1. ESTATE PLANNING, VETERANS
BENEFITS, MEDICARE, AND
MEDICAID: HELPING A LOVED ONE
WITH ALZHEIMER’S
Alzheimer's Association-West Michigan
P. Haans Mulder, JD, MST, CFP®
Cunningham Dalman, P.C.
321 Settlers Road
Holland, MI 49423
(616) 392-1821
phmulder@holland-law.com

2. Background
• Partner at Cunningham Dalman, P.C.
• Has a Masters in Tax, CFP®, and
specialize in estates/elder law and
business planning
Serving the Holland area since 1900

3. Overview
• Elements of an estate plan and what the
process involves
• Most common types of estate plans
• Veteran’s Aid & Attendance benefits and
eligibility rules
Serving the Holland area since 1900

4. Overview
• Medicare Parts A-D
• Transition from Medicare to Medicaid
• Medicaid process and eligibility rules
• Example of how Medicaid planning works
Serving the Holland area since 1900

5. What is estate planning?
• Process of planning for the future
management and distribution of your
assets and your future medical care
• Includes documents such as wills, trusts,
and powers of attorney (financial and
health care)

6. Why is it important?
• Reduces the cost of administration
• Minimizes stress for family and friends
• Determines who will receive your assets
• Authorizes who will make your medical
decisions

7. What is probate?
• Probate is a court process to administer
a deceased person’s financial affairs
• Required when someone passes away
with assets in his or her own name or
fails to name a beneficiary

8. Why avoid probate?
• It is a public process
• Can exacerbate family situations
• Can be costly to administer ($5,000)
• Takes time to complete (6-9 months)

9. What are the most common
estate plans?
• Basic plan includes wills (potentially with
a trust) and powers of attorney
• For clients who do not have a house or
are not concerned with avoiding probate

10. What are the most common
estate plans?
• More comprehensive plan includes a living
trust, pour-over wills, and powers of
attorney
• Designed for clients who want to avoid
probate

11. Veteran’s A&A Benefit
• Veteran is eligible for up to $1,704 per
month (expenses must exceed income)
• Surviving spouse is eligible for up to
$1,094 per month
• Veteran with a spouse is eligible for up to
$2,020 per month
Serving the Holland area since 1900

12. Veteran’s A&A Benefit
• Will cover in-home, assisted living, and
nursing home care
• Can either have low monthly income or
medical expenses that exceed income
• Must have not more than $80,000 of
countable assets
Serving the Holland area since 1900

13. Medicare and Medicaid
• 40% of people 65 years and older will
stay in a nursing home
• Average cost to stay in a local nursing
home is $7,500-9,000/month
Serving the Holland area since 1900

14. Medicare and Parts A-D
• Medicare is a government insurance
program that has many aspects and is
divided into parts
• Have to be 65 years old, be disabled, or
fit specific criteria
• Part A covers hospital
expenses
Serving the Holland area since 1900

15. Medicare Parts A-D
• Part B deals with doctor’s and out-patient
expenses
• Part C is a private insurance plan that
covers your medical expense in general
• Part D is your prescription drug coverage
Serving the Holland area since 1900

16. Transition to Medicaid
• Many people who are eventually
approved for Medicaid start on Medicare
• Must have a three day hospital stay
• Medicare will cover up to 100 days, but
there can be a co-pay after the 20th day
Serving the Holland area since 1900

17. What is Medicaid?
• State and federal program that pays
for medical treatment (including
nursing home care)
• Oftentimes confused with Medicare
Serving the Holland area since 1900

18. When does Medicaid apply?
• Applies principally in a nursing home
(could apply in your home or an
assisted living facility)
• Applies to people who are 65 years or
older, blind, or disabled
• Must pass the income
and asset tests
Serving the Holland area since 1900

19. Who does Medicaid apply to?
• Under income test, you cannot have
enough income to pay the monthly
cost of staying in a nursing home
($7,500-9,000 in this area)
Serving the Holland area since 1900

20. Who does Medicaid apply to?
• Under assets test, a single person can
only have $2,000 in countable assets
• Can keep your home (if it’s not in your
trust) and a vehicle
• All other assets are countable
Serving the Holland area since 1900

21. Who does Medicaid apply to?
• Asset test allows a married couple to
keep their home (again, if it’s not in a
trust), a vehicle, and one-half of their
other assets
Serving the Holland area since 1900

22. Example
• Clients were husband and wife
• Wife had to go to a nursing home
• Didn’t stay in a hospital for three days
so Medicare didn’t cover stay
• Had house, vehicle, and investments
Serving the Holland area since 1900

23. Example
• Could keep the house (because it was
properly owned) and their vehicle
• Without any Medicaid planning, they
would have had to spend down one-half
of their investments
Serving the Holland area since 1900

24. Example
• Drafted a trust that allowed them to
protect all of their investments (as
opposed to just half)
• This provided peace of mind to the
husband
Serving the Holland area since 1900

25. Questions……
Serving the Holland area since 1900

26. Thank You
P. Haans Mulder, JD, MST, CFP®
Cunningham Dalman, P.C.
321 Settlers Road
Holland, MI 49423
(616) 392-1821
phmulder@holland-law.com
www.holland-law.com
Serving the Holland area since 1900