Welcome to My Blog

Attorney Michael MillonigHi,

I’m Michael Millonig, and you’ve managed to find your way to my blog.

As an attorney who specializes in elder law, I know that there are a lot of elder care issues facing adults with elderly parents that don’t necessarily either require, or get covered by, a lawyer. There are also many changes in elder law, especially Ohio’s Medicaid program, that happen quickly which make it difficult for me to keep you up to date with my email newsletter or seminars. That’s why I’ve started this blog.

Over time, I have no doubt that the topics will evolve, and that we’ll meander a little bit. Occasionally, I’m sure there will be some difficult discussions; but I hope that equally there will be some light-hearted ones. And regardless of the nature or tone of the topics, I’m looking for input from you, my dear readers. So, if there’s something you have a question about, something you’d like to know more about, or simply something you’d like to share, please don’t hesitate to reach out and let me know.

In the meantime, I’m going to get rolling and start writing about things like caring for aging parents, role reversal, supporting siblings with elderly parents, Ohio’s Medicaid program, revocable living trusts, powers of attorney, retirement communities, home-care, elder care and any other topic I can think of that might be useful to you.

Hopefully you enjoy what you find here, learn some things, and join the conversation.

Once again, welcome to my blog.

Michael  J.  Millonig
Certified as an Elder Law Attorney
by the National Elder Law Foundation since 1998
OSBA Board Certified Estate Planning
Trust and Probate Specialist
937-438-3977

Any legal information communicated in this blog is a general statement of the law.  It is not intended as legal advice and should not be relied upon to answer any specific questions concerning your own circumstances or for purposes of legal planning. These communications are not intended to create an attorney-client relationship. Please contact my office for an appointment if you have any legal questions.

Three Great Estate Planning seminars are presented by Michael Millonig this October.

 

Estate Planning For Funerals and Burial : a consumer oriented seminar by Michael J. Millonig, Attorney At Law, Ohio State Bar Association Board Certified Estate Planning, Trust and Probate Specialist, Certified as an Elder Law Attorney by the National Elder Law Foundation . Time & Place: Friday October 11, 2019 at 1:00 to 2:30 PM at Rec West Enrichment Center,965 Miamisburg-Centerville Rd., Dayton Ohio 45459. Please call Kathy Ferrante at Rec West for reservations (937)432-2839

Estate Planning & Elder Law Overview : seminar by Michael J. Millonig, Attorney At Law, Ohio State Bar Association Board Certified Estate Planning, Trust and Probate Specialist, Certified as an Elder Law Attorney by the National Elder Law Foundation. Time & Place: Wednesday, October 23, 2019 at 10:00 to 11:30 AM,  Miamisburg Community Center, 305 East Central Ave., Miamisburg Ohio 45342 . Please call for reservations 866-8999

Protecting Your Estate from Nursing Home Costs: Medicaid eligibility for nursing home costs, Trusts, risks of gifting to children and understanding Medicaid’s gift transfer rule. Presentation by Michael J. Millonig, Attorney At Law, Certified as an Elder Law Attorney by the National Elder Law Foundation, Ohio State Bar Association Board Certified Estate Planning, Trust and Probate Specialist. Time & Place: Woodbourne Library, 6060 Far Hills Avenue, Dayton Ohio 45459, Saturday, October 26 @ 10:30 AM to 12:00 PM.

Will My Advance Directive Work in Another State?

Making sure your end-of-life wishes are followed no matter where you happen to be is important. If you move to a different state or split your time between one or more states, you should make sure your advance directive is valid in all the states you frequent.

An advance directive gives instructions on the kind of medical care you would like to receive should you become unable to express your wishes yourself, and it often designates someone to make medical decisions for you. Each state has its own laws setting forth requirements for valid advance directives and health care proxies. For example, some states require two witnesses, other states require one witness, and some states do not require a witness at all.

Most states have provisions accepting an advance care directive that was created in another state. But some states only accept advance care directives from states that have similar requirements and other states do not say anything about out-of-state directives. States can also differ on what the terms in an advance directive mean. For example, some states may require specific authorization for certain life-sustaining procedures such as feeding tubes while other states may allow blanket authorization for all procedures.

To find out if your document will work in all the states where you live, consult with an attorney in the state. 

