A doctor’s visit for most people is an important event. Often, you must explain your ailment quickly and succinctly, trust that your doctor has your best interests at heart and will keep your confidentiality; and make yourself vulnerable and talk about health issues that may be uncomfortable. Having a good relationship with your doctor can alleviate all these issues and can even increase the quality of your healthcare. So, you have a good relationship with a doctor you like, and you find out he is no longer in your health insurance network. Now what?

First, let’s examine why doctors leave health insurance networks. Usually, doctors leave health insurance networks for normal reasons such as retirement or if they move geographic locations. They are professionals, after all, and just as you probably have had to move to a new job, they do the same. Sometimes, there are other more technical reasons, such as if the doctor is unhappy with how the health insurance network conducts business. You’ll most likely be warned ahead of time if your doctor is leaving your network so you have time to plan, however, your doctor and your health insurance provider are not legally obligated to inform you if he is no longer covered. Unfortunately, huge surprise medical bills are all too common and these can leave you financially crippled for years. This is why it is so important when you reach your open enrollment dates each year that you call your doctor’s office and ensure your doctor is still covered under your plan.

So, what do you do if your doctor leaves your network? You may have continuity of care protection, which enables you to retain the same level of care from your doctor, for the same copays and fees, temporarily. If you are a senior who participates in a Medicare Advantage plan, you have the option to leave your health care network if your doctor does and if the network change is “considered significant based on the [effect] or potential to affect current plan enrollees” according to the Centers for Medicare and Medicaid Services guidebook. If you are currently covered under a private plan and are considering switching, it is prudent to call your doctor’s office and ensure they are covered under the new plan you are considering.

What if you can’t switch plans? Often, doctors will allow you to pay cash for your visits. You may be able to negotiate a reasonable cash price with your doctor because they won’t have to bill your insurance, which would save them time and administrative costs. If your doctor’s cash price is relatively expensive, it may still be worth it to you to maintain continuity of care.

If the previous options are out of the question for you, the next best thing to do is just to ask your doctor if they have any referrals. After all, your doctor will know your situation best and how to provide the best care and may know someone else who will be a good fit for you.

Having a doctor you like and trust can be such a relief and it’s always an unfortunate circumstance when your health insurance network no longer covers that doctor. Fortunately, there are ways you can plan for this and methods to make a smooth transition to a new doctor. If you need assistance in this process, please  contact  our office at 973-226-0050.

The post What Happens When Your Doctor Leaves Your Health Plan? appeared first on Faloni Law Group.

In-home care is the preferred living arrangement for many aging seniors. However, many medical conditions and personal care needs as adults age can cause this to become more difficult due to cost. The cost of in-home care varies from place to place, but generally follows the cost of living. Places where the cost of living is lower usually have lower costs for in-home care and the opposite is also true. In areas with a higher cost of living, in-home care is generally more expensive. Another challenge of paying for in-home care is the strict limitations on using Medicare and Medicaid to pay for in-home care. However, it is possible to pay for in-home care. Let’s look at some of the options.

Medicare and Medicaid

Although these two options are more limited in the in-home care covered, there are occasions where they can be used to pay for in-home care. Medicare generally pays for in-home care services for a period of time and most often occurs for a time after a patient is discharged from a hospital or rehabilitation facility. Treatment generally would not be covered for a chronic condition. Medicaid rules vary from state to state but are often similar to Medicare. All programs cover short-term in-home care when the patient has an acute condition. Medicaid offers long-term coverage in some areas, but this is often limited to patients who are ill enough to qualify for nursing home coverage. This care must be provided by a Medicaid-certified care agency. With Medicaid, each state runs its program differently and coverage will vary from state to state.

Reverse Mortgage

A reverse mortgage is an option for paying for in-home care. If the senior, age 62 or older, owns a home outright or owes little on the home, they can apply for a reverse mortgage. A reverse mortgage gives seniors the option of using the value of the equity in their home to get cash. The bank enforces strict rules about taxes, maintenance, homeowner’s insurance, and mortgage insurance. Therefore, it is important to do research on reverse mortgages and find a reputable bank, to lower the risk of defaulting on the reverse mortgage. Another important consideration is the length of time that care may be needed, as compared to the value of the equity. If a senior decides the reverse mortgage is a good choice for them, the cash can be used to cover the cost of in-home care.

