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Elder LAW

Our clients often have questions about how to pay for their long-term care.
Their focus may be:

  1. to remain in their home as long as possible;
  2. to avoid nursing home care by going into the many options for assisted living;
  3. to make plans if one spouse needs assisted living or nursing home care and the other wants to stay at home;
  4. to plan for a possible decline in health, so they won’t burden their family.

We will take time to answer your questions and explain the Medicare benefits that are available for long-term care.  They are very limited.  We will explain how you qualify for Title 19 payments for long-term care costs.  Title 19 is basically a welfare program and is available only to those with limited income and property.  There are many stumbling blocks.  You need to be very careful in what you do and the planning steps you take.  We will review your options with you including long-term care insurance.  We will review your estate plan.  Specifically, we will discuss with you the use of a revocable living trust for your protection in the case of incapacity.  This trust will also prevent Wisconsin from collecting what they have paid for Title 19 benefits from your estate after your death. 

The number one mistake is not planning early enough.  The earlier you plan, the better the result.  This is especially true with the new Title 19 rules which were fully implemented in Wisconsin in 2008.  These are some of the changes that were made:

  1. Basically, any person or couple (other than a spouse of a person in a nursing home) with equity in a home of more than $750,000 will be barred from getting Title 19.  There used to be no limit.
  2. Wisconsin will look for prohibited asset transfers (divestments) during the five years before an application for Title 19 (look-back period).  That’s a change from three years.
  3. If there are any divestments during the look back period, the applicant will not get Title 19 coverage until the expiration of a penalty period beginning on the date of the application for Title 19.  This is a substantial rule change.  The penalty period used to start on the date of the transfer.  More people will be barred from getting benefits as a result.
  4. There are significant limits on the use of annuities.
  5. The formula for calculating the penalty period changed so they will be longer.
  6. The purchase of loans, promissory notes, or mortgages will be banned unless there are sound repayment terms including equal payments without deferrals or balloon payments. 
  7. The purchase of a life interest in the home of another person will prevent the receipt of Title 19 unless the purchaser actually resides in the home for at least one year.

What does this mean for you?

  1. Do not wait to do Title 19 planning.  See an elder law attorney immediately.
  2. There is a lot of confusion.  Not everything is clear. 
  3. Do not make any gifts without consulting us.  This includes:  birthday, holiday and charitable gifts.

What do you do in the meantime?

  1. Purchase long-term care insurance.  The long-term care insurance market has grown over the years and offers a wide array of choices and options.  For example, there are long-term care insurance policies that return a portion of the premiums to your designated beneficiaries at your death if you have not used it.
  2. Look into a reverse home mortgage.  The lender pays a monthly amount to you during your life.  The mortgage is paid after you die.  The costs of getting this mortgage are relatively high, but it is a way of paying for long-term care without selling your home.  The size of the monthly payment depends on the amount of equity that you have in your home and your life expectancy.
  3. Keep track of all gifts and donations.  Keep checks, invoices, and receipts.
  4. Document all transactions with relatives.  Doing this may allow you to prove that there was no gift or divestment.  You should get an appraisal.