Annapolis, Maryland Wills, Trusts & Estate Planning

Taking Control After Alzheimer’s By Planning for Care Costs - Annapolis Estate Planning

Facing Alzheimer’s is never easy. The impacts of this condition can be felt in every area of life, and it can be hard to escape the added stress. While there is no easy fix for dealing with the repercussions of Alzheimer’s, there are ways to plan ahead to cope with and cover the costs of care.

Budget for Care and Insurance Costs

Regardless of whether you have a family history of Alzheimer’s, you should still make an effort to prepare for long-term care when planning for the future. Even without an Alzheimer’s diagnosis, long-term care is almost an inevitable part of every senior’s future, so it makes sense to include this kind of care in your financial planning. Doing so helps you avoid unpleasant surprises, like finding out that Medicare will not cover the care you need.

Contrary to popular belief, Medicare offers no financial support when it comes to long-term care. However, if you know this ahead of time, you can plan for other ways to finance these costs. For veterans, there may be additional benefits you can tap into. This may include using a VA long-term care facility or accessing financial resources to help you hire in-home care or modify your home. Another benefit of planning ahead is that you are more likely to afford long-term care coverage. This kind of insurance is not for everyone, but if you know you are at increased risk for Alzheimer’s and you are planning in your 50s, long-term supplements may be more accessible for you.

Though death can be difficult to think about, you should consider planning ahead for when that time comes. Burial insurance can ease the financial burden of loved ones when it’s time to make funeral arrangements. This type of insurance can cover funeral costs and help pay off debt, such as loans and medical bills. Before you purchase a policy, decide on a budget by thinking about the funeral arrangements and any debts you want to be covered.

Know How Alzheimer’s Care Needs Will Progress

Often, the need for long-term care is sudden for seniors. This can make it a little more difficult to find compassionate, affordable care. If you or a loved one is showing signs of Alzheimer’s and have had a medical diagnosis, you are in a position of being able to plan out your care more efficiently. That’s because Alzheimer’s typically follows a predictable path of progression. The level of care needed will follow this same path. During the beginning stages, Alzheimer’s patients can still take care of themselves, but they may have difficulty controlling emotions, staying organized, and interacting with others. At this point, seniors may just need a little extra help around the house with cleaning and other daily tasks.

As the disease advances, however, those with the condition can become a danger to themselves and will need constant care. This can mean living with a family member or hiring a home health aide to provide more stable supervision and assistance. In the final stages of Alzheimer’s, nursing homes or skilled-care facilities are a necessity, and unfortunately, death is also inevitable. Knowing this information can be heartbreaking, but it does help individuals and family members better prepare for the financial strains of Alzheimer’s.

 Prepare Yourself and Your Family for the Emotional Costs

Bracing your finances for the costs of Alzheimer’s care can save you and your family a lot of headaches as time passes. The real costs of this devastating disease, however, are those that don’t impact your bank account. Knowing what is ahead can be disheartening, but watching the progression of Alzheimer’s in a loved one can be emotionally draining as well.

So, in addition to putting together a financial strategy, be sure to find ways to manage those complicated emotions. For patients, that may mean going to therapy, finding a support group, or looking for a constructive outlet for your pain and anger. It’s common for seniors to experience depression and anxiety after being diagnosed with the disease, but it’s crucial to your well-being that you seek self-care and support. Self-care is also important for caregivers and loved ones so that they can stay strong throughout this painful journey.

 Alzheimer’s can leave individuals and their family members feeling helpless. However, you do have the power to plan for the costs of Alzheimer’s care and prepare for the years ahead. By doing so, you will give everyone peace of mind during a time already filled with pain.

Reference: Rise Up for Caregivers, http://riseupforcaregivers.org/blog/

Holden & Campbell, LLC – Annapolis Estate Planning Attorneys

When the Unexpected Occurs - Annapolis Estate Planning

We’ve all had fender benders, but a catastrophic auto accident can be life-altering. Having all the right insurance is necessary to protect your retirement.