Veteran’s Aid and Attendance Benefits

Aid and Attendance is an often-overlooked benefit available to veterans who are paying out of pocket for care. Veterans who served on active duty for 90 days, with one day during wartime, and who were honorably discharged, may be eligible for aid and attendance benefits. However, the qualification process is not easy and many veterans become frustrated when trying to do so.  As a result, the majority of veterans who may be eligible for the benefits never receive them.

Once qualified, a veteran can receive a monthly cash benefit, tax-free, to use for care. For veterans and their spouses, these benefits can be a major help in paying for in-home care. Surviving spouses of wartime veterans can also qualify for a monthly cash payment through the aid and attendance benefit.

Life Insurance

Life insurance is another possible way to pay for in-home care. If the life insurance policy is no longer needed to care for someone after death, it can be an option for paying for in-home care. A life insurance policy can be sold back to the company for a percentage of the value – usually 50 – 75%. This money can then be used to pay for in-home care. Many policies have flexibility, but some require the senior adult to be terminally ill. A policy with an Accelerated Death Benefit rider allows the policyholder to take a cash advance on the policy that is subtracted from the amount beneficiaries would receive. In this instance, the premiums are still paid and the policy still belongs to the policyholder.

Although in-home care is costly, the good news is that there are options available to help seniors pay for this care. The above are just a few options that may help seniors who wish to continue to live at home even when extra assistance is needed.

We help seniors and their loved ones find and pay for good long-term care using many of the options discussed above. We also create legal plans to protect the home and savings to make sure our clients never run out of money or options for good care. If you would like to learn more, please feel free to contact us.  If you’d like to discuss ways we can help, please contact  our office at 973-226-0050.

The post Ways to Finance In-Home Care appeared first on Faloni Law Group.

The need for estate planning becomes more and more critical as we age. Many people avoid estate planning because they do not want to think about the end of life, failing health, or disability. Others believe that an estate plan is only for rich people. However, an estate plan is helpful for the senior adult and their families regardless of overall wealth.

The estate is all the property owned both individually and jointly, including bank accounts, real estate, jewelry, etc., and what is owed. Without an estate plan, it is very difficult to carry out a person’s wishes and can bring on a long, drawn-out probate that can be very expensive for the family. If an estate plan is in place, it can provide peace of mind for the senior adult and their family, as well as protection for the wishes of the senior.

Below are some basic guidelines for what should be included in an estate plan.

Having an estate plan is necessary if you or your senior loved one wishes to have a say in what happens at the end of life and with assets after death. Consulting and planning with an elder law attorney will help to ensure that all options are explored and the best possible solution is utilized. The elder law attorney can walk you through all of the necessary parts of the estate plan, provide an explanation, and prepare the paperwork. Elder law attorneys will help take the guesswork out of estate planning.

If you have any questions about something you have read or would like additional information, please feel free to contact us at 973-226-0050.

The post Your Estate Plan Must Include These 5 Items appeared first on Faloni Law Group.

Retirement planning is becoming more of a reality for Gen Xers as they journey into their 40s and 50s. There are many things to consider, including finances, investments, insurance policies, legal documents, living arrangements, and healthcare. It is advisable to make a detailed checklist within these categories and take action on each item. Meeting with an attorney can help you establish overall goals for your retirement and legacy planning while ensuring the steps you take will lead you to retirement success.

With regards to longevity, things may not be what they seem in the United States. While the world is experiencing an increase in life expectancy, Americans have seen a life expectancy decline for three years in a row. The Center for Disease Control and Prevention ( CDC ) considers this a worrying trend. Assessing life expectancy based on these CDC numbers using their traditional approach is just one part of the equation for Gen X retirement planning because the statistic is derived from birth years while retirement years are calculated from age 65 and beyond. Yes, some Americans are living until the age of 100, and fewer are having heart attacks in their 50s because of prescription medications; however, according to the Smithsonian Magazine , there is “no large extension of adult lifespan in old age.” Making a reasonable estimation of your life expectancy is crucial as it affects planning for how long retirement will likely be and the amount of money needed to cover associated expenses.

