What Doesn’t Medicare Cover?

Medicare Part A and Part B are also known as Original Medicare or Traditional Medicare. These two parts cover a large portion of your medical expenses, after you turn age 65. Part A is hospital insurance that helps pay for inpatient hospital stays, stays in skilled nursing facilities, surgery, hospice care and even some home health care.

Part B is your medical insurance that helps pay for doctors’ visits, outpatient care, some preventive services and some medical equipment and supplies. Most seniors can enroll in Medicare three months before the month they turn 65.

Kiplinger’s article, “7 Things Medicare Doesn’t Cover,” takes a closer look at what isn’t covered by Medicare, plus information about supplemental insurance policies and strategies that can help cover the additional costs, so you don’t wind up with unanticipated medical bills in retirement.

Prescription Drugs. Medicare doesn’t provide coverage for outpatient prescription drugs. However, you can purchase a separate Part D prescription-drug policy for that or a Medicare Advantage plan that covers both medical and drug costs. You can sign up for Part D or Medicare Advantage coverage, when you enroll in Medicare or when you lose other drug coverage. You can switch policies during open enrollment each fall.

Long-Term Care. Medicare provides coverage for some skilled nursing services but not for custodial care. That includes things like help with bathing, dressing and other activities of daily living. However, you can purchase LTC insurance or a combination long-term-care and life insurance policy to cover these costs.

Deductibles and Co-Pays. Part A covers hospital stays and Part B covers doctors’ services and outpatient care. Nonetheless, you have to pay out-of-pocket for deductibles and co-payments. Note that over your lifetime, Medicare will only help pay for a total of 60 days beyond the 90-day limit (“lifetime reserve days”). After that, you’ll pay the full hospital cost. Part B typically covers 80% of doctors’ services, lab tests and x-rays. However, you must pay 20% of the costs, after a $183 deductible (in 2018). A Medigap (Medicare supplement) policy or Medicare Advantage plan can fill in the gaps, if you don’t have the supplemental coverage from a retiree health insurance policy. If you purchase a Medigap policy within six months of signing up for Medicare Part B, insurers can’t reject you or charge more because of preexisting conditions. Medicare Advantage plans have medical and drug coverage through a private insurer. They also may also provide additional coverage, like vision and dental care. You can switch Medicare Advantage plans annually in open enrollment.

Most Dental Care. Medicare will not provide coverage for routine dental visits, teeth cleanings, fillings, dentures or most tooth extractions. There are Medicare Advantage plans that cover basic cleanings and x-rays, but they usually have an annual coverage cap of about $1,500. You could also get coverage from a separate dental insurance policy or a dental discount plan.

Routine Vision Care.  Medicare doesn’t cover routine eye exams or glasses (exceptions include an annual eye exam, if you have diabetes or eyeglasses after certain kinds of cataract surgery). However, some Medicare Advantage plans give you vision coverage, or you may be able to purchase a separate supplemental policy that provides vision care alone or includes both dental and vision care. If you saved money in a health savings account before you enroll in Medicare, you can use the money tax-free at any point for glasses, contact lenses, prescription sunglasses, and other vision care out-of-pocket expenses.

Hearing Aids. Medicare doesn’t cover routine hearing exams or hearing aids, but some Medicare Advantage plans cover hearing aids and fitting exams, and some discount programs provide lower-cost hearing aids.

Medical Care Overseas. Medicare usually doesn’t cover care you receive while traveling outside of the U.S., except for very limited situations (like on a cruise ship within six hours of a U.S. port). However, Medigap plans C through G, M, and N cover 80% of the cost of emergency care abroad with a lifetime limit of $50,000. There are some Medicare Advantage plans that cover emergency care abroad. Another option is to purchase a travel insurance policy that covers some medical expenses, while you’re outside of the U.S.

Reference: Kiplinger (May 23, 2018) “7 Things Medicare Doesn’t Cover”

Just What are the Responsibilities of a Financial POA?

The concept of a power of attorney sounds simple but there is a lot to know about this important part of an estate plan, says the Rushville Republican in “Financial power of attorney responsibilities.” Whether you are named as someone’s power of attorney or you are considering who to name on your behalf, it is important to understand the terminology, the role and the responsibilities.

