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Should Vets Be on Look-out for COVID Vaccine Scams?

Officials from Operation Protect Veterans — a joint effort from the U.S. Postal Inspection Service and AARP that works on scams targeting veterans and military members — said they have seen a recent uptick in the number of illicit offers for veterans to “cut in the vaccination line,” if they provide cash to third-party groups.

Military Times’ recent article entitled “Warning: Post Office sees rise in COVID vaccination scams targeting veterans” says that the group also warned of scammers offering “cash payments or other incentives around obtaining a COVID vaccination.”

VA officials will reimburse veterans for the cost of vaccines by the department’s Foreign Medical Program. However, they do not help them find vaccine appointments.

Legislation approved last month by Congress allows all veterans, their spouses and caregivers to get coronavirus vaccines through the Department of Veterans Affairs free of cost. The timing and availability of those shots depends on local supplies.

However, VA officials have stressed the fact that people do not need to pay to receive a dose. Any outside group promising quicker delivery in exchange for cash are taking advantage of confused or frustrated veterans.

“In addition to many of the same scams that fraudsters use to target veterans, we’re now seeing more ‘timely’ scams, like those related to COVID,” said Chief Postal Inspector Gary Barksdale in a statement.

“And as May is Military Appreciation Month, it’s a great time for everyone to become informed and spread the word about scams targeting veterans in order to, in some small way, help repay the tremendous debt we all owe those who have served.”

An AARP survey from 2017 found that vets are twice as likely to be victims of scammers as the general public. The survey found that one in six veterans reported losing money to a bogus offer of benefits or assistance.

The U.S. Postal Service cautions vets not to divulge their personal information over the phone to strangers, especially bank account numbers, credit card numbers or Social Security numbers.

Moreover, they also said any veteran with questions about an unsolicited offer or program should check out the deal with a family member, friend, or local Veterans Affairs office.

Anyone who demands veterans act immediately on such a transaction are like scammers.

More information on scams and protections for vets is available at the Postal Inspection Service web site.

Reference: Military Times (April 30, 2021) “Warning: Post Office sees rise in COVID vaccination scams targeting veterans”

How to Protect Loved Ones from Elder Abuse

Predators had an open season on the elderly during the pandemic, as isolation necessitated by COVID severely limited family member’s ability to visit in person. In some instances, caregivers themselves were the predators, and manipulation on important legal documents, including durable power of attorney, trusts, wills and ownership of homes has occurred. All this was reported the article “Warning: Isolation Of Your Aging Parent May Be A Red Flag” from Forbes. The enforced isolation has created worrisome situations for all concerned.

If you haven’t seen your parents or grandparents for a year or more, and are all fully vaccinated, one expert strongly encourages visitation, as soon as is possible. Use the visit to review all of their legal matters and talk about how to increase engagement and end the isolation.

Consider the following a checklist of what needs to be done at that first visit:

Look for any signs that anyone who had access to loved ones may have taken advantage of their isolation during the past year. Don’t assume the best behavior of everyone around them. It’s not how we like to think, but caution needs to be exercised in this situation.

Check on their will and trusts. The pandemic has reminded everyone that life is fragile, and it’s important to go over legal documents or, if they don’t exist, create them. Find out if anyone has pressured family members to change legal documents—if they have been changed in the last year and you weren’t told about it, find out what happened.

If aging parents do not have a will or trusts, or these documents were altered in your absence, speak with an estate planning attorney who can create a new estate plan. Make sure all copies of older wills are destroyed. At the same time, this would be a good time to have their powers of attorney, healthcare proxy and living wills updated.

If your parent or grandparent lives on their own, find out if they are now in need of any caregiving. A year is a long time, and elderly people who started out fine during the epidemic may have had changes in their health or ability to live independently. Go see for yourself how they are managing. Is the house clean? Are the stairs too steep to be managed?

Not everyone will be able to return to “normal” without some help. Senior centers, gyms and recreational facilities have been shut down for a long time. They may need some help getting back into a routine of socializing and exercising.

The end of enforced isolation can also mean the end of an easy cover for anyone who was using isolation as a protection for financial elder abuse or any other type of abuse.

Isolation itself is a form of abuse, including not allowing others to visit in person or speak with a parent alone. You can overcome this by being engaged with family members on a regular basis, by phone, video visits or, if you are able to, more frequent in person visits.

