Writing Your Tulsa Estate Planning Blog

Every few years it seems the federal government needs to do something to fix Medicare or risk running out of available funds for the program. One attempt to fix Medicare was undertaken in the early 2000s. It is now known as Medicare Advantage.

The program privatized parts of Medicare by turning things over to insurance companies. The idea was that insurers would do a better job of controlling costs in the program than the government.

Instead of doing that, however, a whistle-blower alleges that insurers have used the program to make billions of dollars from Medicare they are not entitled to, as The New York Times reports in “A Whistle-Blower Tells of Health Insurers Bilking Medicare.”

The alleged fraud is a relatively simple one.

Insurers are said to have used the medical coding system to make patients look sicker than they really are. As a result, the insurers easily collect more money from the government than they actually should.

The government has already announced plans to sue one insurer based on these allegations and more lawsuits against other companies are expected.

It is important for the government to stop this fraud, if true, and any other Medicare fraud.
The Medicare system is yet again close to running out of funds and in need of a fix. The government cannot afford to lose billions to fraud.

Reference: New York Times (May 15, 2017) “A Whistle-Blower Tells of Health Insurers Bilking Medicare.”

Studies continue to show that the how and when Americans would prefer to pass away, is not how they actually pass away. That needs to change.

Most of the time, the medical profession treats its patients in keeping with what the patients want. If someone has a broken leg, for example, then doctors set the leg, put a cast on it and let it heal.

That is what people want.

When we get sick, doctors give us the best known treatment for whatever disease we have and everyone is satisfied. However, this does not necessarily hold true when people are at the end of their lives.

What medical professionals do at the end of their patients’ lives, is not what studies suggest patients necessarily want, as The New York Times reports in “We’re Bad at Death. Can We Talk?”

The disconnect at the end of life between doctors and patients, stems from the fact that doctors are trained to do everything they can to sustain life. On the other hand, most patients would prefer to be let go with the least amount of pain and discomfort.

This leads to terminally ill patients being placed in intensive care units on artificial life support, when they would prefer to be placed in palliative care or return home so that they can pass away in peace.

This is something that needs to be addressed by the medical community.

There is something you can do about it for yourself. You can get advanced medical directives to let doctors know what you want, when you are terminally ill.

Reference: New York Times (May 10, 2017) “We’re Bad at Death. Can We Talk?”

More and more elder Americans are choosing not to get married to their partners. Instead, they are just living together.

The trend over the last few decades has been for people to get remarried late in life. This has created many issues for estate planning and the families of the people who do get remarried.

That trend is starting to reverse, but that does not mean people are not finding companionship in their retirement years.

Today, rather than getting married, many elderly people are just moving in together and foregoing a marriage certificate, according to The New York Times in “More Older Couples Are ‘Shacking Up’.”

While this might solve some problems, such as getting around the laws of intestate and spousal election to make sure that any assets go to the children and remain in the family, it does not solve all of the problems. Instead, it creates a different set of problems that need to be worked through in an estate plan.

If two elderly people are living together, it becomes important to create estate plans that do not leave one of them in a bad position when the other passes away.

You do not want to create a situation where a partner is unable to afford the rent after you pass away or gets kicked out of the property you own by your heirs.

These do not need to be major problems with proper estate planning, but they can be without that planning.

Reference: New York Times (May 8, 2017) “More Older Couples Are ‘Shacking Up’.”

How, when and where people pass away has changed in the last 100 years. Evidence suggests that people are not entirely happy about that.

A long time ago, most people passed away in their homes. There were not many hospitals or hospices for people to go to, when they were terminally ill.

There are now many of those places and most people pass away in some sort of facility.

That has been both good and bad.

People generally like that they do not die as young and from as many diseases as people used to, but most people would still rather die in their homes than in a facility, as the Economist reports in “How to have a better death.”

In fact, the majority of people are not happy that they cannot choose when and where to die. People are often given life-saving treatment by doctors that they do not want.

