You may email comments to Bob by clicking HERE.

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 transfer 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 owners' 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 to plan for disability. A power of attorney will ensure family members have access to your finances in 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!

Advertisements make it sound so easy. "I was having trouble with mobility and I called this number and they helped me get my power chair and I didn't have to do anything".

I'm not sure who these people are or what alternate universe they are living in, but I've never seen the system work this way. In fact, it used to be a lot easier to get a wheelchair or even a walker for a patient. I could write a prescription, include a diagnosis code and give the prescription to the patient.  I would get a form back from the supplier asking a few questions and if the patient's situation fit the criteria, the wheelchair or other device would be paid for by Medicare. The most important criterion was whether a patient needed the wheelchair inside the home to accomplish activities of daily living (ADLs).

Today, for multiple reasons, including increased numbers of seniors due to an aging population, increased costs of all medical services for Medicare and some Medicare fraud, there is now a new evaluation form that must be completed. The 5 page form includes detailed questions about the patient's difficulty with ADLs, medical problems and why the needs cannot be met with a cane or a walker.

The major factor is still to document need inside the home. To get the information for the form can require more than one appointment as well. Frequently I have sent patients for a physical therapy evaluation to gauge arm strength to push a manual wheelchair, oxygen saturations while walking, or total distance a patient can ambulate in a minute.

Scooters, in my experience, are not a practical solution for most people because of the protruding front wheel and handlebars/steering device that sit between the operator and the sink, stove etc. There is a mechanism to swivel the seat sideways to allow a person to be closer to the appliances but the patients who need a scooter or a wheelchair don't usually have the upper body strength , muscle coordination or balance to be able to do this.

The solution for most patients with a medical need for a mobility device will be a manual wheelchair or a power wheelchair. There are patients who qualify and get a power wheelchair, but there are certainly those who would like the convenience of one who do not fit the medical necessity criteria.

Suppliers of diabetic supplies have also marketed "diabetic shoes" to all of their clients. Again, acquiring diabetic shoes isn't quite as easy as saying "I'm a diabetic and I need shoes so why not let Medicare pay for them?" The suppliers do not tell the patients that diabetes is the first of two diagnoses that a patient must have to qualify for the shoes. There must be documented nerve damage or circulatory complications for example. Just as I described for wheelchairs, if a patient qualifies for diabetic shoes, they should have them.

You've worked hard all your life for what you have.  You're concerned about being left destitute by long term care costs.  You'd like to leave something of your hard work to your children.  You're tired of worrying about it all.

Maybe we've just described a parent. If so, you're concerned about your mother's or father's health care needs, you are busy and don't know where to start, your prime concern is making sure your parent's assets are used in the best way possible for their care.

We can help you.  Using state of the art mastery of complex trust, tax, testamentary, Medicaid, and VA law we can save you thousands, give you a sense of security and ease your troubled mind.