Part of retirement planning is making sure that you have enough assets to protect yourself against the ever-rising costs of healthcare. We talk about this and we plan for it. However, one topic that is often overlooked is the impact that a serious auto accident can have on investments, retirement savings and your economic future. A plan for risk management is something everyone needs to do.

It’s estimated that 3.14 million Americans were involved in an auto accident in 2016, according to the National Highway Safety Administration. This shows how common they are.

Think Advisor’s recent article, “How Car Accidents Can Wreck Retirement Accounts,” looks at the case of a 35-year-old single professional with more than $600,000 in her investment account.

This woman, Sue, was driving home from work, when an uninsured motorist ran a traffic light and ran into her new convertible. The car was totaled and she was severely injured. Sue was rushed to the hospital, required surgery for several broken bones and then went to a rehab facility for physical therapy upon her release.

Fortunately, Sue’s medical coverage from work covered her hospitalization, rehab stay, and at-home visits during her recovery. Sue’s own auto insurance policy paid for a new car. However, Sue was unable to work for a year. Her employer-paid short-term disability insurance that covered about 65% of her lost income for three months, but she had no long-term disability coverage and had to pay some health-related expenses out of pocket. In total, Sue lost $120,000 in income, had to pay $10,000 in medical expenses not covered by her plan, and spent $65,000 for at-home assistance during her recuperation.

Luckily, she had savings outside her investment accounts that covered those expenses. However, there are many other accident victims who aren’t as fortunate as Sue. They must use investments that may have been intended for their children’s education and their retirement. The result is paying penalties for tapping into qualified accounts.

Sue didn’t tap into her investments. However, she did have to stop making contributions to her qualified accounts and adding to other investments. Because the accident occurred during her prime earning years, the compounded effect on her nest egg will be significant.

In addition, Sue could’ve avoided the loss of income and the out-of-pocket expenses if she’d been covered by a more comprehensive auto insurance policy and purchased additional disability insurance.

Review your coverages and your entire estate plan with a knowledgeable attorney to be certain you have the best protection.

Reference: Think Advisor (March 26, 2019) “How Car Accidents Can Wreck Retirement Accounts”

Holden & Campbell, LLC – Annapolis Estate Planning Attorneys

Taking Control After Alzheimer’s By Planning for Care Costs - Annapolis Estate Planning

Facing Alzheimer’s is never easy. The impacts of this condition can be felt in every area of life, and it can be hard to escape the added stress. While there is no easy fix for dealing with the repercussions of Alzheimer’s, there are ways to plan ahead to cope with and cover the costs of care.

Budget for Care and Insurance Costs

Regardless of whether you have a family history of Alzheimer’s, you should still make an effort to prepare for long-term care when planning for the future. Even without an Alzheimer’s diagnosis, long-term care is almost an inevitable part of every senior’s future, so it makes sense to include this kind of care in your financial planning. Doing so helps you avoid unpleasant surprises, like finding out that Medicare will not cover the care you need.

Contrary to popular belief, Medicare offers no financial support when it comes to long-term care. However, if you know this ahead of time, you can plan for other ways to finance these costs. For veterans, there may be additional benefits you can tap into. This may include using a VA long-term care facility or accessing financial resources to help you hire in-home care or modify your home. Another benefit of planning ahead is that you are more likely to afford long-term care coverage. This kind of insurance is not for everyone, but if you know you are at increased risk for Alzheimer’s and you are planning in your 50s, long-term supplements may be more accessible for you.

Though death can be difficult to think about, you should consider planning ahead for when that time comes. Burial insurance can ease the financial burden of loved ones when it’s time to make funeral arrangements. This type of insurance can cover funeral costs and help pay off debt, such as loans and medical bills. Before you purchase a policy, decide on a budget by thinking about the funeral arrangements and any debts you want to be covered.

Know How Alzheimer’s Care Needs Will Progress

Often, the need for long-term care is sudden for seniors. This can make it a little more difficult to find compassionate, affordable care. If you or a loved one is showing signs of Alzheimer’s and have had a medical diagnosis, you are in a position of being able to plan out your care more efficiently. That’s because Alzheimer’s typically follows a predictable path of progression. The level of care needed will follow this same path. During the beginning stages, Alzheimer’s patients can still take care of themselves, but they may have difficulty controlling emotions, staying organized, and interacting with others. At this point, seniors may just need a little extra help around the house with cleaning and other daily tasks.

