Texas Miller Trust | Houston Medicaid Attorney

The Greater Houston Nursing Home Guide

Rich Shea — Thu, 26 Aug 2010 12:18:49 +0000

Families faced with placing a loved one in a skilled nursing facility are often overwhelmed. Where do you begin? How do you find a good nursing home? How can your loved one receive good care while staying in the nursing home? And lastly, how can your loved one afford a nursing home without losing everything?

Those are just a few of the questions I help local families solve and today I have a new free resource available to all of the families that visit TexasTitle19.com looking for answers to those questions.

I am proud to announce the availability of my free guide to nursing homes in the greater Houston area. At this time only nursing homes in Montgomery and Harris County are included; however the information about how to find a good nursing home and pay for it without going broke applies no matter where you live in Texas. In the future I will be including additional neighboring counties to the Nursing Home Guide.

You can download your free copy of the Texas Nursing Home Guide by clicking on the link below.

Houston Nursing Home Guide

Which Special Needs Trust is Right for Your Family?

Rich Shea — Sun, 27 Jun 2010 16:40:26 +0000

Many people throw the term “special needs trust” around without much thought. There are actually two distinct types of special needs trusts. Each type has its own very specific set of rules to follow in order to achieve success. If you have a family member with a chronic medical condition that needs a special needs trust the first step is deciding what kind of special needs trust is appropriate.

Third Party Special Needs Trust

The most common type of special needs trust is a situation where a parent desires to set aside an inheritance or other funds for their disabled child to enhance their quality of life without losing everything to chronic medical costs. This kind of special needs trust is referred to as a third party special needs trust because the parent is creating the trust for the child with assets owned by the parent. If the assets used to create the special needs trust are owned by the beneficiary of the special needs trust then you are looking at the other type of trust. That type of trust is called a “”self-settled” special needs trust.

Self Settled Special Needs Trust

A self-settled special needs trust is funded with assets owned by the beneficiary of the trust. Common examples of how this occurs are as part of the recovery in a personal injury lawsuit or if parents failed to take advantage of the benefits of a third party special needs trust. There are two unique components to the self-settled trust. First, with a self-settled special needs trust the Texas Health and Human Services Commission must be repaid upon the death of the trust beneficiary for the Medicaid benefits it paid on behalf of the beneficiary. Second, only the parent, grandparent, legal guardian or court can establish the trust. The beneficiary cannot establish the trust. If the beneficiary’s parents and grandparents are deceased and a guardian is not already in place additional court delays and costs are required to put a guardian in place to establish the trust.

Get Help Today

This is only the beginning of our discussion on the Special Needs Trust. Attorney Richard Shea of The Shea Law Firm can help you leave a legacy for your disabled loved one to protect their quality of life even after you are no longer there to provide for them. Call (832) 426-3913 today.

TexasTitle19.com is your connection to an experienced Houston Medicaid Attorney who can help you find the right nursing home, get the best care, and pay for it all without going broke. We are currently focused on Harris and Montgomery Counties, including the areas of Houston, Conroe, The Woodlands, Spring, Tomball, Humble, and Katy. We also provide Elder Law and Medicaid consulting services throughout all of Texas.

Medicaid Mistakes: Bad Advice from Unqualified People

Rich Shea — Sat, 01 May 2010 12:28:27 +0000

I regularly receive requests to help families that have already tried their own asset protection plan for Medicaid. Sometimes they come to me after a family member has done something with an account the previous week or it could involve an action from years ago and now the money is all gone. Can you see where this is going? If they contact me to fix something, obviously the do it yourself plan went wrong and they are now in a lurch between the nursing home and the Health and Human Services Commission (HHSC) with past due nursing home bills usually past the $10,000 mark or more.

How Does This Happen?

