Welcome to My Blog

Attorney Michael MillonigHi,

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

I have been a certified specialist in elder law since 1998. [see https://www.michaelmillonig.com/cela-certification/ ]. There are frequent changes in elder law, estate planning, trust and probate law. The Ohio Medicaid program is constantly changing even at the county level. It is difficult for me to keep you up to date with my email newsletter, seminars or client appointments. That’s why I’ve started this blog.

I will try to keep you updated on new developments in elder law, estate planning, trust and probate. I will particularly be focusing on local issues in Dayton and Ohio law in general. Some specific topics I will cover are: caring for aging parents, nursing homes, assisted living facilities, home care, independent senior retirement communities, Ohio’s Medicaid program, protecting your estate from nursing home costs, revocable living trusts, avoiding probate, financial powers of attorneys, health care powers of attorney, living wills and other topics related to elder law.

Hopefully you enjoy what you find here and learn some things. 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.

SEMINARS FOR CPA’S & FINANCIAL PLANNERS

The following seminars are offered for CPA’s, financial planners and insurance agents for continuing education credits. These are not consumer oriented seminars. Registration links are at the bottom of this post.

ASSET PROTECTION PLANNING
FOR NURSING HOME COSTS
Friday, December 11, 2020 @ 8:45 AM – 12:00 PM
via ZOOM online of course

▸ Review of all new changes resulting from Ohio’s conversion to an SSI/1634 State
▸ Review all new resource eligibility rules
▸ Miller Trusts (aka Qualified Income Trusts) now required for many applicants
▸ Problems with clients not using Miller trusts correctly; caseworkers now requiring stricter compliance
▸ New rule for Residence exemption for single persons & our success with exemptions
▸ Medicaid Transfer rule; more changes and problems
▸ Resource exemptions for the community spouse (spouse at home)
▸ Restrictions on Medicaid annuities and planning opportunities
▸ Annuities used for planning & related malpractice of agents
▸ Medicaid Transfer rule; not just 5 years but an ineligibility period beginning after spend down!
▸ Office procedures to avoid malpractice
▸ Long Term Care Insurance for nursing home costs
▸ Additional Medicaid exemptions for persons with Partnership Plan Policies
▸ Assisted Living rules for Medicaid
▸ Many other planning options to protect the estate and qualify for Medicaid
▸ Why your clients should not be giving their assets to their children
▸ Special Needs Trusts under Medicaid law for children with disabilities

OHIO TRUST CODE
(also approved as “The Complete Trust Course”)
Thursday, December 10, 2020 @ 8:45 AM – 12:00 PM

Trusts are usually the centerpiece in estate planning for high net worth individuals. Therefore, it is important to understand some fundamentals about trusts and the specifics of the many types of trusts used in estate planning.

▸ This presentation will cover fundamental legal principles of trust law to help you be able to read a trust document and understand legal terminology.
▸ Comprehensive Review of a Trust Document; this will help you in your discussions with the attorney who drafted the document.
▸ Rights of beneficiaries that apply even if contrary to the trust.
▸ Avoiding probate with a revocable living trust; common mistakes by clients; comparison to TOD, POD accounts and beneficiary designations; disadvantages of the latter.
▸ How to explain trusts to clients; Trust Terminology review
▸ A-B Trusts, Life Insurance Trusts, Incentive Trusts, Spendthrift Trusts, Trusts for second marriages
▸ Estate tax planning under the higher exclusion amount ($11,580,000 for 2020)
▸ A-B Trusts compared to the portability election; pitfalls of portability
▸ Asset Protection Trusts to protect clients from lawsuits
▸ Ohio Legacy Trust Act: an asset protection trust under Ohio law
▸ Foreign Asset Protection Trusts under laws of other countries
▸ Perpetual Dynasty Trusts that continue to provide protection and avoid estate tax for grandchildren and beyond
▸ Many other different types of trusts will be covered

CONTINUING EDUCATION CREDIT

The above seminars have been approved for CE credit by the Ohio Department of Insurance. There is no exam required to obtain CE credit. Michael Millonig LLC is registered with the Accountancy Board of Ohio as a Continuing Education Sponsor. Asset Protection Planning for Nursing Home Costs and The Ohio Trust Code (“The Complete Trust Course”) are each approved for 3 CE Credits.

REFUND POLICY: Cancellations received by 5:00 PM two business days prior to the seminar will be refunded less a $15 office fee. Those not attending will receive the course materials in full consideration of tuition paid.

TUITION: Tuition is $60 per seminar if pre-registered and paid two business days prior to the day of the seminar. Registration on the day before or the day of the seminar is $70.00. There is a discount if you pre-register for two courses (see below).

