Elder Law Update
North Carolina Edition
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Vol 2 Issue Eleven
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May 2009
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Upcoming Speaking Engagements
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Savannah Estate Planning Council
May 7, 2009
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HBO Special
on
Alzheimer's Disease
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Don't miss . . .
In May,
HBO will use all of its channels to support a multi-part campaign focusing on
Alzheimer's disease: its causes, symptoms, treatment and possible cures.
Collectively titled The Alzheimer's
Project, the initiative includes four HBO documentaries premiering from May
10-12; 17 short supplemental films; a companion book; a robust hbo.com website;
and a nationwide community-based outreach campaign.Click HERE for complete info. |
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PLEASE VISIT MASON LAW
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I WANT TO KNOW
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| If you have an idea or comment that will help me make this a better newsletter please send it to me. Just click! |
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Greetings!
Just before writing this column, I prepared my last "Chairman's Corner" column for Gray Matters, the North Carolina Bar Association's Elder Law section newsletter. I admit to feeling a bit of a twinge as I finish up my term as Chair of the Elder Law section . . . it went so fast. All I can say is "Watch out! Now I'm looking for other things to get involved with." On the other hand . . . maybe not. I have enough on my plate.
One of those "things on my plate" is transformation of the Mason Law, PC Savannah office. As many of you know I have been spending a week a month in Savannah (which is Ann's . . . and as Bobby my son is quick to point out . . . HIS hometown). That has been getting a bit frantic and has added miles to the odometer.
The solution: MasonCerbone. Friend and colleague Kristi Cerbone, a Savannah attorney, and I have formed that firm to serve our Georgia clients. Kristi has an elder law background and has come out of "new mom" semi-retirement. Here's a quick peek at the logo.
What effect will that have on Mason Law, PC? None! Other than I might have a bit more time to focus on North Carolina with Kristi holding down the Georgia fort. Thought you'd be interested. Also . . . great picture if I do say so myself . . . I took it a few years ago around the corner from my mother-in-law's house. High tide on the marsh.
Incidentally, Kristi's article below looks at the wisdom of joint accounts . . . a common enough practice that I don't always like. You'll see why.
Dr. Beth Hodges weighs in on an EXTREMELY timely topic. If you don't think vaccinations are for you, think again.
Recently I met with a couple (new clients) who had been newsletter subscribers for some time. After I explained a certain planning option and they realized how good it was for them they scolded me for not telling more people about it. So, in order to get out of their dog house, I offer up the article below on what could be an outstanding opportunity for some couples.
Finally, for those of you interested in Alzheimer's Disease, see the sidebar notes to the left on what might be an interesting HBO special.
Bob Mason
Certified Elder Law Attorney
Certified by the
National Elder Law Foundation, recognized by the American Bar Association as
the certifying entity for specialization in Elder Law.
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Save Your Assets: An Important Tool For Couples
- Bob Mason
 Most
couples are keenly interested in protecting most, if not all, of their assets
after the death of the first spouse. When I explain that it can be done, I
usually have their attention. Call it the "Protect Everything For The Surviving
Spouse" tool.
Although
the planning technique doesn't do too much "asset protecting" while both spouses are alive, it is
a wonderful approach if it is in place before one spouse dies. That usually is
not an insurmountable problem for two reasons.
First,
most married couples are concerned that assets be conserved for the survivor .
. . who may live many years and who may end up in a nursing home. Second, many
other planning opportunities work well with the "Protect Everything For The Survivor"
strategy and can be used if one spouse does need to go into a nursing home
while his or her mate is alive.
Personally,
my favorite feature is the relief (sometimes near elation) that many of my
clients show when they begin to understand how this approach works and that a
wife or husband "will be taken care of" after the death of the first spouse.
The
downside is that this opportunity can be somewhat complex and can take a bit of
mental gymnastics to fully understand. But I have had very few clients who
simply could not figure out what I was trying to explain. Often it can be
helpful working with other family members (perhaps an adult child) if the
client approves.
