Can I Get a Tax Break for Long-Term Care?

The skyrocketing costs of long-term care (LTC) can ruin your retirement savings. The U.S. Department of Health and Human Services found that 27% of Americans turning 65 this year will have at least $100,000 in long-term-care costs, and 18% will require care costing more than $250,000. However, the IRS allows some limited tax breaks on medical expenses and insurance premiums related to long-term care.

Kiplinger’s recent article entitled “Deduct Expenses for Long-Term Care on Your Tax Return” says that if you need LTC, you may be able to deduct a portion of the costs on your tax return. If you purchased a long-term-care insurance (LTCI) policy to cover the costs, you may also be able to deduct some of your premium payments. Since retirement planning includes long-term care, it’s important to know how these tax deductions can help to offset overall costs.

Long-Term-Care Costs

The IRS allows you to deduct unreimbursed costs for long-term care as a medical expense, if certain requirements are met. This includes eligible expenses for in-home, assisted living and nursing-home services. The long-term care must be medically necessary and may include preventive, therapeutic, treating, rehabilitative, personal care, or other services. The cost of meals and lodging at an assisted-living facility or nursing home is also included, if the primary reason for being there is to receive qualified medical care.

The care must also be for a chronically ill person and provided under a care plan prescribed by a doctor. The IRS says that a person is “chronically ill,” if he or she can’t perform at least two activities of daily living. These are things like eating, bathing, or dressing. They must be unable to do these without help for at least 90 days. This condition must be certified in writing within the last year. A person with a severe cognitive impairment, like dementia, is also considered chronically ill, if supervision is needed to protect his or her health and safety.

To get the deduction, you have to itemize deductions on your tax return. However, itemized deductions for medical expenses are only allowed to the extent they exceed 7.5% of your adjusted gross income.

An adult child can claim a medical expense deduction on his own tax return for the cost of a parent’s care, if he can claim the parent as a dependent.

Insurance Premiums

The IRS also allows a limited deduction for certain LTCI premiums. Similar to the deduction for long-term-care services, this has to be an itemized deduction for medical expenses. Again, only premiums exceeding the 7.5% of AGI threshold are deductible. (Note that self-employed individuals may be able to deduct premiums paid for LTCI as an adjustment to income without having to itemize.)

In addition, the LTCI policy is required to satisfy certain requirements for the premiums to be deductible. The policy can only cover long-term-care services, so the deduction only applies to traditional LTCI policies, not “hybrid” policies that combine life insurance with long-term-care benefits. This deduction also has an age-related cap. For 2021, the cap is $5,640 if you’re older than 70, $4,520 if you’re 61 to 70 and $1,690 if you’re 51 to 60. (For those 41 to 50, it’s $850, and for 40 or younger, it’s $450.)

These deductions can be valuable for people in their seventies and older.

Reference: Kiplinger (March 23, 2021) “Deduct Expenses for Long-Term Care on Your Tax Return”

How Do Special Needs Trusts Work?

A trust of any kind is a document that expresses your wishes while you are alive and after you have passed. The need for a dedicated trust for loved ones differs with the situations or issues of the family. Getting this wrong can lead to financial devastation, explains the article “Take special care with Special Needs trusts” from the Herald Bulletin.

A Special Needs Trust or supplemental trust provides protection and management for assets for specific beneficiaries. The trustee is in charge of the assets in the trust during the grantor’s life or at his death and distributes to the beneficiary as directed by the trust.

The purpose of a Special Needs or supplemental trust is to help people who receive government benefits because they are physically or mentally challenged or are chronically ill. Most of these benefits are means-tested. The rules about outside income are very strict. An inheritance would disqualify a Special Needs person from receiving these benefits, possibly putting them in dire circumstances.

The value of assets placed in a Special Needs trust does not count against the benefits. However, this area of the law is complex, and requires the help of an experienced elder law estate planning attorney. Mistakes could have lifelong consequences.

The trustee manages assets and disperses funds when needed, or at the direction of the trust. Selecting a trustee is extremely important, since the duties of a Special Needs trust could span decades. The person in charge must be familiar with the government programs and benefits and stay up to date with any changes that might impact the decisions of when to release funds.