 

How to Plan Your Funeral

Thinking about your funeral may not be fun, but planning ahead can be exceedingly helpful for your family. It both lets them know your wishes and assists them during a stressful time. The following are steps you can take to plan ahead:

  • Name who is in charge. The first step is to designate someone to make funeral arrangements for you. State Law dictates how that appointment is made. In some states, an informal note is enough. Other states require you to designate someone in a formal document, such as a health care power of attorney. If you do not designate someone, your spouse or children are usually given the task.
  • Put your preferences in writing. Write out detailed funeral preferences as well as the requested disposition of your remains. Would you rather be buried or cremated? Do you want a funeral or a memorial service? Where should the funeral or memorial be held? The document can also include information about who should be invited, what you want to wear, who should speak, what music should be played, and who should be pallbearers, among other information. The writing can be a separate document or part of a health care directive. It should not be included in your will because the will may not be opened until long after the funeral.
  • Shop around. It is possible to make arrangements with a funeral home ahead of time, so your family does not have to scramble to set things up while they are grieving. Prices among funeral homes can vary greatly, so it is a good idea to check with a few different ones before settling on the one you want. The Federal Trade Commission’s Funeral Rule requires all funeral homes to supply customers with a general price list that details prices for all possible goods or services. The rule also stipulates what kinds of misrepresentations are prohibited and explains what items consumers cannot be required to purchase, among other things.
  • Inform your family members. Make sure you tell your family members about your wishes and let them know where you have written them down.
  • Figure out how to pay for it. Funerals are expensive, so you need to think about how to pay for the one you want. You can pre-pay, but this is risky because the funds can be mismanaged or the funeral home could go out of business. Instead of paying ahead, you can set up a payable-on-death account with your bank. Make the person who will be handling your funeral arrangements the beneficiary (and make sure they know your plans). You will maintain control of your money while you are alive, but when you die it is available immediately, without having to go through probate. Another option is to purchase a life insurance policy that is specifically for funeral arrangements.

Taking the time to plan ahead will be a big help to your family and give you peace of mind.

For more information on planning your funeral  see http://www.michaelmillonig.com/practice-areas/funerals-burial/

Annual Mental Examination

An annual physical with a doctor is something most of us do. Especially as we get older or if we have a medical problem it is important to monitor our health. What about our mental health? Have you ever thought of having an annual mental checkup? Probably not. I suggest that you should consider this for legal reasons related to your estate planning.

Unfortunately, some family members or other friends often take advantage of an older person by exerting influence on them to change their will or “loan” them money. This is a very common form of elder abuse. If there is a will contest after the person dies or other legal action, a necessary piece of evidence will be proof of the person’s mental competency or lack thereof at the same time as the signing of the will or other elder abuse. This requires that a doctor perform one or more of the competency evaluation tests used by doctors. Many times this medical evidence is just not available. If you had done an annual mental checkup, you would already have this in your medical records. That proof will be essential in a successful will contest or other legal action against a person taking money from a vulnerable older person.

The annual mental checkup with the doctor might even result in suggested medications, treatment or other activities that might improve your mental health.

Estate Planning For Funerals and Burial

This is a consumer oriented seminar by Michael J. Millonig, Attorney At Law, Ohio State Bar Association Board Certified Estate Planning, Trust and Probate Specialist, Certified as an Elder Law Attorney by the National Elder Law Foundation . Time & Place: Friday October 11, 2019 from 1:00 PM to 2:30 PM. Please call Kathy Ferrante at Rec West Enrichment Center for reservations @ (937)432-2839

Illegal Refusal to return body for transport

There are some other laws that you need to be aware of if you are planning a home funeral. It is possible you might run into a problem with a funeral home, hospital or other official that may refuse to release custody of the body to you. If you are demanding custody of the body for transport, you must be the person holding the right of disposition under Ohio law. This person will be named in a written declaration signed by the decedent. If there is no written declaration, then Ohio law sets forth the persons who are vested with the right of disposition in order of priority. For more information see http://www.michaelmillonig.com/practice-areas/funerals-burial/

It is illegal under Ohio law for anyone to refuse to return custody of a corpse or cremated remains to the person legally entitled to it. This is prohibited under several sections of the Ohio Revised Code with possible penalties and criminal fines. See O.R.C. §4717.13(A)(11), O.R.C. §1713.40 & 1713.41.

Medicare Launches App to Help Beneficiaries Find Out What’s Covered

At the doctor’s office and want to know if a procedure is covered by Medicare? There is an app for that. Medicare has launched a free app that gives beneficiaries a quick way to see whether the program covers a specific medical item or service.

The “What’s Covered” app allows you to search or browse to learn what’s covered and not covered under Medicare Parts A and B, how and when to get covered benefits, basic cost information and other eligibility details. You can also see a list of covered preventive services.  The app does not give results for extra benefits that Medicare Advantage plans may cover but that Original Medicare does not, such as certain vision, hearing or dental benefits.

Examples of the types of questions the app can answer include:

  • When are mammograms covered?
  • Is home health care covered?
  • Will Medicare pay for diabetes supplies?
  • Can I get a regular cervical cancer screening?
  • Will my Medicare benefits cover a service to help me stop smoking?

