Volume 17, No. 4, Fall 2009
By Sheila Curtis
Great news for Medicare beneficiaries! Due to the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) many positive changes will take effect with the new year.
These changes will:
Anyone who had been denied extra help due to a life insurance policy or in-kind assistance should re-apply after January 1.
You can do this in several ways:
Call Social Security (1-800-772-1213) and apply over the phone or request an application; go to the Social Security Web site (www.socialsecurity.gov) and apply online or in person at your local Social Security office.
Don’t forget: the annual Coordinated Election Period annually occurs from November 15-December 31. This is when Medicare beneficiaries can join, disenroll or switch plans (such as Part D and Medicare Advantage). If you do nothing during this period you will remain in the same plan for 2010 unless that plan is no longer available.
If you would like to go over your options and/or review your current plans call your local senior center or your regional office of SHINE (Serving the Health Information Needs of Elders) at 508-394-9326 or 1-800-334-9999 to schedule an appointment. Don’t delay, appointments fill up fast.
(Ms. Curtis is Regional Director of SHINE, a division of the Massachusetts Executive Office of Elder Affairs.)
By Charles C. Case, Jr.
This past January, the Massachusetts Uniform Probate Code (MUPC) was signed into law. Some parts were entirely stricken—most changes becoming effective in July. Other portions of the law regarding probate will become effective on July 1, 2011.
If you have created a Power of Attorney and a Health Care Proxy, then theoretically, you’re okay. But if you have failed to put in writing your wishes as to whom you want to control the decisions over either your person or assets when you can no longer do so yourself, then a court will have to make that decision. The special proceeding is called the guardian or conservator petition.
Prior to July 1, a guardian was in charge of both the person and their property. The new law now requires a division of these responsibilities into a “guardian” over the “person” and “conservator” over the “property.” A primary definition also was changed, shifting the focus away from a person being classified as “incompetent” or “ward.” They now are called an “incapacitated person” under a guardianship or “protected person” under a conservatorship. For simplicity, I’ll refer to both as the “incapacitated person” or IP.
The previous law gave full authority to the appointed guardian over the “ward’s” person or property. The new version provides more protections for those being protected, limits the authority of the person in control and helps IPs retain as much control over their life as possible. This will require more attention from the medical and legal professions when dealing with identifying what services the IP will need and what they can still continue doing for themselves. In their final decree, the court will look for the least restrictive alternative while still maintaining the IP’s safety.
A power of attorney and/or health care proxy can nominate whom the IP wishes to have appointed as guardian or conservator. These nominations have priority over any other petitioner seeking appointment. Also, a healthcare agent’s decision trumps that of an appointed guardian. Conversely, a conservator’s decision supersedes the Power of Attorney agent’s decision, and the POA’s authority can be revoked by the conservator.
Guardians also can be the IP’s representative payee, deal with small amounts of recurring income, and a small amount of assets [probably no more than $5,000] without having to apply as the Conservator. One very important change requires that guardian receive prior court permission to admit the IP into a skilled nursing facility when moving from somewhere else like a private residence, assisted living or hospital.
Many more technicalities are involved here, so it would be prudent to contact an attorney specializing in this particular area of the law for assistance.
(Mr. Case is a Centerville attorney specializing in Elder and Estate Law, 508-790-3050 or CCase@CaseEstateLaw.com.)
By G. Robert King II, CFP®, AIF®
If you purchased a home recently or contemplate doing so in the next few months, you likely know many of the benefits of homeownership—including the possibility of tax savings. What you may not know is that if your purchase falls between April 9, 2008, and November 30, 2009, you could be eligible for a first-time homebuyer tax credit.
What’s more, if the purchase occurs this year, you don’t necessarily have to wait until the 2009 tax filing season to claim your credit.
The provisions for this tax credit are not new. On July 30, 2008, President Bush signed H.R. 3221, better known as the Housing and Economic Recovery Act of 2008. This act provided many protections for homeowners, along with incentives such as the tax credit for first-time buyers.
What is new is that the latest legislation enhances the tax credit.
The new legislation has resulted in two different sets of rules relating to the tax credit, differentiated by date of purchase.
Generally, you qualify as a first-time homebuyer if you—and your spouse, if you are married—did not own any other principal residence during the three-year period ending on the date of purchase.
The new legislation, however, continues to eliminate the credit for those with higher incomes. The credit is reduced if your modified adjusted gross income (MAGI) exceeds $75,000 ($150,000 if you’re married and filing a joint return). And it is completely eliminated if your MAGI reaches $95,000 ($170,000 if married and filing a joint return).
The American Recovery and Reinvestment Act of 2009 makes it possible for you to elect to report a qualifying home purchase made in 2009 as if it occurred on December 31, 2008 (allowing you to claim the credit on your 2008 federal income tax return). You should speak to your tax professional about how to do this.
(Mr. King is a Certified Financial Planner in Hyannis, 508-790-7100 or info@capitalportfolios.net.)
By Steven Minninger
Becoming the caregiver for a sick or disabled loved one can be stressful physically, emotionally, mentally…and financially.