As the disease advances, however, those with the condition can become a danger to themselves and will need constant care. This can mean living with a family member or hiring a home health aide to provide more stable supervision and assistance. In the final stages of Alzheimer’s, nursing homes or skilled-care facilities are a necessity, and unfortunately, death is also inevitable. Knowing this information can be heartbreaking, but it does help individuals and family members better prepare for the financial strains of Alzheimer’s.

Prepare Yourself and Your Family for the Emotional Costs

Bracing your finances for the costs of Alzheimer’s care can save you and your family a lot of headaches as time passes. The real costs of this devastating disease, however, are those that don’t impact your bank account. Knowing what is ahead can be disheartening, but watching the progression of Alzheimer’s in a loved one can be emotionally draining as well.

So, in addition to putting together a financial strategy, be sure to find ways to manage those complicated emotions. For patients, that may mean going to therapy, finding a support group, or looking for a constructive outlet for your pain and anger. It’s common for seniors to experience depression and anxiety after being diagnosed with the disease, but it’s crucial to your well-being that you seek self-care and support. Self-care is also important for caregivers and loved ones so that they can stay strong throughout this painful journey.

Alzheimer’s can leave individuals and their family members feeling helpless. However, you do have the power to plan for the costs of Alzheimer’s care and prepare for the years ahead. By doing so, you will give everyone peace of mind during a time already filled with pain.

Reference: This post is by guest writer June Duncan, caregiver and author of the upcoming book, The Complete Guide to Caregiving: A Daily Companion for New Senior Caregivers. Books can be purchased at her website, http://riseupforcaregivers.org/.

Holden & Campbell, LLC – Annapolis Estate Planning

Iowa Senator Sponsors Elder Abuse Prevention and Prosecution Act - Annapolis Estate Planning

“Iowa Senator Charles Grassley is among those in Congress calling for a crackdown on elder abuse crimes in the country.”

The witnesses of loved ones affected by elder abuse incidents testified at a recent Senate Finance Committee hearing in Washington.

Those witnesses included Pat Blank, longtime Iowa Public Radio host, and past winner of the Iowa Broadcast News Association's Jack Shelley Award. Blank's mother, Virginia Olthoff, died in an Iowa nursing home in February 2018 because of alleged neglect.

Another witness was Maya Fischer, her 87-year-old mother—an Alzheimer's patient—was allegedly raped by a nursing aide.

Grassley said that in these cases, the victim's trust was betrayed by those entrusted to care and protect them, reported KMA in the article “Grassley hearing targets elder abuse issues.”

"Sadly, these are not isolated cases," said Grassley. "They could happen to anyone. According to the Inspector General, a whopping one-third of nursing home residents experience harm while under the care of federally-funded facilities. And, in more than half of these cases, the harm was preventable."

Grassley sponsored the Elder Abuse Prevention and Prosecution Act. This is legislation that calls for the training of elder abuse investigators, the collection of data on elder abuse and collaboration among federal officials tasked with combating seniors' exploitation.

Even with the bill's passage in the last session of Congress, Senator Grassley says the work in this area isn't done.

"Hardly a week goes by without seeing something about nursing home abuse or neglect in the national news," he said. "Every family has a loved one—a mother, a father or a grandparent—who may someday need nursing home care. That makes this a topic of enormous concern to every American."

Grassley said that the Inspector General's alert cautioned the public about deficiencies cited at nursing homes in 33 states.

Many of the cases involved sexual abuse, substandard care and neglect.

As finance committee chair, Senator Grassley says he'll continue to ensure the elderly have access to quality long-term care in an environment that is "free from abuse and neglect."

Reference: KMA (March 6, 2019) “Grassley hearing targets elder abuse issues”

Holden & Campbell, LLC – Annapolis Estate Planning

What You Need to Know About Medicare - Annapolis Estate Planning

The first rule of Medicare is that it does not pay for everything. The next rule: you have to do your homework. Don’t be swayed by strong sales pitches.

