one needs a nursing home on a long-term basis, the vast majority of families will go broke in short order. A significant part of our practice is devoted to helping families get access to government benefits like VA benefits or Medicaid, allowing the family to preserve some portion of its assets. This is a particularly urgent issue when the patient has a well spouse whose nest egg is threatened by nursing home costs.

As you can see, we elder law attorneys have a lot on our plate. If any of these issues I've mentioned concern you, we look forward to assisting you!