Answers To Common Questions

Aging adults often are concerned about their future, especially when it comes to health and finances. Seniors in need of care, their caregivers and family members, and disabled persons may face complicated social and legal questions relating to Long-Term Care needs.

Information about public benefits programs and other care issues can be difficult to locate or are presented in legal language, making it difficult if not impossible to understand. Here we attempt to answer some of the most frequently asked questions about Elder Law in a simple, straightforward manner.

At ELG Estate Planning, we help clients understand their options to ensure the highest quality of life, and maintain the autonomy and dignity of the senior. We focus on Asset Protection Estate Planning™, Special and Supplemental Needs Trusts, Long-Term Care planning and utilization of government benefits, including Medicaid and Veterans benefits through Medicaid Asset Preservation Strategies®, as well as Probate and Trust administration.

Frequently Asked Questions

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Estate Planning

Estate planning is the necessary steps taken during your lifetime to put into place the documents required to make sure that your financial affairs are in order and health care wishes will be honored, and that loved ones are provided for upon your passing.
 

Fundamental Estate Planning Documents Should Include:

What is a Will with an Asset Protection Trust?

A Will with an Asset Protection Trust protects assets for a surviving spouse or any beneficiary. To allow for flexibility, funding of the Trust can either be mandatory or contingent. If contingent, upon the death of the first spouse, a decision will be made at that time whether to protect assets through funding the Asset Protection Trust for the surviving spouse with the deceased spouse’s assets. Importantly, the Asset Protection Trust shields assets from unnecessary depletion. Assets in the Trust are not considered “countable” by Medicaid or other government needs-based benefit programs. Thus a Will with an Asset Protection Trust avoids depleting funds unnecessarily, and is especially useful if expensive Long-Term Care is needed by the surviving spouse. Couples can protect 50% to up to 100% of their estate from Long-Term Care expenses, creditors, and the State.

A Will with an Asset Protection Trust not only protects assets for the surviving spouse, but also for other beneficiaries should they need asset protection at the time they inherit. Furthermore, assets that remain in the trust ultimately will be distributed according to the wishes of the first spouse to pass, thus avoiding “unintentional disinheritance” of your beneficiaries due to unforeseen future events, such as remarriage.

What are a Special Needs Trusts or Supplemental Needs Trusts?

“Special Needs” or “Supplemental Needs” describes any trust intended to provide benefits without causing the beneficiary to lose public benefits he or she may be entitled to receive.

When individuals with special needs who receive government needs-based benefits receive money from personal injury settlements, inheritances or other sources, they can lose their public benefits. You can structure your estate so that you provide assistance to your disabled child or grandchild without jeopardizing their receipt of benefits. This also can include a surviving spouse who may need Long-Term Care. Such a trust preserves those benefits and sets aside additional funds for the person with special needs. For a surviving spouse needing Long-Term Care, such a trust renders those assets non-countable for Medicaid qualification.

Does a “Supplemental Needs” trust differ from a “Special Needs” Trust?

It depends. Both terms can be interchangeable, and describe the purpose of the trust rather than being a limited legal term. However, the term “Special Needs” trust commonly is used to refer to a trust that a disabled person creates for themselves, or to a trust created for a disabled child. A “Supplemental Needs” trust often refers to a trust created by a third-person for someone, like a spouse or child, who would benefit from asset protection, though who would not be referred to as a person with “special needs”.

Does the existence of a Special or Supplemental Needs trust qualify the beneficiary for public benefits?

No. The existence of a Special or Supplemental Needs Trust does not itself make public benefits available. The beneficiary must meet eligibility criteria to qualify for the benefits program. If properly drafted and established, funds in the trust will not cause a loss of benefits.

Should I choose a Revocable Living Trust?

A Revocable Living Trust is an arrangement for the management and distribution of your property. Such an arrangement is revocable during your lifetime. Your assets are transferred to the Trustee of the Revocable Living Trust, who manages and distributes the property according to the terms of the trust. The grantor/trustor, meaning the person who creates the trust, often serves as their own Trustee.

