How to Find New Doctor for Mom if She Moves

Seasons’ recent article entitled “How do I help an older adult switch doctors after a move?” advises that breaking the process into manageable pieces will help you make sure you don’t miss any details.

First, check mom’s insurance because Medicare options are different when moving states. Check with Medicare to determine the process based on your mom’s existing coverage. Then you can find new health care providers.

Caregivers should have at least one dedicated three-ring notebook with dividers specifically for their loved one’s important information. Two is even better: one for financial information and one for medical information. Separate notebooks allow you to take the one with medical information to appointments without having sensitive financial information out and about at appointments.

Place some blank calendar pages in the front of the medical notebook. You’ll be able to organize your mom’s appointments in one place, as well as have a record of past appointments.

If you also use an online calendar like Google Calendar or iCalendar, create a color specifically for your mom’s appointments, so you can easily see the dates and times of her appointments.

Try using the paper option even if you also use an online calendar because this makes certain the information is easily accessible in case you need to share information with another person who helps with the caregiving.

Having all of your loved one’s medical information in one place that’s easily accessible will be invaluable when going to appointments at different doctors’ offices. You’ll have all of the info ready to share with different medical providers.

Once you get a system started to keep your mom’s information in an easily accessible place, it will be a pretty simple process to keep doctor appointments and medical information organized.

Reference: Seasons (Nov. 28, 2022) “How do I help an older adult switch doctors after a move?”

What are Biggest Medicare Open Enrollment Mistakes?

MSN’s recent article entitled “Don’t make these 5 common Medicare mistakes during open enrollment,” provides some of the common Medicare open enrollment mistakes:

Not checking your doctors for 2023. If you have a Medicare Advantage plan, you have to get medical care from doctors in the plan’s network. However, a plan’s network can change at any time. Therefore, before you decide to stick with the plan you’re in, make certain your preferred medical providers are still in the plan’s network in 2023. The best thing is to call the doctor’s office and just confirm with them.
Failing to compare prescription drug plans. No matter if you have Original Medicare or Medicare Advantage, your prescription drug coverage comes from a private insurance company. As a result, it may change what it covers each year. Your regular prescription medication may cost more in 2023, or an insurer may not cover it at all. Another plan may also cover it for less. It is, therefore, wise to plug your drugs into Medicare.gov to see what plans they suggest for you. If you log into your account at Medicare.gov, your medication history is already there.
Believing all doctors will take your PPO plan. A preferred provider organization (PPO) plan is a health plan that lets members see out-of-network doctors but usually at a higher price. People sometimes think because they have a Medicare Advantage PPO, they’ll be able to go to any doctor they want. However, providers don’t always take out-of-network coverage and can simply refuse someone at the point of service, if they don’t want to bill the plan.
Being influenced by the splashy ads. Medicare open enrollment season means Medicare commercials abound, and Medicare Advantage plans have appealing things to offer such as no premiums and some coverage for hearing, dental and vision care. However, shopping for your health coverage is about more than the side benefits. In fact, most don’t cover much dental, and hearing aid coverage is limited. This isn’t the reason to change your plan. It is more important to make sure that the plan covers your doctors and prescriptions for next year.
Waiting too long to ask for help. Medicare open enrollment ends December 7. However, you don’t want to wait to start your research. If you have questions, you can get help through programs like the State Health Insurance Assistance Program, or SHIP. Counselors at SHIP programs can offer free assistance with your Medicare choices.

Reference: MSN (Nov. 21, 2022) “Don’t make these 5 common Medicare mistakes during open enrollment”

Should You Agree to Being a Guardian?

Yes, it is an honor to be asked to be the guardian of someone’s children. However, you’ll want to understand the full responsibilities involved before agreeing to this life-changing role. A recent article from Kiplinger, “3 Key Things to Consider Before Agreeing to Be A Guardian in a Trust,” explains.

For parents, this is one of the most emotional decisions they have to make. Assuming a family member will step in is not a plan for your children. Naming a guardian in your will needs to be carefully and realistically thought out.

For instance, people often first think of their own parents. However, grandparents may not be able to care for a child for one or two decades. If the grandparent’s own future plan includes downsizing to a smaller home or moving to a 55+ community, they may not have the room for children. In a 55+ community, they may also not be permitted to have minor children as permanent residents.