Reference: Forbes (April 23, 2021) “Warning: Isolation Of Your Aging Parent May Be A Red Flag”

Link Possible between Diabetes, Dementia and Age

New research says those people who had type 2 diabetes for more than 10 years had more than twice the risk for developing dementia, as compared with those who were diabetes-free at age 70, according to Archana Singh-Manoux, PhD, of the Université de Paris in France.

MedPage Today’s recent article entitled “Diabetes, Dementia, and Age: What’s the Link?” reports that at age 70, every additional five years younger that a person was diagnosed with diabetes was linked to a 24% increased risk of incident dementia, even after adjustment for sociodemographic, health-related and clinical factors including cardiovascular disease, hypertension, body mass index and use of antidepressant or cardiovascular medications, among others.

This is equal to a dementia rate of 8.9 per 1,000 person-years among patients age 70 without diabetes versus a rate of 10 to 18.3 for those with diabetes, depending on age at onset:

  • Diabetes onset 5 years earlier: 10.0 per 1,000 person-years
  • Diabetes onset 6-10 years earlier: 13.0 per 1,000 person-years
  • Diabetes onset 10+ years earlier: 18.3 per 1,000 person-years

The strongest connection with incident dementia appeared to be younger age at onset of type 2 diabetes. Patients at age 55 who were diagnosed with diabetes within the past five years saw a twofold increased risk for incident dementia; those age 60 who were diagnosed with diabetes six to 10 years prior saw a similar twofold increased risk. However, late-onset diabetes wasn’t found to be tied to incident dementia. Prediabetes (fasting blood glucose of 110-125 mg/dL) also was not linked to risk of subsequent dementia. Singh-Manoux said this finding suggested that “a certain threshold of high glucose” might be needed to ultimately see hyperglycemia-induced brain injury.

However, cardiovascular comorbidities played into this link. Patients with diabetes who also had a stroke had a dramatically higher risk for dementia. Those with three heart conditions — stroke, coronary heart disease and heart failure – were at five times increased risk for subsequent dementia. Thus, these findings emphasize the importance of age at diabetes onset and cardiovascular comorbidities, when determining risk for dementia, the study authors said.

A few possible explanations could explain the connection between diabetes and dementia. “One hypothesis is that brain metabolic dysfunction is the primary driver of Alzheimer disease, highlighting the role of decreased transport of insulin through the blood-brain barrier, impairments in insulin signaling and consequently decreased cerebral glucose utilization,” they wrote. This idea was supported by findings from the 2019 SNIFF trial, which found some benefit with 40 IU of daily intranasal insulin for Alzheimer’s disease patients. The group also suggested that episodes of hypoglycemia, more often experienced by those with a longer diabetes duration, may increase the risk for dementia.

Reference: MedPage Today (April 27, 2021) “Diabetes, Dementia, and Age: What’s the Link?”

Do I Need to Pay Taxes on Life Insurance Proceeds?

Life insurance is designed to pay out a death benefit to your beneficiaries, if you die while the policy is in effect, usually in a lump sum. Fox 6’s recent article entitled “Is life insurance taxable?” explains that when large amounts of money change hands, taxes are usually a given. However, that’s not the case with most life insurance.

There are some special situations that may involve taxes, like inheriting a large estate or electing to receive policy benefits in installments. However, there are strategies you can leverage to avoid paying taxes on life insurance.

Beneficiaries don’t usually have to pay taxes on money received from a life insurance policy because the IRS doesn’t consider life insurance proceeds as taxable income. If you have an accelerated death benefit rider and need to access your own policy’s proceeds due to a terminal illness, that also won’t be taxed.

While you most likely won’t have to worry about taxes on a life insurance payout, there a couple of exceptions:

  • If all the policyholder’s assets meet the IRS’ federal estate tax threshold ($11.7 million in 2021), the policy’s proceeds could be taxable
  • If you elect to get the policy benefits in incremental installments instead of a one-time life insurance payout, you’ll have to pay taxes on any interest that accrues
  • If a person takes out a life insurance policy on someone other than himself – or herself, then policy’s benefits are considered a gift, and any monetary gifts above $15,000 are taxable; and
  • If the policyholder dies with an outstanding cash value loan, the policy’s death benefit could be used to settle it. Any amount the policyholder borrows beyond what they’ve paid into the policy is taxable.

