The Benefits of Immediate Annuities An immediate fixed annuity may be the answer for those seeking a steady stream of income in retirement. When you purchase an immediate fixed annuity, you give a lump sum to an insurance company. The insurance company then pays you a set amount each month for the rest of your life… read more →
As I reported here and here, federal district and appellate courts in Pennsylvania have ruled that an annuity purchased with a couple’s excess resources and payable to the community spouse is not countable in determining the institutionalized spouse’s eligibility for nursing home Medicaid benefits. Recently, an administrative court, for the first time, reached the same.. read more →
A New Jersey appeals court recently determined that a Medicaid applicant is not entitled to a fair hearing to appeal the state’s assessment of a one-month penalty period because her representative waited more than three months after the decision to request the hearing. Talarico v. Department of Human Services, Division of Medical Assistance and Health.. read more →
The U.S. District Court for the Western District of Pennsylvania, in a case entitled Weatherbee v. Richman, ____ F. Supp. _____ (C.A. No. 07-134, January 22, 2009), has issued an opinion essentially following the reasoning of the United States Court of Appeals of the Third Judicial Circuit in James v. Richman in a case involving an.. read more →
In a recent study, “Three Phases of Retirement and Planning for the Unexpected,” the Society Of Actuaries (SOA) identified three stages of retirement and offered advice on how to prepare for each stage of retirement. The SOA said that retirement is often depicted as life on the golf course, holidays with the grandchildren, and traveling.. read more →
As I reported in a blog post in October at https://vanarellilaw.com/2008/10/07/nj-judge-recently-ruled-that-a-medicaid-applicants-prepayment, ALJ Paone ruled, in a case entitled C.S. v. Division of Medical Assistance and Health Services and Union County Board of Social Services, that Medicaid applicants who prepaid for personal care services to be provided in the future by family members under Life Care Contracts were ineligible for.. read more →
An annuity is a type of insurance product in which an insurer, in exchange for charges (akin to premiums), makes a series of income payments at regular intervals over a set period. Senior citizens and other consumers often obtain annuity coverage for use as future retirement income. Because nearly $15 trillion dollars is invested by.. read more →
The The Times Leader newspaper, a daily newspaper located in Wilkes-Barre, Pennsylvania, recently posted a report on its internet homepage on the James vs. Richman lawsuit. The James case was originally filed in federal district court in Pennsylvania, and concerned an application for Medicaid benefits submitted by Pennsylvania residents. The James case substantially changed the.. read more →
The pace of decisions in Medicaid appeals has picked up recently, with several significant decisions being rendered in courts and administrative agencies in New Jersey. As a result, there has been a spike in interest by attorneys who seek to identify and understand the estate planning strategies that can successfully accelerate eligibility for Medicaid benefits.. read more →
What emerging case law is demonstrating about Medicaid planning techniques: SITUATION PLANNING TECHNIQUE Applicant does not have a community spouse Use a promissory note with a “gift and loan” strategy. G.L. v. DMAHS, Docket No. HMARP 05080-2008N (Middlesex County), Final Agency Decision Oct. 23, 2008. Applicant has a community spouse Use funds above the resource.. read more →
In James v. Richman, 465 F.Supp.2d 395 (M.D.Pa. 2006), aff’d, 547 F.3d 214 (3rd Cir. 2008), an institutionalized spouse who was a nursing home resident brought a lawsuit against the Pennsylvania Department of Public Welfare (DPW) alleging that the DPW’s decision to deny his eligibility for Medicaid benefits violated the federal regulations governing annuities under.. read more →
In E.S. vs. Division of Medical Assistance and Health Services, petitioner, a 91 year old nursing home resident, transferred $42,053 to her son after paying the nursing home privately from her savings for two years. The nursing home payments and the gift combined to leave petitioner with no assets, so she applied for Medicaid. The.. read more →
