VETERANS BENEFITS - Part 2

Co-Payments

There are no costs for certain veterans and low-income veterans. The following veterans are eligible to receive cost-free health care benefits automatically:

-A service-connected veteran receiving VA compensation benefits
-A veteran seeking care for a specific service-connected disability
-Former POWs
-Purple Heart Medal recipients
-A veteran with conditions related to exposure to herbicides during the Vietnam-era, ionizing radiation during atmospheric testing, ionizing radiation during the occupation of Hiroshima and Nagasaki
-A veteran who sustained a service-related condition while serving in the Gulf War, in combat in a war after the Gulf War, or during a period of hostility after November 11, 1998
-A veteran with military sexual trauma
-A veteran with cancer of the head or neck caused by nose or throat radium treatments given while in the military
-A veteran who is participating in a VA approved research project

If you don’t fit into one of those categories, the VA will ask you to provide your household income and net worth from the previous year. If your income is below certain thresholds, you will not have to make a co-payment. In addition, you must not have more than $80,000 in property. Those whose income exceeds the threshold or who refuse to submit to the means test may have to make a co-payment.

Unlike the Medicaid program, there is no penalty for transferring assets before applying for veterans benefits, including long-term care. Remember, however, that if you do transfer assets it may affect your eligibility for Medicaid.

Even if your income is above the threshold, you do not have to make co-payments for the following services:

-Special registry examinations offered by the VA to evaluate possible health risks associated with military service
-Counseling and care for sexual trauma
-Compensation and pension examination requested by the Veterans Benefit Administration
-Care that is part of a VA-approved research project
-Out-patient dental care
-Readjustment counseling and related mental health services for Post Traumatic Stress Disorder
-Emergency Treatment at other than VA facilities
-Care for cancer of the head or neck caused fro nose or throat radium treatments given while in the military
-Publicly announced VA public health initiatives, i.e. health fairs
-Care related to service for veterans who served in combat or against a hostile force during a period of hostilities after November 11, 1998
-Laboratory services such as flat film radiology services and electrocardiograms

Out-patient co-payments
The following are the out-patient co-payments for non-service-related conditions:

-Services provided by a primary care clinician are $15 (in 2008) for each visit
-Services provided by a clinical specialist are $50 (in 2008) for each visit

Preventive care services (such as screenings and immunizations) are free.

In-patient co-payments
The inpatient co-payment is calculated by adding:

-$10 per day of hospitalization (in 2008), and
-$1,024 for the first 90 days of hospitalization and $512 for each additional 90 days (in 2008).

There is a reduced co-payment rate (20 percent of the full in-patient rate) for certain individuals whose income is above the VA income thresholds, but below the Geographic Means Threshold (GMT).

Prescription co-payments
Prescription co-payments are charged only for out-patient treatment. The following veterans do not have to pay anything for medications:

-A veteran who is 50 percent disabled or more with a service-connected disability
-A veteran who has been determined by the VA as unemployable due to his service-connected conditions
-A veteran who needs medication to treat a specific service-connected disability
-Former POWs
-A veteran whose income is below the maximum annual rate for a VA pension
-A veteran who needs medication to treat conditions related to a veteran’s exposure to herbicides during the Vietnam era ionizing radiation during atmospheric testing, or ionizing radiation during the occupation Hiroshima and Nagasaki
-A veteran who served in the Gulf War, in combat after the Gulf War, or during a period of hostility after November 11, 1998, and who needs medication to treat a service-related condition
-A veteran who needs medication to treat a military sexual trauma
-A veteran with cancer of the head or neck caused by nose or throat radium treatments given while in the miliary
-A veteran participating in a VA approved research project

If you don’t fit into one of these categories, you must pay $8 (in 2008) for each 30 days or less supply of medication. If you are in one of the Priority Groups 2 through 6, there is an annual limit on the amount you have to pay for prescriptions. You will not be charged more than $960 during the calendar year. If you are in Priority Groups 7 and 8, you will have to pay the full co-payment amount, with no annual limit.