These situations usually concern beneficiaries, but there are a few situations that could leave the policyholder responsible for taxes. In addition to taking out a policy loan, when you sell or surrender your policy and the cash value exceeds the amount you’ve contributed through premiums, the excess is taxable.

There are strategies for getting around this situation:

  • To avoid taxes, you can work with your life insurance company to legally transfer the policy to a new owner, such as the beneficiary so the policy’s proceeds aren’t included in the estate. However, this will place the responsibility for making premium payments and the ability to change the policy in the new owner’s hands.
  • An irrevocable life insurance trust or ILIT irreversibly transfers ownership of the policy to the trust, removing it from the taxable estate.
  • Installment payouts accrue interest and may be taxed, but a lump sum payment isn’t.

Talk to an experienced estate planning or elder law attorney about life insurance and how it can fit into your estate planning strategy.

Reference: Fox 6 (April 14, 2021) “Is life insurance taxable?”

How Long has Medicare Sequestration Holiday Been Extended?

The U.S. House of Representatives has overwhelmingly voted by a 384-38 margin in favor of a continued sequestration delay.

The bill was one of two measures introduced since early March designed to delay the return of Medicare sequestration, which is an automatic 2% cut for all health care providers paid through Medicare.

Home Healthcare News’s recent article entitled “Biden, Congress Extend Medicare Sequestration Holiday Through 2021” reports that recently President Joe Biden officially signed the legislation. Because the U.S. Centers for Medicare & Medicaid Services (CMS) has been expecting Congress to pass this type of law, it hasn’t been enforcing the 2% cut, despite the holiday’s expiration coming earlier in April.

Organizations, such as the Partnership for Quality Home Healthcare (PQHH) and others have supported the legislation. CMS has been cutting Medicare reimbursements to home health providers by 2%, as directed by Congress, since 2014. Under the law, payments that exceed Medicare’s cap must be returned to CMS.

In 2020, the Coronavirus Aid, Relief and Economic Security (CARES) Act stopped the automatic 2% cut to all Medicare providers. In December, this temporary moratorium was extended through March 2021.

This was intended to let home health providers have the resources to provide care during the COVID-19 emergency, while staying afloat financially.

The legislation will defer $36 billion in previously scheduled Medicare cuts in 2021.

In March, the House passed different sequestration legislation. However, the key difference between the two laws is, in addition to extending the sequestration delay, the previously introduced bill also dispensed with statutory pay-as-you-go (PAYGO) budget enforcement measures.

The PAYGO rule requires new legislation not to raise the federal budget deficit or lower the surplus.

The bill passed last week in the House and signed by the president doesn’t address the PAYGO issue.

Reference: Home Healthcare News (April 14, 2020) “Biden, Congress Extend Medicare Sequestration Holiday Through 2021”

Are You Clueless about Social Security?

If you haven’t a clue about Social Security, it’s vital that you learn, so you can be ready to grow and maximize your benefits.

Lake Geneva Regional News’ recent article entitled “35% of Near-Retirees Failed a Basic Social Security Quiz. Here Are 3 Things You Need to Know About It” provides several important things you should know:

Your benefits are determined by your top 35 years of earnings. The monthly benefit you get in retirement is based on your specific earnings during your 35 highest-paid years in the workforce. If you don’t work a full 35 years, you’ll have $0 factored into that equation for each year you’re missing an income. So, you can see how important it is to try to fill in those gaps. If you lost your job during the pandemic and are thinking about early retirement, check your earnings history before you do.

You’re only entitled to your full monthly benefit when you hit full retirement age. You can claim your monthly retirement benefit in full once you hit your full retirement age (FRA). However, many people don’t know what that age is. About a quarter (26%) of those aged 60 to 65 couldn’t correctly identify their FRA on the quiz. Your FRA is based on your year of birth.

You can claim Social Security as early as age 62 or wait until age 70 and grow your benefits in the process. However, you’ll need to know your FRA first.

You can collect Social Security, even if you never worked. If you are or were married to someone who’s entitled to Social Security, you may be eligible for spousal benefits that amount to 50% of what your current or ex-spouse collects.

MassMutual found that 30% of older Americans didn’t know that a person who’s divorced may be able to collect Social Security benefits based on a former spouse’s earnings history. Thus, it pays to read up on spousal benefits as retirement nears, even if you never held a job.