The person who signs the POA is called the “principal” and the person to whom authority is given, is often referred to as the “attorney in fact” or the “agent.”

What powers are given to the person who becomes the agent? In some POAs, there are limits placed on the person, but in most cases the power is “general.” In these cases, the agent can do whatever the individual would do. That includes opening bank accounts, buying and selling property, managing investments, filing taxes, cashing checks and closing accounts. An agent is a considered a fiduciary of the principal, which means that he has a legal duty to act in the principal’s best interest.

The agent may not change the principal’s will and he is not permitted to transfer such authority to act as an agent for the principal to anyone else, unless specifically authorized in the POA itself.

There are different types of POAs. When they become effective, depends on their type.  A financial POA is typically effective the moment it’s signed by the principal. However, a “springing” POA becomes effective, only when a specific event, which is described in the POA document, takes place. If the springing POA is to take effect when the principal becomes incapacitated, usually one or more physicians must agree that the principal can no longer make decisions on their own behalf. If you have been named a POA, talk with the principal about their intentions.

The POA generally is not recorded in a courthouse. If you are signing a document for the principal that does have to be recorded with the county, like a deed to a house, then you will need to present and record the POA with the county recorder, before the document can be recorded. The laws in your state or county may be different, so check with your estate planning attorney to be certain.

Some people decide to have more than one agent. It’s not unusual, but it can lead to some complications. The wording should include the agents being appointed “severally,” so that they can act independently of one another, if that is appropriate under the circumstances. If one person is on the West Coast while the principal and another agent live on the East Coast, not having the ability to act independently could create problems for the agent and the principal.

The POA should remember to keep his assets and the principal’s assets separate. Money should not be intermingled in bank accounts or investment accounts. This is a very important point, since the fiduciary responsibility is a serious matter. The POA can be changed or revoked by the principal at any time, as long as she is mentally competent.

The POA ends with the death of the principal. It is meant to be used as a helpful tool, while the person is living. After the person dies, the executor takes over as the personal representative of the person’s estate.

Speak with your estate planning attorney about making the decisions as to who should be your Power of Attorney. This is a very important role and it must be someone who you can trust implicitly and who is also willing to take on the responsibilities.

Reference: Rushville Republican (Jan. 22,2019) “Financial power of attorney responsibilities”

What’s so Bad About Having a Will Probated?

The process of probating a will and why it matters, is reviewed by nwi.com in the article “Estate Planning: Do wills need to be probated?” When most people refer to probate, they typically mean that a court appoints or approves a personal representative and opens the estate. If that is what is being described, an estate plan can be established without opening a probate estate. Not all wills are probated.

Bear in mind that the only assets subject to probate, are those that are controlled by the will. Assets that the decedent owned in his or her name alone without beneficiary designations are probate assets. If the asset is owned in two people’s names or contains a beneficiary designation or is a POD—Payable on Death—or TOD—Transfer on Death—those assets are not probate assets.

One reason to probate an estate, is to determine who receives the property of the person who has passed. If the account is owned jointly in two people’s names, typically a husband and wife or parent and child, then the surviving joint owner becomes the full owner at the time of death. A bank or financial institution will probably want to see a death certificate to verify that the other person on the account has passed.

This is also true for a CD—Certificate of Deposit—if there are two names on it.  It also applies to any real estate that is held in two names. Ownership for these assets, properly titled in more than one name, are not a big deal, if the titles have been done properly.

Therefore, using joint ownership or naming beneficiaries for most or all of the assets, removes the need to probate much of the will. However, in some instances, some attorneys like to present the will for probate, but ask that a personal representative not be appointed, and no estate opened. This is called “spreading the will for record” and it preserves the will. Wills need to be presented for probate within the statutory deadline for your state. These timeframes can range from six months to within three years of the death of the decedent (your estate planning attorney will know your state’s laws on this matter). If this is not done, then the will may not be accepted by the court as valid.

By spreading the will, the will is preserved in the outside chance that an asset is uncovered in the future, even after the statutory timeframe has expired. When the beneficiaries of the will are not the same as family members found under intestate statutes, like a pour-over will, where the trust receives all the property under the will, it makes this strategy especially valuable. Spreading the will further ensures that the trust estate plan will be carried out. Trusts are rarely presented to the court for probate.