To register, click below
Asset Protection Planning for Nursing Home Costs:
https://zoom.us/webinar/register/6816063141111/WN_767br6d7QFuNt3gcccjggA

Trust seminar:
https://zoom.us/webinar/register/7316063140479/WN_464eBaU7TsCEinPM-s4L7w

Reservations must be made in advance on online with Zoom. Please check your email for the link for Zoom registration. In addition, you must send payment in advance. Please send a check via U. S. Mail to Michael Millonig LLC, Attn: Agent/CPA CE Seminars, 7929 Washington Woods Drive, Dayton, Ohio 45459-4026.

Thanksgiving during COVID

This is a difficult time for us to continue to balance COVID-19 safety protocols & government restrictions with spending time with our families and loved ones. The CDC has issued some guidelines for celebrating Thanksgiving :
https://m.emailupdates.cdc.gov/rest/head/mirrorPage/@lIie1UBTdMtWe9u7NFnRaoqgvmZv-N5jV6fmPS2nYOQXVIPyuiVz9uULj_TGPOZSg-G–UIZHBdxY-xmVVBRTO7q0jrfS1VkJRnfxjMYMBm5F1d5.html

The National Consumer Voice for Quality Care is an organization that is an advocate for nursing home residents and their families. They have also issued some specific guidance related to nursing home residents:

https://act.theconsumervoice.org/site/MessageViewer?dlv_id=6827&em_id=3465.0

Have a safe and happy Thanksgiving holiday.

 

Asset Protection with Trusts

Clients often ask me about protecting their estate. Sometimes they are not specific and I have to ask them: Who or what do you want to protect your estate from? Often the reply is something vague about the government or taxes. After some discussion, we usually narrow this down to the following risks:

1. Protecting your estate from the cost of nursing home care.
2. Avoiding probate.
3. Protecting against lawsuits.
4. Protecting against possible civil unrest or major changes to our political, tax or legal system.

All of these financial risks are valid concerns but require a client discussion of the potential risk and the client’s risk tolerance. There are many persons who have lost their hard earned life savings or their business because they did not plan for one of these events.

There are certain types of trusts and other legal arrangements that can accomplish protection against all these threats to preservation of your estate. However, especially with respect to items 3 & 4 above, you must do this planning prior to any actual lawsuit or government action. There are laws that will prevent you from successfully implementing this type of planning if the government or a creditor has already taken action against you. Legal planning in advance is essential for a successful estate plan to protect your estate.

MEDICAID ELIGIBILITY FOR NURSING HOME RESIDENTS

Thursday, November 18, 2020 @ 8:45 AM – 12:00 PM
and Wednesday December 9 2020 @ 8:45 AM – 12:00 PM
via ZOOM online of course

This seminar has been approved for 3 CEU’s for Licensed Social Workers & Counselors. This is not a consumer oriented seminar. The intended audience is nursing home and other personnel who work with residents applying for Medicaid eligibility. This seminar will focus on Medicaid eligibility from the point of view of the nursing facility. It will not focus on planning techniques to preserve assets and achieve Medicaid eligibility. The objective is to provide information, tips and relate the experience of Michael J. Millonig to assist nursing homes in avoiding problems with Medicaid applications.

TUITION: Tuition is $40 for persons requiring credit if pre-registered and paid two business days prior to the day of the seminar. Registration on the day before or the day of the seminar is $60.00. COVID-19 special: If you do not need Licensed Social Workers & Counselors CEU credit, there is no charge. However, you must register. Please send a check for $40.00 via U S Mail to Michael Millonig LLC, Attn: Medicaid CE Seminars, 7929 Washington Woods Drive, Dayton, Ohio 45459-4026.

November 18 Zoom registration link:

https://zoom.us/webinar/register/8516040660756/WN_jORW2WfUQ3CrEXgaXsLoRA

December 9 zoom registration link:

https://zoom.us/webinar/register/8316040662131/WN_nB6W7TKOTqaPm1DHhvCXBA

Medicare Open Enrollment Starts October 15: Is It Time to Change Plans?

Medicare’s Open Enrollment Period, during which you can freely enroll in or switch plans, runs from October 15 to December 7. Now is the time to start shopping around to see whether your current choices are still the best ones for you.

During this period you may enroll in a Medicare Part D (prescription drug) plan or, if you currently have a plan, you may change plans. In addition, during the seven-week period you can return to traditional Medicare (Parts A and B) from a Medicare Advantage (Part C, managed care) plan, enroll in a Medicare Advantage plan, or change Advantage plans.

Beneficiaries can go to www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to make changes in their Medicare prescription drug and health plan coverage.