Switching to Medicare from a traditional employer’s health insurance plan can be a little unnerving at first. There are things that Medicare does cover. However, there are also things that it doesn’t. Let’s start with Original Medicare or Traditional Medicare. These are known as Medicare Part A and Part B. They cover a good amount of medical expenses, once people turn age 65. Part A is all about hospital insurance when you are an inpatient, part of your stay in a skilled nursing facility, surgery, hospice care and some (but not all) health care provided at home.

Part B is your medical insurance that helps pay for doctors' visits, outpatient care, some preventive services and some medical equipment and supplies. Most seniors can enroll in Medicare three months before the month they turn 65.

Kiplinger’s article, “7 Things Medicare Doesn't Cover,” takes a closer look at what isn't covered by Medicare, plus information about supplemental insurance policies and strategies that can help cover the additional costs, so you don't wind up with unanticipated medical bills in retirement.

Prescription Drugs. Medicare doesn’t provide coverage for outpatient prescription drugs. However, you can purchase a separate Part D prescription-drug policy for that or a Medicare Advantage plan that covers both medical and drug costs. You can sign up for Part D or Medicare Advantage coverage when you enroll in Medicare or when you lose other drug coverage. You can switch policies during open enrollment each fall.

Long-Term Care. Medicare provides coverage for some skilled nursing services but not for custodial care. That includes things like help with bathing, dressing and other activities of daily living. However, you can purchase LTC insurance or a combination long-term-care and life insurance policy to cover these costs.

Deductibles and Co-Pays. Part A covers hospital stays and Part B covers doctors’ services and outpatient care. Nonetheless, you have to pay out-of-pocket for deductibles and co-payments. Note that over your lifetime, Medicare will only help pay for a total of 60 days beyond the 90-day limit (“lifetime reserve days”). After that, you’ll pay the full hospital cost. Part B typically covers 80% of doctors’ services, lab tests and x-rays. However, you must pay 20% of the costs after a $183 deductible (in 2018). A Medigap (Medicare supplement) policy or Medicare Advantage plan can fill in the gaps, if you don’t have the supplemental coverage from a retiree health insurance policy. If you purchase a Medigap policy within six months of signing up for Medicare Part B, insurers can’t reject you or charge more because of preexisting conditions. Medicare Advantage plans have medical and drug coverage through a private insurer. They may also provide additional coverage, like vision and dental care. You can switch Medicare Advantage plans annually in open enrollment.

Most Dental Care. Medicare will not provide coverage for routine dental visits, teeth cleanings, fillings, dentures or most tooth extractions. There are Medicare Advantage plans that cover basic cleanings and x-rays, but they usually have an annual coverage cap of about $1,500. You could also get coverage from a separate dental insurance policy or a dental discount plan.

Routine Vision Care.  Medicare doesn’t cover routine eye exams or glasses (exceptions include an annual eye exam if you have diabetes or eyeglasses after certain kinds of cataract surgery). However, some Medicare Advantage plans give you vision coverage, or you may be able to purchase a separate supplemental policy that provides vision care alone or includes both dental and vision care. If you saved money in a health savings account before you enroll in Medicare, you can use the money tax-free at any point for glasses, contact lenses, prescription sunglasses and other vision care out-of-pocket expenses.

Hearing Aids. Medicare doesn’t cover routine hearing exams or hearing aids, but some Medicare Advantage plans cover hearing aids and fitting exams, and some discount programs provide lower-cost hearing aids.

Overseas Medical Care. With a few exceptions, Medicare does not pay for care you receive when outside of the country. The exceptions are few and far between, like if you were on a cruise ship, and then only if you are within six hours of a U.S. port. There are Medigap plans that will cover 80% of the cost of emergency care abroad with a lifetime limit of $50,000. Those are parts C-G, M and N. It is also possible to purchase select Medicare advantage plans to cover emergency care while overseas. You can also buy a travel insurance policy to cover some medical expenses, while outside of the United States. However, shop wisely for these policies, since there can be strict limits on what they actually pay.