The Medicare prescription drug benefit
As part of the new Medicare law enacted in December 2003, Congress added a modest prescription drug benefit, which took effect January 1, 2006. The benefit is available to anyone who is eligible for Medicare Part A or B coverage. The benefit is completely voluntary, so you must decide whether you want to participate in a plan or not based on your own situation. If you decide to participate in the Medicare plan, your VA prescription drug coverage will not be affected.

Most Medicare beneficiaries must choose a plan or be subject to significant financial penalties for late enrollment. However, because the VA prescription drug coverage is considered “creditable coverage,” you will not face a penalty if you do not sign up for the Medicare plan. If you disenroll or lose your VA prescription drug coverage, you will have 62 days to sign up for a Medicare plan without being subject to a penalty.

Long term care co-payments
The first 21 days of long term care are free. Co-payments start on the 22nd day. Long term care co-payments are calculated differently from other co-payments - they are set based on the individual veteran’s financial status. Veterans must fill out a financial assessment to determine their co-payments. This is a separate form from the form veterans had to fill out to determine if they were eligible for free health care. This form assesses your current income as opposed to the previous year’s income. The co-payment will be adjusted for each individual veteran based on his or her ability to pay. Once you have submitted a form, a social worker will contact you to let you know how much your co-payments will be.

What to do if you can’t afford co-payments
There are several options if you cannot afford your co-payments. One option is to request a waiver. You will have to submit proof that you can’t financially afford to make payments to the VA.

If your income changed since you applied for free health care, you can request a hardship determination. This will change your priority group assignment. To do this, you will need to provide current financial information to the VA.

Another option is to request a compromise and make a partial payment. Most compromise offers that are accepted must be for a lump sum payment payable in full 30 days from the date of acceptance of the offer.

Source: www.elderlawanswers.com

VETERANS BENEFITS - Part I

Medical Care
The Veterans Administration (VA) provides health care benefits to veterans. The plan covers a number of health care services, including preventative services, diagnostic and treatment services, and hospitalization. It may also cover nursing home and other long term care options.

Who is Eligible?
To receive care, most veterans must be enrolled in the VA health system. Eligibility for the health system depends on a number of factors, including the nature of your discharge from military service, your length of service, whether you have service-connected disabilities, your income level and available VA resources, among others.

To be eligible, you must not have been dishonorably discharged from the military. Your length of service may also be important. Former enlisted persons who started active duty before September 8, 1980, and former officers who first entered active duty before October 17, 1981, do not have a length-of-service requirement. Otherwise you must have 24 months of continuous active duty military service, though there are several exceptions for reservists, national guard members, service-connected disabilities, and hardship discharges, among others.

Certain veterans do not need to be enrolled in the VA health system to receive benefits if: you are 50% or more disabled from a service-connected disability, you are seeking care for a VA rated service-connected disability, or it has been less than one year since you were discharged for a disability that the military determined was caused or aggravated by your service, but the VA has not yet rated the disability.

The VA has limited resources, so if you are eligible for services, you will be assigned to a priority group. The priority groups range from 1-8 with 1 being the highest priority for enrollment. As of Jan. 17, 2003, veterans assigned to priority 8 are not eligible for enrollment or care for non-service connected conditions.

What is Covered
The standard benefits package includes: Preventative care services, out-patient diagnostic and treatment services (including mental health and substance abuse treatment), in-patient diagnostic and treatment services, prescriptions, and long term care (including nursing home care for some veterans).

Long Term Care: The VA offers a number of long term care options through its health plan.

All enrolled veterans are eligible for the following services:

-Geriatric evaluation - provides either an in-patient or out-patient evaluation of a veteran’s ability to care for him or herself
-Adult day health care - a therapeutic day care program that provides medical and rehabilitation services to veterans
-Respite care - provides either in-patient or out-patient supportive care for veterans to allow caregivers to get a break
-Home care - nursing, physical therapy and other services provided in the veteran’s home
-Hospice/palliative care - provides services for terminally ill veterans and their families

Some services are limited to certain veterans: nursing home care and domiciliary care are not automatically available to all veterans enrolled in the VA health plan.

The following veterans automatically qualify for unlimited nursing home care:

-Veterans who are seeking nursing home care for a service-related condition
-Veterans with a service-connected disability rating of 70% or more
-Veterans who have a service-connected disability of 60% and are unemployable

A service-connected disability is a disability that the VA has officially ruled was incurred or aggravated while on active duty in the military and in the line of duty. The VA must rule that your illness/condition is directly related to your active military service, and it assigns each disability a rating. The ratings are established by VA regional offices around the country.