At other times, people with little hope of long term survival are not given the opportunity to choose the timing of their own deaths, which leads them to linger on in pain.

This is the primary reason for the movement to legalize physician-assisted suicide, which is slowly picking up steam, as more and more states consider it.

Since it will not be an option for everyone for a long time, however, it is important that people take some matters they can control into their own hands.

Everyone should have advanced medical directives, at a minimum, that dictate what procedures doctors can and cannot use to prolong their lives.

Reference: Economist (April 29, 2017) “How to have a better death.”

It is well-known and accepted that parents are required to provide care and support for their minor children. What is less well-known, is that in over half the states, adult children can be required to provide care and support for their elderly parents.

There are many laws on the books that receive very little attention because they are very rarely used. If few ever bother to attempt to enforce a law, then there is usually no reason for people to bring it up.

However, sometimes those laws do eventually become important, because of a general change in circumstances that sees those laws starting to be used more frequently.

An example of this is filial-responsibility laws.

These are laws that have been passed in 28 states that require adult children to provide financial support for their elderly parents, if the parents are unable to pay their own bills, as the Wills, Trusts & Estates Prof Blog discusses in “Filial-Responsibility Laws Could Cost You.”

These laws were not used much in the past because government programs for the elderly such as Social Security, Medicare and Medicaid provide financial support for the elderly.

Today, with people saving less and living longer, many elderly people are not able to afford the costs of their own care, which is increasing.

Nursing homes in states with filial-responsibility laws are increasingly looking to enforce them against children with parents who do not pay their bills.

This is yet another reason to make sure that you plan for your retirement and estate. If you do not, your children might be required to pay for you.

Reference: Wills, Trusts & Estates Prof Blog (May 3, 2017) “Filial-Responsibility Laws Could Cost You.”

A recent survey found that most Americans think they know how the Social Security program works. The same survey found that most actually have some important misunderstandings about the program.

The Social Security program seems simple enough. When you reach retirement age, you can stop working and the government will send you a check, the amount of which is based upon your income during your working years.

People understand that much which leads them to believe that they know all they need to about the program.

However, a recent survey found that most people between the ages of 55-61 believe some myths that need to be corrected, as CNBC reported in “The three biggest myths about how Social Security works.” The myths include:

•Many people think that when they become eligible for Social Security, the government will know and automatically start sending them a monthly check. That is not true. You need to apply for Social Security and you need to do so, three months before you plan to receive it.

•Another common misconception is the retirement age to receive full benefits. It depends on when you were born.

•People also believe that if an ex-spouse claims Social Security benefits under their work history that it will decrease the amount of their benefits. This is also a myth. An ex-spouse’s claim will result in no changes to any benefits that you will receive.

Reference: CNBC (April 25, 2017) “The three biggest myths about how Social Security works.”

Tracking what people do online is intended to increase the value of advertising, but it has the potential to be used to worsen the elder abuse problem.

Regardless of whether you are aware of it, some computer somewhere knows you are currently reading this article. This is most likely true, even if you did not give explicit permission for the computer to know.

Everything you do online is potentially tracked and collected by computers that compile a profile of you. It is what is known as big data.

No, this is not the result of the government spying on people. The people behind this data collection are people who want to sell you things. The better profile they can compile of who you are and what you like, the better they can create advertisements that cater to your interests and that are more likely to make you want to buy something.

This data knowledge increases the value of the ad space on the Internet and makes more money for companies selling that space, such as Facebook and Google. In other words, most people find this data collection and tracking to be mostly benign and necessary for popular Internet sites to continue to be free to use.

However, there are potential downsides to the data collection that worry elder law experts, as Financial Advisor explains in “AI, Big Data May Become Tools for Elder Financial Abuse.”

In the wrong hands, this same data could be used to more effectively target elderly people for financial scams. That has elder law advocates worried, since elder financial abuse is already a big problem.