What about siblings? A trusted aunt or uncle might be able to be a guardian. However, do they have children of their own, and will they be able to manage caring for your children as well as their own? You’ll also have to be comfortable with their parenting styles and values.

Other candidates may be a close friend of the family, who does not have children of their own. An “honorary” aunt or uncle who is willing to embark on raising your children might be a good choice. However, it requires careful thought and discussion.

Financial Considerations. What resources will be available to raise the children to adulthood? Do the parents have life insurance to pay for their needs, and if so, how much? Are there other assets available for the children? Will you be in charge of managing assets and children, or will someone else be in charge of finances? You’ll need to be very clear about the money.

Legal Arrangements. Is there a family trust? If so, who is the successor trustee of the trust? What are the terms of the trust? Most revocable trusts include language stating they must be used for the “health, education, maintenance, and support of beneficiaries.” However, sometimes there are conditions for use of the funds, or some funds are only available for milestones, like graduating college or getting married.

Lifestyle Choices. You’ll want to have a complete understanding of how the parents want their children to be raised. Do they want the children to remain in their current house, and has an estate plan been made to allow this to happen? Will the children stay in their current schools, religious institutions or stay in the neighborhood?

In frank terms, simply loving someone else’s children is not enough to take on the responsibility of being their guardian. Financial resources need to be discussed and lifestyle choices must be clarified. At the end of the discussion, all parties need to be completely satisfied and comfortable. This kind of preparedness provides tremendous peace of mind.

Reference: Kiplinger (Nov. 17, 2022) “3 Key Things to Consider Before Agreeing to Be A Guardian in a Trust”

The Basics of Estate Planning

No matter how BIG or small your net worth is, estate planning is a process that ensures your assets are handed down the way you want after you die.

Forbes’ recent article entitled “Estate Planning Basics” explains that everybody has an estate.

An estate is nothing more or less than the sum total of your assets and possessions of value. This includes:

Your car
Your home
Financial accounts
Investments; and
Personal property.

Estate planning is the process of deciding which people or organizations are to get your possessions or assets after you’ve died.

It’s also how you leave directions for managing your care and assets if you are incapacitated and unable to make financial or medical decisions. That is done with powers of attorney, a healthcare directive and a living will.

Your estate plan details who gets your assets. It also designates who can make critical healthcare and financial decisions on your behalf should you become incapacitated. If you have minor children, your estate plan also lets you designate their legal guardians, in case you die before they reach 18. It also allows you to name adults to safeguard their financial interests.

Your estate plan directs assets to specific entities or people in a legally binding manner. If you want your daughter to have your coin collection or your favorite animal rescue organization to get $500, it’s all mapped out in your estate plan.

You can also create a trust to safeguard a minor child’s assets until they reach a certain age. You can also keep assets out of probate. That way, your beneficiaries can easily access things like your home or bank accounts.

All estate plans should include documents that cover three main areas: asset transfer, medical needs and financial decisions. Ask an experienced estate planning attorney to help you create your estate plan.

Reference: Forbes (Nov. 16, 2022) “Estate Planning Basics”

What Documents are Needed in an Emergency?

Most people don’t have any idea where to start when it comes to their emergency documents. This often keeps them from going anywhere near their estate planning. This is a big mistake, says a recent article, “3 tasks your family needs to complete to ease any anxiety over unexpected emergencies,” from MarketWatch.

Estate planning is not just about wealthy people putting assets into trusts to avoid paying taxes. Estate planning includes preparing for life as well as death. This includes a parent preparing for surgery, for instance, who needs to have the right documents in place so family members can make emergency medical or financial decisions on their behalf. Estate planning also means being prepared for the unexpected.

Power of Attorney. Everyone over age 18 should have a POA, so a trusted person can take over their financial decisions. The POA can be as specific or broad as desired and must follow the laws of the person’s state of residence.

Medical Directives. This includes a Medical Power of Attorney, HIPAA authorization and a Living Will. The Medical POA allows you to appoint an agent to make health care decisions on your behalf. A HIPAA authorization allows someone else to gain access to medical records—you need this so your agent can talk with all medical and health insurance personnel. A living will is used to convey your wishes concerning end of life care. It’s a serious document, and many people prefer to avoid it, which is a mistake.