The VA may provide nursing home care to other veterans if space permits. Veterans with service-connected disabilities receive priority.

There are also state-run veteran’s nursing homes. The VA provides funds to states to help them build the homes and pays a portion of the costs for veterans eligible for VA health care. The states, however, set eligibility criteria for admission.

A Domiciliary is a VA facility that provides care on an ambulatory self-care basis for veterans disabled by age or disease who are not in need of acute hospitalization and who do not need the skilled nursing services provided in a nursing home. Domiciliary care is available to low-income veterans with a disability.

Careful planning by a knowledgeable elder law firm is crucial in applying and becoming eligible.

Part 2 will discuss Co-Payments.


Source: www.elderlawanswers.com

Learn the Ins and Outs of Being an Executor or Trustee

Learn the Ins and Outs of Being an Executor or Trustee

Taking on the job of executor or trustee is not a role to be taken lightly. If you ignore certain problem signs, you could be setting yourself up for aggravation, red tape, years of work, angry battles with family members and even lawsuits, according to an article on the MSN Money Web site.

"I think people would be shocked to know what's often involved", is often stated by many elder law attorneys.

"Often the most difficult part is not dealing with the money or the lawyers or the courts; It's the personal property. People have been known to fight over Tonka toys."

An executor is a person designated in a will to see that the deceased's last wishes are carried out and to settle the deceased's probate estate. An executor's job typically lasts from a few months to two years. If you're asked to be the trustee of an ongoing trust, by contrast, your job could go on for decades. A trustee is in charge of investing the money in the trust, making distributions and filing tax returns. Attorneys say the trustee's job is often harder and has the potential for more conflict.

"If you're held to have mismanaged the trust, then you're held personally responsible, you're required to make the trust whole out of your own pocket." Executors can be sued as well.

All this doesn't mean you should necessarily say no when asked to be an executor or trustee. Very few wills or trusts are contested in court -- fewer than 3 percent -- and a competent elder law attorney can help guide you.

But the article identifies a number of red flags that should prompt you to think twice before saying yes:


You can't obtain a copy of the will or trust to read beforehand. Browning recommends that you also sit down with the lawyer who drafted the document to discuss your duties and the situation you're likely to face.

Someone's being disinherited

There is already family tension

The person who's asking you isn't well organized

The trust was created with a kit or software rather than by a lawyer

You're being put in charge of a sibling's money.

Source: MSN Money article, 6/08.

ESTATE TAX LEGISLATION UPDATE

Earlier this year (March 13, 2008), the Senate voted on four amendments to the estate tax that were filed as a part of the budget resolution debate. As background, the budget resolution gives Congress non-binding fiscal guidelines for the upcoming year. These budgetary guidelines are passed by a simple majority, rather than the 60 votes it takes to survive a filibuster and pass a bill. Given the non-binding nature of the budget resolution and the amendment, they can only serve as an indication of what the Senate might do when voting on actual estate tax reform legislation.

Senator Baucus (D-MT) proposed the first amendment, which prevents the estate tax from rising above the 2009 levels ($3.5 million exemption and a top estate tax rate of 45%). Senator Baucus’ amendment passed the Senate with a vote of 99-1.

Senator Caucus’ amendment was followed by an amendment proposed by Senator Graham (R-SC) that provided for a $5 million exemption and a maximum estate tax rate of 35%. The Senate voted against this amendment 47-52.

Senator Ken Salazar (D-CO) introduced an amendment that was “revenue neutral,” by setting aside reserve funds in order to reach a $5 million exemption with a 35% maximum estate tax rate. The Salazar amendment failed by a vote of 38-62.

The final amendment was proposed by Senator Jon Kyl (R-AZ) and it set the exemption at $5 million with an estate tax rate of no higher than 35%. Senators Lincoln (D-AR) and Landrieu (D-LA) joined the Republicans in the voting with Senator Voinovich (R-OH) voting with the Democrats. This amendment failed with a 50-50 vote because the Vice President was not present to break the tie.