In some regions, probate is a quick and relatively painless process. Depending on the situation, there may be little gained by over-engineering the estate just to avoid probate. Speak with your estate planning attorney about probate and also determine how much of your estate will be probate assets.

Reference: nwi.com (Jan. 20, 2019) “Estate Planning: Do wills need to be probated?”

Who Will Pay for Your Nursing Home Care?

It’s hard for everyone in the family, when a beloved parent or grandparent must enter a nursing home, because they can no longer live on their own. Often the result of a physical or mental decline, the difficultly is compounded by worries about how to pay for the care, reports The Ledger in the article “The Law: Are you eligible for Medicaid nursing home coverage?”

Once health insurance coverage ends, the cost of care becomes enormous, with the monthly cost for a private-pay resident at nursing homes often exceeding $10,000 a month. What usually happens? Residents can’t afford the care and only have two options: qualify for Medicaid Nursing Home coverage, or sell every asset they can, impoverish the spouse, and ask adult children or other family members for help. Most people contact an elder law attorney and explore becoming eligible for Medicaid Nursing Home coverage.

Let’s use the state of Florida for an example of how to qualify for this coverage. A person must pass a three-part test that examines their assets, income and health, at the time the application is filed.

Income. As of Jan. 1, 2019, you could have a maximum of $2,313 per month in income (before deductions) to be eligible for Medicaid Nursing Home coverage. If your income was above that number, then legal planning is necessary to create a qualified income trust. Timing is extremely important, because if the trust is not set up correctly or in a timely fashion, you will not qualify for Medicaid.

There is a common mistake made about a spouse’s income being too high. It’s happily not true: a spouse’s income can be unlimited, and it does not impact a Medicaid applicant’s eligibility for benefits.

Assets. As of Jan. 1, 2019, you may have a maximum of $2,000 of countable assets and be eligible for Medicaid Nursing Home coverage. If the assets are above that threshold, there are a number of acceptable legal options to help the individual become eligible. There are two types of asset classes to consider when applying for Medicaid Nursing Home coverage: countable and non-countable.

Some non-countable assets are as follows: In South Dakota, homestead property up to $858,000 in value, one automobile, a prepaid burial contract and term life insurance without a cash value. Countable assets include bank accounts, investment accounts, life insurance with cash value, CDs and annuities.

As of Jan. 1, 2019, a spouse may have a maximum of $126,420 of countable assets, without having an impact on their spouses’ Medicaid eligibility.

An elder law attorney should be consulted to help the family understand the income and asset tests and create a strategy to help the individual qualify, if they anticipate needing Medicaid Nursing Home coverage. It’s best to do this well in advance, if possible.

Reference: The Ledger (Jan. 9, 2019) “The Law: Are you eligible for Medicaid nursing home coverage?”

How Caregiving Can Impact Older Women

When an older woman takes care of a loved one, it can be at the expense of the caregiver’s physical, emotional, and financial health. Many women end up in poverty in retirement because they had to leave the workforce at the peak of their careers to care for someone. With more than 40 million people in America serving as unpaid caregivers for family members and most of the caregivers being women, we need to understand how caregiving can impact older women.

Caregiving Affects Our Entire Economy

When you have tens of millions of workers or former workers who have to reduce their hours or drop out of the workforce because a family member needs care, the caregivers face poverty, but our overall economy suffers as well. Whenever significant numbers of people are unemployed or under-employed, the economy loses those wages, the income taxes and everything that the person would have bought, if fully employed.

Caregivers Take a Hit on Social Security Benefits

The amount you receive in monthly Social Security retirement benefits will depend on several factors, including:

  • Your average wages for your 35 highest-earning years. Making less money a year because of caregiving will lower your Social Security check when you retire. If you have to quit work to take care of a family member before working for 35 years, those missed years will count as zero earnings, which can slash the amount of your average wages. Since our last working years tend to be when we make the most money, missing out on these years will leave you with a check based on things like your jobs during college.
  • When you retire. If you start collecting benefits early, your monthly Social Security check will be much smaller than if you can wait until full retirement age. If you can wait beyond your full retirement age, you will get a bonus added to every Social Security check you ever receive. The bonus gets larger the longer you wait to start collecting benefits, until age 70, when there is no additional bonus. You will still collect the bonuses for the rest of your life, but they will not increase in size, except for things like cost-of-living adjustments (COLA).