I started
to write a detailed article about how this technique works until I realized I
often spend an hour or so covering the same ground in a personal client
meeting. Then I remembered: This is a newsletter, not a textbook. Don't bore
your readers, Bob.
Just keep this in mind: A couple interested in
protecting most (maybe even all) of their assets after the death of one of the
spouses can do so. Just ask me!
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Joint Accounts: Be Careful!
- Kristin Cerbone
Many
people believe that joint accounts are a good way to avoid probate and transfer
money to loved ones. These accounts are sometimes referred to as "the
common person's estate plan." But while joint accounts can be useful in
certain circumstances, they can have dire consequences if not used properly.
Adding a loved one to a bank account can affect Medicaid planning as well as
expose your account to the loved one's creditors.
When
a person applies for Medicaid long-term care coverage, the state looks at the
applicant's assets to see if the applicant qualifies for assistance. While a
joint account may have two names on it, both North
Carolina and Georgia
assume the applicant owns the entire amount in the account regardless of who
contributed money to the account. If your name is on a joint account and you
enter a nursing home, the state will assume the assets in the account belong to
you unless you can prove that you did not contribute to it.
In
addition, if you are a joint owner of a bank account and you or the other owner
transfers assets out of the account, this can be considered an improper
transfer of assets for Medicaid purposes. This means that either account holder
could be ineligible for Medicaid for a period of time, depending on the amount
of money in the account. The same thing happens if a joint owner is removed
from a bank account. For example, if your spouse enters a nursing home and you
remove her name from the joint bank account, it will be considered an improper
transfer of assets.
Another
problem with joint accounts is that the account is vulnerable to all the
account owner's creditors. For example, suppose you add your daughter to your
bank account. If she falls behind on credit card debt and gets sued, the credit
card company can use the money in the joint account to pay off your daughter's
debt.
Finally,
you need to be sure you can trust the joint account holder because he or she
will have full access to the account. Either account owner can take money out
of the account regardless of who contributed to the account.
There
are better ways to conduct estate planning and plan for disability. A power of
attorney will ensure family members have access to your finances in the case of
your disability. If you are seeking to transfer assets and avoid probate, a
trust may make better sense. To learn more, talk to an elder law attorney . . .
we know of at least two good ones!
Savannah elder law attorney Kristin Cerbone is Bob's partner in MasonCerbone, Savannah's elder law firm. You may email her by clicking HERE.
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Shots Aren't Just For Kids
Beth Hodges, MD
 In my practice, we are very
proactive towards the prevention of disease.
I tell my patients it is because I would rather see them in my office at
3 o'clock in the afternoon than in the emergency room at 2 o'clock in the
morning.
After all, a girl needs her beauty
sleep.
Most of my patients are pretty good about
asking for an annual mammogram and a physical.
They know I will want to check their blood sugar and their cholesterol;
but some of my new patients are surprised when I start quizzing them about
their vaccine history. They associate
shots with childhood, yet it is every bit as important to review that history
in an adult.
Every year in North Carolina there are several recorded
cases, often deaths, due to tetanus. The
victims are not children. We do a good
job as a medical community of protecting kids against that pathogen. The victims are invariably seniors who have
lost their immunity due to not getting booster shots. Some of the seniors new to my office tell me
they do not think they have EVER had a tetanus vaccine. I have only ever met two seniors who survived
tetanus infections. Both had severe
neurological sequelae from their disease and were never the same, eventually
dying of complications related to long term damage from the infection. Just thinking about them makes me want to
roll up my sleeve and get in line for a booster.
Another important senior vaccine is the
pneumonia vaccine. Often, this is
confused with the annual flu vaccine.
The pneumonia vaccine only needs to be given once, preferably with a
booster in five years, though Medicare in 2008 announced a cost cutting measure
and will now only pay for one dose. It protects against 23 serotypes of
pneumococcal pneumonia, which as a group have a 25% mortality rate in the
elderly. It does not protect against the
flu or all types of pneumonia, common misconceptions.