These are just a few of the considerations for a trustee:

  • How should disbursements be made, balancing current needs and future longevity?
  • Does the request align with the rules of the trust and the assistance program requirements?
  • Will anyone else benefit from the expenditure, family members or the trustee? The trustee has a fiduciary responsibility to protect the beneficiary, first and foremost.

Parents who leave life insurance, stocks, bonds, or cash to all children equally may be putting their Special Needs child in jeopardy. Well-meaning family members who wish to take care of their relative must be made aware of the risk of leaving assets to a Special Needs individual. These conversations should take place, no matter how awkward.

An experienced elder law estate planning attorney will be able to create a Special Needs trust that will work for the individual and for the family.

Reference: Herald Bulletin (March 13, 2021) “Take special care with Special Needs trusts”

Do I Make Too Much Money for Medicaid?

A 73-year-old single retiree is collecting Social Security and a small state pension. He recently was told that he probably collects too much money to be eligible for Medicaid assistance to help with any kind of long-term care, if it was required in the future. He owns a house with a mortgage.

What options does he have, except for buying a long-term care insurance policy, which may be extremely expensive at his age.

Nj.com’s recent article entitled “I think I make too much money for Medicaid. What can I do?” says that there are some steps a person can take. However, it may take time before these actions will help your situation.

Medicaid has a five-year lookback. Therefore, if the Medicaid applicant gave away all of his assets this year and went into a nursing home expecting Medicaid to pay, the program would “look back” over five years at what he owned. The program can claw back what it spends on the applicant.

But just because you are not eligible for Medicaid and its long-term care benefits today, that does not mean that you will not be eligible in the future.

That is because even if your income is above the limit, you still might be able to qualify for Medicaid, if you have significant medical expenses.

In order to qualify financially, you need to have very limited resources.

In many states, for long-term care, an applicant’s assets cannot be more than a certain amount, such as $2,000 if you are single. However, not all property counts towards the resource limit. A home may be exempt, if it is your primary residence and worth less than the limit.

One option is a reverse mortgage which would free up some of the equity in the home to use towards a long-term care insurance policy.

Long term care policies can still be issued for people in their 70s, but the premiums will be higher than if you had enrolled 10 or 20 years ago. However, it is still an option and would keep the retiree in his home.

There are also a number of federal and state-funded programs that make it easier for seniors to live in the community and in their homes as long as possible.

If you would like to know more about this or other topics from Calvin Curtis, click here.

Reference: nj.com (March 11, 2021) “I think I make too much money for Medicaid. What can I do?”

Am I a Senior Citizen?

Here are some milestones that could signal that you have become a senior citizen, according to US News and World Report’s recent article entitled “When Do You Become a Senior Citizen?”

Eligibility for Senior Benefits. There are exact ages when you qualify for a host of retirement benefits. In some ways, society makes it very clear when we become senior citizens. For example, we know that at age 65, we qualify for Medicare. Social Security benefits can begin as early as age 62 or as late as age 70. And senior discounts begin at some retailers and restaurants for those who are 55 or older.

If you’re 50 or older, you’re eligible to become an AARP member.

Spending Retirement Savings. Retirement accounts are developed to motivate workers to save for their retirement. Thus, accounts like a 401(k) plan or IRA usually impose a penalty for early withdrawals. If you take money out before age 59½, you’ll typically be hit with a 10% penalty. You may consider yourself a senior citizen when you no longer have to concern yourself with that 10% penalty for early withdrawals from your IRA or 401(k).

However, when you hit a certain age, you will need to take required minimum distributions from retirement accounts. Also called “RMDs,” these withdraws from traditional IRAs and 401(k) plans must be taken each year after age 72. Once you reach 72, you may think of yourself as a senior citizen because you have to start taking your RMDs from your retirement account.

Retirement. After you retire from working every day, your family and friends may consider you to have attained senior citizen status. The transition might bring on a feeling of meaning and purpose. Once you reach a certain age, you look back and go through self-reflection.

As you stop going to the office every day, you might feel a sense of gratitude for the years you were able to work and pursue a passion.

Health Issues. Medical conditions like arthritis, hypertension, or hearing loss may cause you to feel like you have reached senior citizen land. A person that is battling several age-related medical issues can feel olde,r just by the number and type of medications or medical devices they use.