Reference: Kiplinger (May 23, 2019) “7 Things Medicare Doesn't Cover”

Holden & Campbell, LLC – Annapolis Estate Planning

Talking About Future Care Needs with Parents - Annapolis Estate Planning

It’s great to take a trip home and catch up with family, especially when you live far away.  However, if this is the year that you arrive to find big changes in your aging parents, here’s some help about what your next steps might be.

When nostalgia doesn’t quite match up with reality, it’s time for some challenging conversations with aging parents and, if you have them, your siblings. It’s not an easy topic, according to the article, “Making the best care decisions for aging parents,” from KARE 11 in Minneapolis, but it is better to have the conversation and make the plans for what’s next than it is to bury your head in the sand and pretend that nothing’s wrong.

Many families find this out the hard way. When a parent requires immediate urgent care, the family must jump into “go” mode. It can be overwhelming. There are many options, which range from various levels of in-home care, to independent living, to assisted living and even to skilled nursing care. You should understand the level of care you need and what you can afford.

Unless you qualify for Medicaid, you’ll need to pay for assisted living out of your own pocket. For most of us, this could drain assets in short order. Many people also aren’t planning for long-term care in retirement.

It’s best to plan early. If you're going to buy a long-term care policy, the best time to apply is in your 40s or 50s, when your health is good and the cost is cheaper.

Sit down with an elder law attorney, regardless of your assets, because the laws concerning Medicare and Medicaid are confusing. Every situation is different.

Many people aren’t aware that Medicare doesn’t cover many long-term care services. In fact, that limited benefit is designed to get somebody back to independent living, not help them with basic activities of daily living. Therefore, if it becomes a situation where somebody is going to need help with such basics as dressing, bathing and other activities of daily life for the rest of their life, Medicare is not going to cover it.

If you believe gifting your estate away now will stop you from losing it in the future, remember that most states have a five-year look back period. Any gifts of money or property in the 60 months before applying for Medicaid can be taken back to pay for the program or the applicant will be penalized.

There’s very little about this that is easy for aging parents or adult children. However, planning in advance, in an intelligent and sensitive manner, is better than having to make hard choices in an emergency.

Reference: KARE 11 (Minneapolis) (November 27, 2018) “Making the best care decisions for aging parents”

Holden & Campbell, LLC – Annapolis Estate Planning

New Law in Massachusetts Enhances Treatment and Support for Alzheimer’s and Dementia - Annapolis Estate Planning

“H.4116 An Act Relative to Alzheimer’s And Related Dementias in The Commonwealth” is now law in Massachusetts, following an August 15 ceremony.

A ceremonial signing took place in Massachusetts Governor Baker’s office as community members, legislators and members of the administration gathered at the Alzheimer’s Association’s Waltham office, where the governor signed the new bill into law.

“Raising awareness about Alzheimer’s and dementia is key to supporting the Massachusetts families who are impacted by this horrible disease,” Governor Baker remarked in an article in the Framingham Source, “Governor Baker Signs Law Strengthening Alzheimer’s and Dementia Treatment in Massachusetts.”

“This legislation will enhance efforts to train front line caregivers on recognizing and treating dementia more effectively, and work with families of loved ones to prepare and manage the effects of Alzheimer’s.”

Senate President Karen E. Spilka noted that the important legislation acknowledges that Alzheimer’s and other dementia affect not just individuals but also communities and families. She went on to say, “as someone who has been affected personally by Alzheimer’s and dementia in my family, I am grateful for this comprehensive approach.”

There are more than 130,000 Massachusetts residents living with dementia.

“Despite its widespread impact, lack of information, fear, and stigma can prevent those affected from feeling safe, socially connected, and able to thrive in their communities. Family members often carry the financial and emotional burden from caring for their loved ones,” said Massachusetts Health and Human Services Secretary Marylou Sudders.

Sudders also said that the law brings the diseases of Alzheimer’s and dementia to the forefront.  It will promote early detection and diagnosis, reduce risk, prevent avoidable hospitalizations, support caregivers and mitigate health disparities.”

