Veterans Day, Veterans Benefits

November 11^th is a day that we set aside to remember those who have served our country in the armed forces.  It all started back in 1919 when President Woodrow Wilson declared November 11^th an “Armistice Day” to honor those who served in World War I.  Eventually the name was changed to “Veterans Day” and it was to honor all veterans of all wars.

U.S concern for veterans goes back even further in our history.  For example, President Abraham Lincoln once said that we must strive to care for and “to honor him who has borne the wounds of battle and his widow and his orphan.”  Toward that end, in I930 the U.S. officially established the Department of Veterans Affairs.  The Department, now known as the Veterans Administration (“VA”) has developed numerous programs to help veterans, their spouses and dependent children.

At the present time there are numerous veterans who served our country during wartime that are aging.  Many of these aging veterans need help with long-term care and therefore the VA has provided the following benefits:

Veterans’ Benefits Affected by Budget Cuts

Since 1927 the State of Michigan has provided funds to Veterans’ Service Organizations (“VSOs”) in order that Michigan veterans would have advocacy in obtaining and retaining veterans benefits.  However, budget concerns have prompted the governor to curtail the support that veterans have enjoyed for decades.

VSOs provide extensive support to numerous veterans’ organizations around the state, including but not limited to: the VFW, American Legion, AmVets, etc.  They provide free assistance to veterans in need, including help in filing applications for the aid & attendance pension, health and pharmacy benefits, burial and memorial benefits, survivors’ benefits, and numerous others.  They work collaboratively with the Department of Veterans affairs to help veterans and their dependents gets the benefits they deserve.  In the past, 75 to 90 percent of all claims originated with Veterans’ Service Organizations.

Medicaid Legislative Update

With all of the constant changes in the Medicaid laws, seniors and their families need to keep up-to-date to make sure their care needs are provided for.  In this post I hope to highlight some of the important recent changes:

1.   Estate Recovery – While the estate recovery law that permits the state to “take” the home was passed in September of 2007, the law is not currently being enforced.  However, the state is working with the federal government to find a version that will be approved by the federal government.  Apparently Lansing is working on some additional legislation.  When that passes and is approved it can be applied for care costs dating retroactively back to September of 2007.

Solutions to Long Distance Caregiving

It is becoming increasingly common for family members to provide care to a loved one from a distance.  This is an inevitable result of the shift from the days when families were multigenerational in the same area (or sometimes the same house!) to the modern trend where the family members are distant from one another.  Hence, it is not uncommon to find a child from a different area or state being responsible for an aging parent or parents.

With the distance approach, however, comes a unique set of problems.  The distant caregiver cannot generally take the proper amount of time to care for the loved one. This is especially true as the care needs increase over time.  The caregiver increasingly relies upon telephone contact with medical and other professionals to meet the needs of the loved one.

Home Care Paid for by Medicaid

In the past I have discussed various ways of paying for home care though the Veteran’s programs and private pay.  In this post I will discuss how and under what conditions Medicaid will pay for long-term care services provided in a person’s home.

While senior citizens usually think of Medicaid as a program that helps pay for nursing home care, there is the option of having Medicaid pay for care in the home.  The Medicaid program that handles home care is called the “MI Choice Waiver Program.”  It provides home and community-based services for aged and disabled persons who, if they did not receive such services, would require care in a nursing home. 

The MI Choice Waiver Program is administered by various branches of the Area Agency on Aging.  A list of the branch offices and the counties they serve can be found at: http://www.mfia.state.mi.us/olmweb/ex/pem/106.pdf.

Children Responsible for Elderly Parents’ Nursing Home Bill?

A recent case in Connecticut shows how the fallout from the new Deficit Reduction Act is hurting not only nursing homes and their residents, but the residents’ families as well.  In the case of Glastonbury Healthcare Center, Inc. v. Esposito, the nursing home successfully sued the adult son of a resident for over $100,000.  This has sent up a loud warning for those families who are tempted not to plan ahead for their long term care needs.  It also sends a warning to facilities that assume patients can handle the Medicaid process without professional help.

