MEDICAID, MEDICARE, VETERANS
BENEFITS, AND ESTATE PLANNING:
HOW TO DEVELOP A PEACE OF
MIND IN UNCERTAIN TIMES
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
Background
• Partner at Cunningham Dalman, P.C.
• Masters in Tax, CFP®, and specialize in
  estates/elder law and business planning
• Cunningham Dalman, P.C. has been
  serving the greater Holland/Zeeland since
  1900

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



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


                            Serving the Holland area since 1900
Did you know?
 • 40% of people 65 years and older will
   stay in a nursing home
 • Average cost to stay in a local nursing
   home is $6,500-7,500/month



                             Serving the Holland area since 1900
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
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
Who does Medicaid apply to?
 • Under income test, you cannot have
   enough income to pay the monthly
   cost of staying in a nursing home
   ($6,500-7,500 in this area)




                           Serving the Holland area since 1900
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
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
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
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
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
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
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
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
Veteran’s A&A Benefit
 • Veteran is eligible for up to $1,632 per
   month (expenses must exceed income)
 • Surviving spouse is eligible for up to
   $1,055 per month
 • Veteran with a spouse is eligible for up to
   $1,949 per month

                              Serving the Holland area since 1900
Veteran’s A&A Benefit
 • Will cover in-home, assisted living, and
   nursing home care
 • Financial eligibility is based in general on
   $40,000 of countable assets for a single
   person and $80,000 for a couple


                               Serving the Holland area since 1900
Did you know?
 • You could save approximately $6,000
   by having an estate plan that will cost
   you $850




                             Serving the Holland area since 1900
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
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
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
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)
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
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
What does the estate planning
process look like?
 • Complete estate planning questionnaire
 • Attend a meeting that we discuss your
   goals and the types of estate plans
What does the estate planning
process look like?
 • Review draft of documents
 • Attend a signing conference
 • Change beneficiaries or/and fund your
   trust
Questions……




              Serving the Holland area since 1900
Thank You
 P. Haans Mulder
 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

Alzheimer's Association Presentation

  • 1.
    MEDICAID, MEDICARE, VETERANS BENEFITS,AND ESTATE PLANNING: HOW TO DEVELOP A PEACE OF MIND IN UNCERTAIN TIMES 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 atCunningham Dalman, P.C. • Masters in Tax, CFP®, and specialize in estates/elder law and business planning • Cunningham Dalman, P.C. has been serving the greater Holland/Zeeland since 1900 Serving the Holland area since 1900
  • 3.
    Overview • Medicaid process and eligibility rules • Example of how Medicaid planning works • Medicare Parts A-D • Transition from Medicare to Medicaid Serving the Holland area since 1900
  • 4.
    Overview • Veteran’sAid & Attendance benefit and eligibility rules • Elements of an estate plan and what the process involves • Most common types of estate plans Serving the Holland area since 1900
  • 5.
    Did you know? • 40% of people 65 years and older will stay in a nursing home • Average cost to stay in a local nursing home is $6,500-7,500/month Serving the Holland area since 1900
  • 6.
    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
  • 7.
    When does Medicaidapply? • 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
  • 8.
    Who does Medicaidapply to? • Under income test, you cannot have enough income to pay the monthly cost of staying in a nursing home ($6,500-7,500 in this area) Serving the Holland area since 1900
  • 9.
    Who does Medicaidapply 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
  • 10.
    Who does Medicaidapply 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
  • 11.
    Example • Clientswere 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
  • 12.
    Example • Couldkeep 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
  • 13.
    Example • Drafteda 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
  • 14.
    Medicare and PartsA-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.
    Veteran’s A&A Benefit • Veteran is eligible for up to $1,632 per month (expenses must exceed income) • Surviving spouse is eligible for up to $1,055 per month • Veteran with a spouse is eligible for up to $1,949 per month Serving the Holland area since 1900
  • 18.
    Veteran’s A&A Benefit • Will cover in-home, assisted living, and nursing home care • Financial eligibility is based in general on $40,000 of countable assets for a single person and $80,000 for a couple Serving the Holland area since 1900
  • 19.
    Did you know? • You could save approximately $6,000 by having an estate plan that will cost you $850 Serving the Holland area since 1900
  • 20.
    What is estateplanning? • 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
  • 21.
    Why is itimportant? • Reduces the cost of administration • Minimizes stress for family and friends • Determines who will receive your assets • Authorizes who will make your medical decisions
  • 22.
    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
  • 23.
    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)
  • 24.
    What are themost 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
  • 25.
    What are themost 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
  • 26.
    What does theestate planning process look like? • Complete estate planning questionnaire • Attend a meeting that we discuss your goals and the types of estate plans
  • 27.
    What does theestate planning process look like? • Review draft of documents • Attend a signing conference • Change beneficiaries or/and fund your trust
  • 28.
    Questions…… Serving the Holland area since 1900
  • 29.
    Thank You P.Haans Mulder 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