It’s not easy to feel young when you are being fitted with a walker or hearing aid, and you’re lining up pill bottles every morning and evening. Feeling fatigued or ready for bed by 9 p.m. might be signals that you are getting older.

For more information about this or other topics, click here.

Reference: US News and World Report (Jan. 27, 2021) “When Do You Become a Senior Citizen?”

What are Most Common Side Effects of COVID-19 Vaccines?

AARP’s recent article entitled “What Are the Side Effects of COVID-19 Vaccines?” reports that the FDA says the most common side effects among participants in both the Pfizer-BioNTech and Moderna Phase 3 clinical trials were the following:

  • Injection site pain
  • Fatigue
  • Headache
  • Muscle pain
  • Chills
  • Joint pain; and
  • Fever.

These reactions are temporary and will “self-resolve” within a few days.

Side effects from vaccines aren’t uncommon. For example, the seasonal flu shot can cause fever and fatigue, or reactions.

Doctors say that a mild to moderate reaction is a good thing because it shows that the immune system is responding to the vaccine. However, the key, experts say, is temporary discomfort versus the long-term benefits of a potentially high level of protection from COVID-19, a disease that’s responsible for the deaths of more than 1.6 million people globally.

Federal analyses of both vaccine trials show that few adverse events, which the CDC defines as any health problem that happens after a shot (separate from the less serious side effects), were reported. There have been a few people who’ve reported severe allergic reactions — known as anaphylaxis —after receiving the Pfizer-BioNTech vaccine. As a result, the CDC is recommending that anyone who has ever had a severe allergic reaction to any ingredient in a COVID-19 vaccine not get it. The ingredients of authorized vaccines are on the FDA’s website. Talk to your doctor, if you have questions and keep in mind that serious reactions are relatively rare.

People must continue their prevention efforts to help slow the spread of the disease: mask wearing, social distancing and frequent handwashing. Note that it typically takes a few weeks for the body to build immunity to a disease after vaccination, so it’s possible you can get sick with COVID-19 even after you’ve been vaccinated. Experts also aren’t certain if the vaccines also block transmission of the virus.

Remember that it takes time to build up herd immunity, where enough of the population is protected from the virus that transmission slows significantly. Scientists aren’t sure what the magic number is to obtain herd immunity for COVID-19, but they think it’s around 70% of the population, which could take months to achieve through vaccination.

Reference: AARP (Dec. 21, 2020) “What Are the Side Effects of COVID-19 Vaccines?”

For more information about this or other topics, click here.

Little Things Add Years to Your Life

Get moving, says a 20-year study conducted with nearly 15,000 residents of the United Kingdom age 40 to 79. Considerable’s recent article entitled “This small lifestyle change can add years to your life” explains that the subjects who kept or increased to a medium level of activity were 28% less likely to die than those who stayed at a low level of activity.

The research was conducted by the MRC Epidemiology Unit at the University of Cambridge, and the results were published in The British Medical Journal.

The researchers split the sample into three groups who engaged in low, medium, and high levels of activity. They monitored changes to their activity for about eight years. Then they looked at the health effects over the next 12½ years.

The researchers found that those who stayed or increased their level of activity from low to medium were 28% less likely to die during that second phase than those who kept a low level of activity.

Moreover, those subjects who’d been moderately active but raised their activity level achieved a significant 42% increase in survival, compared to the low-activity subjects.

This impact was present even for those respondents who ate an unhealthy diet or had experienced a health condition, like high blood pressure, high cholesterol, or obesity.

So, the big question is just how much activity is required?

The study defined the activity levels according to the following guidelines:

  • Low: Less than the guideline of 150 minutes per week of moderate intensity activity
  • Medium: achieving the guideline of 150 minutes of moderate-intensity activity per week; and
  • High: The guideline of 300 minutes of moderate-intensity weekly activity.

The high level also allowed for an equivalent, like 75 weekly minutes of high-intensity activity, or 60 minutes of high-intensity activity and 30 minutes of medium-intensity activity per week.

The researchers think that their study will motivate more people to take it up a notch, regardless of their age.

“These results are encouraging, not least for middle aged and older adults with existing cardiovascular disease and cancer, who can still gain substantial longevity benefits by becoming more active, lending further support to the broad public health benefits of physical activity,” the authors commented.