The Physical and Emotional Toll of Caregiving

Being responsible for someone with fragile health puts a mountain of stress on your shoulders.  Unless you have a large, involved family nearby, you might be carrying this responsibility by yourself. Imagine what would happen to an ICU nurse who was on duty 24 hours a day, seven days a week, 365 days a year. Before long, her health would suffer.

The physical and emotional exhaustion would be unbearable, yet millions of Americans call that description everyday life. When a caregiver who had to leave her job gets sick, she often does not have health insurance. Her medical bills then add to her already overwhelming stress.

Are There Solutions to the Caregiver Problem?

Most developed countries offer better supports to families, who have a person with care needs. As a result, women can stay in their labor force in much higher numbers, which helps the family’s income and the country’s overall economy. Without additional supports, American caregivers face a bleak future.

Talk with an elder law attorney near you to see if your state’s regulations differ from the general law of this article.

References:

AARP. “The Trickle-Down Effect of Caregiving on Women.” (accessed January 8, 2019) https://www.aarp.org/caregiving/basics/info-2018/women-caregiving-trickle-down-effect.html

Self Employed People Get to Retire Too–If they Plan Well

People who work for companies have access to perks like 401(k) plans, with automatic deductions that let them put retirement savings on autopilot. However, when you work for yourself, it’s all up to you, says Zing! in the aptly-titled article “Saving for Retirement When You’re Self-Employed? It Takes Planning and Commitment.” If you have the discipline and self-motivation to run a business, you should be able to apply those skills to your retirement.

Here are some tips for self-employed people who are concerned with building their retirement savings.

Embrace a budget. One of the biggest challenges is income that fluctuates. It’s hard to save when one month has you earning $10,000 and $3,000 the next month. You’ll need to create a budget and stick with it, including budgeting a percentage of your income for retirement. While you’re creating a budget, set goals for short- and long-term objectives to keep your budgeting focused.

A budget should include necessary expenses for each month, including mortgage or rent, car loans and credit card payments. Include groceries, transportation, and health care costs. Some self-employed people pay for some items like transportation or entertainment out of their business accounts. If you do that, just work with one budget, so you can measure spending. There is no need to split things out for yourself. You should then look at discretionary items like vacations, entertainment, gym memberships, clothing and things that are not basic necessities.

Now see what’s left at the end of the month. If there’s no regular stream of money going into retirement savings because there’s not enough after spending, you may need to make some changes.

Create an item in your expense budget for retirement savings. Make it automatic. Set a fixed amount of your income, by dollar amount or percentage of monthly income, and put it away every month for your retirement. This takes discipline at first and then becomes a habit. Once you see how the account grows, you’ll be more inclined to continue.

Talk with your accountant about the best savings vehicle for you. Some self-employed individuals use a “solo” 401(k) account, known as a SEP or Self-Employed 401(k). Designed for employers who have no employees other than themselves (or their spouses), it offers the same benefits as traditional 401(k)s. In 2019, you can contribute up to $19,000 when contributing as an employee, or up to $24,500 if you are 50 and older. As an employer, you can contribute up to 25% of your compensation – not counting catch-up contributions for those 50 and older, you can go as high as $55,000 in 2019.

Another factor if you are self-employed is your estate plan. Entrepreneurs are often so busy working on their business, that they forget about the legal side of their personal lives. You need a will, power of attorney, health care power of attorney and, depending on your business and life situation, a succession plan.

Reference: Zing! (Jan. 7, 2019) “Saving for Retirement When You’re Self-Employed? It Takes Planning and Commitment”

What is Some Good Advice on Charitable Giving in 2019?

Research shows that about a third of the year’s online giving is done in December. That looks like some last minute gifts. But what if you took the time to define your charitable mission and prepared in choosing your charities?

The Reno Gazette Journal’s article, “Get an early jump on charitable giving” looks at tax planning opportunities for charitable giving, specifically in light of the Tax Cuts and Jobs Act and Qualified Charitable Distributions (QCD). Here’s a review of why people give. The primary reasons for donating include the following:

  • Personal experience;
  • Being proactive in solving a problem;
  • Taking a stand on an issue;
  • Personal recognition;
  • It’s a good thing to do; and
  • Making a difference.