According to the New York Times, few Medicare beneficiaries take advantage of Open Enrollment, but of those who do, nearly half cut their premiums by at least 5 percent. Even beneficiaries who have been satisfied with their plans in 2020 should review their choices for 2021, as both premiums and plan coverage can fluctuate from year to year. Are the doctors you use still part of your Medicare Advantage plan’s provider network? Have any of the prescriptions you take been dropped from your prescription plan’s list of covered drugs (the “formulary”)? Could you save money with the same coverage by switching to a different plan?

For answers to questions like these, carefully look over the plan’s “Annual Notice of Change” letter to you. Prescription drug plans can change their premiums, deductibles, the list of drugs they cover, and their plan rules for covered drugs, exceptions, and appeals. Medicare Advantage plans can change their benefit packages, as well as their provider networks.

Remember that fraud perpetrators will inevitably use the Open Enrollment Period to try to gain access to individuals’ personal financial information. Medicare beneficiaries should never give their personal information out to anyone making unsolicited phone calls selling Medicare-related products or services or showing up on their doorstep uninvited. If you think you’ve been a victim of fraud or identity theft, contact Medicare.

Here are more resources for navigating the Open Enrollment Period:

Medicare Plan Finder, which helps you find a plan to match your needs: www.medicare.gov/find-a-plan
Medicare coverage options: https://www.medicare.gov/medicarecoverageoptions/
The 2020 Medicare & You handbook, which all Medicare beneficiaries should have received. The handbook can also be downloaded online at: medicare.gov/forms-help-resources/medicare-you-handbook/download-medicare-you-in-different-formats
The Medicare Rights Center: www.medicareinteractive.org
Your State Health Insurance Assistance Program, which offers independent counseling: https://www.shiptacenter.org

Medicare May Not Cover the Coronavirus Vaccine After All

While Medicare would cover a coronavirus vaccine approved through normal channels, if the Food and Drug Administration approves the vaccine through an emergency use authorization (EUA), Medicare will not cover it unless the government acts.

As we previously reported, the CARES Act provides that if a COVID-19 vaccine becomes available, Medicare is required to cover this vaccine under Part B with no cost sharing. Medicare Advantage plans are required to include the basic coverage offered by Medicare Parts A and B, so this coverage also applies to beneficiaries in Medicare Advantage plans.

However, it is possible that the federal government will authorize the use of the vaccine through an EUA, which is a faster method of approving drugs needed in a crisis situation, like the coronavirus pandemic. Medicare does not cover costs of vaccines approved under EUAs.

In order to ensure that the vaccine is free, the government will need to act. One option is that Congress could change the language in the CARES Act to ensure coverage. In addition, doses purchased by the federal government will be free of charge.

Michael Millonig selected for Best Lawyers in America- Elder Law

Michael J. Millonig has been selected for inclusion in the 27th Edition of The Best Lawyers in America in the practice area of Elder Law. Inclusion in Best Lawyers is based on a rigorous peer-review survey comprising a total of more than 9.4 million confidential evaluations by top attorneys across the nation. This rankling is reserved for the top 5% of private practice attorneys nationwide. For more information see  https://www.bestlawyers.com/ Michael has also been Certified as an Elder Law Attorney by the National Elder Law Foundation since 1998, is an OSBA Board Certified Estate Planning, Trust and Probate Specialist and a member of the National Academy of Elder Law Attorneys since 1991. The practice of elder law includes preparation of wills, trusts, powers of attorney, living wills, probate, guardianships, planning for special needs children, asset protection planning from lawsuits and protecting estates from nursing home costs.

Which Nursing Home Rating System Should You Trust?

Choosing a nursing home for a loved one is a difficult decision and it can only be made more confusing by the various rating systems. A recent study found that using both Medicare’s Nursing Home Compare site and user reviews can help with the decision making.

The official Medicare website includes a nursing home rating system. Nursing Home Compare offers up to five-star ratings of nursing homes based on health inspections, staffing, and quality measures. See https://www.medicare.gov/nursinghomecompare/search.html However, Medicare’s rating system is far from perfect. The staff level and quality statistics ratings are based largely on self-reported data that the government does not verify. The ratings also do not take into account state fines and enforcement data or consumer complaints to state agencies. Nursing homes have learned how to game the system to improve their ratings.