MDVIP Health and Longevity Survey reveal that more than half of Gen Xers want to live past 90 years of age, with some wanting to make it to 100, and yet, nearly half have not had a comprehensive medical exam in the past five years. One-third of Generation X avoids going to the doctor at all out of fear of finding something medically wrong. Two-thirds admit they could be doing better when it comes to regular exercise, eating healthy, maintaining a healthy weight, and managing stress levels. There is good news, however. Generation Xers have a reasonable amount of lifespan left to identify changes that need to be made and implement them. Barring an unforeseen accident or illness, time is still on the Gen Xer’s side to make their retirement a success story.

The face of retirement has changed. The vision for most retirees is a full life bustling with activity and interpersonal relationships. Semi-retired is how many prefer to see their goal. There are many excellent reasons to keep working beyond age 65. Continuing to earn an income from work is great for health reasons and economic reasons. Generation X will further test the solvency of social security benefits after most of the baby boomer generation will have stressed the federal program to its limits. Staying productive and useful are key elements to financial well-being, happiness, and long-term health. Entrepreneurial pursuits and consulting are more accessible than ever with the advent of the World Wide Web online community. Try pursuing or inventing a new career, perhaps something you have always dreamed about doing.

Joint life expectancy, whether married or not, is an important consideration when planning for and working toward retirement goals. According to the Vanguard Group, a heterosexual Gen X couple where both partners are age 50, the female partner has a 50 percent chance of reaching 85 years of age while her male counterpart only a 38 percent chance of reaching that same age. Since the couple is most likely to pass away at different times, factoring in the longevity of the surviving partner is crucial to planning. When extending longevity retirement scenarios understand that what is discretionary spending for fun in your 70s and 80s may shift to cover increasingly extensive medical aid and expenses in your 90 ^th
decade and possibly beyond. A financial planner can help you to create scenarios that will accommodate the repurposing of monies.

We welcome the opportunity to work with you on your retirement goals to help create a legal plan that supports those goals. If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050.

The post Time for Gen Xers to Plan for Retirement appeared first on Faloni Law Group.

Long-term nursing care is awfully expensive. Costs can run around $7,000.00 or more per month, depending on location. Hundreds of thousands of people presently need that kind of care and the numbers are rising. Ten thousand “baby boomers” a day turn 65, and it’s projected that seven of ten of those people will need long-term care.

By astute financial planning, our law firm reduces or eliminates the impact of such phenomenal costs on many families’ life savings. But many others who are not our clients pay and pay until they simply run out of money. The Medicaid program is available to step in and pay, but it is questionable how long that program can continue in its present state. For 2018, Medicaid spending was at $597.4 billion, according to the Centers for Medicare and Medicaid Services. Policy-makers are looking for other alternatives.

One option is to require adult children to pay for the cost of their parents’ care. This obligation can be imposed through “filial responsibility” laws. Around thirty states have enacted these laws, some of which even impose criminal fines and imprisonment if an adult child is able, but fails, to pay. For which states have such laws, see the table in this article.

In Pennsylvania in 2012, a son whose mother owed $93,000 to a nursing home was held liable for her bill under that state’s filial responsibility law. The case is Health Care & Retirement Corp. v. Pittas, available here.

The rationale for such laws is that parents supported children for many years and the children owe a debt of gratitude: they should return the favor when parents grow old and become unable to provide for themselves. Such laws are supposed to motivate children to exert pressure on parents, to ensure that long-term care planning is done before the children are called on to pay.

There are numerous objections to this kind of law. Children may resent being forced to pay and treatment of the elderly may suffer as a result. The laws differ widely across the states and produce inconsistent results. Courts may not have the power to enforce these laws against children who live in disparate states. Filial-responsibility laws provide no protection for seniors who have no children.

Further, federal law currently prohibits nursing homes from demanding payment from funds other than those belonging to the resident – like a child’s money.

