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Thank you for choosing to meet with us today. We look forward to serving your long term care planning needs. A Long Term Care Planning Firm.

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Presentation on theme: "Thank you for choosing to meet with us today. We look forward to serving your long term care planning needs. A Long Term Care Planning Firm."— Presentation transcript:

1 Thank you for choosing to meet with us today. We look forward to serving your long term care planning needs. A Long Term Care Planning Firm

2 Services Education & Planning You indicated an interest in... Arizona Long Term Care System Medicare Cost-Sharing and acute care AHCCCS Veterans Administration Legal document preparation Non-government benefit financial planning Mortgage Debt Reduction Planning A Long Term Care Planning Firm

3 3 Phases for today’s appointment PHASE ONE Education PHASE THREE Summary & Options PHASE TWO Interview & Questionnaire A Long Term Care Planning Firm

4 ALTCS AHCCCS

5 ARIZONA’S VERSION OF MEDICAID AHCCCS ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM Programs for elderly, physically disabled, children, pregnant women, and indigent families. Programs administered through the AHCCCS Administration and the Department of Economic Security. A Long Term Care Planning Firm

6 ALTCS ARIZONA LONG TERM CARE SYSTEM Program helps pay for long term care and acute care expenses for the Elderly Physically Disabled Blind Developmentally Disabled A Long Term Care Planning Firm

7 ALTCS ELIGIBILITY CRITERIA NON-FINANCIAL MEDICAL FINANCIAL A Long Term Care Planning Firm

8 AHCCCS/ALTCS Non-Financial Eligibility Checklist Can the applicant be “linked” to the program through age or disability? Can the applicant verify his/her Social Security Number? Can the applicant prove US Citizenship or a qualified alien status? Can the applicant prove identity? Does the applicant live in and intend to remain in Arizona? If married, can the applicant verify marriage? Is the applicant residing in an ALTCS-approvable setting? Is the applicant potentially eligible for other benefits? Does the applicant have third-party liability? For ALTCS only—Is the applicant at risk of institutionalization? A Long Term Care Planning Firm

9 AHCCCS/ALTCS Medical Eligibility Checklist Requires nursing care by or under the supervision of a nurse on a daily basis; Requires regular medical monitoring; Impaired cognitive functioning; Impaired self care with activities of daily living; Impaired continence; Psychosocial deficits. A Long Term Care Planning Firm

10 ALTCS Financial Eligibility INCOME LIMIT RESOURCE LIMIT UNCOMPENSATED TRANSFERS A Long Term Care Planning Firm

11 ALTCS METHOD OF SERVICE DELIVERY Assigns Case Manager Program contractor works with Contracted Providers NURSING FACILITIES (semi-private) ADULT CARE HOMES (semi-private) ASSISTED LIVING CENTERS (semi-private) ADULT FOSTER CARE HOMES HOME & COMMUNITY-BASED SERVICES Adult day care, Personal Care, Attendant Care, Respite, Home-delivered meals, Home health aid & nursing, Homemaker, Companion, Behavioral health, Home infusion DOCTORS HOSPITALS PROGRAM CONTRACTOR 1. Mercy Care Plan or 2. SCAN Long Term Care or 3. Bridgeway ALTCS AHCCCS A Long Term Care Planning Firm

12 COST TO ALTCS MEMBER Gross Income minus the allowable deductions: personal needs allowance spousal allowance health insurance premiums equal the Share of Cost (SOC) or Room & Board (R&B) payment A Long Term Care Planning Firm

13 Medicare Cost-Sharing AHCCCS

14 Qualified Medicare Beneficiary & ACUTE CARE AHCCCS The QMB program provides medical assistance including payment of a member’s Medicare Part B premium, annual deductibles, and co- insurance, up to and including acute care medical services. Members may qualify for this program if they meet non-financial guidelines, have Medicare Part A, and meet the income guidelines. If total gross monthly income < $867.00, a single applicant is potentially eligible. If total gross monthly income < $ , a married couple is potentially eligible. A Long Term Care Planning Firm

15 Specified Low-Income Medicare Beneficiary The SLMB program provides medical assistance by paying for a member’s Medicare Part B premium. Members may qualify for this program if they meet non-financial guidelines, have Medicare Part A, and meet the income guidelines. If total gross monthly income $ $ , a single applicant is potentially eligible. If total gross monthly income $ $ , a married couple is potentially eligible. A Long Term Care Planning Firm

16 Qualified Individual-1 The QI-1 program provides medical assistance by paying for a member’s Medicare Part B premium. Members may qualify for this program if they meet non-financial guidelines, have Medicare Part A, and meet income guidelines. If total gross monthly income $ $ , a single applicant is potentially eligible. If total gross monthly income $ —$ , a married couple is potentially eligible. A Long Term Care Planning Firm