A Revocable Living Trust can be a good Estate Planning tool for those who own property in other states. However, unless it is properly funded and administered, upon the Trustor’s death there will need to be both a trust administration and a probate. A primary goal of a Revocable Living Trust is to avoid probate, especially in states such as California where probate is expensive and complicated – which is not the case in Washington.

Also, it is very important to understand that Revocable Living Trusts provide no Long-Term Care Medicaid planning benefit for a surviving spouse in Washington. In fact, Revocable Living Trusts can prove harmful to asset protection and Long-Term Care benefits planning in Washington. It is important to consult with an Elder Law attorney if you have or are considering a Revocable Living Trust.

Power Of Attorney For Financial Matters

A Durable Power of Attorney is a legal document through which you grant authority to a trusted individual to act on your behalf. It does not take away your authority to act. And it can be revoked at any time (as long as you have the capacity to do so).

Durable Powers of Attorney for financial matters and health care can be separate documents or a combined document. It is “durable” because it remains in effect even should you lose capacity.

Who would you want taking care of your financial matter if you could not?

A Durable Power of Attorney is a legal document through which you grant authority to a trusted individual to act on your behalf. It does not take away your authority to act. And it can be revoked at any time (as long as you have the capacity to do so). Durable Powers of Attorney for financial matters and health care can be separate documents or a combined document. It is “durable” because it remains in effect even should you lose capacity.

The person appointed under your Durable Power of Attorney is known as an “Attorney-in-Fact,” “POA,” “Agent”, or for health decisions, a “Health Care Agent.”

Without an effective Durable Power of Attorney, if you were unable to manage your affairs due to incapacity or other reasons, the state in which you live would require a court-appointed Guardian to manage your finances and direct your care with expenses to be paid from your assets. The Guardian may be a family member, or could be a stranger you have never met!

A good Durable Power of Attorney, on the other hand, not only lets you appoint who you trust to handle your affairs, a well-drafted Durable Power of Attorney authorizes your decision-maker to take steps to protect assets for you, especially important if Long-Term Care needs arise.

What is an Attorney-in-Fact?

The person appointed under your Durable Power of Attorney for finances is known as an “Attorney-in-Fact” or “POA.”

The Attorney-in-Fact is someone specifically named through the Durable Power of Attorney document to act and conduct business on your behalf. That authorization includes signing documents, transacting business, paying bills, accessing your bank accounts, and if the document includes specific powers important to Elder Law planning, it should include authority to enter into Long-Term Care planning to protect your assets.

Because the Attorney-in-Fact has the authority to handle your financial decisions if you cannot, this person should be someone you trust implicitly to follow your wishes and look out for your best interests. You should talk with the person you want to name as your Attorney-in-Fact to ensure he or she understands your wishes concerning financial decisions.

Power Of Attorney For Healthcare

The Durable Power of Attorney for Health Care is a legal document in which you authorize a trusted individual to make health care decisions on your behalf in the event you are unable to do so due to illness or incapacity.

A Durable Power of Attorney allows for responsiveness to changing health care situations as the Health Care Agent that you appoint will express your wishes and respond to unexpected changes in your condition; thus decisions will be based not just on your written wishes, but will be guided by your Agents familiarity with you and your desires regarding your care.

Who would you want making your health care decisions if you were unable?

The Durable Power of Attorney for Health Care is a legal document in which you authorize a trusted individual to make health care decisions on your behalf in the event you are unable to do so due to illness or incapacity. The person you appoint is known as your “Attorney-in-Fact,” “POA,” or “Health Care Agent”. Your agent must follow your wishes regarding the provision or withholding of medical treatment. The person you choose should be a trusted family member or friend with whom you have discussed your values and medical treatment choices.

