Protect Assets from Medicaid Recovery

Medicaid is a government program used by Americans to pay long-term care, typically for nursing homes or in-home care.   What some people don’t realize is that Medicaid seeks reimbursement for money spent on someone’s behalf after they pass away.  The Medicaid Estate Recovery Program (MERP) is used to recoup costs paid toward long term care, so that the program can be more affordable for the government, says the article “What is Medicaid Estate Recovery?” from kake.com. Beneficiaries of Medicaid recipients are often surprised to learn that this impacts them directly, and are even more surprised that you can protect assets from Medicaid recovery with some planning.

Medicare was created to help pay for healthcare costs of Americans once they reach age 65. It covers many different aspects of healthcare expenses, but not costs for long-term or nursing home care. That is the role of Medicaid.

Medicaid helps pay the costs of long-term care for aging seniors. It is used when a person has not purchased long-term health care insurance or does not have enough money to pay for long-term care out of their own funds.  Medicaid is sometimes used by individuals who have taken steps to protect their assets in advance by using trusts or other estate planning tools.  See here for more detail.  https://galligan-law.com/can-i-afford-in-home-elderly-care/

The Medicaid Estate Recovery program allows Medicaid to be reimbursed for costs that include the costs of staying in a nursing home or other long-term care facility, home and community-based services, medical services received through a hospital when the person is a long-term care patient and prescription drug services for long-term care recipients.

When the recipient passes away, Medicaid is allowed to pursue assets from the estate. In fact, Federal law requires the states to have such a program.  Now, this is critical to recognize, but the scope of Medicaid varies widely between what state provided the benefits.  For the most part it means any assets that would be subject to the probate process after the recipient passes. That may include bank accounts, real estate, vehicles, or other real property.  Texas Medicaid recovery is happily limited to the estate.  So, there are many options to protect assets from Medicaid recovery in Texas.

In some states, recovery may be made from assets that are not subject to probate: jointly owned bank accounts between spouses, payable on death bank accounts, real estate owned in joint tenancy with right of survivorship, living trusts and any assets a Medicaid recipient has an interest in.

An estate planning attorney will know what assets Medicaid can use for recovery and how to protect the family from being financially devastated.

While it is true that Medicaid can’t take your home or assets before the recipient passes, it is legal for Medicaid to have a claim to assets before the beneficiaries, similar to the way other creditors of a decedent must be satisfied before beneficiaries receive property.  Let’s say your mother needs to move into a nursing home. If she dies, you’ll have to satisfy Medicaid’s claim before you can take possession or will pay the claim as part of a sale.

Strategic planning can be done in advance by the individual who may need Medicaid in the future. One way to do this is to purchase long-term care insurance, which is the strategy of personal responsibility. Another is removing assets from the probate process. Married couples can make that sure all assets are owned jointly with right of survivorship, or to purchase an annuity that transfers to the surviving spouse, when the other spouse passes away.

In most cases we can advance clients on how to change the the titling of their accounts to protect assets from Medicaid recovery before the person passes away.  We may also be able to create a Medicaid Asset Protection Trust, which may remove assets from being counted for eligibility.

As a final point, clients often encounter the medicaid claim in the estate, which is the first time an attorney is involved in the process.  Now, you may not have the same options to protect assets from Medicaid recovery because you’ll have lost prospective planning, but their are exceptions to recovery and ways to defend against the claim.  They are all very time sensitive however, so you should reach out to an attorney immediately upon encountering them.

Speak with an estate planning attorney to learn how to prepare for yourself or your parent’s future needs. The earlier the planning begins, the better chances of successfully protecting the family.

Reference: kake.com (Feb. 6, 2021) “What is Medicaid Estate Recovery?”

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The Irrevocable Life Insurance Trust (“ILIT”): Why should you have one?

Irrevocable Life Insurance Trusts, or “ILITs” are irrevocable trusts which own life insurance.  ILITs are used to manage estate taxes by removing the value of the death benefit out of your estate. There are complexities to using an ILIT, but the benefits for some people could be big, according to the article “What Advisors Should Know About Irrevocable Life Insurance Trusts” from U.S. News & World Report.

What is the goal of an ILIT? The goal of an Irrevocable Life Insurance Trust is to own a life insurance policy, so the proceeds of the policy are left to heirs, who avoid estate tax. It’s a type of living trust but one that cannot be dissolved or revoked, unless the trust does not pay premiums and the insurance policy owned by the trust lapses.

The federal estate tax exemption is currently $11.58 million for individuals, and $23.16 for married couples. Most people don’t need to worry about paying federal estate taxes now, but this historically high level will not be around forever. The current law ends in 2025, cutting the exemption by half.  Most experts agree that the exemption will come down well before that time.  See here for another recent article on how to prepare for the estate tax.  https://galligan-law.com/locking-in-a-deceased-spouses-unused-federal-estate-tax-exemption/  

Who needs an ILIT?

The main advantage of an ILIT is providing immediate cash, tax free, to beneficiaries. The value of the ILIT is out of the estate and not subject to taxable estate calculations. The life insurance policy ownership is transferred from the insured to the trust. The insured does not own or control the insurance policy, but this is a small price to pay for the benefits enjoyed by heirs.

ILITs are attractive because there are not many benefits to an individual personally owning life insurance, especially term insurance.  Term life insurance has no cash value, and so is of little importance until death.  However, the death benefit is the amount applicable for estate tax.  So, even though a $2,000,000 term life insurance policy has little to no value during life, that won’t be true for your beneficiaries when they pay estate tax.