The Senate Finance Committee also held the second of three planned estate tax hearings, this one discussing the inheritance tax regime versus the current estate tax regime. While none of the Senators present seemed receptive to the idea of an inheritance tax, all of the witnesses at the hearing expressed philosophical support for wealth redistribution through an inheritance tax system.

Despite the national attention given to estate tax reform in general, there has been a dramatic reduction in the number of estate tax returns filed. The IRS Statistics of Income Bulletin (IR 2007-153) indicated that in 2005, when the estate tax exemption was $1,500,000, the number of estate tax returns filed fell by 58% to about 45,000 returns, down from about 108,000 returns filed in 2001. The total amount of assets represented by those returns fell by 14% to $185 billion in 2005 and from $216 billion in 2001.

Medicaid Announces Resource Level Revision

Recently, Medicaid announced that they are raising the Resource Level to $13,050 for a single individual and to $19,200 for a couple on Medicaid.

The increase of the Medicaid resource allowance from $4,350 to $13,050 for a single individual (and from $6,400 to $19,200 for a couple) may make it more possible for some individuals and couples to qualify for Medicaid and to access Medicaid nursing home and home care services.

Income Tax Deductions for Families with Special Needs Children

Deduction for Dependents. The most common, and often the most important, income tax benefit is the deduction provided for an individual who is dependent on you for support. Of course minor children, whether suffering from a disability or not, provide dependent deductions. Not all parents realize that adult children with a disability can also qualify as dependents for income tax purposes, as well.

In fact, not only children of the taxpayer qualify as dependents. A stepchild, foster child, grandchild, nephew, niece or sibling can also be a dependent. The taxpayer must provide more than half of the dependent's support, and the dependent's own income can not exceed the exemption amount ($3,400 for tax year 2007, and $3,500 in 2008).

If a married but dependent child files a joint income tax return, he or she can not qualify as a dependent on your return. Similarly, if he or she is not a U.S. citizen or resident, or a citizen of Canada or Mexico, the dependent deduction is not available.

There are a few other categories available, so even if the dependent is not described here it may be worth making further inquiry. The key element: if you provide more than half of the support for another person, you may be able to list them as a dependent on your tax return.

Medical Conferences and Seminars. Did you attend a specialized program to learn more about your child's disability and treatment? If so, you may be able to deduct the registration fees and travel costs as medical expenses. To perfect this deduction, you should have your child's doctor give you a written recommendation for the seminar. Make sure the program is specific to the condition from which your child suffers, as a general program about healthy practices or living will not qualify.

School Expenses. If your child attends a special school designed to prepare him or her to compensate for or overcome a disability, the school costs may be a deduction. The key element here is that the program must be specifically geared toward helping your child prepare for future mainstream education or living arrangements. It is not enough that the school is specialized and offers supportive and focused education. If, however, the school is properly focused tuition may qualify as a medical deduction.

Remember that all medical deductions must exceed 7.5% of your income before the deduction is available at all (for federal tax purposes -- state taxes may have different limits or no limitations). What kinds of specialized schools qualify? The IRS has provided a few specific examples, including Braille or lip reading programs, focused training programs for the developmentally disabled, boarding schools for the psychologically disabled and staffed by psychiatrists, psychologists and social workers.

Work Expenses. Do you suffer from a disability yourself? Does your child earn enough income to be required to file an income tax return? You might need to consider deductions for expenses that enable the person with disabilities to maintain employment.
Deductions in this category might include attendant care or adaptive equipment. The most important element: these expenses are categorized as unreimbursed employee expenses, not medical expenses. That means they are not subject to the 7.5% limitation on the latter category.

Conclusion: These are only a few of the income tax deductions available to individuals with disabilities and the family members who provide their support. If you have questions about the specifics of any of these, you should contact your accountant or an attorney familiar with income tax and disability issues.

Another important resource: the Internal Revenue Service website. Perhaps surprisingly, it is helpful, easy to navigate and well constructed. One good entry point: the IRS "frequently asked questions" (FAQ) page.

Source: www.specialneedsalliance.com

Legislation to Protect the Elderly

Governor David A. Paterson announced the signing of legislation to help
curb predatory attacks on New York's elderly. Governor Paterson was joined for the bill signing at St. Margaret’s House on Fulton Street by Assembly Speaker Sheldon Silver and several members of the State Legislature, which overwhelmingly approved the legislation.