A Durable Power of Attorney allows for responsiveness to changing health care situations as the Health Care Agent that you appoint expresses your wishes and will be able to respond to unexpected changes in your condition and base decisions not just on your written wishes, but also on their familiarity with you and your desires regarding your care.

If you don’t have a Durable Power of Attorney for Health Care, and if you were to lose the ability to communicate and make decisions, state laws grant authority concerning medical decision-making (though not financial) to someone who will speak for you, even if you don’t agree! Thus is it very important that you designate who should speak for you through a Durable Power of Attorney so that you determine who will speak for you.

Without a Durable Power of Attorney for Health Care, the following people, in order of priority, are authorized to make health care decisions for you, including withdrawing or withholding care:

  • A guardian with health care decision-making authority, if one has been appointed
  • Your spouse
  • Your adult children
  • Your parents
  • Your adult brothers and sisters

When there is more than one person, such as children, parents or brothers and sisters, all must agree on the health care decision.

What if I don’t have an Attorney-in-Fact for Health Care Decisions?

If you don’t have a Durable Power of Attorney for Health Care, and if you were to lose the ability to communicate and make decisions, State laws grant authority concerning medical decision-making (though not financial) to someone who will speak for you, even if you don’t agree! Thus is it very important that you designate who should speak for you through a Durable Power of Attorney so that you determine who will speak for you.

Without a Durable Power of Attorney for Health Care, the following people, in order of priority, are authorized to make health care decisions for you, including withdrawing or withholding care:

  • A guardian with health care decision-making authority, if one has been appointed by the courts
  • Your spouse
  • Your adult children
  • Your parents
  • Your adult brothers and sisters

When there is more than one person, such as children, parents or brothers and sisters, all must agree on the health care decision.

Medicaid

Very simply stated, Medicaid is a government-funded health care program for individuals who meet income or resource qualifications. Medicaid provides benefits to pay for Long-Term Care costs.

Many planning techniques exist to preserve assets and achieve current or future Medicaid Long-Term Care benefits eligibility.

What is the difference between Medicaid and Medicare?

Medicare is a federal program of health insurance available to people 65 or older or who have certain disabilities, regardless of income. Medicaid is a program jointly funded by the federal and state governments available to those who meet income and resource tests to help pay for medical and Long-Term Care. Each state has its own Medicaid program. Thus, if you are planning to retire to or move a loved one to another state, you should consult an Elder Law attorney to understand the impact of this decision on benefits. Medicaid is often used to fund Long-Term Care.

What benefits does Medicaid provide?

Medicaid benefits can be divided into two broad categories: acute care (medical) and Long-Term Care; (there are also separate program rules for the developmentally disabled and the seriously mentally ill, but they are beyond the scope of this FAQ). Eligibility for each kind of benefit is different, though they are similar. The Medicaid program pays for all prescription drugs. Medicaid beneficiaries may receive their drugs through Medicare’s Part D program, but the premiums and co-payments are paid by Medicaid.

Does the Medicaid recipient have to pay for any portion of his or her care?

Yes – usually. The recipient’s portion is known as “participation.” The participation amount is calculated from the recipient’s gross income, less the amount of supplemental insurance premium paid by the recipient, less their personal needs allowance. The recipient’s participation is paid directly to the facility or care provider.

Will the state file a lien against a recipient’s home or property?

The state has a right to recover Medicaid costs paid on a recipient’s behalf from the estate of a deceased Medicaid recipient over the age of 55. This may include a lien against any real property owned by the deceased Medicaid recipient. Through utilization of Medicaid Asset Preservation Strategies®, estate recovery liens can be avoided in many instances.

Must an applicant’s home be sold to qualify for Medicaid?

No. A home is an exempt resource, though for single people there is an equity limit. If a home is gifted, usually in an attempt to preserve the asset or avoid the state’s lien, a penalty period of ineligibility can be imposed.