All of these documents are part of an estate plan. They answer the hard questions in advance, rather than putting family members in the terrible situation of having to guess what a loved one wanted.

An estate plan includes a will, and it might also include a trust. The will covers the distribution of property upon death, names an executor to be in charge of the estate and, if there are minor children, is used to name a guardian who will raise them.

A list of important information is not required by law. However, it should be created when you are working on your estate plan. This includes the important contacts from doctors to CPAs and financial advisors. Even more helpful would be to include a complete health profile with dates of previous surgeries, current medications with dosage information and pharmacy information.

Don’t overlook information about your digital life. Names of financial institutions, account numbers, usernames and passwords are all needed if your agent needs to access funds. Do not place any of this information in your will, as you’ll be handing the keys to the vault to thieves. Create a separate document with this information and tell your agent where to find the information if they need it.

Reference: MarketWatch (Nov. 19, 2022) “3 tasks your family needs to complete to ease any anxiety over unexpected emergencies”

What Is Wife of Chrysler Building Billionaire Owner Entitled to Under Prenup?

Sixty-two-year-old Michael Fuchs and 47-year-old Alvina Collardeau-Fuchs, who are in the process of divorcing, lived the “billionaire lifestyle” during their marriage with a string of luxury properties around the world, reports The Digital Journal’s recent article entitled “French wife of Chrysler Building billionaire owner entitled to £37 mn under prenup.”

Money was “never a concern” and the couple enjoyed “fully staffed homes” in fashionable locations such as the Hamptons, New York City, Paris, Miami, Cap d’Antibes, Capri and London.

Fuchs is originally from Germany but moved to the U.S. in the 1990s. He and former journalist Collardeau-Fuchs married in New York in 2012 and went on to have two children. However, they separated in 2020, and the High Court in London was asked to rule on the amount to which Collardeau-Fuchs was entitled. Fuchs’ lawyers argued his estranged wife should get about $36 million, but she claimed it should be more than $53 million.

Despite the two having signed a prenuptial agreement, accusations have been lobbed both ways, including Collardeau-Fuchs’ alleging that Fuchs tried to control her spending and made her daily life “intolerable.”

At one hearing, the court heard that Fuchs had enjoyed an “extraordinarily successful career” and owned a “very significant amount of prime mid-town Manhattan real estate”. In fact, the Art Deco Chrysler Building on the East Side of Manhattan, one of New York’s most distinctive landmarks, is owned by Fuchs’ company. However, Fuchs said the value of his fortune had plummeted recently due to the turbulent economic climate.

Such litigation is usually avoided with a properly drafted prenuptial agreement.

A prenuptial agreement is a legal agreement between two partners engaged to be married and is effective upon marriage.

A prenup [also known as an antenuptial agreement or premarital agreement] can set out the property rights and financial arrangements upon which the engaged couple has agreed.

It also allows the couple to contract for themselves–how they want their property, assets, income and inheritance to be viewed or considered in their marriage.

Reference: Digital Journal (Nov. 14, 2022) “French wife of Chrysler Building billionaire owner entitled to £37 mn under prenup”

How to Transfer Business to the Next Generation

The reality and finality of death is uncomfortable to think about. However, people need to plan for death, unless they want to leave their families a mess instead of a blessing. In a family-owned business, this is especially vital, according to a recent article, “All in the Family—Transition Strategies for Family Businesses” from Bloomberg Law.

The family business is often the family’s largest financial asset. The business owner typically doesn’t have much liquidity outside of the business itself. Federal estate taxes upon death need special consideration. Every person has an estate, gift, and generation-skipping transfer tax exemption of $12.06 million, although these historically high levels may revert to prior levels in 2026. The amount exceeding the exemption may be taxed at 40%, making planning critical.

Assuming an estate tax liability is created upon the death of the business owner, how will the family pay the tax? If the spouse survives the business owner, they can use the unlimited marital deduction to defer federal estate tax liabilities, until the survivor dies. If no advance planning has been done prior to the death of the first spouse to die, it would be wise to address it while the surviving spouse is still living.