This year, the National Academy of Elder Law Attorneys held its Advanced Institute in Kansas City, Missouri from October 23 – 26. The program-of-events-10-31-08 shows that the presentations at the Institute covered a wide array of subjects. I attended two terrific sessions on the eligibility criteria for Veterans Administration (VA) service-related compensation benefits and non-service.. read more →
As I reported in a May 22, 2008 blog posting several months ago, I received a denial notice from the Middlesex County welfare agency in a case in which the applicant’s Medicaid eligibility plan involved making a loan to a relative. The borrowing relative signed a promissory note agreeing to repay the note in monthly installments, including.. read more →
Updated Figures for 2009. The Centers for Medicare & Medicaid Services (CMS) has released the community spouse resource allowance and the maximum monthly maintenance needs allowance for 2009. The new minimum CSRA is $21,912 and the new maximum is $109,560. The new maximum monthly maintenance needs allowance is $2,739. The minimum monthly maintenance needs allowance.. read more →
On September 30, 2008, NJ Administrative Law Judge Stephanie M. Wauters issued a written opinion in a case entitled E.S. vs. Division of Medical Assistance and Health Services and Monmouth County Board of Social Services, OAL Docket No. HMA 14-08, ruling that the payments to a nursing home for care by a Medicaid applicant’s son.. read more →
In a trio of cases which were consolidated because the cases presented a common question of law, NJ Administrative Law Judge Joseph A. Paone recently ruled that a Medicaid applicant’s prepayment for personal care services to be provided in the future by a family member under a Life Care Contract constituted a transfer of assets.. read more →
A New York appeals court held that a community spouse is entitled to an increased minimum monthly maintenance needs allowance (MMMNA) because her basic monthly expenses are almost double her monthly income and therefore qualify as “exceptional circumstances” necessitating access to her husband’s income. Matter of Balzarini v. Suffolk County Dept. of Social Servs. (N.Y… read more →
The Center for Medicare and Medicaid Services (“CMS”) states that the Deficit Reduction Act of 2005 (Pub. L. No. 109-171, 120 Stat. 4, 151) (“DRA”) does not permit a person to receive benefits under a Medicaid waiver program (including assisted living facility Medicaid) if there has been a transfer of assets within sixty months of the.. read more →
The U.S. Department of Health and Human Services has issued a new notice addressing the problems that occur when a Medicaid applicant purchases a long-term care insurance “partnership” policy in one state and then applies for Medicaid in another state. See, 73 Fed. Reg. 51302-51305 (2 Sept 2008), available here. The Deficit Reduction Act of.. read more →
New Jersey’s Office of Administrative Law recently issued a significant ruling that may make it easier to qualify for Medicaid. In K.R. vs. Somerset County Board of Social Services, O.A.L Docket No. HMA 12343-07 (Aug. 25, 2008), New Jersey’s Office of Administrative Law ruled that an account titled to a Medicaid applicant “or” another person.. read more →
The Deficit Reduction Act of 2005 (“DRA”) authorized the expansion of the Long Term Care Insurance Partnership Program into the various states. New Jersey’s Long Term Care insurance Partnership Program was approved by the Center for Medicare and Medicaid Services (“CMS”) on February 12, 2008 and will become effective on July 1, 2008. Under this.. read more →
I recently received a denial notice from the local Medicaid agency in a case in which the applicant’s Medicaid estate plan involved making a loan to a relative. The borrowing relative signed a promissory note agreeing to repay the note each month at a regular payment amount with included a reasonable interest rate. The note.. read more →
The federal Deficit Reduction Act of 2005 (DRA), which became effective on February 8, 2006, made major changes to the federal Medicaid law. One such major change in the federal law is in the treatment of annuities owned by the spouse of a Medicaid applicant (called the “Community Spouse” in the law) . Under the.. read more →
An administrative law judge has concluded that an individual who is trying to avoid nursing home care by applying for home- or community-based coverage under a Medicaid waiver program, but who has made a transfer during the look-back period, must have the penalty period begin on the date on which the applicant would otherwise be.. read more →
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