However, there are exceptions allowing the home to be gifted without penalty; for example to a disabled child or to a “caregiver-child”. Due to the complex rules applicable to transfers, anyone considering gifting or transferring any asset, including the home, should first consult with an experienced Elder Law attorney.

What other assets can a Medicaid recipient retain?

In addition to the home, a Medicaid recipient is also permitted to retain an automobile (without any limitation on its value), household furniture and furnishings, prepaid funeral/burial benefits, a burial plot, a burial fund of $1,500 or less or a life insurance policy with a face value of $1,500 or less, certain sales contracts, a Long-Term Care partnership insurance policy exemption amount, items listed for sale that cannot be converted to cash within 20 days, business property upon which the person relies upon for support. Other than those categories, a single person’s total assets must be under $2,000.

Many planning techniques exist to preserve assets and achieve current or future Medicaid Long-Term Care benefits eligibility.

What assets can a married couple retain and still have one spouse qualify for Medicaid benefits?

The rules are more complicated and generous for a married couple where only one spouse will be institutionalized. Currently, Washington allows combined non-exempt resources of a married couple $56,726, up to $122,900 if skilled nursing care is needed.

The resources for both spouses are counted, regardless of whether the property is a community, separate or held in trust. All assets are valued according to the fair market value of the applicant’s equity interest in the resource.

How much income can a Medicaid recipient have?

A single person’s income must be less than the private pay rate in the nursing home plus the applicant’s regularly recurring monthly medical expenses (health care premiums, prescriptions, etc.). For one spouse of a married couple to receive Medicaid benefits, the income of that spouse must be less than the private pay rate in the nursing home plus the applicant’s regularly recurring monthly medical expenses (health care premiums, prescriptions, etc.).

How much of a couple’s income can be retained by the spouse who does not receive Medicaid benefits?

The Medicaid recipient’s spouse may be entitled to keep some or all of the ill spouse’s income. The calculation of this amount, referred to as the Minimum Monthly Maintenance Needs Allowance, is complicated and will vary significantly in individual cases. One piece of simple (and good) news: the community spouse is not required to contribute any portion of the income in his or her name alone toward the Medicaid recipient’s care costs.

What is the “lookback” period for Medicaid benefits?

When an application is filed, Medicaid’s financial eligibility worker will inquire about any gifts made by the applicant, the applicant’s spouse or anyone acting on behalf of either of them within the preceding 60 months. This five years before the application is known as the “lookback” period.  Gifts made before that period will not affect eligibility. Gifts made during the “lookback” period usually will result in a period of ineligibility, and that disqualifying period will not start to run until the applicant has already spent down all of his or her assets and applied for benefits.

Can someone receive Medicaid benefits even if they have made gifts during the preceding five years?

If gifts have been made during the “lookback” period, the applicant usually will be ineligible for a number of months calculated from the date of application (NOT from the date of the gift). The ineligibility period is determined by dividing the value of the gift by a number intended to approximate the monthly cost of Long-Term Care in the community. The actual application of this penalty period is further complicated by multiple gifts, a return of some or all of a gift and other factors. This overview must be reviewed with caution, and we recommend you consult with an Elder Law attorney for help interpreting a specific gift.

Can Medicaid applicant purchase a new home, car, home furnishings or prepaid burial arrangements?

Yes. Available resources can easily be made unavailable by purchasing exempt assets.

How can annuities benefit Medicaid recipients?

A Medicaid-compliant annuity is a critical planning tool available in Washington. It results in the conversion of countable resources to non-countable and allows almost immediate resource eligibility without a five-year look-back concern!

The best advice is to seek the help of a skilled and compassionate Elder Law attorney. The best time is well before you or a loved one needs Long-Term Care!

What is COPES?

COPES is a Medicaid program that pays for Long-Term Care in a person’s own home, adult family home or assisted living facility. It is designed to help people who, without COPES, would need to be in nursing homes.

What about Veterans Benefits?