Certain provisions in the tax code may mitigate or prevent the need to sell the business to raise funds to pay the estate tax. One law allows the executor to pay part or all of the estate tax due over 15 years (Section 6166), provided certain conditions are met. This may be appropriate. However, it is a weighty burden for an extended period of time. Planning in advance would be better.

Business owners with a charitable inclination could use charitable trusts or entities as part of a tax-efficient business transition plan. This includes the Charitable Remainder Trust, or CRT. If the business owner transfers equity interest in the business to a CRT before a liquidity event, no capital gains would be generated on the sale of the business, since the CRT is generally exempt from federal income tax. Income from the sale would be deferred and recognized, since the CRT made distributions to the business owner according to the terms of the trust.

At the end of the term, the CRT’s remaining assets would pass to the selected charitable remainderman, which might be a family-established and managed private foundation.

Family businesses usually appreciate over time, so owners need to plan to shift equity out of the taxable estate. One option is to use a combination of gifting and selling business interests to an intentionally defective grantor trust. Any appreciation after the date of transfer may be excluded from the taxable estate upon death for purposes of determining federal estate tax liabilities.

For some business owners, establishing their business as a family limited partnership or limited liability company makes the most sense. Over time, they may sell or gift part of the interest to the next generation, subject to the discounts available for a transfer. An appraiser will need to be hired to issue a valuation report on the transferred interests in order to claim any possible discounts after recapitalizing the ownership interest.

The ultimate disposition of the family business is one of the biggest decisions a business owner must make, and there’s only one chance to get it right. Consult with an experienced estate planning attorney and don’t procrastinate. Succession planning takes time, so the sooner the process begins, the better.

Reference: Bloomberg Law (Nov. 9, 2022) “All in the Family—Transition Strategies for Family Businesses”

How Can Seniors Be Prepared for Winter?

Snow, storms, power outages, extreme heat, wildfire smoke and other weather events and emergencies can pose extra hazards for seniors. The Spokesman-Review’s recent article entitled “Seniors should make plan to stay safe at home during emergencies” says that good communication, planning and a willingness to ask for and give help are essential in any emergency situation, regardless of age. However, there’s some preparation we can do that’s specific to older adults.

Have medications on hand: Anticipate prescription medication needs and see if your pharmacy will provide mail order or delivery.

Stay warm enough: Older adults can lose body heat faster, so identify a backup heat source for power or gas outages, like a wood-burning stove or backup generator, and know how to use it safely. Don’t use a gas oven or stove to heat indoors because it can cause carbon monoxide poisoning.

Stay cool enough: People also have less heat tolerance as they get older, so make sure the air conditioning is in good working condition with clean filters, or have a plan for staying somewhere cool when the temperatures spike.

Make sure you’re connected: Have a plan with a friend, neighbor, or relative nearby to check in with older adults during heat waves, power outages and storms. If the power goes out, phones can be out, so get a cellphone and learn how to use it.

Air quality matters: The prevalence of chronic obstructive pulmonary disease (COPD) is two to three times higher in people over 60, so seniors and people with health concerns should limit time outdoors when air quality is poor. Air filters improve indoor air quality and keep your air conditioning and furnaces running smoothly.

Avoid falls in the dark, wet or snow: Seniors frequently aren’t as stable on their feet, and falls are a leading cause of hospitalization. In snow, it can be useful to use a four-wheel walker with brakes or a quad-cane to walk. In a power outage take extra care when moving around with a flashlight. Consider getting a fall detection and medical alert device that can call the medics and get help quickly in an emergency.

People like to be independent, and that includes seniors.

A little bit of advanced preparation and planning for good communication during an emergency or severe weather can help keep everyone safe and comfortable and avoid a crisis.

Reference: The Spokesman-Review (Nov. 10, 2022) “Seniors should make plan to stay safe at home during emergencies”

How Will Social Security Change Next Year?

Money Talks News’ recent article entitled “5 Ways the Social Security System Will Change in 2023” looks at several ways in which Social Security will change for 2023.

