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       In last week’s blog, I started to tell you about annuities and how unique they are when we are considering Medicaid.  In order to achieve Medicaid eligibility, I must spend down my assets to below $2000 (married couple rules permit assets up to, in some cases, $120,900).        Remember that an annuity in its basic form involves taking an asset and turning it into a stream of income.  Is it possible, then, that an annuity is not an asset for Medicaid purposes, but instead is really income?  If true the annuity would not need to be spent down.  The answer, as with much surrounding Medicaid is sometimes yes and sometimes no.        There are Medicaid regulations that address the question and provide that certain types of annuities are in fact treated as income and not assets.  They are commonly referred to as Medicaid compliant annuity.  The requirements are that the annuity must be an immediate annuity.  It must also be noncancelable, nonassignable and actuarially sound.        Let’s break it down.  Remember from last week that an annuity can be immediate or deferred.  If I buy an annuity from the insurance company for $100,000 and

       The topic of annuities comes up regularly when we get a call regarding the need for Medicaid benefits to pay for long term care.  Sometimes the caller has questions about whether it is a good idea to buy an annuity in anticipation of Medicaid.  Other times someone has been sold an annuity years before and now we must figure out what to do with it so he/she can qualify for Medicaid.        Before we get into specifics, let’s define an annuity.  Very simply, an annuity is a contract which exchanges an asset in return for a stream of income paid over a set period of time.  These contracts are typically sold by insurance companies who offer a rate of return depending on how soon one starts receiving that income stream and how the assets entrusted to the insurance company are invested.        Annuities come in many shapes and sizes but can be classified in a few ways.  For example, there are fixed annuities and variable annuities.  Fixed annuities provide a guaranteed amount based on the terms of the contract entered into.  On the other hand, payments from a variable annuity can vary because some or

          Last week I was talking about options when considering estate planning for pets. One is to leave your pet to someone or some organization along with a sum of money to provide for the pet’s care.  I leave my dog Casey to my friend George, for example, with $15,000 to care for her.  But, what if I want some assurances that George won’t give Casey away and keep the money?           In that case it would be better to set up a “pet trust”. A written document establishes the purpose of the trust (ie. who it is to benefit) and how the assets held in the trust are to be administered for the beneficiary.  You might remember Leona Helmsley, the hotel heiress who left $12 million to her dog.  She actually left the money in trust, managed by a trustee for the life of her Maltese.  The trust should also provide who receives any money left in the trust when the pet dies (a remainder beneficiary).           New Jersey law expressly allows for the creation of a trust for the care of an animal alive during the settlor’s (the person creating the trust) lifetime.  The trust terminates at the death of

                Everyone loves their pet.  We spend millions in pet products and vet bills each year and that number seems to increase every year.  A question I increasingly am asked is what happens to my pet when I pass away?  What are my options in terms of providing a safe home for him or her after I’m gone?                 First of all, since animals aren’t people they don’t have the same rights as people do.  Animals can’t own property so you can’t simply say in your will “I leave $50,000 to Casey for her to use in finding a new home for herself”.   That much is pretty obvious.  So what are the options?                 Generally there are two options.  One is to leave your pet and a sum of money to someone to care for the animal.  For example, I might leave Casey to my friend George and the sum of $5,000 to cover the costs of food, toys etc.  If Casey has a medical condition maybe I want to leave $15,000 to cover anticipated vet bills.  This is the simpler option, although there is no guarantee that George will keep Sparky.  There is nothing preventing him from keeping the money and

     It’s a common mistake, confusing a health care directive and a HIPAA release.  Both are necessary but they are not identical.      First let’s look at a health care directive.  There are actually two types of directives, an instruction directive and a proxy directive, both of which are important.  An instruction directive is commonly known as a living will.  It is a set of instructions of what you would or would not want done medically.  It is typically used to express a desire of what you do or don’t want done in an “end of life” situation.      A proxy directive, known as a health care power of attorney, is a document in writing that designates someone – your health care representative – who you wish to make medical decisions for you if you can’t make them yourself.  That could be, for example, when you are in surgery under anesthesia.  It could also be when you are no longer mentally capable of making decisions such as in the case of advance stages of dementia.      A HIPAA authorization, on the other hand, provides consent to medical providers and others to release medical information about you to persons whom you designate.  HIPAA stands

                Last week I wrote about trusts and how they are treated by Medicaid.  Specifically, I am talking about irrevocable trusts.  Most people assume that if they have placed their assets in an irrevocable trust, that by itself is enough to protect the assets from having to be spent down before achieving Medicaid eligibility.                 Unfortunately, it’s more complicated than that.  We must look to the terms of the trust.  What portion, if any, of the trust assets can be paid to the Medicaid applicant?  In other words, are there any circumstances under which the Medicaid applicant, as a beneficiary of the trust, can receive payments from the trust?  Whatever can be received is counted as an asset under Medicaid resource (asset) rules.  This is the case regardless whether he/she actually received the asset.  A trust that permits – but does not require – the trustee to distribute trust assets to a beneficiary counts as an asset under Medicaid’s rules.                 As I explained last week the Medicaid program consists of federal and state laws and regulations.  Each state is charged with administering its own Medicaid programs.  It is free to implement its own laws and regulations as long as they don’t