17 AHCCCS & MCS RESOURCE ELIGIBILITY There are no resource (asset) guidelines for the acute AHCCCS*, QMB, SLMB, and QI-1 programs. A Long Term Care Planning Firm

18 If not a Veteran or a widow of a Veteran who served during wartime, please skip next section. Benefits through the Veterans Administration

19 VETERANS ADMINISTRATION POTENTIAL BENEFITS If you are a Veteran or widow of a Veteran who served at least 90 days active duty with at least one day served during a war-time period, and you were discharged other than dishonorably; AND... If your assets (not necessarily including your home and automobile), are just enough to cover 12 months of expenses or less; AND... If your income each year is less than the threshold set by the Veterans Administration. NOTE: The actual cost of unreimbursed medical care minus 5% of the MAPR can be used to offset your annual income. Medical care may include, but is not limited to monthly charges by assisted living or nursing facilities, adult care home, costs of doctor’s appointments and non- reimbursed prescription amounts, medical supplies, eye glasses, hearing aids, travel to medical appointments, etc.); THEN... You may be eligible for a cash benefit from the Department of Veterans Affairs (VA). THOSE THAT... Have a medical diagnosis by a doctor (yours and/or the VA doctor) that states that you cannot live independently and need regular assistance and care, MAY QUALIFY FOR MORE CASH!!! A Long Term Care Planning Firm

20 VETERANS ADMINISTRATION POTENTIAL BENEFITS VA Compensation can pay the Veteran a monthly compensation if the Veteran is at least 10% disabled as a result of military service. VA Pension can pay the Veteran a monthly pension if the Veteran served at least one day within a war-time period, has limited income, as is permanently & totally disabled OR at least 65 years old. VA Dependency and Indemnity Compensation (DIC) can be paid to eligible survivors of service members who died on active duty, Veterans who died from service-related disabilities, and Veterans who were being paid 100% VA Disability when they passed away. Death Pension can be paid to a surviving spouse and dependent children when the death of the war-time Veteran was not service- connected. This type of benefit is based on need. Aid and Attendance and Housebound assistance are additional funding that can be obtained when a Veteran or widow of a Veteran requires the assistance of another person with some of their activities of daily living (ADLs) and cannot live independently OR if the Veteran or widow of the Veteran is blind. ADLs include bathing, dressing, grooming, toileting, mobility, transferring, meals, transportation, housekeeping, etc. These benefits are also needs- based; however, VA does reduce the income by the medical expenses incurred by the Veteran or widow. A Long Term Care Planning Firm

21 VA EXCLUDED* ASSETS VA COUNTABLE ASSETS SINGLE FAMILY UNIT DWELLING Cash Financial Accounts Annuities Investments Property Other vehicles Anything else of value, not excluded AUTO TERM LIFE INSURANCE BURIAL PLANS/CREMATION PLANS BURIAL PLOT & RELATED ITEMS HOUSEHOLD GOODS/PERSONAL EFFECTS A Long Term Care Planning Firm

22 ESTIMATED VA CASE NET WORTH Net worth of Countable Assets (CMV less encumbrances)= $ Minus 12 month’s cost of living- Remaining net worth=$ Those with a remaining net worth at or below $0.00 have a greater chance of proving need for VA pension.

23 A Long Term Care Planning Firm ESTIMATED VA INCOME ELIGIBILITY Gross yearly income (use both spouses income if married)= $ Minus the total yearly unreimbursed medical expenses - Plus 5% of the maximum* rate of pension + Sum of Income for VA purposes (remaining total)= $ Minus the maximum* rate of pension for this case - Remaining total after last subtraction= $ If remaining total is a negative number, divide it by twelve (12). If remaining total is not a negative number, you are not eligible for benefits at this time. The quotient equals the monthly pension estimate. $ For year 2009 the numbers are as follow: MAPR CategoryYearly incomeMAPR CategoryYearly income Veteran only11,830Widow only7,933 Veteran + 1 dependent15,493Widow + 1 dependent10,385 Housebound Vet only14,457Housebound Widow only9,696 Housebound Vet + 1 dependent18,120 Housebound Widow + 1 dependent 12,144 Vet only A&A19,736Widow only A&A12,681 Vet + 1 dependent A&A23,396Widow + 1 dependent A&A15,128 Two Vets married to each other15,493 For each addt’l child, add2,020

24 Legal Document Preparation Getting Your Paperwork in Order

25 Legal Document Preparation DID YOU KNOW... One out of every two Americans will suffer a period of prolonged disability in his or her lifetime. There is a need for pre-crisis planning and for getting your legal documents signed and in place. The alternative if you do not have your legal documents completed will be for your family to ask the court to appoint a guardian and/or conservator for you. Such procedures may be cumbersome, time-consuming and expensive. A Long Term Care Planning Firm