Other alternatives are more-wisely designed to care for elderly people at home, to delay the need for institutional care for as long as possible. In-home care is estimated to cost one-third the amount of institutional care. Further, personal care can be more suited to the individual if it is given by family and community caregivers. The emotional benefit to the elder can be incalculable.

The need for such programs has been recognized by the Affordable Care Act, which greatly expanded options for states to increase funding for home- and community-based services. Additionally, there are HUD funds available for projects like ECHOs (elder cottage housing opportunity units) – “granny cottages,” small houses for the elderly on a child’s property, to keep family help close by. A 2003 study on the results of that program is available here.

Additional tax deductions and exemptions, like those already allowed in the Medicaid rules, could provide more incentives for at-home improvements like wheelchair ramps and grab-bars. Easing qualifications for long-term care insurance deductions could be encouraged. Family and medical leave from employment could become more available, to relieve the caregiving burden that currently rests disproportionately on women and low-income workers. Subsidies to community elder-care services could be beefed up.

The problem of paying for elder care is multi-faceted and should be tackled on numerous fronts. The options other than filial-responsibility laws seem better-advised to relieve the Medicaid program from the stresses it faces now and into the future.

In the meantime, experienced elder-law attorneys are here to help you protect your finances from the burgeoning costs of aging. Give us a call to discuss your particular needs and how we can help.  If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050.

The post Should Children Be Required to Pay for Their Parents’ Care? appeared first on Faloni Law Group.

Outside Winnie’s nursing home room, Kevin stands teary-eyed. The medical staff just finished inserting a feeding tube into Winnie – an act Kevin knew she didn’t want. Unfortunately, Winnie couldn’t express her wishes due to advanced dementia, and she had no legal documents that expressed her wishes not to be fed by artificial means.  Kevin had no choice but to sit back and watch his wife go through a procedure she didn’t want.

The situation with Kevin and Winnie could have been avoided through the use of proper advance directives. An advance directive is actually a collection of documents. What that includes differs depending on your needs and wishes, along with what the law allows. However, it usually means at least a Living Will, and a Power of Attorney for Healthcare.

The purpose of this set of documents is to allow you to control what happens to your health care in case you cannot speak for yourself. If certain criteria are met, your doctors must consult with your advanced directive before making decisions about your care.

Usually, what this means is that two doctors agree that an individual is terminally ill, permanently unconscious, or at the “end-stage” of a condition. Once that happens, and the individual cannot express their preferences, doctors turn to the advance directive to figure out what the individual wants.

A Living Will determines what happens to an individual making it, unlike a Last Will and Testament, which determines what happens to their money and possessions. A Living Will describes what healthcare providers can and cannot do to prolong your life and/or ease your pain when you cannot express those preferences yourself. For example, do you want to be placed on a ventilator if you cannot breathe on your own? Do you want a feeding tube and IVs set up, and if so, for how long? Do you want to be an organ or tissue donor?

A Durable Power of Attorney for Healthcare lets you choose someone to make healthcare decisions for you when you cannot. They still must follow your Living Will, but they will be able to make decisions not explicitly considered by your Living Will, in accordance with the facts of the situation. In most states, there are “default surrogate consent laws” which allow family members to make treatment decisions on your behalf, but who is chosen to make these decisions and what they choose to do may not be in accordance with your wishes, as it hopefully would be with a Durable Power of Attorney.

Other documents may be part of an advance directive by law, or they may be worth including on your own volition. These include Do Not Resuscitate orders and Physician Orders for Life-Sustaining Treatment, among others. You might also consider an advance directive in case of a mental health crisis.

This is a difficult subject to consider, and it always seems like it won’t be necessary. But nearly 70 percent of Americans don’t have plans in place for a worst-case scenario, which means for some of them, decisions may be made for them with which they would not agree if they had the capacity to choose. For that reason, it is worth thinking about implementing an advance directive even if it seems unnecessary now.

If you or a loved one would like more information about advance directives, please don’t hesitate to reach out. If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050.

The post Advance Directive Explained appeared first on Faloni Law Group.

