Are you a Caregiver for a Family Member? Then get Paid for it! MN010

Welcome Medicare Nation!  Today’s discussion spells out the essential elements of Elder Law, and how the specialty is necessary for so many circumstances.  That’s why I am talking to an expert in the field today, who can help us clarify some common misconceptions, and also point us to the right resources to make sure you and your family are protected.

My guest today is Andrew Brusky, who is an attorney who specializes in elder law, offering services designed to provide greater options and security for the elderly and disabled.  Mr. Brusky regularly handles cases and is a frequent speaker on issues involving Medicaid eligibility, health care and financial powers of attorney, trust documents, as well as long-term care options for the elderly.  Andrew has worked for Legal Assistance to the Elderly in San Francisco, California and as an intern with the Center for Public Representation in Madison, Wisconsin.  Mr. Brusky received his Undergraduate degree in psychology and gerontology from Santa Clara University and his law degree from the University of Wisconsin Law School.  He is a member of the Milwaukee and Wisconsin Bar Associations (State Bar Elder Law Section Board Member and Past Chair, founding member of the Milwaukee Bar Elder Law Section serving as its Past Chair), the National Academy of Elder Law Attorneys, past chair and board member for the Greater Milwaukee Interfaith Older Adult Program, and is currently a member of the Life Navigators trust committee in Wauwatosa.  Andrew has been listed in The Best Lawyers in America in the specialty area of Elder Law and Wisconsin Super Lawyer.

What is Elder Law and the difference between estate planners, etc?

Elder law attorneys are looking at your estate, looking at what counts and what doesn’t.  They determine what needs to be spent down, and what steps you need to take for estate recovery.  There are also considerations for post-eligibility estate planning as well.  There are so many nuances to the law for each specific situation, such as considering what happens if the healthy spouse passes prior to the nursing home spouse, so it really is imperative to have a specialist to make sure there are no surprises down the road.  You want to leave yourself and your estate in the best situation possible in regards to taxation, etc.

What is Divestment and how is that associated with Elder Law?

It helps to think of it in terms of gifting, because you are not getting anything in return for the asset you transfer.  It’s problematic because it can be a barrier to qualifying for Medicaid.  Currently there is a 5 year period prior to eligibility that you cannot conduct these transactions.  An elder law attorney will be able to do things on the front end to make sure you aren’t losing your option for Medicaid.  There are many mitigating actions if this isn’t done correctly from the start, but it takes more time and money than if you did it the right way from the beginning.

Can Financial Powers of Attorney be helpful in the context of Elder Law?

Yes, many times the spouse who has all or part of ownership, isn’t able to administer it themselves, so someone else will need to do it for them.  Many of the pitfalls can be alleviated with a well drafted Financial Power of Attorney.

Are there times when a court guardianship may be necessary?

In cases of abuse, this frequently happens.  If there is mismanagement , there isn’t any family to handle the responsibility or even if there is a dispute about the existing Financial Powers.  It is always a last resort when there are problems with the administration of the directives.

Can having all the documentation in place ahead of time avoid Probate court?

Yes, and no, but while you are already putting steps into place, there is no harm in putting probate avoidance tactics into place.  Good advanced directives and financial power of attorney documents can go a long way in avoiding probation.

Will Medicare cover Long Term Care?

Medicare was not designed for long term care.  It is rehabilitative, and designed to help short term with injury or illness.  It doesn’t have the funds to pay for it ether.  The chronic issues that require custodial care are generally not going to be covered by Medicare.  Lawyers, discharge planners, and geriatric case managers can all be helpful in navigating these complex issues.  If you need monitoring of the care provided, these case managers can be extremely helpful.  It’s as if they are your eyes and ears on the ground, when you can’t always be present to intercede for your loved one.

You can pay your relatives to provide care for you.  Many times it has to be structured and done at fair market value, but there is no reason not to utilize it.  You cannot give away money to your children, but you can pay for them to take care of your, without ruining your eligibility.  

What does the future of Elder Care look like?

Baby boomers are just now starting to retire.  Government is trying to get out of the business of providing long term care.  So, there are lots of changes on the horizon.  As more people become eligible, it may bring down the cost of providing care.  It’s important to have funds available to get yourself into an institution, if necessary.  Families are becoming more fractured and living in different locations, so more than ever we will be dependent on these types of programs.  The spectrum continues to swing back and forth between, people needing help and private planning for the financial burdens associated with these services.

Resources:

You can reach Andrew at [email protected]

NAELA - National Association of Elder Law Attorneys

lawyers.com - referrals

Local bar association can provide referrals

Alzheimers Associations will have referral lists

Consult neighbors and friends for referrals 

Andrew speaks and the NAELA chapters and the Local Bar Association in the Milwaukee area.

Got questions about elder law?  Send them to [email protected].  We will address them in future episodes.

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