Benefits to U.S. Veterans include health care, disability compensation, burial, pension and Long-Term Care. A pension benefit is paid to wartime Veterans who have limited income and assets and who are either over 65 or are under 65 and disabled. There is no service-connected injury or disability requirement, however.  To apply for Veterans benefits, contact (800) 827-1000 to find the nearest Veterans Service Office (VSO).

Probate

Probate is the legal process for transferring property upon death. It is a relatively quick and inexpensive process in Washington and Idaho. The Will is filed with the court, the Personal Representative is appointed and given legal authority to act on behalf of the estate, usually through the issuance of Letters Testamentary. Most probates are called “non-intervention”, meaning the court is not involved in the estate’s administration.

What are the costs associated with probate?

In addition to filing fees, copy costs and recording fees, the cost of probate mostly consists of legal fees. The Personal Representative may also charge a fee, but if he or she is also a beneficiary of the estate it is not uncommon for the Personal Representative to waive any fee.

Are beneficiary designations a good probate avoidance approach?

Beneficiary designations are used to direct non-probate assets (those not governed by a Will), such as life insurance policies, retirement accounts, and other financial accounts. This is a critical part of an estate plan which is often overlooked.

Are there any good things about probate?

Yes! Not only does probate make sure assets go where they are directed, it also provides for protection from creditors. And in Washington, it is the only way to protect assets for a surviving spouse against Long-Term Care costs. Assets within a testamentary Asset Protection Supplemental Needs Trust (meaning a Trust created by a Will) are non-countable for government benefits purposes. Plus such assets are not available to creditors, and not subject to the state’s lien for benefits paid to the surviving spouse. A Will with an Asset Protection Supplemental Needs Trust is the best asset protection tool available for couples who wish to ensure the surviving spouse does not become impoverished.

When is probate required?

Assets in the decedent’s name alone, with no joint tenancy and no beneficiary designation, must go through the probate process to determine who is entitled to receive them. If some assets must be probated, that does not mean that every asset the decedent owned is subject to the probate process — only those assets in the decedent’s name alone need to be probated.

An estate of less than $100,000 can be administered through the use of a simple affidavit if the decedent owns no real property solely in their name.

What about estate taxes and probate?

Estate taxes are calculated on all assets that were subject to the decedent’s control just before death. The federal estate tax is due on estates of more than $5,450,000 in 2017. Washington State’s estate tax exclusion amount in 2017 is $2,129,000.

Does that mean my children will have to pay income taxes on what they receive from my probate estate or trust

No. Inheritances and gifts are not income to the recipient. Two important qualifications to this broad principle:

IRAs and qualified retirement funds will be income to the recipient when withdrawn, whether that is you or your heirs, and
Inheritances may include some portion of income earned between the date of death and the date of distribution — and that income is subject to income taxation to the recipient.

Health Care Directives & Living Will

A Health Care Directive, an Advance Directive and a Living Will are the same thing, a document where you state your health care wishes if you are at end of life. The term “Living Will” is confusing as it bears no relationship to a Last Will and Testament. To avoid confusion we will only use the term “Advance Directive.”

An Advance Directive refers to a legal document in which you specify in writing your wishes regarding your health care should you be at end of life or in a permanent vegetative condition and unable to communicate your wishes. It is critical that you make your health care wishes known through your Health Care Directive.

The Advance Directive is an important document that works with your Durable Power of Attorney for Health Care Decisions to empower your Attorney-in-Fact to confidently carry out your wishes.

What is included in an Advance Directive?

An Advance Directive provides specific direction to health care providers about the types of treatments you do or do not want. Some people choose not to have various kinds of medical treatment, while others choose to have certain medical treatments or all available medical options (pain relief, resuscitation, artificial nutrition/hydration, intubation or mechanical intervention, such as a ventilator, dialysis, provision of antibiotics, etc.). It is your choice as to whether you want your life prolonged or if you want to be permitted to die naturally.