The true effect of the new tax laws won’t be known, until after the country’s tax returns are filed in April. Some–such as Giving USA–think that charitable giving will decrease, but others contend that high-income taxpayers will be motivated to donate more.

It’s now more difficult for individuals to hit the threshold required to qualify for the deduction. Taxpayers can either take the standard deduction or itemize their deductions. The standard deduction has doubled. Deductions for state and local taxes are capped at $10,000, and mortgage interest may be limited. The Council on Foundations estimates 5 to 12% fewer Americans will itemize. So if you can only take the standard deduction, think about “lumping” contributions into every two or three years to itemize deductions for that year.

QCDs are direct transfers from IRAs to eligible charities. For this to happen, the IRA accountholder must be 70½ or older. The benefits of the QCD include:

  • The distribution goes directly to charity from the IRA;
  • It’s not includible in your income; and
  • It counts towards satisfying your required minimum distribution (RMD).

Note that QCDs can come only from IRAs and not from employer-sponsored plans (SEP, SIMPLE and 401(k)). However, you might be able to roll those employer plans to IRAs to be eligible for QCDs.

If you qualify for itemized deductions, the QCD is still better for you because it reduces your AGI, which is more favorable than a charitable deduction which reduces taxable income.

You should also remember that donor-advised funds and private family foundations are excluded.

Reference: Reno Gazette Journal (January 9, 2019) “Get an early jump on charitable giving”

Market Volatility Has You Worried? Here’s Something You Can Control

When investors are faced with turbulent markets, there’s a human response to want to do something—sometimes, anything. We’re hardwired to try to take control. That doesn’t always help us make the best investment decisions. However, as reported in this Daily Camera’s article, there is something that you can do that may make you feel better: “Freaked out about the market? Resolve to get your estate in order.”

If you care about your health care, financial affairs, minor children and even your beloved pets, this is an important task to take care of. An estate plan includes legal documents that help you, when you are living and helps your heirs, when you die. In addition to a will, powers of attorney that will give your loved ones the ability to manage your affairs, if you become incapacitated. An updated will ensures that your assets go to the inheritors you chose. Don’t forget your beneficiaries.

Your beneficiaries are the people who are named on several accounts and life insurance policies. You may have named people on investment accounts, life insurance policies, IRAs, bank accounts, annuities and other assets. If you have not done a full review of those documents in a while, you want to take care of this right away. Life and relationships change over time, and the people you originally named as your beneficiaries, may no longer be the ones you would select today. Note that any changes must be made while you are living—when you are passed, the beneficiaries receive the asset, regardless of what is written in your will.

If you’re not sufficiently motivated to make an appointment with an estate planning attorney, you should be aware that if you don’t have a will, the laws of your state will determine who gets your assets and even, lacking a will that names a guardian, who rears your minor children. You may or may not be a fan of court proceedings, but if you don’t have a properly prepared will, the court is going to be making a lot of decisions on your behalf.

Contact an estate planning attorney to begin the process of putting your affairs in order. An attorney whose practice focuses in this area of the law, is most likely a better choice than one who does wills on the side. There are many complex laws in estate planning, and there are many opportunities available to make the most out of your assets and grow your legacy. An estate planning attorney will know what will work best for you and your family.

Reference: Daily Camera (Jan. 6, 2019) “Freaked out about the market? Resolve to get your estate in order”

Suggested Key Terms: Estate Plan, Will, Power of Attorney, Minor Children, Guardian, Beneficiaries

Legacy Planning for Farm and Ranch Families

An inheritance is more than money or property, especially when it comes to family farms, ranches and businesses. Many survive for multiple generations, says the Woodward News in the article “Plenty to consider in legacy planning,” but it takes planning.

Knowing that one day your grandchildren, and hopefully their children, will walk the land their great-grandparents did, and take the same satisfaction in knowing that the work they do, is a part of our country’s economy. Every family’s situation is different but one thing they all share in common, is that succession goals need to be evaluated critically, even though there is great emotion involved in passing on a legacy.

Dividing assets, sharing control and management decisions and transferring ownership are all things that must be examined and formalized as part of a succession plan.

