Affordable Care Act (ACA) and ALTCS

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In case you missed our latest Arizona Republic article in the weekly Seniors and the Law Column, it is written below. Our column runs every Saturday in select Arizona cities.

Q: I have heard a lot about the expansion of Medicaid under the Affordable Care Act.  This seems to suggest that there will be greater access to ALTCS, is this true?

While the Affordable Care Act (“ACA”) does indeed expand Medicaid, this expansion has no impact on ALTCS.  The ACA will uniformly extend Medicaid coverage to individuals who earn less than 133 percent of the Federal Poverty Limit, which will allow a great number of additional individuals onto the rolls of Medicaid.  Importantly, though, long-term care is a subcategory of Medicaid, to which the ACA did not make any significant changes.  Put succinctly, then, the ACA will allow greater ease of eligibility for AHCCCS, but it does not facilitate eligibility for ALTCS.

The ACA did try to address long-term care concerns with a provision commonly referred to as the CLASS Act.  This provision aimed to provide the public with an option to purchase long-term care insurance, but there was evidence indicating that the insurance program lacked actuarial soundness.  Resultantly, the CLASS Act was repealed in January 2013, and a bi-partisan commission was created in its place to address the challenges that seniors face with accessing long-term care.  Once the commission is fully formed, it will have six months to prepare its recommendations for addressing our nation’s long-term care dilemma, and it is possible that the recommendations could be submitted as a Senate Bill for congressional adoption.

The take-away point here is that while there is some attention being devoted to long-term care, there are currently not any changes coming down the pike for ALTCS.  Seniors who need coverage for long-term care should not expect greater ease of eligibility once the ACA is fully implemented.  Just like before the ACA, ALTCS eligibility is reserved for those who satisfy stringent medical, income, and resource tests.

Seniors and the Law is authored by the attorneys at JacksonWhite Attorneys at Law and addresses legal issues that arise for the elderly and their families.  Questions can be sent to firm@jacksonwhitelaw.com.

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It’s wise to start ALTCS plans early

By | Arizona Republic Column Articles | No Comments

In case you missed our latest Arizona Republic article in the weekly Seniors and the Law Column, it is written below. Our column runs every Saturday in select Arizona cities.

Q: As a widower, can you help me understand why it would help me to plan in advance for the ALTCS benefit, as opposed to simply applying for the benefit once I meet the resource requirement?  

That you are making this inquiry indicates you understand that single ALTCS applicants can have no more than $2,000 in available resources to qualify for the program.  You probably also understand that ALTCS penalizes applicants who make uncompensated transfers of assets, so your question really does raise a great point – If you can’t give assets away without penalty, then why not simply wait until you qualify naturally to apply for the program?

If ALTCS could really approve an application in a matter of days, then perhaps waiting until after you satisfied the resource requirement to investigate the benefit would not be such a bad approach.  In reality, though, ALTCS takes months, not days, to approve most ALTCS applications.  This means that if you were to wait until you were down to $2,000 before investigating ALTCS, you would be without the funds to pay for your care while the application processed.  Further, many applicants have unique issues that simply take time to resolve, and when funds are already gone it can be difficult to cover much-needed care while these issues are sorted out.

Without exception, the best approach is to start preparing for the ALTCS application before the funds are gone.  With careful planning, it is possible to arrange the circumstances so that care can be covered while the application processes, and while any potential issues are resolved.  In many instances, applicants are also able to preserve at least a portion of their resources along the way.  Without planning, however, it is all too often the case that family members are left to cover the bill.

Seniors and the Law is authored by the attorneys at JacksonWhite Attorneys at Law and addresses legal issues that arise for the elderly and their families.  Questions can be sent to firm@jacksonwhitelaw.com.

Click to view all of our Seniors and the Law columns. 

ALTCS Planning Helps Couples | Arizona Republic

By | Arizona Republic Column Articles | No Comments

In case you missed our latest Arizona Republic article in the weekly Seniors and the Law Column, it is written below. Our column runs every Saturday in select Arizona cities.

Q:  In a recent article, you discussed the reasons for which ALTCS planning is beneficial for single individuals.  You seemed to allude to the notion that ALTCS planning is different for those who are married.  Can you please elaborate?

You are correct to infer that ALTCS planning is different for married and single applicants.  In a few short words, married individuals have quite a bit more to gain from ALTCS planning than single individuals.  To be clear, the end goal for both single and married applicants is the same – to obtain coverage for long-term care.  But, married applicants can sometimes preserve quite a bit more assets because they have the ability to transfer resources to their spouse who is still living in the community.

Without getting too far into the details, a very general way to look at ALTCS planning for married applicants is to say that the community spouse gets to keep about one-half of the available resources, and the applicant him or herself is expected to spend the other half on care before becoming eligible.  However, given that certain assets are considered unavailable, many married applicants can implement strategies to convert their half of the resources into those that are considered unavailable, and end up saving substantially more than just one-half of the resources for the community spouse.

Even in cases where there are only few resources to preserve, married applicants still need to set a plan in motion to minimize or eliminate any inability to pay for care.  ALTCS applications can take several months to process, and it is important for all applicants to have their affairs in order before they submit the application to increase their chances of approval.  Married applicants who plan in advance can almost always eliminate coverage gaps, and can most times preserve resources along the way.

Seniors and the Law is authored by the attorneys at JacksonWhite Attorneys at Law and addresses legal issues that arise for the elderly and their families.  Questions can be sent to firm@jacksonwhitelaw.com.

Click to view all of our Seniors and the Law columns. 

Does your loved one have Alzheimer’s Disease?

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How can I help my loved one with Alzheimer’s disease?

The best person to contact for your loved one’s long-term care is his or her doctor.  If the doctor feels they need immediate long-term care, he can complete the necessary paperwork to have their condition reviewed by Medicaid.

When Medicaid agrees to long-term care, the next step will be to counsel with a Medicaid planning attorney to go over your loved one’s legal documents.  The attorney will take a look at monthly income and overall wealth to decide what Medicaid planning tools are needed to protect their estate.  If they have too much monthly income (over $2130 each month), then the attorney will prepare a Qualified Income Trust to insure your loved one passes the income test.  If they get less than $2130 each month, then this step is not necessary.

The attorney will then review your loved one’s assets.  Being a Medicaid applicant, she is only allowed to retain $2,000 in assets.  If there are excess assets, the attorney can look and see what other avenues are available to protect the remaining assets.

The doctor or attorney should be able to assist you in picking out the proper living environment for your loved one.  Be sure to visit all the facilities consider to ensure you are picking the best fit.

The Medicaid application can be filled out by your attorney, paralegal, or someone at the assisted living facility.  If you have a good doctor and attorney, the application process should be a breeze.

If you have any questions about elder care, feel free to call an elder care attorney at JacksonWhite. You can call 480-818-6912 to schedule a consultation with an elder care advisor.