There is a lot of information on Texas Medicaid out there that is flat out wrong, mildly inaccurate, or completely inappropriate when applied to a specific family’s set of circumstances. Often times you may hear stories from friends or family about what worked for them and it is not uncommon for medical staff personnel in hospitals and rehab centers to make bold statements on your family member’s Medicaid eligibility.

Think twice before putting your loved one’s financial resources and Medicaid eligibility in their hands. Ask yourself, “Do they work for me? Do they know the details of my situation? Do they know the nuances of Texas and Federal Medicaid laws? Will they stand beside me in front of the HHSC?”

In my experience, most pieces of anecdotal advice from unqualified people are horribly inaccurate. Medicaid rules that may seem black and white at first glance often become a lot more complicated when you consider the very important details that make the difference between receiving benefits and being charged with a penalty. (Ordinarily this is where I jump into a story of how many families think qualifying for certain Medicaid exemptions is much easier than it actually is, but we will cover those situations in a separate article)

I hope you are here to educate yourself before going down this same dangerous road. This is my critical Medicaid mistake #1: relying on bad advice from unqualified people.

What Is The Worst That Can Happen?

Bad advice, or no advice, usually creates more problems than solutions. For example, bad advice has led families to transfer assets out of a parent’s name and then spend all of the funds within the look back period of the parent’s application for Title 19 Medicaid benefits. From a legal perspective, there is no rhyme or reason to these situations and they often lead to disaster. So in a case like this a family has transferred and spent everything and gotten themselves into trouble with the HHSC. What happens now?

Now, that the Medicaid application was denied they recognize they need a Montgomery County Elder Law Attorney to fix the Medicaid eligibility issue. They have already spent everything, how are they going to afford a Montgomery County Medicaid Attorney to help them out of this hole? Speaking for myself, it usually costs more to fix an ill-advised asset protection plan than to create a well designed plan.

Don’t Let This Happen to You

If you are interested in asset protection from nursing home costs without jeopardizing Texas Medicaid eligibility speak with a Houston Medicaid Attorney and do it right the first time. Hope is not a strategy when it comes to proving your case for Medicaid nursing home benefits that cost an average of $5,000 per month.

If you are considering a do it yourself asset protection plan, be prepared to go it alone from start to finish. There are some mistakes that cannot be undone by even the best attorney.

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Event – Chocolate Lover’s Ball

Rich Shea — Sat, 24 Apr 2010 21:51:15 +0000

The Houston Chapter of the Alzheimer’s Association has a fundraiser taking place in The Woodlands next week. This is a great opportunity to support the wonderful work done by the local Chapter and, if that is not enticing enough, there is a chocolate fountain! Here are the details:

Location: Terrace at the Woodlands
1730 Woodstead Court
The Woodlands, TX 77380

Date: 4/28/2010
Time: 5:00 PM to 7:00 PM

Come enjoy the chocolate fountain and other sweet treats. Funds raised from raffle sales will benefit the Alzheimer’s Association Houston & Southeast Texas Chapter.

RSVP To: (281) 681-9900

If you have a loved one with Alzheimer’s feel free to download our recently updated Alzheimer’s Legal Survival Kit. Learn how to protect your loved one’s health and property.

TexasTitle19.com is your connection to an experienced Woodlands Medicaid Attorney who can help you find the right nursing home, get the best care, and pay for it all without going broke. We are currently focused on Harris and Montgomery Counties, including the areas of Houston, Conroe, The Woodlands, Spring, Tomball, Humble, and Katy. We also provide consulting services throughout all of Texas.

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When Does Income Become a Resource?

Rich Shea — Mon, 12 Apr 2010 11:46:22 +0000

What happens to income after you receive it? As we have covered in other articles Texas Medicaid has very specific rules for the treatment of income and the treatment of assets. Therefore, it is critical your Houston Medicaid Attorney understands when property is labeled as income and when it is labeled as a resource.

