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Estate Recovery Presentation
1. ESTATE RECOVERY IS HERE: HOW TO HELP PROTECT YOUR PATIENTS AND THEIR FAMILIES 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 Attorney and Partner at Cunningham Dalman, P.C. Have a Masters in Tax (MST), CFP® and specialize in estates/elder law and business planning Serving the Holland area since 1900
3. Background Cunningham Dalman, P.C. has been serving the lakeshore since 1900 We have 15 attorneys specializing in all areas of the law Serving the Holland area since 1900
4. Overview Discuss the Medicaid rules and process Cover the what, who, when, where, and how’s of Medicaid…. What is estate recovery and why is it important to your patients and their families Serving the Holland area since 1900
5. Overview What types of assets does estate recovery apply to How it might impact your business How do your patients and their families protect against it Serving the Holland area since 1900
6. What is Medicaid? It is a state and federal program that pays for medical treatment (including long term care) Oftentimes confused with Medicare Serving the Holland area since 1900
7. When does Medicaid apply? Historically, it only paid for nursing home care In certain counties (that have the MI Choice Waiver program), it will pay for care in someone’s home or in an assisted living facility Serving the Holland area since 1900
8. Who does Medicaid apply to? Applies to people who are 65 years or older, blind, or disabled Must satisfy the medical requirements (level of care assessment) Need to meet the income and asset tests Serving the Holland area since 1900
9. Who does Medicaid apply to? A patient’s monthly income cannot exceed the monthly cost of the nursing home ($6-7,000 in this area) For the Waiver program, a patient’s income (not a spouse) must be less than $2,022/month Serving the Holland area since 1900
10. Who does Medicaid apply to? The asset test requires that a single person cannot have more than $2,000 in countable assets A patient can keep his or her home (as long as its not in a trust) as well as a vehicle Serving the Holland area since 1900
11. Who does Medicaid apply to? Asset test allows a married couple to keep their home (again, if it’s owned properly), a vehicle, and one-half of their other assets (up to a maximum of $109,560) Serving the Holland area since 1900
12. What is estate recovery? It is a process that the State of Michigan gets reimbursed for the Medicaid services it has paid for It does not put a lien (i.e. Medicaid lien) on exempt assets during a patient’s life or force a sale Serving the Holland area since 1900
13. What is estate recovery? It applies to people age 55 years or older who have received Medicaid (i.e. long term care) services Covers Medicaid services back to September 30, 2007 Serving the Holland area since 1900
14. What assets does estate recovery apply to? It only applies to assets that have to be probated That has the potential to include all assets (house, bank accounts, investments, vehicle, personal property, etc.) Serving the Holland area since 1900
15. What assets does estate recovery apply to? But…the only assets that are typically left are: bank account, personal property (including vehicle), and a patient’s house The house will be the most significant asset, but do not lose sight of the others Serving the Holland area since 1900
16. What effect might this have on your business? Estate recovery might incentivize patients to stay at home longer Patients might be more likely to sell their house and have more liquid assets for their care Serving the Holland area since 1900
17. How do people protect against estate recovery? The most effective way to protect the house is with a “ladybird deed” The house remains an exempt asset during the Medicaid recipient’s life The costs and hassle of probate are avoided Serving the Holland area since 1900
18. How do people protect against estate recovery? What about other assets besides the house The patient should make sure those assets avoid probate (i.e. having a trust named as owner, naming a beneficiary, etc.) Serving the Holland area since 1900
19. Some other things to be concerned about When a single person is on Medicaid, he or she can keep the house However, he or she will not be able to use Social Security and other income to pay the house expenses Serving the Holland area since 1900
20. Some other things to be concerned about This typically means that a child or beneficiary must pay these expenses Children should protect their right to be reimbursed by executing and recording a mortgage against the house Serving the Holland area since 1900
21. Some other things to be concerned about This gives a child’s reimbursement claim higher priority than the State of Michigan’s estate recovery right A child will get paid when the house sells Serving the Holland area since 1900
22. Some other things to be concerned about You should make sure the Medicaid recipient has signed a financial (also known as a general durable) power of attorney That way, the agent can execute the mortgage Serving the Holland area since 1900
23. This is subject to change so you have to stay informed… Serving the Holland area since 1900
24. Stay informed by receiving our monthly newsletter (register by emailing laura@holland-law.com) 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 mary@holland-law.com www.holland-law.com Serving the Holland area since 1900