The benefit increase. Social Security recipients will see their monthly payments go up by 8.7% in 2023. That cost-of-living adjustment (COLA) means an extra $146 a month. Not all retirees will see much extra Social Security income in 2023 because the Medicare Part B premium is withheld from some retirees’ Social Security payments.
The earnings limit for working retirees. If you claim Social Security retirement benefits before reaching your full retirement age (FRA) and also continue working, the SSA will withhold some of your benefits, if your income exceeds the earnings limit. This limit generally increases annually as the national average wage index increases. For 2023, it will rise from $19,560 to $21,240 if you reach full retirement age after 2023, and from $51,960 to $56,520 if you reach full retirement age in 2023. However, you don’t lose any benefits withheld due to your income exceeding the applicable earnings limit.
The tax cap on workers’ income. The maximum amount of a worker’s income subject to Social Security payroll taxes will increase from $147,000 in 2022 to $160,200 in 2023. As a result, if you’re lucky enough to earn more than $160,200 in 2023, you won’t owe Social Security payroll taxes on every dollar you earn. The Social Security payroll tax rate itself will remain the same in 2024: 6.2% for employees (employers pay another 6.2% on their employees’ behalf) and 12.4% for the self-employed.

“To receive Social Security retirement benefits, most people need to accumulate at least 40 ‘credits’ during their working lifetime, according to the U.S. Social Security Administration (SSA). Currently, you can earn up to four credits per year, if you work and pay Social Security taxes.”

The earnings required for you to get a Social Security credit, also known as one-quarter of coverage, will go up from $1,510 in 2022 to $1,640 in 2023.

The maximum benefit. There’s a limit to how much money a retiree can get in monthly benefits—the maximum Social Security benefit. Your maximum Social Security benefit is based upon the age at which you retire. The maximum benefit for a person who retires at their full retirement age will go up from $3,345 per month in 2022 to $3,627 per month in 2023.

Reference: Money Talks News (Oct. 13, 2022) “5 Ways the Social Security System Will Change in 2023”

What Is the Government Doing about Misleading Medicare Ads?

Kathryn A. Coleman, director of the agency’s Medicare Drug and Health Plan Contract Administration Group, said in a three-page letter that CMS is immediately upgrading its review of marketing materials, which must be submitted under its regulatory “File and Use” authority for Medicare Advantage and Part D drug plans, and “may exercise its authority to prohibit” their use, reports MedPage Today’s recent article entitled “CMS Puts the Kibosh on Misleading Medicare Advantage Sales Pitches.”

Medicare Advantage marketing materials can now go live five days after submission, provided the company submitting them “certifies the material complies with all applicable standards.” However, beginning on January 1, Coleman said no television advertisements will qualify to be submitted under its “File and Use” authority, meaning the ads will not run until CMS approves them.

Coleman said the agency is “particularly concerned with recent national television advertisements promoting MA [Medicare Advantage] plan benefits and cost savings, which may only be available in limited-service areas or for limited groups of enrollees, overstate the available benefits, as well as use words and imagery that may confuse beneficiaries or cause them to believe the advertisement is coming directly from the government.”

CMS is also looking at recordings of agent and broker calls with potential enrollees and is continuing its secret shopping of marketing events “by reviewing television, print, and internet marketing and calling related phone numbers and/or requesting information via online tools.”

CMS approved a final rule that requires all Medicare Advantage agents, brokers and third-party marketing organizations to record all their calls with potential enrollees “in their entirety, including the enrollment process.” In her letter, Coleman said reviews of recordings will continue.

“Our secret shopping activities have discovered that some agents were not complying with current regulation and unduly pressuring beneficiaries, as well as failing to provide accurate or enough information to assist a beneficiary in making an informed enrollment decision,” she wrote.

Coleman also noted that the agency will take “compliance action against plans for activities and materials that do not comply with CMS’ requirements.”

It also will review “all marketing complaints” received during the annual enrollment period, which runs from October 15 to December 7, and will target its “oversight and review on MA organizations and Part D sponsors with higher or increasing rates of complaints.”

Reference: MedPage Today (Oct. 21, 2022) “CMS Puts the Kibosh on Misleading Medicare Advantage Sales Pitches”

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How to Find New Doctor for Mom if She Moves