Although the app provides beneficiaries with basic information, it doesn’t provide personalized information. It doesn’t ask details about each user’s specific insurance information, so it doesn’t take into account the user’s supplemental insurance, co-insurance, and deductibles. Essentially, the app provides another way for Medicare beneficiaries to get the same information that is available online and in the Medicare handbook.

The app is part of an initiative by the Centers for Medicare and Medicaid Services (CMS) focused on modernizing Medicare and empowering beneficiaries. Other initiatives include:

  • Enhanced interactive online decision support to help beneficiaries better understand and evaluate the coverage options and costs of original Medicare compared to Medicare Advantage plans.
  • New price transparency tools that let consumers compare the national average costs of certain procedures between settings, so people can see what they’ll pay for procedures done in a hospital outpatient department versus an ambulatory surgical center.
  • A new webchat option in the Medicare Plan Finder.
  • New easy-to-use surveys across Medicare.gov so consumers can tell CMS what they want.

To get the new “What’s Covered” app, go here: https://www.medicare.gov/blog/whats-covered-mobile-app.

Home Funerals under Ohio Law: Update

If you plan to hold a home funeral service without use of a funeral home, you have the right to do that under Ohio law. O.R.C. §4717.12. However, this will not be easy to do since the legal system and normal procedures are set up assuming use of funeral home. It will be difficult to obtain a death certificate, burial permit and transport the body without use of a funeral home. However, it can be done. This procedure is outlined below.

1. Ohio law provides that the funeral director or “other person in charge of final disposition” must register the death with the Bureau of Vital Statistics. Thus, you can obtain a death certificate without use of a funeral director. The death certificate form is issued and must be signed by the attending physician or coroner. O.R.C. §3705.16. If a funeral home is not registering the death, then you need to contact the Ohio Dept. of Health, Vital Statistics, in Columbus to get the death certificate. You cannot get the death certificate issued by the County department. Contact information for Columbus is: : VS.Registration@odh.ohio.gov 614-466-2531. You will need a written statement certifying the death from a licensed physician, coroner, or other licensed healthcare professional which you should request immediately.

2. You must call the County Coroner to report the death if the person died as a result of a crime, casualty, suicide, child under age 2, developmentally disabled person, or death in any suspicious or unusual manner. O.R.C. §313.12. If no funeral home is involved, it is probably best to call the Coroner or ask the hospital or nursing home to call the Coroner.

3. The body will need to be removed from the place where the person died. If they are in a hospital, there will be a refrigeration unit for temporary storage. Nursing homes generally do not have a refrigeration unit and you will need to arrange for transportation immediately. You could contact a funeral home to arrange for transportation and temporary storage in a refrigeration unit or embalming if desired. You might be able to use a transport service for transporting the body to a cemetery or crematory but will need to have a death certificate and burial or cremation certificate. In order to find a transport service other than a funeral home, try to find out who is used by the County for indigent persons or by an organization accepting direct body donations. You could perform an internet search for body transport or mortuary transport.

4. After obtaining the death certificate from the Columbus office, you then get the burial or cremation permit from the County Bureau of Vital Statistics. O.R.C. §3705.17 & O.R.C. §4717.22.

5. After all the above are completed, the next step is to make cemetery arrangements for burial or cremation. If you do not use any of the transport options in 3 above, you may want to transport the body by yourself. However, you should be careful since this is unusual. First, you must make sure that you have completed the above steps. The person with the “right of disposition” under Ohio law should be present during transport of the body. You can transport the body to the home or other place of funeral service or to the cemetery. Although there is no law prohibiting a private person transporting a body for this purpose, it is unusual and if you are stopped by the police, you should have a death certificate and burial/transport permit with you If you are transporting the body across State lines, you need to comply with the law of each State which might be different.

6. You can hold a funeral/memorial service at a community facility, family residence or a grave site/cemetery service. The right for a home funeral is preserved in Ohio law. O.R.C. §4717.12.

If you have any problems with the above procedure, please call me for assistance.

Six Things to Consider Before Making Gifts to Grandchildren

Grandparents often are particularly generous to grandchildren as they see their family’s legacy continuing on to a new generation. In many cases, grandparents feel they have ample resources and their children or grandchildren may be struggling financially. Assistance with summer camp fees, college tuition, wedding costs or the downpayment on a first home, can relieve pressure on the next generation and permit grandchildren to take advantage of opportunities that otherwise would be out of reach. Some grandparents also don’t feel it’s right that children and grandchildren should need to wait for an inheritance, when they have more than they need.