The law will create an advisory council and an integrated state plan to effectively address Alzheimer’s disease, and will require that content about Alzheimer’s and related dementias be incorporated into physicians, physician’s assistants, registered nurses and practical nurses continuing medical education programs that are required for the granting or renewal of licensure.

With the new law, doctors will now be able to share a diagnosis and treatment plan with a family member or a personal representative, within the existing framework of federal and state privacy laws. Hospitals will now be required to have an operational plan in place for recognizing and managing individuals with dementia within three years of the law’s enactment, and elder protective services caseworkers will be required to have training on Alzheimer’s disease.

Reference: Framingham Source (August 15, 2018) “Governor Baker Signs Law Strengthening Alzheimer’s and Dementia Treatment in Massachusetts”

Holden & Campbell, LLC – Annapolis Estate Planning

When the Diagnosis is Alzheimer’s, What Should You Do? – Annapolis Estate Planning

People who receive a diagnosis of Alzheimer’s disease, an incurable type of dementia, are overwhelmed by hopelessness. But two authors want to change that.

The authors of a new book, “Better Living With Dementia,” say it’s time to break the “cycle of despair” that accompanies an Alzheimer’s diagnosis. The Washington Post discussed this new perspective with the well-credentialed authors in a recent article, “Learning To Live Well With Dementia.”

Author Laura Gitlin is dean of the College of Nursing and Health Professions at Drexel University and Chair of the Department of Health and Human Services advisory council on Alzheimer’s Research, Care and Human Services. Her co-author is Nancy Hodgson, the Anthony Buividas endowed term chair in gerontology at the University of Pennsylvania.

These leading experts on care for people with cognitive impairment, say that while there’s no cure for Alzheimer’s, there are many things that can be done to make life better for people with dementia and their caregivers.

At a minimum, people newly diagnosed with dementia should consult with the Alzheimer’s Association, the Lewy Body Dementia Association, the Association for Frontotemporal Degeneration and the government’s website, alzheimers.gov. These are all great sources of information and potential assistance. Individuals and families should also get referrals to elder law attorneys, financial planners, adult day centers, respite services, caregiver support services and other resources.

About 70% of people with Alzheimer’s and other types of dementia live at home. Few professionals ask about patients’ living conditions, even though these environments play a major role in shaping people’s safety and well-being. It’s not uncommon for professionals to fail to let patients know what to expect as dementia progresses. This can fosters isolation, which worsens their sense of despair.

Even small steps could help improve quality of life. For example, give focused attention to the home setting itself. Hire an occupational therapist, ideally with expertise in dementia, to do a home assessment and recommend modifications. It’s also important to know what to expect. Individuals with dementia and their caregivers will find their needs changing as their illness progresses.

Initially, the most critical need may be getting a reliable diagnosis and understanding more about the type of dementia identified by your physician. A new study by Johns Hopkins University reports that 60% of people with dementia haven’t been diagnosed or aren’t aware of their diagnosis.

Further, depression and anxiety may need to be addressed, because people can struggle with the reality of a diagnosis, withdraw from work or social activities and worry about the future. Looking for ways to keep people engaged with meaningful activities can become a challenge.

In the final stage, severe dementia, people need sensory stimulation, like enjoyable music or a fragrant bouquet of flowers. Addressing distress, discomfort and pain are the big care challenges.

The challenge for family members and caregivers is to let dementia patients know that they belong and are surrounded with warmth and affection, at every stage of the disease. Even if they cannot acknowledge the presence of family and friends, their company is important.

Reference: The Washington Post (August 9, 2018) “Learning To Live Well With Dementia”

Holden & Campbell, LLC – Annapolis Estate Planning

Need Something Else to Worry About? Try Long-Term Care – Annapolis Estate Planning

The statistics aren’t encouraging. About three quarters of Americans are likely to need long-term care, but very few are ready for the costs.

A recent article from Think Advisor paints a dismal picture of Americans who are just not preparing themselves for the inevitable facts of aging. The article, “Now You Can Add Long-Term Care to Death and Taxes,” says this may be one of the biggest disconnects in the USA: the gap between how many Americans will need long-term care versus what people actually think they’ll need.