The General Rule of Income for Texas Medicaid

Income is anything a person receives in cash or in kind that can be used to meet the person’s needs for food and shelter. It is the receipt of any property or service a person can apply, either directly or by sale or conversion, to meet basic needs for food and shelter. Income is normally counted on a monthly basis.

Is Income Always Treated as Income?

No. The legal definition of income for Texas Medicaid eligibility only applies for a limited time. For example, if you receive pension checks that you do not spend but rather deposit into a separate bank account where nothing else goes; is that account treated as income because that is all that was deposited into it? Unfortunately no, property loses its label as income through the passage of time, not through how it is used.

For Texas Medicaid the receipt of a payment – in the form of cash, property, or service – is income in the month of receipt and a resource as of 12:01 a.m. on the first day of the month after receipt. If you receive a payment on April 26th the payment may be treated as income only until 12:01 a.m. on May 1st.

Sort Out Income and Resources

Speak with a Woodlands Medicaid Attorney today if you need help sorting out what property is treated as income and what property is treated as a resource for Texas Medicaid eligibility. The wrong identification of property can cost your family thousands of dollars in unpaid nursing home bills while the mistakes are remedied.

The Spousal Assessment of Assets

Rich Shea — Tue, 16 Mar 2010 13:19:15 +0000

How will you be able to survive if your spouse needs expensive nursing home care? I hear this question a lot from families facing an unexpected nursing home placement. Unfortunately some families that contact me have already spent more of their own funds than they need to before qualifying for Texas Medicaid nursing home benefits. For the families that contact me early enough to protect assets for the healthy spouse or parent the process all begins with something called the “Spousal Assessment.”

The Spousal Assessment for Texas Medicaid is rather straightforward. It is a snapshot of a married couple’s combined countable resources. This snapshot is the starting point for determining the amount of assets the spouse at home will be able to keep while the spouse in the nursing home pursues Medicaid eligibility. The Spousal Protected Resource Amount is later determined from this initial assessment which many people do not even understand is taking place behind the scenes.

When Can You Initiate a Spousal Assessment

The request and assessment may be made any time from the beginning of the continuous period in an institutional setting to the date of application for Medicaid. Ordinarily this is handled by the Woodlands Medicaid Attorney handling the application for the family.

If you do not have a Woodlands Medicaid Attorney representing you then the couple must provide information on their resources and verification as required by HHSC. If the couple does not provide the verification within the time frame requested by HHSC, HHSC does not complete the assessment and takes no further action = no Medicaid benefits.

When is the Assessment Date

The couple’s combined countable resources are assessed as of 12:01 a.m. on the first day of the month in which the first continuous period in an institutional setting began. When determining the first day of the month in an institutional setting for the Spousal Protected Resource Amount, HHSC may count days the person spent in a hospital if the person admits directly from the hospital to an institutional setting. After the continuous period begins, hospital stays and therapeutic home visits are not considered as breaks in the 30-consecutive-day period.

Are You Giving Away Assets You Can Keep?

The Spousal Assessment procedure is a reminder of how important it is to understand the legal rights you have when faced with a nursing home situation. As I mentioned at the beginning, some families do not contact me until it is too late and they have already spent more than they need to. In situations like that, the family voluntarily gave up assets the healthy spouse was entitled to and it can make surviving that much more difficult for the healthy spouse when they are left with less assets than the law allowed them to keep. Don’t make the same mistake. Speak with a Texas Medicaid Attorney today to protect your rights and property.

How Much Can You Give Away Without Penalty?

Rich Shea — Sat, 20 Feb 2010 16:25:29 +0000

In the world of Texas Medicaid eligibility, the words “gift” and “penalty” go together like “sunshine” and “lollipops”. In almost every case where there is a gift within the look back period you will find a penalty that prevents a person from obtaining Texas Medicaid benefits. I regularly speak with families that heard from someone, somewhere, at some point in time that a certain type of transfer or gift is acceptable. In every instance that I can remember this advice was given by someone that is not even a lawyer, or in the few instances where it is from a lawyer, it is not from an experienced Texas Medicaid Attorney. And that is usually the beginning of a long line of mistakes before they find their way to me.