The level of anxiety and fear in us has risen drastically since we have been faced with unprecedented challenges during this COVID-19 crisis in America. The reactive part of your brain called the amygdala, a human physiological response when faced with fear, takes control of your actions, and you enter what is known as the fight-flight-freeze response. This stress response induces your body to produce a steroid called cortisol to handle the feelings of fear. Unfortunately, cortisol has another effect on your physiology; it weakens your immune system. This effect makes you more vulnerable at a time when you need strength.

No matter what your challenges are during this pandemic, there is one thing you can bring to the crisis from which all other problems can be better solved, overcome your fear with mental toughness. Being afraid can quite literally make you more susceptible to becoming sick. As such, the proper precautions like getting adequate rest, staying hydrated, and social distancing should have an additional component, help your brain to feel safe to maximize your physical health.

Some of the techniques you can employ include shifting your focus to those things you are grateful for, like a roof over your head, food in your refrigerator, your health. Consider all of the things you have that others may not; the things we all may typically take for granted. If you can’t find gratitude about your circumstances, think of those people working on the front lines in this continuing pandemic and be grateful it is not you. Finding something to be grateful for will immediately get you out of the fight-flight response.

Begin to practice empathy. Look at the time you spend with your loved ones at home as a gift and not a jail sentence. Embrace being with them, laugh, tell them you appreciate them because when you spread joy to others, it will boost their immune system as well. It turns out that being positive is healthy and
contagious.  We all have a rare opportunity to forge better, more loving relationships with our immediate family, or if you live alone, take the time to recharge and re-center yourself. Take full advantage of this moment and choose positive behaviors. Extend your empathy to those who are feeling ill if possible, through video chat, phone calls, texts, or prayer. This moment is so much bigger than just ourselves.

Turn off the news and turn on personal growth and connection. News reports are full of data, some of which are not accurate. Being addicted to the 24/7 news cycle breeds uncertainty and fear as it touts mostly negative statistics and woeful stories of the moment. The basics about this pandemic are well documented at this point. Practice proper hygiene, particularly with your hands, avoid touching your face, avoid large gatherings, and implement social distance but do not do this out of fear, do it as an act of service. Flip how your brain associates your daily choices by knowing that your actions are preventing the potential deaths of others.

Find something in media or on television that brings a smile to your face or makes you laugh. Break out the board games, cards, art projects, or walk outside (distant from others!) and get some sun. Sun provides vitamin D for your system, which also boosts your immune system. Whatever you choose, staying active and busy in a positive way will lessen any concerns or fears that you are experiencing about the pandemic.

These points of view may all may read as cliché, but in 2009 Dr. Alvaro Pascual-Leone conducted a study consisting of two groups of people learning to play a simple piano melody. For five days, one group practiced the melody for two hours a day while the other group, over the same time, sat in front of the keyboard, imagining they were playing the melody. Dr. Pascual-Leone mapped the brain activity of the study participants before, during, and after the experiment, and the results were surprising. Both groups experienced the same brain changes. What this means is the brain does not differentiate between imagination and reality. What this also means is you have a choice, a choice to be riddled with anxiety, worry, and uncertainty, or the opportunity to be courageous, bold, and confident by simply imagining those feelings. How you feel is a choice.

In simple terms, when you have a thought, your brain sends a pulse of electrical activity at the same moment. This electrical activity stimulates a release of neuropeptides that communicate with your body to produce a feeling. So truly, your thoughts create feelings. Activate your brain’s natural superpowers and boost your immune system by redirecting your brain’s thought patterns. Remind yourself daily to think positive thoughts, be grateful, and practice empathy which will give you the mental toughness to endure what still lies ahead.

We are open for business and would be happy to discuss any concerns you have. The pandemic we are living through has opened everyone’s eyes to the importance of having healthcare documents, as well as other planning documents like a will or trust. If you’d like to discuss your particular needs, please contact us – we’d be happy to help. Please  contact  our office at 973-226-0050.

The post Your Mental Health and the Coronavirus Pandemic appeared first on Faloni Law Group.