There are currently few rules about to whom marketers can sell their data. That might need to change to protect the elderly and others from abuse.

Reference: Financial Advisor (March 22, 2017) “AI, Big Data May Become Tools for Elder Financial Abuse.”

Despite what many people want to believe, some elderly people are sexually active. That reality needs to be confronted, so that sexually active elderly people are properly protected.

Absolutely no one wants to think about the possibility of their grandparents having sex. That is somewhat understandable. However, you do not have to think of the act itself, to think about the reality that elderly people do continue to be sexually active.

It is actually very important that we do think about that reality, because it is true.

The unwillingness of people to confront that reality causes problems for the elderly, as USA Today explains in “Yes, your grandmother is having sex.”

One of the biggest problems is that elderly people are getting sexually transmitted diseases at increasingly alarming rates.

One of the reasons appears to be that elderly people are far less likely to use condoms than younger people. Some of that might be the result of nursing home policies that often tend to be completely silent on issues of resident sexual activity and thus do not make protection available.

Many elderly people also think condoms are for preventing pregnancy not for preventing the transmission of diseases.

Elder law advocates need to address this issue and insist that nursing homes write appropriate sexual activity policies.

Families should also make sure that their elderly members are informed and protected.

Reference: USA Today (April 12, 2017) “Yes, your grandmother is having sex.”

Americans are putting off retirement and continuing to work at an increasing rate. Many seniors who do retire later, chose to go back to work. One of the consequences is that it often leads to having a younger boss.

People often do not like taking directions and orders from others who are much younger. It seems to go against the natural order of things for younger people to be in charge of older people. However, that is exactly what is frequently happening in the American workplace today.

As The New York Times reports in “When the Boss Is Half Your Age,” 38% of Americans have a younger boss. One of the reasons for this trend is that many employers want to hire managers who grew up with the technology used in today’s workplaces, such as cell phones and email.

There is a belief that being a native to the technology, makes younger people better at understanding it and using it to their advantage.

Another reason for this phenomenon is that Americans are working longer than before and many people who have chosen retirement go back to work for one reason or another. As a result, many senior citizens have immediate superiors at work who are much younger than they are which can lead to problems.

Elders do not always like being told what to do by younger people, and younger bosses are often on guard against older employees who think that the old way of doing things is best.

Seniors who do have a much younger boss need to be aware that the law does protect them against discrimination due to age. However, they should also be open to new things and be willing to do their work, as directed by their younger boss.

Reference: New York Times (March 17, 2017) “When the Boss Is Half Your Age.”

People who plan to rely on Medicaid, if they ever need long-term care in a nursing home, often make a very big mistake.

Nursing home care is one of the most expensive things facing elderly people. It costs a lot of money to get long-term care in a nursing home.

Many older people do not have the money for it and do not have a realistic way of getting that money.

As a result, they look to the government to pay for that care. The government will step up through Medicaid, but only if the elderly person, who is in need of nursing home care, has no assets.

When seeking to qualify for Medicaid, however, many people make a big, big mistake.

This mistake is discussed in the Pauls Valley Daily Democrat article titled “Misunderstandings create traps in planning.”

The mistake is a simple one to explain, but it is important to make sure you understand it so you will not make it. You cannot give your assets to your children, just before you go into a nursing home, at Medicaid’s expense.

Unfortunately, that is just what many people are planning to do and it will not work.

What is the problem?

Medicaid has a five-year lookback window, which means that the program will look at any asset transfers the applicant (or anyone on his or her behalf) made within five years of needing long-term care.

If those transfers were not made at market value, then Medicaid will not pay for care until the expenses start to exceed the value of the transferred assets. There is a formula to calculate the “penalty period” that will be applied.

This simple mistake is a big source of problems for the elderly. Make sure that you understand it and ask an elder law attorney, if you have any questions about it.

Reference: Pauls Valley Daily Democrat (March 8, 2017) “Misunderstandings create traps in planning.”