So let’s get the record straight on what you need to be aware of before making that gift you’ve been thinking about. And if you have already made that gift and your family member needs Medicaid benefits within the look back period then run, don’t walk, to a Medicaid Attorney.

First - any transfer of any asset for less than fair consideration within the lookback period (up to 5 years) of applying for Texas Title 19 Medicaid benefits creates a penalty period of ineligibility. Say it with me out loud – any transfer of any asset for less than fair consideration within the lookback period of applying for Texas Title 19 Medicaid benefits creates a penalty period of ineligibility.

Now that we understand the rule, let’s go over some basics.

You will notice all types of transfers are included in the rule. Be it writing a check to a friend or family member, handing them cash, signing a deed over to someone etc. As it says, any and every transfer for less than fair consideration is included in the scope of the rule. A simple way to look at it is if the person gives away an interest and access to property, you are at risk for your transaction being labeled a penalizing transfer and resulting in a period of ineligibility for Texas Title 19 Medicaid benefits.

One popular transaction that comes up often is taking a joint account and removing the Medicaid applicant’s name from the account. This is a gift. The Medicaid applicant had unrestricted access to the full value of the account on one day and after his or her name was removed from the account they no longer had access to the account. This transaction results in a period of ineligibility.

Another popular question concerns Medicaid penalties and annual exclusion gifts. For tax purposes, each person is allowed to gift a certain value to any person tax free. That is where the annual exclusion gifts end, for tax purposes only. In the context of a Texas Title 19 Medicaid application, a gift that you made which is tax-free can very well be (and almost always is) a gift subject to penalties for Medicaid eligibility purposes.

Another example is special occasion gifts such as birthdays and graduations etc. There is no exclusion for these types of transfers no matter how noble or small they may be. Any and every gift is subject to the penalty period of ineligibility rules whether it is $5,000 or $500.

But I Heard About Such and Such Exception

You may be right, there are a few very narrow exceptions of transfers that do not create a penalty, however the burden is on you and your Houston Medicaid Attorney to establish by the evidence that you qualify within one of the specific exceptions. If you do not prove your case you are left with a penalty, and that is what this article is about. We will review some of these exceptions in detail in future articles.

One final word; if you are considering a strategy of stonewalling the Health and Human Services Commission by denying information, then think again. You bear the burden of proving your eligibility. If the law presumes a transfer is a penalty and you do not prove otherwise your loved one will be denied benefits.

So how much can you give away without creating a penalty?

If you are outside the look back period then you can give away as much as you want. If you are within the look back period then you really can’t give away anything. The best thing you can do is to speak with a Houston Medicaid Attorney to find out what your options are to structure transfers to avoid them being labeled as “gifts” in the first place.

Texas Medicaid Eligibility for 2010

Rich Shea — Wed, 06 Jan 2010 13:00:26 +0000

Certain numbers used to determine eligibility for Texas Medicaid benefits are subject to change every January 1st. This year there were not many changes. Unfortunately the minimum and maximum Community Spousal Protected Resource Amounts remained the same. The current figures are listed below.

Income Limit for an Individual: $2,022/month

Income Limit for a Couple: $4,044/month

Resource Limit for an Individual: $2,000

Resource Limit for a Couple: $3,000

Home equity is limited to $500,000

Minimum Community Spousal Protected Amount: $21,912

Maximum Community Spousal Protected Resource Amount: $109,560

How Does this Impact Your Family?

If your loved one’s income or assets exceed the values listed above do not give up. A Houston Medicaid Attorney can help you establish Medicaid eligibility through proven techniques while protecting everything your family is entitled to protect. Remember, only you can protect your rights and property. The nursing home and the DADS are not responsible for helping you with asset protection. Call (832) 426-3913 to get started today.