Just 46% think they’ll need it, according to a new study that surveyed 2,000 people to see how prepared Americans were for the realities of long-term care.

Another misconception is the out-of-pocket cost of long-term care. The study found that the actual out-of-pocket cost of long-term care is more than $47,000. However, many Americans think it’s about half that, $25,350.

In addition, $47,000 is the low end of the scale for the yearly cost per stay. While some assisted living costs may be $45,000, semi-private nursing homes are closer to $85,000. Private nursing home care is $97,455, according to the study, which was conducted by Digital Third Coast. The study was made up of 57.7% males and 42.3% females, while 56% were age 35 and younger, 33% were 36 to 55 years old and 11% were 56 and older.

Can you believe that 64% have nothing saved for long-term care, and 67% can’t contribute to a parent’s long-term care? The study found that Americans intend to save about $657 per month for long-term care.

Another issue between reality and perception, is the age that people think they’ll be when they need any sort of long-term care. Most study participants say it’s 79 years old. However, it’s actually 73 years old, according to the study. Women will require long-term care on average for 3.7 years, and men will need it for about 2.2 years.

People in our country also have worries about putting relatives in long-term care, the study found. For example, 73% are concerned about physical/sexual mental abuse. About 41% said the cost was more than anticipated, and 48% hadn’t expected to put loved ones in long-term care. Only 33% actually have had discussions with family about when care is necessary.

One thing we do know is what we want when it comes to long-term care. We want quality of care, but we also want low costs, and we want facilities that are not too far from family members.

We just don’t want to think about how that’s going to be paid for.

Reference: Think Advisor (August 6, 2018) “Now You Can Add Long-Term Care to Death and Taxes”

Holden & Campbell, LLC – Annapolis Estate Planning

Medicare Facts and Penalties You Need to Know – Annapolis Estate Planning

Start with the basics, to make sure you’re making informed decisions.

Created in July 1965 as part of the Social Security Act, Medicare is how most adults over age 65 cover their healthcare costs. Medicare has four parts. They are Part A: Hospital, Part B: Outpatient Services, Part C: Medicare Replacement and Part D: Prescription Drugs. This useful article from Think Advisor, “Essential Medicare Facts & Penalties Advisors Should Know on One Page,” covers Medicare fundamentals.

As a general rule, if you are 65 and you or your spouse have paid Medicare taxes for at least 10 years, you may enroll in the program. Those under 65 may also enroll, if they are disabled or have end stage renal disease.

Let’s look at the different parts of Medicare:

Part A is free for most people. If you didn’t pay Medicare taxes, you may be able to enroll and pay for Part A. If you’re under 65 and didn’t pay into Medicare, you may be eligible if you have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months or you are a kidney dialysis or kidney transplant patient.

Everyone is required to pay a premium for Medicare Part B, which is deducted from your Social Security retirement payment. If you’re eligible but haven’t yet begun to receive a Social Security retirement benefit, Medicare will send you a bill.

Part C is also known as a Medicare Advantage plan. It’s issued by a Medicare-approved private insurer. Even if you choose Medicare Part C, you still are required to pay a Part B premium. Although these plans cover all services in Part A and Part B, they frequently have other benefits like vision, dental, hearing, and prescription drugs.

Part D covers prescription drugs. Each Medicare drug plan list its approved drugs and a “tier” for them. A lower tier drug will generally cost less, and a higher tier drug will cost more.

The window to enroll in Medicare starts on the first day of the third month prior to your birth month and ends on the last day of the third month following the month of your birth.

There is a separate “late enrollment” penalty, if you go 64 continuous days or more beyond the end of your initial enrollment period and did not have a Medicare Prescription Drug Plan, a Medicare Advantage Plan (Part C) and another Medicare plan that offers prescription drug coverage, including a plan through an employer or union.

Make sure to review your coverage and plan in advance to avoid any penalties. If you make a mistake, you may end up paying a premium for certain types of coverage, for as long as you have Medicare.

Reference: Think Advisor (July 31, 2018) “Essential Medicare Facts & Penalties Advisors Should Know on One Page”

Holden & Campbell, LLC – Annapolis Estate Planning