For starters, determine the overall goal. Every family’s goals are different. Should assets be held for end-of-life-care for aging parents, passed on to children, donated to charity or are they needed to ensure the successful transition of the business to the next generation?

People work hard their whole lives to accumulate assets, so it’s important to have a legacy plan.  In this way, everything you’ve worked for is preserved for the next generation or available for your needs as you age.

In 2019, gift and estate tax exemptions are up dramatically, but strategic planning still needs to be done.

For farm families, the Farm Journal Legacy Project offers printable downloads, including a succession planning action guide, family meeting agenda, conversation starters and a goals clarification worksheet.

Family meetings will need to tackle some topics that may benefit from the presence of an estate planning attorney, who is experienced with family farms and succession planning.

  • How will the transfer of property, including farm equipment, property, and livestock, be done with minimal taxes due?
  • How can the non-farming members of the family receive their fair share of their inheritance, without taking away valuable resources needed to keep the farm or ranch going?
  • What resources will be available for the older parents to live on, when they retire?
  • Can the farm support multiple generations?

Succession planning that works best, begins long before the farm family is thinking about retirement. Determining roles and responsibilities and setting accountability for those roles must start happening long before the oldest generation steps away from the day-to-day operations of the farm or ranch.

Reference: Woodward News (Jan. 2, 2019) “Plenty to consider in legacy planning”

 

Do I Need a Business Budget?

Estimating and matching expenses to revenue (real or anticipated) is vital. This exercise helps small business owners to determine whether they have enough money to fund operations, expand the business and generate income. Investopedia says in its article “6 steps to a better business budget” that without a budget or a plan, a business runs the risk of spending more money than it’s taking in, or not spending enough money to grow the business and compete successfully.

Every business owner will have a somewhat different process, situation or way of budgeting. However, every business owner should consider the mortgage, utility bills, payroll expenses, cost of goods sold, expenses (raw materials), interest, tax payments and any other costs specifically associated with the business, when setting up or taking over an existing business.

A business that’s already up and running can make assumptions of future revenue based on recent trends in the business. If it’s a startup, you’ll have to make assumptions based on your geographic area, hours of operation and research of other local businesses.

After you have this information, you should then match the business’s revenue with expenses. Calculate what an average weekly expense would be for overhead, utilities, labor, raw materials, etc. Based on this information, you may then be able to estimate whether you’ll have enough extra money to expand the business, or to save. Similarly, owners may see that to have three employees instead of two, they’ll have to generate more in revenue each week.

Use these six tips to help you put together a small business budget:

  1. Industry Standards. Conduct some research for data about the industry, speak with local business owners, visit the local library, and look at the IRS web site to get an idea of what percentage of the revenue coming in will likely be allocated toward cost groupings. Small businesses can be extremely volatile, since they are more susceptible to industry downturns than larger, more diversified competitors.
  2. Create a Spreadsheet. Prior to buying or opening a business, make a spreadsheet to estimate what total dollar amount and percentage of your revenue will need to be allocated toward raw materials and other costs. Talk with any suppliers you’d have to work with before you continue. Do the same thing for rent, taxes, insurance, etc.
  3. Add in Some Breathing Room. While you may estimate that the business will generate a certain rate of revenue growth going forward or that certain expenses will be fixed or can be controlled, these are never set in stone. Factor in some slack and make certain that you have more than enough money saved or coming in, prior to expansion or adding new employees.
  4. Cost-cutting. Review items that can largely be controlled. You should also wait to make purchases until the start of a new billing cycle, or take full advantage of payment terms offered by suppliers and creditors. A little maneuvering could give a business owner some much needed breathing and expansion room.
  5. Review the Business. Although many firms draft an annual budget, small business owners should do so this more often. It’s not uncommon for small business owners to plan only a month or two ahead, because business can be quite volatile and unexpected expenses can ruin revenue assumptions.
  6. Keep an Eye Out for Less Expensive Services and Suppliers. Don’t be afraid to shop around for new suppliers or to save money on other services being used by your business.

Budgeting is easy, but it’s an essential process that business owners use to forecast (and then match) current and future revenue to expenses. Make certain that enough money is available to keep the business operating, to grow the business, to compete and to ensure a solid emergency fund.

Reference: Investopedia (June 26, 2018) “6 steps to a better business budget”