The grantor is the insured person, and the policy is purchased with the ILIT as the owner and the beneficiary. The insured cannot be the trustee of the trust. In most cases, the trustee is a family member, and the insurance premiums are paid through annual gifting from the insured to the trust. These are the details that should be explained by an estate planning attorney to maintain the trust’s legitimacy.

If all goes as planned, when the insured dies, the ILIT distributes the life insurance proceeds tax-free to beneficiaries.

How does an ILIT work?

Let’s say that you have assets worth $15 million. You buy a life insurance policy that will pay $5 million to your children. When you die, your taxable estate would be $20 million, which in 2020 would incur about $3.3 million in federal estate taxes. However, if you used an ILIT and the ILIT owned the $5 million policy instead of you, your taxable estate would be $15 million. Your federal estate tax in 2020 would be about $1.3 million. The estate would save $2 million simply by having the ILIT own the $5 million life insurance policy.

What if the estate tax exemption goes down before you die?

If the estate tax exemption goes down and you have already funded the ILIT, it remains safe from estate taxes. Here is another reason to consider an ILIT—as long as the funds remain in the trust, they are safe from beneficiary’s creditors.

Are there any downsides to an ILIT?

ILITs are not do-it-yourself trusts. They are complex and need to be structured so that the annual contributions used to pay the insurance premiums qualify for the $15,000 gift tax exclusion. To do this, an estate planning attorney will often include a “Crummy” power, which allows the insured to pay the trust for the premium, without reducing their lifetime gift tax exemption amount. However, it also means that beneficiaries need to be well-educated about the ILIT, so they don’t make any errors that undo the trust.

When a contribution is made, Crummey letters are sent to the beneficiaries, letting them know that a gift was made to the trust and they have the right to withdraw the money. However, if they withdraw the money, the insurance policy could collapse.

You’ll need to be committed to keeping this policy for the long run. You’ll need to be able to fund it appropriately.

There is also a three year look back for existing insurance policies that are moved into the ILIT, so the grantor must be alive for three years after the policy is given to the ILIT for it to remain outside of the estate. This does not apply when a new policy is established in the ILIT and does not apply if the ILIT buys the policy from the grantor.

Reference: U.S. News & World Report (Oct. 29, 2020) “What Advisors Should Know About Irrevocable Life Insurance Trusts”

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When to Take Social Security?

Kiplinger’s recent article entitled “Waiting to File for Social Security Benefits Is Hard, but Payoff Is Sweet” asks you to imagine if, when you were a child, your mom baked your favorite pie and made you an offer. She could serve you a piece of pie right then and let you eat it. Alternatively, if you waited until after dinner, you’d get a bigger slice. Or, if you could wait until bedtime, your piece would be even larger. And not just that day, but for the rest of your life.

Every time you had pie for dessert, the size of your piece would be based on the decision you made that one day.

There are many justifications for taking the smaller piece of pie right away, when offered. Many people want to begin their retirement as soon as possible, and they want or need the Social Security income to do so. Some want to claim their benefits and invest the money to further grow their nest egg. Many people are concerned that the Social Security trust fund will be depleted before they get their share.  Others are concerned about health and whether they will receive Social Security for very long. Finally, there are some who just aren’t aware of how much bigger their monthly payment could be if they waited.

While you can get your benefits as early as 62, that choice, can mean a permanent reduction in benefits of up to 30% less than what you could receive by filing at your full retirement age (FRA). Retirees who file after their FRA receive a delayed retirement credit of 8% per year until they turn 70.

Admittedly, eight years (from 62 to 70) is a long time to wait to tap into this significant income stream. Most seniors would jump at the chance for more money, particularly as many baby boomers face these challenges that could put even the best-laid income plans to the test in retirement:

Longevity. The longer you live, the greater the chance that your savings will have to endure multiple financial storms, such as increased taxes, inflation and costly health care issues as you get older. The Social Security Administration estimates that the average 62-year-old woman born in 1958 can expect to live another 23½ years, and a man with the same birthdate can expect to live another 20⅔ years. That’s a long time to have to make your money last. However, if you maximize your Social Security benefits by earning delayed retirement credits, you’ll always have that guaranteed income.

Low interest rates. In the current low-interest environment, the return on “safe” investments, such as CDs, bonds, and money market accounts, won’t protect you from inflation. Thus, one of the best investments that retirees can make right now isn’t really an investment at all, but rather it’s growing their Social Security payments by delaying to take them.

Continuing to work.  Many seniors are continuing to work  well past traditional retirement ages to make ends meet.  Taking Social Security while still working may result in devastating tax losses.  It may make sense to delay Social Security until completely retired.

Decline in employer pensions. The retirement savings system in the United States traditionally has been built on three pillars: Social Security, a workplace pension and individual savings. However, over the past two decades, many employers have stopped offering pensions. As a result, the full responsibility for retirement investing has been shifting to employees with defined contribution plans. However, 40.2% of older Americans now depend on Social Security alone for income in retirement. Only 6.8% receive income from a defined benefit pension, a defined contribution plan, and Social Security. Fidelity Investments also reports that the median 401(k) balance in the first half of 2019 was $62,000 for savers in the 60 to 69 age group.

Ask an elder law attorney who practices in Social Security matters to help you make some calculations to determine your “break-even” age, which is when you’d come out ahead by waiting instead of claiming early. If you haven’t already, sign up with the Social Security Administration to get an estimate of your retirement benefits at 62, 67, and 70, using their online benefits calculator.  You may also consider speaking with a financial advisor who can evaluate opportunities to earn greater income with money in hand with earlier Social Security.

If your objective is to land the biggest possible piece of pie — and you can manage it — waiting is the name of the game.

Reference: Kiplinger (Oct. 21, 2020) “Waiting to File for Social Security Benefits Is Hard, but Payoff Is Sweet”

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