The Advance Directive is referred to by your health care provider if you have a terminal condition or are in an irreversible coma or other permanent unconscious condition and there is no reasonable hope of recovery. The Advance Directive must be signed by you and two witnesses who are not related to you, who will not inherit anything from you and who are not individuals providing health care services to you.

It is important to let your physicians and loved ones know what your wishes for treatment would be should you face a terminal illness or permanent vegetative condition. Medical facilities may assume you want all available medical treatment, including life-sustaining care, unless you direct otherwise. Your Advance Directive, together with your Health Care Agent’s direction authorized under your Durable Power of Attorney for Health Care will ensure that your wishes are honored, whatever they may be.

Your Advance Directive may include provisions such as:

  • Refusing all medical care
  • Removing life support in the event of a permanent vegetative state or terminal condition
  • Instructions to use all efforts to sustain life, no matter the circumstances
  • Specifying a time period to remain on life support or to withdraw it
  • Religious considerations such as refusal of blood products or transfusions
Will Advance Directives be recognized in emergencies?

No. During most emergencies, there is not enough time for emergency service personnel to consult the patient’s Advance Directive. Once the patient is under the direct care of a physician, there will be time for the Advance Directive to be evaluated and/or the Health Care Agent to be consulted. For the document that speaks to emergency situations, see below regarding POLST forms – Physician Order for Life-Sustaining Treatment.

What is a POLST?

A POLST is a Physician Order for Life Sustaining Treatment. It is a document that tells emergency responders and physicians what to do in an emergency.

For individuals with serious health conditions who are in the final stage of life, or suffering from an advanced stage terminal illness or illness from which they are not expected to recover, a Physicians Order for Life Sustaining Treatment (POLST) form is available.

Idaho’s form is called a Physician Orders for Scope of Treatment (POST)

POLST forms allow individuals to summarize their wishes regarding end-of-life treatment. The POLST is complementary to the Advance Directive but does not replace it. A POLST form is a medical order, signed by you and your physician, which outlines specific medical orders to be honored by health care workers during a medical crisis. The POLST is a brightly colored form (often green) which is immediately recognizable and can be used by doctors and first responders (including paramedics, fire departments, police, emergency rooms, hospitals and nursing homes). POLST forms are usually recommended by physicians for those individuals who no longer wish to be resuscitated so that they may die naturally. A POLST form is usually posted on a refrigerator or other conspicuous place where it will be seen by first responders.

Do I need both an Advance Directive and a Durable Power of Attorney for Health Care?

Yes! Having both an Advance Directive and a Durable Power of Attorney for Health Care will provide the best protection for your treatment wishes and comprehensive guidance regarding your care.

Making your wishes known in an Advance Directive will provide your doctor and your Health Care Agent the clear guidance necessary to carry out your wishes.

What is the Washington Death With Dignity Act? Can my Health Care Agent make choices for me under the Act?

Washington is one of just a few states in the United States that allows an individual who meets residency and medical diagnosis requirements to request lethal doses of medication which will hasten end-of-life. The Washington Death with Dignity Act, Initiative 1000, codified as RCW 70.245, passed on November 4, 2008, and went into effect on March 5, 2009. This act allows terminally ill adults seeking to end their life to request lethal doses of medication from medical and osteopathic physicians. These terminally ill patients must be Washington residents who have less than six months to live.

The Act contains many protections to ensure that the person is competent, acting voluntarily, and making an informed decision. This means that your Health Care Agent cannot make this choice on your behalf. You must be competent and request the medication for yourself.

What is the difference between an Advance Directive and Power of Attorney for Health Care?

An Advance Directive is different than a Durable Power of Attorney for Health Care. A Durable Power of Attorney for Health Care is the legal document through which you appoint a Health Care Agent to speak for you. Not uncommonly an Advance Directive is combined with the Durable Power of Attorney for Health Care, providing all information about your health care wishes and who is authorized to speak for you in one document.