While Nursing Home Compare doesn’t include consumer feedback, Yelp and other online platforms like Facebook, Google, and Caring.com allow users to review individual nursing homes. These user reviews are highly subjective, and it can be difficult to judge their legitimacy. These reviews are not usually taken seriously–for example, consumer guides to finding a nursing home do not usually suggest that consumers consult online reviews. (It should be noted, however, that Caring.com goes to great lengths to ensure the integrity of its reviews, including having senior care experts read every submission before publication.) See https://www.caring.com/about/review_guidelines/

In order to better understand what consumers were saying about nursing homes online, researchers at the University of Southern California evaluated 264 Yelp reviews and grouped them into categories. The researchers found that consumers rate different aspects of nursing home care than does the official rating system. User reviews were more emotional and more likely to focus on staff attitudes and responsiveness rather than on the quality of health care. See https://academic.oup.com/gerontologist/article/58/4/e273/4980329

The researchers concluded that user reviews can be used in conjunction with the Nursing Home Compare site to paint a fuller picture of life at the nursing home because they present complementary information. According to the study, online reviews shouldn’t be dismissed because they “directly capture the voices of residents and family members, precisely the kind of information nursing homes and their consumers need to hear and may want to act on, if resident-directed care is to be achieved.”

Yelp has gone a step further than other consumer review sites and has teamed up with the investigative news organization, ProPublica, to provide users with additional information. ProPublica’s Nursing Home Inspect site, allows users to compare nursing homes based on federal data. Yelp users viewing a nursing home review page see a ProPublica box that provides information on the nursing home’s deficiencies and fines.

To read an article about the study, See
https://www.nytimes.com/2018/05/11/health/nursing-home-ratings-yelp.html

Profile of Older Americans

A report tiled the 2019 Report on Older Americans was just released by the Administration on Aging (AoA), part of the Administration for Community Living, an operating division of the U.S. Department of Health and Human Services. Some of the many interesting facts revealed are:

1. Over the past 10 years, the population age 65 and older increased from 38.8 million in 2008 to 52.4 million in 2018 (a 35% increase) and is projected to reach 94.7 million in 2060.

2. In 2018, older women outnumber older men at 29.1 million older women to 23.3
million older men.

3. A larger percentage of older men (69%) were married as compared to older women (47%). In 2019, 31% of older women were widows.

4. The need for caregiving increases with age. In 2018, the percentage of older adults age 85 and older who needed help with personal care (21%) was more than twice the percentage for adults ages 75–84 (8%) and five times the percentage for adults ages 65–74 (4%).

5. The 85 and older population is projected to more than double from 6.5 million in 2018 to 14.4 million in 2040 (a 123% increase).

6. There were 93,927 persons age 100 and older in 2018 – almost triple the 1980 figure of 32,194.

7. The older population is expected to continue to grow significantly in the future. Growth slowed somewhat during the 1990’s because of the relatively small number of babies born during the Great Depression of the 1930’s. But the older population is beginning to burgeon again as more than one-third (36%) of the “baby boom” generation is now age 65 and older.

8. The population age 65 and older increased from 38.8 million in 2008 to 52.4 million in 2018 (a 35% increase) and is projected to reach 94.7 million in 2060. By 2040, there will be about 80.8 million older persons, more than twice as many as in 2000.

The full report is available at
https://acl.gov/aging-and-disability-in-america/data-and-research/profile-older-americans

How Will the Coronavirus Pandemic Affect Social Security?

The coronavirus pandemic is having a profound effect on the current U.S. economy, and it may have a detrimental effect on Social Security’s long-term financial situation. High unemployment rates mean Social Security shortfalls could begin earlier than projected.

Social Security retirement benefits are financed primarily through dedicated payroll taxes paid by workers and their employers, with employees and employers splitting the tax equally. This money is put into a trust fund that is used to pay retiree benefits. The most recent report from the trustees of the Social Security trust fund is that the fund’s balance will reach zero in 2035. This is because more people are retiring than are working, so the program is paying out more in benefits than it is taking in. Additionally, seniors are living longer, so they receive benefits for a longer period of time. Once the fund runs out of money, it does not mean that benefits stop altogether. Instead, retirees’ benefits would be cut, unless Congress acts in the interim. According to the trustees’ projections, the fund’s income would be sufficient to pay retirees 77 percent of their total benefit.

With unemployment at record levels due to the pandemic, fewer employers and employees are paying payroll taxes into the trust fund. In addition, more workers may claim benefits early because they lost their jobs. President Trump has also floated a suspension of payroll taxes as a form of economic relief, which could negatively affect Social Security and Medicare funds.

Some experts believe that the pandemic could move up the depletion of the trust fund by two years, to 2033, if the COVID-19 economic collapse causes payroll taxes to drop by 20 percent for two years. Other experts argue that it could have a greater effect and deplete the fund by 2029. However, as the Social Security Administration Chief Actuary morbidly noted to Congress, this pandemic different from most recessions: the increased applications for benefits will be partially offset by increased deaths among seniors who were receiving benefits.

It remains to be seen exactly how much the pandemic affects the Social Security trust fund, but the experts agree that as soon as the pandemic ends, Congress should take steps to shore up the fund.

For more information about the pandemic and Social Security benefits, click here  https://www.nextavenue.org/pandemic-could-shrink-social-security-benefits/