Zostavax, the trade name for the "shingles
vaccine" is another worthwhile expenditure.
Shingles is a "gotcha" infection left over from the chicken pox virus
most of us had as kids. The virus spends
most of our lives hiding out in our spinal cords, and comes out at the most
inconvenient times, usually holiday weekends, when doctors offices are closed. It causes a very painful localized rash. Many patients who have had shingles would say
that that last sentence is the understatement of the year. Nerve pain can be severe and unrelenting and
can last for weeks or months. I had a
patient who was a truck driver. She
missed three months of work because her shingles were so painful she could not
bear to wear clothing until it resolved.
Sometimes the rash goes away, but the patient is left with a severe
chronic pain that continues. I have had
two patients who lost vision in one eye due to shingles outbreaks, and I saw an
elderly man die from encephalitis, a brain infection, from shingles back when I
was in medical school. The vaccine is
costly, nearly $200, but is well worth it in my opinion. Incidentally, Medicare approves of the
vaccine, but refuses to pay for it, making it an out of pocket expense for most
people. It is approved for anyone over
the age of 49, and most private insurers will cover it from age 60-65, some
from age 50 and upwards.
And finally, a timely reference to the recent
Swine Flu outbreak. Quite frankly, it
stuns me to see the panic this disease has created. Yes, it is a dangerous disease for the
elderly and for very small children.
What stuns me is the public reaction.
It is Influenza A, which is what the same people who are panicking now
refused to get vaccinated for last fall, because after all, it is "just the
flu, and I hate those shots." It remains
to be seen what this recent outbreak will do, but Influenza A kills 36,000 people in this country alone
every year, causes 250,000 hospitalizations, and brings about 55,000 heart
attacks in the elderly. Everyone over
the age of 55 should have an annual flu shot (except in the case of egg allergy
or a history of Guillain Barre syndrome).
In my opinion, in the absence of a
shortage of the vaccine, as many people as possible should get vaccinated,
because it cuts down on the overall spread of disease.
And that
helps to ensure my beauty sleep.
Beth Hodges, MD, is a principal
in Hodges Family Practice, with
offices in Asheboro and Ramseur, North Carolina.
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Stimulus Checks For The Disabled On The Way
- Bob Mason
As
part of the Stimulus Bill Congress authorized one-time $250 payments to most
Social Security Disability Insurance (SSDI) and Supplemental Security Income
(SSI) beneficiaries. Beneficiaries of either program who were eligible for
benefits during November or December 2008 or January 2009 will probably receive
the additional payment in May.
According
to the Social Security Administration (SSA), the payments will be distributed
to beneficiaries in the same manner that they currently receive their benefit
(either by check, debit card, or direct deposit) but the payments will not be
included in the same transaction as a beneficiary's regular monthly payment.
This means that beneficiaries should be on the lookout for two separate
payments during May.
People
with special needs who receive both SSDI and SSI benefits will receive only one
$250 payment, and SSDI beneficiaries under age 18 (or 19 if they are still in
school) will not receive any payments at all. However, anyone receiving a
payment does not have to worry about the additional income affecting his
government benefits -- the stimulus payments do not count as "income"
for either program, and will not count as an available resource for nine months
following receipt of the funds.
The SSA has created an online pamphlet describing the
payments and providing additional details for beneficiaries. You can read the
pamphlet by clicking HERE.
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The Usual Disclaimer: This newsletter is for general information only. Please do not rely on anything you read in this email as definitive legal advice applicable to you. All situations are different, including yours. Nothing you read in this newsletter is a suitable substitute for professional advice you may receive from your attorney, your accountant, or your tax advisor.
All contents copyrighted 2009 by Mason Law, PC. Contents may be republished with written permission of Mason Law, PC (which permission will usually be given!). |
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