In every State, you have the right to make your own health care decisions. Under the principle of “informed consent,” your medical care must be explained so you understand it and can make informed decisions. (Treatment without consent, however, is allowed and will generally be provided in an emergency unless you indicate otherwise). If you are not able to understand your medical treatment options, your Health Care Agent will speak for you based on your wishes as stated in your Advance Directive.

Long-Term Care

Medical care or personal assistance provided by a caretaker or a facility for a period of weeks or months (or longer) is Long-Term Care. Neither the level of care nor the length of time is subject to exact definition. “Long-Term Care” refers instead to the condition of extended or permanent dependence on care from another.

Long-Term Care can be provided in nursing homes, adult family homes, assisted living facilities, congregate living arrangements, adult day care centers and in a person’s own home or apartment. This list of Long-Term Care settings is arranged roughly from more restrictive to less restrictive settings, though seriously impaired individuals might be cared for at home in surroundings that mimic more institutional settings, and some institutions (especially adult care homes) may be homelike and inviting.

How much does Long-Term Care cost?

The cost of Long-Term Care varies widely by geographic region, level of care and individual facilities and caretakers. Costs vary tremendously, with larger metropolitan areas and eastern states generally seeing higher costs than smaller communities in the south and west. In Washington, the average statewide rate for skilled nursing is $9,038 as of January 2017, according to Medicaid. In practicality, however, the rates charged often are $10,000 to $12,000 per month.

Adult family homes and assisted living facility typically charge about half of the skilled nursing rate. The actual cost is dependent upon the care provided and the facility. Care in the home may be the least expensive or most expensive, depending upon the level of care needed.

    Who pays for Long-Term Care?

    Care provided by family members without formal payment accounts for the largest share of Long-Term Care provided. More formal Long-Term Care arrangements in the home and in institutions are paid for by the person’s income and savings, Long-Term Care insurance, and government benefits, such as Veterans benefits, and Medicaid.

    Medicare does not pay for Long-Term Care, except for a limited exception of up to 100 days of rehabilitation. Medicare limits its Long-Term Care benefit in skilled nursing facilities to exclude “custodial care”. Thus Medicare pays for rehabilitation services, such as physical therapy, occupational therapy, and speech therapy, but not for facility costs if rehabilitation care is not being provided.

    What insurance programs pay for Long-Term Care?

    Long-Term Care insurance will pay for nursing home, assisted living or home care in accordance with the terms of the individual insurance contract.

    Long-Term Care insurance is an insurance product designed to protect against the high cost of nursing home and community-based care. When an individual becomes physically or cognitively frail and is no longer able to care for himself or herself safely without assistance, home care services, assisted living, memory care, or nursing home care may become necessary. Long-Term Care insurance is designed to help fund these caregiving needs.

    Why would you purchase Long-Term Care insurance?

    Some individuals will qualify for government assistance with the cost of Long-Term Care relatively easily (usually through the federal/state Medicaid program). Others have sufficient wealth to pay privately for Long-Term Care for the rest of their lives. Most middle class Americans, however, will want to consider Long-Term Care insurance for one or more of these purposes:

    • To prevent impoverishment of the spouse who does not need care: the “well spouse”
    • To protect an estate for inheritance by children or other beneficiaries
    • To avoid relying upon Medicaid thus allowing greater options for care placement
    • To increase the likelihood that care can be provided in the home, and nursing home placement avoided altogether

    As a person ages, he or she may reach a point, either temporarily after an illness or injury, or permanently, when he or she is unable to provide self-care without help. Depending on the person’s abilities, home care services, assisted living, memory care, or skilled nursing care may become necessary. Long-Term Care insurance is designed to help pay for these services as needed at any age, but especially for those who face the challenges of aging.

    Elder Law

    Elder Law is a client-focused practice area where lawyers help seniors plan their estates to optimize asset protection and understand options related to Long-Term Care, including what government benefits may be available to pay for care. Elder Law goes beyond the realm of traditional Estate Planning to address the legal and social issues affecting seniors, the disabled and vulnerable adults. Finding, keeping and paying for Long-Term Care is an integral part of Elder Law. Asset protection against Long-Term Care costs is a key component of Elder Law planning.