Studies estimate that 44 million Americans provide assistance to elderly and disabled adults in their community without any compensation. The market value of that care exceeds $306 billion annually, almost twice the amount spent on nursing home care and home health care costs combined Also, of adults who received long-term care at home, 78 percent got all of their care from family and friends (unpaid), 14 percent from a combination of family and paid assistance, and 8 percent from paid care alone.
It’s estimated that two-thirds of unpaid caregivers work a full- or part-time job, most are women, and most are 35-64 years old.
Becoming a caregiver, either part-time or full-time, can dramatically impact your finances.
Even assuming that the person receiving care has sufficient income streams, becoming a caregiver could require you to reduce your work hours or quit working entirely. If the person requiring care does not have adequate income, you may need to help by covering expenses or taking that person into your home. Social Security, Medicare and Supplemental Security Income (SSI) may provide some help, but qualifying can be difficult and complicated. For example, having too many assets in a disabled child’s name can limit eligibility for SSI.
Many people mistakenly assume that Medicare or Medicaid will pay for nursing home care. Unless your family members are indigent, they won’t qualify for Medicaid. Medicare, which covers retirees over age 65, covers only the highest level of nursing home care–skilled care, provided by trained medical personnel around the clock–and only if your loved one goes from a three-day hospital stay directly to the nursing home. Even then, payments are limited. For the first 20 days, Medicare pays 100 percent. For days 21-100, the individual pays $97 per day. Beyond that, the individual pays the full cost.
Long-term care insurance can provide coverage for nursing home and home health needs, but it must be in place before the insured needs those services. Pricing for these policies varies with the age and health of the individual.
You also may want to consider disability insurance. Thanks to advances in medicine, conditions that once led to death now often lead to disability. The individual and family wind up in a Catch-22, losing family income while facing perhaps greater living costs. Social Security is available to permanently disabled individuals, but it rarely comes close to matching pre-disability income.
Financial issues related to caring for an elderly or disabled loved one can be complicated. You may have time to plan as a family member ages or a disease progresses, but not if an accident or medical event suddenly renders a loved one unable to work or live independently.
(Mr. Minninger, CLU, ChFC, is a Registered Representative with Securities America, Inc., anSEC Registered Investment Advisory firm, 508-240-0079 or
Steve@ MinningerFinancial.com.)Custom Providers
When the opportunity presents itself, To Your Good Health, A Healthcare Newsletter, is happy to pass along information concerning companies or organizations coming on the scene to provide a new or unusual service for consumers and professional caregivers on the Cape.
Concierge: A usually multilingual hotel staff member…who handles luggage and mail, makes reservations, and arranges tours for guests.
This is the most common usage of a French word with Latin roots (for slave, incidentally, according to Webster’s Collegiate dictionary). But in recent times its has been expanded to include all sorts of special services, including blue ribbon medical care, as noted elsewhere in this issue.
Now, from East Dennis comes word of a new application for that word, one that describes special services to be performed during a family’s most trying times.
The new company is called “with Amazing Grace” and owner Annie Gibbons describes her fledgling enterprise as “a funeral concierge service.”
Ms. Gibbons says there are two aspects to her business.
Basically, she takes care of all the family details involved when there is a funeral.
“I don’t just hand out brochures or make suggestions about things like travel, accommodations, bereavement reception, flowers and sitting services. I actually pick up the phone and make any and all the arrangements required to allow family and friends to be together for the services at such an emotional time,” she says.
One example: The deceased resided in New York, her surviving daughters lived on the Cape with the services to be held in Brewster, the reception in Dennis and burial in Plymouth. And this was August, high season on the Cape.
While the funeral home took care of all the usual details having to do with cremation and transportation to the church and cemetery, Ms. Gibbons used her special connections with vendors to make arrangements for a bed-and-breakfast to waive its two-to-three night minimum requirement for out-of-town friends and relatives requiring accommodations for a single night; then dinner reservation for a party of 22 at 7:30 p.m.; family flowers, with the delivery charge waived; a personalized bereavement luncheon with 4x4 sugar cookies frosted and decorated with crossword puzzles, the deceased’s passion; and finally, a town car discreetly waiting at the cemetery to transport out-of-town guests to South Station for their trip back to New York.
In addition, if the family wishes, she offers what she calls “a Personal Tribute Celebration service, which provides a vehicle to create a film retrospective and celebration plan that reflects the essence of my client’s life to be left to all future generations.”
In any presentation, she stresses that she does not infringe on any services that might be provided by a funeral home.
Chance and necessity combined to inspire Ms. Gibbons to establish what she believes is the first service of this kind east of a sole listing in California.
Ms. Gibbons is also a personal trainer. One day a client was talking about all the planning that was involved in gathering the clan for a milestone birthday party. Then he commented that while there were party planners, no such service seemed to exist for funerals.
The light switch turned on and then necessity turned up the wattage. Ms. Gibbons’ husband is a contractor who had just been laid off. And “personal training” is not exactly a high priority item on most budgets in a recession.
So Ms. Gibbons did the research, created a Web site and “with Amazing Grace” was born.
For further information: 508-237-0595, annie@withamg.com or www.withamg.com