It can be a struggle for the entire family when a loved one starts to lose his or her memory. The person who has been the head of the family may soon fade from the person they once were, leaving their loved ones to wonder what will come next. The stigma associated with Alzheimer’s disease has a significant negative impact on the lives of people with Alzheimer’s and their caregivers. Around 25% of dementia patients hide their diagnosis, and 40% said they have withdrawn from many everyday activities according to recent studies. There are many negative public images and stereotypes associated with dementia, which contributes to a lack of engagement with people with this condition. Many people with dementia experience social isolation due to withdrawal from friends and other important people in their lives.

Many misconceptions of Alzheimer’s exist. It is widely believed that Alzheimer’s and dementia are a normal part of aging. This is not true. It is a disease that develops from a wide variety of risk factors. Many people believe that Alzheimer’s patients become violent and aggressive. This only happens with some patients and is typically the result of a deep sense of confusion and fear. It is also widely believed that people with Alzheimer’s can’t function or enjoy activities. Stigma is the use of negative labels to identify a person with a disability or illness. Stigma around Alzheimer’s disease exists, in part, due to the lack of public awareness and understanding of the disease, preventing people from:

Stigma and lack of awareness also impacts Alzheimer’s disease research. The government funds Alzheimer’s research at lower rates than other diseases, even when the cost of caring for Alzheimer’s disease is significantly higher. Stigmas and stereotypes are significant obstacles to the well-being and quality of life for those with dementia and their families. Here are some examples of the stigma those with Alzheimer’s may experience:

With proper assistance, people with Alzheimer’s can enjoy meaningful activities and maintain relationships. There are plenty of reasons why we need to fight Alzheimer’s stigma. Stigma can prevent people from seeking medical treatment when symptoms are present. It can prevent people from receiving an early diagnosis or any diagnosis at all. It can prevent people from developing a support system and benefitting from available treatments allowing them a high quality of life which is absolutely possible with Alzheimer’s disease.

What Can You Do?

If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050
.

The post The Stigma Around Alzheimer’s appeared first on Faloni Law Group.

Long-term care often creates devastating financial impacts on Americans, particularly the elderly, and for those family members who loose hours of income (and more) while providing care for their loved ones. The Medicaid system is still one of the best options to afford long-term care. Medicaid crisis planning is a strategy that can help you qualify for Medicaid without experiencing financial ruin.

As a joint federal and state social safety net Medicaid differs by eligibility rules and regulations in every state, and even by name. Unfortunately, people often wait until a catastrophic event brings about sudden illness, disability, or other medical crises before planning long-term care. Under duress, a family system will listen and take advice from misinformed individuals, such as non-attorneys or attorneys who do not practice elder law. Perhaps unwittingly, these people tend to give the worst advice: spend everything you have until you qualify under the Medicaid eligibility rules. Though this approach can work, there are far better strategies that can be employed.

With the help of an elder law attorney, Medicaid crisis planning allows you to qualify for Medicaid nursing home/LTC without spending down all of your life’s assets. Working with an elder law attorney to devise a personal Medicaid crisis plan is a logical and financially prudent approach to long-term care and allows you or a loved one to use legally approved strategies to qualify for Medicaid before spending everything you own on the high cost of nursing home care.

If you have a loved one who is either in a nursing home or about to enter a nursing home, that is the time to speak to an elder law attorney. There are legal strategies that allow a person who needs long-term care to divest themselves of some of their assets, and use the rest to pay for their care until Medicaid eligibility is met.  The sooner an elder law attorney is employed, the quicker Medicaid eligibility can be met.  However, it’s never too late, even if you or a loved one are already in a nursing home.

The level of complexity involved in Medicaid crisis planning deems it necessary to retain an elder law attorney, preferably one specializing in Medicaid planning. Eligibility requirements vary, calculations are complex, timing is crucial, forms are ever-changing, and laws are amended. An elder law attorney can tailor your financial situation to the best Medicaid crisis planning solution and protect your financial future.

If you’d like to discuss ways we can help, please  contact  our office at 973-226-0050
.

The post When You Should Think About Medicaid Crisis Planning? appeared first on Faloni Law Group.