It Counts: Individual Retirement Accounts

Rich Shea — Wed, 02 Dec 2009 12:24:47 +0000

Retirement accounts can cause a lot of confusion when planning for Texas Medicaid eligibility. This is in large part due to the many different kinds of retirement accounts out there. Today we are going to look at one very common kind of retirement account, the individual retirement account, or IRA. This includes the traditional IRA and the Roth IRA. Many families saved funds in these accounts during their lifetime, but what happens to them when the owner of the account or their spouse needs Medicaid nursing home benefits?

§358.435(d) — The resource value of a time deposit is the net amount due after penalties are imposed for early withdrawal. If the funds cannot be withdrawn before maturity, the time deposit is not a resource until it matures. Time deposits include but are not limited to certificates of deposit, savings certificates, and individual retirement accounts (IRAs).

The Texas Health and Human Services Commission takes the approach that the availability of funds is the controlling factor in determining whether a time deposit such as an IRA is a resource. They examine the terms of the account to determine when the funds can be withdrawn and which penalties to impose. An early withdrawal penalty does not change the HHSC’s view that the account is still a counted resource. The penalties for withdrawal will be subtracted from the total value to determine its resource value.

Put simply, the balance of the retirement account counts as a resource for the purpose of determining eligibility. You may have to face penalties and other negative consequences, but the bottom line is if you can get the funds out of the account under any circumstances, then it counts.

Evidence Needed

If the Texas Medicaid applicant or their spouse own an individual retirement account the more information you can provide to your case worker the faster your case can be decided. Some of the documents you should begin gathering with your Houston Medicaid Attorney are account statements and letters from the financial institution establishing any early withdrawal penalties.

TexasTitle19.com is your connection to an experienced Houston Medicaid Attorney who can help you find the right nursing home, get the best care, and pay for it all without going broke. TexasTitle19.com is currently focused on Harris and Montgomery Counties, including the areas of Houston, Conroe, The Woodlands, Spring, Tomball, Humble, and Katy. If you need legal assistance for eligibility or a Miller Trust, learn more about the author at http://SheaLawOnline.com/.

Welcome New Readers – Help is Here

Rich Shea — Fri, 27 Nov 2009 18:32:49 +0000

I doubt you came here by accident and I bet your are worried, frustrated, and scared about what the future may hold for your loved one who needs nursing home care. Some of the thoughts racing through your mind late at night may include:

Where can my loved one get the best care?
Will they lose everything they have worked for their entire life?
Will their spouse be left with nothing?
What are our responsibilities and potential liabilities for nursing home bills?
If there anyone that can help us?

You are not alone. Many families have stood in the same situation you are in now and have gotten the legal help they needed so they can focus on their loved one’s well being.

The decision to move a spouse or loved one into a nursing home is one of the most difficult decisions you can make. Perhaps the move is being made because your spouse or loved one can no longer care for him or herself…or perhaps the person has a progressive disease like Alzheimer’s…or has had a stroke or heart attack.

No matter the reason, the family is almost always under great stress. I can help you, and I can guide you through the legal maze of eligibility and asset protection you are about to enter.

Are you ready?

Please look around this site to learn about Texas Medicaid. Legal services are available from The Shea Law Firm where we can review your situation, your goals, and your options. I take pride in handling each case myself to assure the job is done right and I represent my clients personally in Medicaid hearings and appeals. Clients of The Shea Law Firm work closely and directly with me, not paralegals or junior associates. Call (832) 426-3913 to get started today.

Thank you for visiting http://TexasTitle19.com. I think that the information I give you here will help you in your quest to pay for costly nursing home care without losing everything. I created this site so that consumers could have good, solid information before hiring an attorney or dealing with the Health and Human Services Commission or the nursing home accounts receivable collectors. I truly believe that you should have this valuable information right now, for free, before you are pressured into reactionary decisions during a time of crisis.

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