In Long Island, what is Elder Law?
Elder law is estate planning for the elderly. Elder law attorneys focus on the concerns of senior citizens. Medicaid Qualification and Medicaid Planning are key parts of creating an estate plan, as are creating trusts and drafting advanced directives such as health care proxies, burial agent designation forms, and powers of attorneys. During the Covid-19 pandemic, new laws were enacted that significantly impact Medicaid Eligibility and create an urgency for long term care planning. Elder Law differs from state to state. The Law Office of Melissa L. Carvajal, P.C. specializes in New York Elder Law, with offices conveniently located in Long Island.
What is Medicaid?
Medicaid is a comprehensive federal and state-funded health care program that assists with health care costs for low-income individuals, disabled persons, pregnant women of all ages and senior citizens (65 years and over). For seniors, Medicaid covers Community Medicaid that supports aging in place (in home care), and Chronic Medicaid that covers long-term placement (e.g. nursing home). Medicaid has specific eligibility rules in Long Island.
In Long Island, what is Medicaid Planning?
Working with New York Medicaid guidelines to create a plan that protects the majority or all of your assets from long-term care expenses. It can be a simple process involving creating a trust and transferring your assets into that trust. Since the trust owns the assets, the assets do not count as assets when Medicaid determines if you are eligible for means-tested benefits like nursing home coverage.
In New York, the rules are very strict regarding what types of trusts can be used for Medicaid planning and the process of determining what assets to transfer into the trust can be complex for those who are not familiar with the Medicaid planning process.
In Long Island, when do you need an elder law attorney?
If you are concerned about affording nursing home or in-home care, Medicaid planning, or how your health and finances will be handled in the future if you cannot handle them yourself, you will benefit from an a elder law attorney. In Long Island, nursing home costs can be astronomical.
Long Island- Medicaid Planning
Why is Medicaid Planning Important in Long Island?
Almost half the population spends some time in a nursing home or assisted living care facility at some point in their lives. Unfortunately, the cost of skilled nursing care is beyond the reach of most family’s budgets. Nursing homes can cost more than $100,000 each year and insurance typically does not cover these astronomical costs.
The good news is that government-run Medicaid does provide payments for nursing home care. The bad news is that you could be forced to spend down a good portion of your estate and lose the assets you have worked your entire life to pay off or attain in order to get coverage. Medicaid planning is aimed at making sure this unfortunate situation does not arise.
When you work with a New York elder law attorney to develop a plan well in advance of the time when long-term care becomes necessary, you can protect your assets. If and when nursing home care is required, Medicaid will cover you right away and you can have your nursing home care costs paid while your assets are kept safe for your family.
In Long Island, it is very important to begin Medicaid planning early, because the process involves transferring assets. When you seek to have your nursing care covered, there is a five-year look back period. Essentially, this means if you transferred assets during this time period, you will not immediately be eligible for nursing home coverage. The period of disqualification is determined by dividing the value of transferred assets by the average monthly cost of nursing home care in your area.
In Long Island, even a brief delay in Medicaid nursing home coverage can cost thousands of dollars, so it is important not to wait.
Wills, Trusts & Estates
In Long Island Protect Your Future With Wills, Trusts And Estate Plans
All your life, you have worked hard to save for rainy days and retirement and to ensure your hard-earned savings will pass to your loved ones. The last thing you need now is to worry about estate taxes, having enough money left over to take care of your family when you are gone or whether the planning documents you executed properly reflect your wishes. In addition, trusts can act as asset protection plans while you are living.
Wills
Your last Will and Testament provides the opportunity to distribute property, establish care for children and otherwise express your final wishes. A Will is the primary means by which you can leave property to a person or entity other than a blood relative. Having a Will allows you to pass your property on to who you choose. Having just a Will, however, will not avoid probate, which can be lengthy and costly. The Law Office of Melissa L. Carvajal, P.C., will address this issue and with some additional planning documents you can avoid probate all together and your assets will be transferred quickly and smoothly without your loved ones having to go through New York probate.
Revocable Living Trusts
A Revocable Living Trust is a written instrument created during the lifetime of the Grantor (the person establishing the Trust) and is effective during the lifetime of the Grantor with respect to the assets which are placed in the Trust. It is an agreement between the Grantor(s) and the Trustees (Administrators of the Trust) as to how property transferred to the Trust is going to be held, distributed and administered both during the lifetime of the Grantor(s) and upon the death of the Grantor(s). The Grantor of a Revocable Living Trust retains the power to freely amend and revoke the Trust as well as to reacquire its assets.
Advanced Directives for Health Care
Health Care Proxies
A Health Care Proxy (HCP) is a written document which enables a competent adult to designate an individual to make all health care decisions for the them when he or she is unable to make his or her own health care decisions. If you become incapacitated physically or mentally because of Alzheimer's, senility, dementia, ALS or multiple sclerosis, you will need a trusted individual to make decisions for you.
Living Wills
A living will is a document that says what your wishes are for end of life if you are in a vegetative comatose state that is irreversible. It is unlike a Health Care Proxy which empowers the agent to act for all purposes. The living will is evidence of what your intentions are regarding end of life care and informs the health care proxy what your wishes are.
MOLST Forms
A MOLST form describes health care wishes for someone facing a life-threatening medical condition. MOLST is intended for patients with serious health conditions who want to avoid or receive any or all life-sustaining treatment; reside in a long-term care facility or require long-term care services; and/or might die within the next year. A MOLST form is a medical document not a legal one. A living will is the legal form that should be used to to provide guidance as to what your wishes are.
Do not Resuscitate Orders "DNRs"
A do-not-resuscitate order (DNR) is a medical order written by a doctor at the direction of the patient which instructs health care providers not to do cardiopulmonary resuscitation (CPR) if a patient’s breathing stops or if the patient’s heart stops beating. DNRs only work in a hospital, medical facility or nursing home. A health care proxy or the person/ agent designated under the Family Health Care Decision Act can sign a DNR in a hospital, medical facility or nursing home if your wishes are known. A living will is the legal form that should be used to to provide guidance as to what your wishes are.
Powers of Attorney
A power of attorney will establish a trusted individual who will manage your property and finances during your lifetime in you do not have the capacity to do so. The New York Power of Attorney law just changed in June 2021. It is important to have any old forms reviewed by a licensed New York Attorney. The Law Office of Melissa L. Carvajal, P.C is located in Hauppauge, Long Island, New York.
Guardianship
If you are faced with a loved one or friend who can no longer make decisions as to his or her personal and financial affairs or is a victim of elder abuse (physical and/or financial), he or she may need the protections provided by a Guardianship proceeding.
If your loved one has physical or mental challenges such as Alzheimer’s, senility, dementia, Lou Gehrig’s disease (ALS) or multiple sclerosis, he or she may no longer be able to make the appropriate health care, financial or property decisions. In such cases, often your best alternative may be the appointment of a guardian for that person, especially if he or she does not have an appropriate power of attorney or health care proxy.
You can avoid the stress and unpredictability of a guardianship proceeding in court if you plan in advance.
In Long Island, incapacity planning involves making decisions in advance of a physical or mental disability where you are unable to take care of yourself. In your plan, you state your wishes regarding how you will be cared for and you give somebody else, such as a spouse or adult child, the power to make financial and health care decisions on your behalf. The Law Office of Melissa L. Carvajal, P.C., addresses these potential challenges and develops an appropriate estate plan that will give you peace of mind that your wishes, both health and financial, will be carried out by a person you select in the unfortunate circumstance that you become physically or mentally incapacitated.
What will you do if you or a loved one becomes disabled? Do you have a plan of action in place?