Helping out family members is to be encouraged, but can raise a number of legal issues involving taxes and eligibility for public benefits, as well as questions of fairness among family members. Here are six issues grandparents should consider before making gifts to family members:

  • Is it really a gift? Does the grandparent expect anything in return, for example that the funds be repaid or that the money is an advance on the grandchild’s eventual inheritance? In most cases, the answer is “no.”  But if it’s “yes,” this should be made clear, preferably in writing, whether in a letter that goes with the check or, in the case of a loan, a formal promissory note.
  • Is everyone being treated equally? Not all grandchildren have the same financial needs, and grandparents don’t feel equally close to all of their grandchildren. While it’s the grandparent’s money and she can do what she wants with it, if she’s not treating all of her grandchildren equally, she might want to consider whether unequal generosity will create resentment within the family. Many elder law clients say that what they do with their money during their lives is their business. They may help out some children and grandchildren more than others based on need, with the expectation that this will be kept private. But they treat all of their children equally in their estate plan.
  • Beware taxable gifts. While this is academic for most people under today’s tax law, since there’s no gift tax for the first $11.4 million each of us gives away (in 2019), any gift to an individual in excess of $15,000 (in 2019) per year must be reported on a gift tax return. Two grandparents together can give up to $30,000 per recipient per year with no reporting requirement. And there’s no limit or reporting requirement for payments made directly to medical and educational institutions for health care expenses and tuition for others.
  • 529 plans. Many grandparents want to help pay higher education tuition for grandchildren, especially given the incredibly high cost of college and graduate school today. But not all grandchildren are the same age, making it difficult to make sure that they all receive the same grandparental assistance. Some grandchildren may still be in diapers while others are getting their doctorates. A great solution is to fund 529 accounts for each grandchild. These are special accounts that grow tax deferred, the income and growth never taxed as long as the funds are used for higher education expenses. Click here to read more about 529 accounts.
  • Don’t be too generous. Grandparents need to make sure that they keep enough money to pay for their own needs. While small gifts probably won’t make any difference one way or another, too many large gifts can quickly deplete a lifetime of scrimping and saving. It won’t do the family much good if a grandparent is just scraping by because he’s done too much to support his children or grandchildren.
  • Beware the need for long-term care. In terms of making certain that they have kept enough of their own savings, grandparents need to consider the possibility of needing care, whether at home, in assisted living or in a nursing home, all of which can be quite expensive. In addition, those seniors who can’t afford to pay for such care from their own funds need to be aware that any gift can make them ineligible for Medicaid benefits for the following five years.  For details, click here.

There are even more issues to consider that may involve specific family situations. Some grandchildren shouldn’t receive gifts because they will use them for drugs, or the gifts may undermine the parents’ plans for the grandchild or their authority. In some instances, grandparents may want to consider “incentive” trusts, which provide that the funds will be distributed when grandchildren reach certain milestones, such as graduation from college or holding down a job for a period of time. Communication with the middle generation can be key to making certain that gifts achieve the best results for all concerned.

Talk to your attorney about devising the best plan for yourself and for your grandchildren.

 

Medicare Beneficiaries Need to Know the Difference Between a Wellness Visit and a Physical

Medicare covers preventative care services, including an annual wellness visit. But confusing a wellness visit with a physical could be very costly.

As part of the Affordable Care Act, Medicare beneficiaries receive a free annual wellness visit. At this visit, your doctor, nurse practitioner or physician assistant will generally do the following:

  • Ask you to fill out a health risk assessment questionnaire
  • Update your medical history and current prescriptions
  • Measure your height, weight, blood pressure and body mass index
  • Provide personalized health advice
  • Create a screening schedule for the next 5 to 10 years
  • Screen for cognitive issues

You do not have to pay a deductible for this visit. You may also receive other free preventative services, such as a flu shot.

The confusion arises when a Medicare beneficiary requests an “annual physical” instead of an “annual wellness visit.” During a physical, a doctor may do other tests that are outside of an annual wellness visit, such as check vital signs, perform lung or abdominal exams, test your reflexes, or order urine and blood samples. These services are not offered for free and Medicare beneficiaries will have to pay co-pays and deductibles when they receive a physical. Kaiser Health News recently related the story of a Medicare recipient who had what she assumed was a free physical only to get a $400 bill from her doctor’s office.

Adding to the confusion is that when you first enroll, Medicare covers a “welcome to Medicare” visit with your doctor. To avoid co-pays and deductibles, you need to schedule it within the first 12 months of enrolling in Medicare Part B. The visit covers the same things as the annual wellness visit, but it also covers screenings and flu shots, a vision test, review of risk for depression, the option of creating advance directives, and a written plan, letting you know which screenings, shots, and other preventative services you should get.

To avoid receiving a bill for an annual visit, when you contact your doctor’s office to schedule the appointment, be sure to request an “annual wellness visit” instead of asking for a “physical.” The difference in wording can save you hundreds of dollars. In addition, some Medicare Advantage plans offer a free annual physical, so check with your plan if you are enrolled in one before scheduling.