26 Legal Document Preparation Carol Aragon-Montgomery is a certified legal document preparer and can prepare the following legal documents for you and your loved ones: Durable Financial Power of Attorney Durable Medical Power of Attorney Mental Health Care Power of Attorney Living Will (Advanced Directives) Deeds Income-only Trust (applicable for ALTCS only) Estate Planning Portfolio (Living Trust, Wills, Powers of Attorney, Directions letters, Duties, etc.) A Long Term Care Planning Firm

27 Having your paperwork in order FINANCIAL POWER OF ATTORNEY A document that allows you to appoint someone to handle your financial affairs Choose someone you trust Durable means that the document continues to be legally valid even if you become incapable or unable to handle your finances You can make this document effective immediately or only upon your incapacitation You may want to name one or two back-up agents in case first person not available or unable to act as your agent Must be witnessed by someone not related to you and notarized A Long Term Care Planning Firm

28 MEDICAL POWER OF ATTORNEY A document that allows you to appoint someone to handle your medical care and health care decisions IF you become incompetent or incapacitated Choose someone you trust to honor your personal wishes with regard to your health care and health care treatments Only valid when you are incompetent or incapacitated and unable to express your health care wishes You may want to name one or two back-up agents in case first person not available or unable to act as your agent Must be either witnessed by two people not related to you OR notarized A Long Term Care Planning Firm Having your paperwork in order

29 Durable Mental Health Care Power of Attorney A document that allows you to appoint someone to handle your mental health care decisions and admit you into a psychiatric treatment facility IF you become incompetent or incapacitated Choose someone you trust to honor your personal wishes with regard to your mental health care and mental health care treatments Only valid when you are incompetent or incapacitated and unable to express your mental health care wishes You may want to name one or two back-up agents in case first person not available or unable to act as your agent Must be either witnessed by two people not related to you OR notarized A Long Term Care Planning Firm Having your paperwork in order

30 Living Will A document that allows you to express, in writing, which medical treatments you want or don’t want at the end of your life A document that tells your family and loved ones what YOU want and how you want to be treated at the end of your life Must be either witnessed by two people not related to you OR notarized Pre-hospital Medical Care Directive (DO NOT RESUSCITATE) A document that informs emergency medical personnel and hospital emergency personnel to NOT resuscitate you You are asking emergency personnel to NOT use equipment, drugs, or devices to restart your heart or breathing Must be on letter-sized orange colored paper or wallet-sized orange colored paper to be valid Must attach a picture or complete personal information with physical description Must be signed by you in front of a witness Must be signed by your witness and health care provider A Long Term Care Planning Firm Having your paperwork in order

31 Living Trust A trust is a written agreement that sets forth who will manage the assets place in it during your lifetime, in the event of your incapacity, and upon your death. Avoids the cost and delays of probate. Upon your death (and your spouse, if married), your Successor Trustee can distribute the assets almost immediately and with little or no additional expense (other than typical costs such as real estate commissions, etc.) Court supervision is not required. Avoids conservatorship if you become incapacitated. Keeps your estate affairs private. A Will that goes through probate makes all aspects of your estate a matter of public record. A Long Term Care Planning Firm Having your paperwork in order

32 Having your paperwork NOT in order... Costly—in cases involving attorneys, these costs can range from $2000 on up Guardianship Done through the court system Court decides if you can be guardian Conservatorship Done through the court system Must have a bond Court must approve expenditures A Long Term Care Planning Firm

33 Reducing Your Mortgage Pay-Off Next:

34 What would you spend your money on if you didn’t have a mortgage payment? Take more vacations? Purchase investment properties? Start your own business? Retire?

35 Innovative program helps homeowners nationwide pay off their mortgages in a fraction of the time WITHOUT refinancing their existing mortgage and with little lifestyle changes. Program uses innovative software with banking systems to reduce interest With this program the only thing you have to lose is your mortgage! Free analysis available.

36 Principals George L. Montgomery Has worked in the long term care planning field since 1992 (retired AHCCCS/ALTCS employee, Montgomery & Associates principal) Carol Aragon-Montgomery Has worked in the long term care planning field since 1991 (at ALTCS, for largest elder law firm in valley, & founder of Montgomery & Associates) A Long Term Care Planning Firm

37 SERVICES Initial evaluation $90.00 an hour ALTCS / AHCCCS / MCS Application Processes Long Term Care Planning Consulting fee quote based on sliding fee schedule / Flat Rate Financial Planning Services (insurance, investments, reverse mortgages, etc.) Mortgage Debt Reduction Planning Legal Document Preparation POAs—Financial, Medical, and Mental Health Living Will Deeds Income-only trust (for ALTCS only) Estate Planning Portfolio (Living Trust, etc.) A Long Term Care Planning Firm

38 Questions?


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