The law, known as “Granny’s Law,” was sparked in part by last year’s brutal beatings of 101-year-old Rose Morat and 85-year-old Solange Elizee of Queens. If an assailant is 10 years younger than a victim, the bill will increase the penalty for assaulting a person 65 years or older from a class A misdemeanor to second-degree assault – a Class D violent felony that is punishable by up to seven years in prison. “It is unconscionable that anyone would assault a senior citizen, but we continue to witness these disturbing acts of violence,” said Governor Paterson. “

I am pleased that my colleagues in the Legislature worked together to pass
this legislation, and that this bill provides a measure of safety for our
elderly.” Under current law, an intentional assault that causes physical injury to the victim constitutes third-degree assault, a Class A misdemeanor punishable by up to one year in jail. The charge is elevated to second-degree assault if there are certain aggravating factors, such as intentionally causing “serious”physical injury, intentionally causing physical injury with a deadly weapon, or causing injury to particular types of victims (i.e. police or peace officers, students, or teachers) who are more likely to be targeted by criminals.

Senate Majority Leader Joseph L. Bruno said: “Last year, 101-year-old Rose Morat and 85-year-old Solange Elizee were brutally attacked within a half-hour of each other, and New Yorkers were outraged by the cowardly, despicable act. As elected officials, our biggest responsibility is protecting our most vulnerable citizens, and I’d like to commend Senators Golden, Maltese, and Padavan for their tireless dedication in getting this legislation passed and signed into law. It’s truly horrendous when criminals seek out and assault the elderly – with this law we are ensuring they will be properly punished.”

Assembly Speaker Sheldon Silver, who sponsored the legislation in the
Assembly, said: “This legislation is a simple matter of dignity, justice and
respect. After lifetimes spent working jobs, raising their families, paying their taxes, serving their communities, and defending this nation, our senior citizens deserve all of the respect, all of the protection, all of the compassion, and all of the assistance this government can provide. The enactment of this law puts New York at the forefront of ensuring that those who prey upon the elderly and the frail are punished swiftly and severely.” Senator Martin Golden, the bill’s lead Senate sponsor, said: “Millions of New Yorkers were outraged by the despicable and cowardly attacks against Rose Morat and Solange Elizee. A person capable attacking the elderly is not simply a mugger – they are a dangerous menace to society who should be kept behind bars for as long as possible. The bottom line is that anyone who physically attacks a senior citizen should be severely punished, and that’s why the additional penalties provided for by this law are very much needed.” Senator Serphin Maltese said: “We cannot allow seniors to be targeted and assaulted simply because they are not physically able to defend themselves. When
anyone gets mugged and assaulted, I consider it to be a serious crime, but assaulting the elderly is an outrageous and potentially life-threatening crime that clearly calls out for more severe penalties. We have an obligation to protect the most vulnerable in our society.”

Senator Frank Padavan said: “Last year the brutal muggings of my constituents Rose Morat and Solange Elizee sparked outrage across the entire country and illustrated the need for stronger state laws to combat crimes against elderly. Now with the enactment of 'Granny’s Law' today, New York will have the criminal penalties needed to put any cowardly delinquent who attacks a senior citizen behind bars.” Assembly Codes Committee Chair Joseph R. Lentol said: “This legislation sends
a message in New York we intend to protect our seniors from those who seek to prey on our most vulnerable citizens.” Assembly Judiciary Chair Helene Weinstein said: “Seniors often appear as soft targets for criminals. Like all citizens, they must be afforded the protection to live and work safely, and to enjoy retirement and family after years of hard work without falling prey to those who may cruelly exploit their age. With the enactment of this legislation, New York helps ensure our seniors that
the law stands with them and that crimes against them are recognized for
their sheer brutality and senselessness.” Assemblywoman Janele Hyer-Spencer said: “Elder abuse should not be tolerated, and these measures take steps to stop this shameful behavior. Our seniors deserve, at the very least, peace of mind. We must do all we can to protect them and to provide them with that peace of mind, and one way to do that is to
deter potential crimes from occurring.”