 

In the Esposito case the adult son, Carmine Esposito, signed an Admissions Agreement when his elderly mother entered the nursing home.  He signed it under the power of attorney from his mother.  He did not sign it personally as the Responsible Party.  Among other things, this document contained the provision that the Responsible Party agrees to “act promptly and expeditiously to establish and maintain eligibility for Medicaid assistance.” 

One Document That Can Help Save Your Estate

In today’s day and age advances in medicine have permitted us to extend and preserve life more than ever before.  However, for most that means that there is a period of time — especially as we age — when we will live with a disability.  Thus, there needs to be a way of appointing someone to help us with legal and financial decisions when we are not able.  This is especially important when long-term care costs threaten to drain an estate that could be saved with the proper grant of authority.   

A “power of attorney” is the most common way of appointing someone to help with important legal and financial decisions.  It is a written document wherein one can appoint someone to handle some or all of their legal and financial affairs.  The document is based on agency law.  You (the one appointing) are called the “principal” and the one appointed is called the “agent”.  

Health Insurance for the Elderly at Risk

Many of Michigan’s senior citizens who spent their working years employed by larger corporations have the comfort of knowing that they are covered by good quality health insurance.  This insurance is supposed to last well into their retirement years or even for the rest of their lives.  However, in an unexpected offshoot of the current financial crisis, many large companies are threatening to cancel the health coverage of their retirees in an effort to cut costs.  Also, seniors can be caught off-guard when companies file for bankruptcy and eliminate their retirement benefits entirely.   

This frightening prospect has already happened to retirees in some of America’s largest corporations.  Some municipalities are threatening to follow their example.  Paul Miller, the Executive Director of the national retiree advocacy group, ProtectSeniors.org, says that the situation is as dire as the financial crisis in the auto industry, Wall Street and America’s banks.

Good News for Seniors Seeking Assisted Living Care

I want to comment on an exciting area of Elder Law that is not well known: Veterans’ Benefits. Why is this area so significant? Because roughly a third of seniors who are candidates for long-term care are either veterans or widows of veterans. None of these persons wants to go to a nursing home if they need only moderately skilled long-term-care. However, Medicaid will only pay for a nursing home, it will not pay for an assisted living facility. As a consequence, many feel they have no choice. Nevertheless, most of these veterans do not realize that they can qualify for an “Aid & Attendance” pension. According to the National Care Planning Council, approximately one-third of all seniors over 65 could be eligible for “Aid & Attendance” benefits, but only about thirty percent of those are actually receiving it. The amounts obtainable are these: monthly payment for an individual: $1519 ($18,234 annually),  monthly payment for a married couple: $1801 ($21,618 annually), and monthly payment for a surviving spouse of a veteran: $976 ($11,712 annually).  Assisted living centers typically charge between $2000-$4000 per month. Thus, many of these persons would not be able to afford the monthly rate without the veterans’ benefit (because they have only $500-$1500 in Social Security and pension). With these Aid & Attendance benefits, most can afford the assisted living care they need.

Insure Your Funds: Ensure a Risk-Free Retirement

As days of retirement approach, health problems often become a concern. Inevitable issues such as stroke, heart disease and cognitive impairment can mean a whole new way of life. 

Even after working long and hard to acquire resources for your retirement, there are more steps to be taken. It has become necessary to insure your funds so that the hard-earned money will still be there when you need it most.

 Many mistakenly believe that government programs such as Medicare or Medicaid will cover the costs of long-term care. Medicare will cover some skilled nursing for a limited period (100 days, if you are responding to treatment).  Medicaid will only cover long-term care costs for impoverished individuals or those who have implemented proper legal strategies. Health insurance does not cover nursing home or other long-term costs except for short-term rehabilitation. When age-related problems call for long term care such as a nursing home stay or assisted living, the out of pocket costs involved (currently over $6000 per month in Michigan) are sure to speedily drain retirement funds and leave the remaining healthy spouse in poverty.