In your estate plan, if you are like most people, you want to make sure that you are in control while you are alive and well, that you and your loved ones are provided for when you are alive and not so well and when your gone, give what you have to whom you want, the way you want, when you want.
Your health plays a huge role in the type of planning that you can do or that your family can do for you. You have worked hard all your life to get what you have. Do you want to protect those assets for you and your loved ones?
If you are alive and well and of sound mind, you can prepare documents to provide for your care during your incapacity and also your asset distributions after you are gone. When you are alive and not so well, you may want to make sure that your instructions are going to be followed, that you are in an appropriate residential setting and your healthcare and other needs are covered.
At a minimum, everyone should have a Will, a Financial Power of Attorney and Durable Power of Attorney for Health Care. Your financial and healthcare powers of attorney will prevent the necessity of going into court for a Conservatorship or Guardianship upon your incapacity.
You may have estate planning documents that are triggered upon your incapacity in the opinion of medical professionals or loved ones. Upon that determination of your incapacity, you can convey a number of powers to your healthcare and financial agents in order to take care of you and your stuff. If you are already old and funny and mentally incapacitated and have done no planning, this limits the type of planning that can be done for you.
If you require nursing home care, do you want to preserve and protect your assets for your spouse who is still living at home or for your loved ones after you are gone? Regardless whether you are single or married, Federal and State legislators have provided you with a number of tools to pay for your nursing home care that you can use to preserve and protect your hard earned assets for your loved ones.
Healthcare issues may also effect what type of coverages that you receive from your Medicare plan. For example, what if you had a medical condition which required inpatient rehabilitative care? Depending on your Medicare plan, your rehabilitation may not be covered. Regular Medicare Part A allows up to one hundred days rehabilitative care, so long as there is a break of at least sixty days since your last coverage for rehabilitative care.
I reviewed one Medicare Part C Advantage Plan which only allowed one period of rehabilitative care of up to one hundred days each year. Another Medicare Part C Advantage Plan allowed for only twenty days of rehabilitative care. Most Medicare Part C Plans change every year, so the coverage that you have this year is not the same coverage that you had last year.
Similarly with Medicare Part D prescription coverages. Depending upon the prescriptions you are taking, the prescription coverage that you have this year could be substantially different than the coverage that you had in the same plan last year.
If you are like most people, you do not want to be placed in a nursing home when you could be at home taking care of yourself. I have encountered more than one case in which a senior was on multiple medications, appeared to be suffering from dementia and was cared for as such in a nursing home setting.
After the patient was weaned off a number of their prescriptions, they came out of their “dementia” fog. It is impossible for pharmaceutical companies to test the side effects of the millions of possible combinations of drugs. Would you want to have spent your life savings on nursing home care when it possibly could have been avoided?
Elder law attorneys deal with these and many other healthcare issues on nearly a daily basis. To make sure that your wishes will be followed, it is important that you and your loved ones understand these and similar healthcare issues.
By: Matthew M. Wallace, CPA JD
Published edited January 10, 2010 in The Times Herald newspaper, Port Huron, Michigan as: Health care issues critical in estate planning