Reference: Considerable (Sep. 22, 2020) “This small lifestyle change can add years to your life”

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Can a Power of Attorney Protect My Assets as I Get Older?

Elder law attorneys help protect individuals as they grow older and then protect their beneficiaries when they pass away.

The Street’s recent article entitled “Guide to Protect Your Assets as You Age – Power of Attorneys” asks us to think about visiting your family doctor for the last 30 years but then needing to see a specialist for the first time. That’s because your family doctor isn’t a specialist, and they might miss something. The article explains that elder law attorneys are the specialists of the legal profession—they take a fresh look at a client’s situation and develop strategies to protect them and their families from the risks as we grow older.

Elder law attorneys show you how to protect yourself and your family. When partnering with an elder law attorney, they make certain that your estate goes to your family as you intended, with little or no tax liability.

An important tool for elder law attorneys is the Power of Attorney (POA). There are two of them: a medical POA and a financial POA. These allow you to designate a trusted agent to make your medical and financial decisions, when you are unable.

Unfortunately, the coronavirus pandemic has placed everyone in difficult circumstances. As a result, many hospitalized patients are without the proper estate planning documents. While things are letting up some, hospitals, nursing homes, and assisted living homes have shuttered their doors to visitors and non-essential workers in an attempt to minimize the spread of this disease. As a result, many patients are unable to get these documents signed.

Although some states initially prevented electronic signatures and notarization that would keep contact to a minimum, many have now permitted patients access to elder law and estate planning attorneys, when needed. These states have signed executive orders that allow for electronic signatures, which has been a huge help. Even so, this can be challenging for an elder individual.

Financial powers of attorney are not all the same either. They are just one tool in the toolbox.

A power of attorney can have a list of things you will permit your designated agent to do for you. Many of these documents do not give your agent enough power to protect you. That’s because they limit your agent’s abilities. That may sound good when you first sign them, but the result is that it makes things harder for your family, if you have a stroke and your loved one needs to protect your finances.

Reference: The Street (Sep. 24, 2020) “Guide to Protect Your Assets as You Age – Power of Attorneys”

What are Power of Attorney Options?

FedWeek’s recent article entitled The Options in Granting Powers of Attorney” explains that a power of attorney designates someone else to handle your affairs, if you can’t.

Here are the major types:

  • Limited power of attorney. This allows an agent to act on your behalf under specific circumstances, like a home sale closing that you can’t attend, and/or for a defined period of time.
  • General power of attorney. Gives broad authority to your agent, who at any time can write checks to pay your bills, sign contracts on your behalf and take distributions from your IRA.
  • Springing power of attorney. This isn’t effective when you execute it, but rather “springs” into effect upon certain circumstances, such as your becoming incompetent. You can say in the document what’s needed to verify your incompetency, like letters from two physicians stating that you no longer can manage your own affairs.

A power of attorney is important because your agent can act, if you become incapacitated. To serve this purpose, a power should be “durable,” so it will remain in effect if you become incompetent. Other powers of attorney may not be recognized, if a judge determines that you no longer can manage your affairs.

Without a power of attorney, your family may have to ask a judge to name a guardian to act in your best interests. A guardianship proceeding can be expensive and contentious. You might also wind up with an unwelcome interloper managing your finances. To avoid this situation, designate a person you trust as agent on your durable power.

A health care power of attorney, also known as a health care proxy or a medical power of attorney, should be a component of a complete estate plan. This document names a trusted agent to make decisions about your medical treatment, if you become unable to do so.

The person you name in your health care power doesn’t have to be the same person that you name as agent for a “regular” power of attorney (the POA that affects your finances).

For your health care power, chose a person in your family who is a medical professional or someone you trust to see that you get all necessary care.

Depending on state law, it may go into effect when a doctor (whom you can name in the POA) determines in writing that you no longer have the ability to make or communicate health care decisions. For more information, click here.

Reference: FedWeek (Aug. 26, 2020) “The Options in Granting Powers of Attorney”

 

What Is a Will Codicil?

There are a number of reasons for adding a codicil to an existing will. KAKE.com’s recent article entitled “Using a Codicil to Modify a Will” says it’s good to know when you might need one and how to add it.