    Is Elder Law a recognized legal specialty?

    The National Elder Law Foundation offers a certification in Elder Law (CELA, which stands for Certified Elder Law Attorney) for those attorneys who have applied for and successfully passed a written examination and who meet specified qualifying criteria. Most State Bar Associations, however, do not recognize Elder Law as a legal specialty.

    Are there any other credentials an Elder Law attorney might demonstrate?

    In Washington State, an Elder Law attorney may be a member of organizations focusing on Elder Law, such as the Washington Academy of Elder Law Attorneys (WAELA), as well as national organizations like the National Academy of Elder Law Attorneys (NAELA).

    What are the legal practice areas in which Elder Law attorneys engage?

    Although the legal problems of seniors span the entire gamut of legal issues, certain topics arise for seniors more regularly than others. Lawyers who focus on Elder Law likely will be familiar with Guardianships, Estate Planning, Trust administration and Probates. Within Elder Law, attorneys may focus on Special and Supplemental Needs Trusts, Long-Term Care planning and government benefits such as Medicaid and Veterans Affairs. Some Elder Law attorneys may also focus on related issues, such as elder abuse, senior exploitation, and nursing home litigation.

    Are there legal practice areas that Elder Law attorneys are uniquely qualified to handle?

    As with other professional specialty areas, the ability of individual Elder Law attorneys to handle specific matters will vary with the experience, competence, and credentials of the individual lawyer. Some of the topics that are not as widely understood by lawyers other than Elder Law attorneys might include Medicaid and Long-Term Care planning, Special and Supplemental Needs Trusts, Estate Planning for disabled family members and Advance Directives.

    How can I find an Elder Law attorney in my area?

    The National Academy of Elder Law Attorneys (NAELA) provides an online resource for locating a member of that organization. NAELA is the only national organization of Elder Law attorneys and has over 3,000 members hailing from every state (and a few U.S. territories and foreign countries).

    As with other legal practice areas, the best method of locating a competent Elder Law attorney is probably to solicit suggestions from friends, relatives, and colleagues, conduct online research, find out the attorney’s rating and what clients say about the attorney. Then contact the Elder Law attorney and ask questions about their specific experience, training, and interests. An important question to ask is how much of their practice is devoted to Elder Law?

    At Elder Law Group PLLC we focus 100% on Elder Law.

    Fees

    At our first meeting, we will discuss your situation and the nature of the services that will be provided, and an estimate of the timeframe for completing the needed services. We will prepare you a fee agreement that spells out the work to be done and the fee we will charge. It will indicate whether you are paying a flat fee or an hourly fee and how often you can expect us to bill you. If the scope of the work changes, or if you require additional work that was not discussed at the initial meeting, we will prepare a new fee agreement to cover the additional work.

    Do you charge for the first meeting with an attorney at Elder Law Group PLLC?

    We may charge a consultation fee (currently $375), depending on the type of matter. However, we do offer complimentary consultations as well. Contact us to see if you qualify for a free consultation.

    Why do you sometimes charge a fee for the first meeting?

    We know your time is valuable, and so is ours. We expect to accomplish quite a lot at our first meeting with you. We will determine the scope of the problem, offer you suggestions on how to address it, help you decide how to proceed, and start gathering the information we need to begin our service to you. To help make the best use of everyone’s time, we send you a questionnaire to complete and bring with you to the first meeting.

    Though you may not have met us before, the initial meeting is far more than a “getting to know you” session. At the end of the consultation, you will have a clear picture of the path forward to address your legal needs.

    Do all (or most) lawyers charge an initial consultation fee?

    Some do and some don’t. While we have not conducted any studies, and know of none available, we believe that legal practitioners are about evenly split on the subject.

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