A codicil is a way to change the terms of an existing will. A codicil allows you to modify a term in your will, without the need to rewrite the whole will. A codicil is used in cases where you only need to make relatively minor changes.

There are different situations that might require a codicil to be added to your will. Here are some examples:

  • You want to add or remove an heir
  • You’ve acquired or disposed of property you need to update in your will
  • You need to change the executor of your will
  • You want to change the person designated as a legal guardian for your minor children
  • You recently were married or divorced and need to change how your assets or property will be distributed; or
  • You want to make changes to how your assets and property will be divided for other reasons.

Adding a codicil to a will make certain that the will is current, as you go through different life events or if your financial circumstances change. This can help eliminate the chance that your will may be challenged after you die, because those named as beneficiaries disagree with the will’s terms. It can also help to avoid lengthy delays in probate associated with property you no longer own or property you haven’t addressed in the will.

Remember that a codicil allows you to change your will. However, revoking a will terminates it completely. Ask an experienced estate planning attorney about the laws for revoking a will in your state. Some states let you simply physically destroy the will, and in others, you may need to draft a written declaration stating that your will has been revoked or draft a new replacement.

If you need to make substantial changes to the terms of your will, then revoking it and creating a new will may be the better plan. A new will in place can avoid confusion during probate, if there are conflicting terms. You may also need to write a new will, if all copies of your existing will are unintentionally lost or destroyed.

Drafting a codicil to a will, is like writing a will itself. The codicil needs to follow the legal guidelines established in your state. Ask an experienced estate planning attorney for help.

Reference: KAKE.com (June 17, 2020) “Using a Codicil to Modify a Will”

Visiting Grandma at the Nursing Home

In spots where visits have resumed, they’re much changed from those before the pandemic. Nursing homes must take steps to minimize the chance of further transmission of COVID-19. The virus has been found in about 11,600 long-term care facilities, causing more than 56,000 deaths, according to data from the Kaiser Family Foundation.

AARP’s recent article entitled “When Can Visitors Return to Nursing Homes?” explains that the federal Centers for Medicare and Medicaid Services (CMS) has provided benchmarks for state and local officials to use, in deciding when visitors can return and how to safeguard against new outbreaks of COVID-19 when they do. The CMS guidelines are broad and nonbinding, and there will be differences, from state to state and nursing home to nursing home, regarding when visits resume and how they are handled. Here are some details about the next steps toward reuniting with family members in long-term care.

When will visits resume? As of mid-July, 30 states permitted nursing homes to proceed with outdoor visits with strict rules for distancing, monitoring and hygiene. The CMS guidelines suggest that nursing homes continue prohibiting any visitation, until they have gone at least 28 days without a new COVID-19 case originating on-site (as opposed to a facility admitting a coronavirus patient from a hospital). CMS says that these facilities should also meet several additional benchmarks, which include:

  • a decline in cases in the surrounding community
  • the ability to provide all residents with a baseline COVID-19 test and weekly tests for staff
  • enough supplies of personal protective equipment (PPE) and cleaning and disinfecting products; and
  • no staff shortages.

Where visits are permitted, it should be only by appointment and in specified hours. In some states, only one or two people can visit a particular resident at a time. Even those states allowing indoor visits are suggesting that families meet loved ones outdoors. Research has shown that the virus spreads less in open air.

Health checks on visitors. The federal guidelines call for everyone entering a facility to undergo 100% screening. However, the CMS recommendations don’t address testing visitors for COVID-19.

Masks. The federal guidelines say visitors should be required to “wear a cloth face covering or face mask for the duration of their visit,” and states that allow visitation are doing so. The guidelines also ask nursing homes to make certain that visitors practice hand hygiene. However, it doesn’t say whether facilities should provide masks or sanitizer.

Social distancing. The CMS guidelines call on nursing homes that allow visitors to ensure social distancing, but they don’t provide details. States that have permitted visits, state that facilities enforce the 6-foot rule.

Virtual visits. Another option is to make some visits virtual. Videoconferencing and chat platforms have become lifelines for residents and families during the pandemic. Continued use after the lockdowns can minimize opportunities for illness to spread.

Reference: AARP (July 22, 2020) “When Can Visitors Return to Nursing Homes?”

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