Being ill-informed about Social Security could make it more difficult to file at the right time and make the most of your Social Security income

Stay up to date on how Social Security benefits work, so you’re able to make wise choices for your retirement.

Reference: Lake Geneva Regional News (April 10, 2021) “35% of Near-Retirees Failed a Basic Social Security Quiz. Here Are 3 Things You Need to Know About It”

Can a Person with Alzheimer’s Sign Legal Documents?

If a loved one has been diagnosed with Alzheimer’s disease or any other form of dementia, it is necessary to address legal and financial issues as soon as possible. The person’s ability to sign documents and take other actions to protect themselves and their assets will be limited as the disease progresses, so there’s no time to wait. This recent article “Financial steps to take when dealing with Alzheimer’s” from Statesville Record & Landmark explains the steps to take.

Watch for Unusual Financial Activity

Someone who has been sensible about money for most of his life may start to behave differently with his finances. This is often an early sign of cognitive decline. If bills are piling up, or unusual purchases are being made, you may need to prepare to take over his finances. It should be noted that unusual financial activity can also be a sign of elder financial abuse.

Designate a Power of Attorney

The best time to designate a person to take care of finances is before she shows signs of dementia. It’s not an easy conversation, but it is very important. Someone needs to be identified who can be trusted to manage day-to-day money matters, who can sign checks, pay bills and supervise finances. If possible, it may be easier if the POA gradually eases into the role, only taking full control when the person with dementia can no longer manage on her own.

An individual needs to be legally competent to complete or update legal documents including wills, trusts, an advanced health care directive and other estate planning documents. Once such individual is not legally competent, the court must be petitioned to name a family member as a guardian, or a guardian will be appointed by the court. It is far easier for the family and the individual to have this handled by an estate planning attorney in advance of incompetency.

An often-overlooked detail in cases of Alzheimer’s is the beneficiary designations on retirement, financial and life insurance policies. Check with an estate planning attorney for help, if there is any question that changes may be challenged by the financial institution or by heirs.

Cost of Care and How It Will Be Paid

At a certain point, people with dementia cannot live on their own. Even those who love them cannot care for them safely. Determining how care will be provided, which nursing facility has the correct resources for a person with cognitive illness and how to pay for this care, must be addressed. An elder law estate planning attorney can help the family navigate through the process, including helping to protect family assets through the use of trusts and other planning strategies.

If the family has a strong history of Alzheimer’s disease or other cognitive diseases, it makes sense to do this sort of preparation far in advance. The sooner it can be addressed, even long before dementia symptoms appear, the better the outcome will be.

Reference: Statesville Record & Landmark (April 11, 2021) “Financial steps to take when dealing with Alzheimer’s”

When do Medicaid Recipients have to Cash Stimulus Checks before Government Collects?

Medicaid enrollees are generally allowed to have only a limited amount of assets, outside of their primary residence, car and other essentials.

For singles, it’s typically about $2,000. Those who exceed that threshold could be deemed ineligible for the health insurance program for low-income Americans.

CNN’s recent article entitled “Nursing home residents have a little more time to spend stimulus checks before losing Medicaid” notes that the $1,200 stimulus payments that many people received last spring didn’t count as income under Medicaid rules.

As a result, nursing home residents didn’t have to give the money over to the facilities where they live and could save it for their own use.

However, the funds are considered an asset after one year. That is a deadline that is rapidly drawing near for the first of the three relief payments Congress has authorized since the pandemic began.

Even so, another coronavirus provision that lawmakers approved last March prevents states from disenrolling residents from Medicaid during the public health emergency, which is currently set to end next month. However, it’s expected to be extended again.

This means that Medicaid recipients, including nursing home residents, don’t have to worry about spending the funds until the pandemic is over.

The same is true for the $600 checks many received from the December relief bill and the $1,400 payment that is being distributed from President Biden’s $1.9 trillion recovery package, but the time on those funds started more recently.

Just the same, people shouldn’t wait until the last minute to spend their stimulus funds. They can buy things they need and can also give the money to family or friends or make a charitable contribution. They just need to prove that the gift isn’t part of a strategy to give away assets to qualify for Medicaid.

“People should just be conscious of Medicaid asset limits and deal with it without trying to wait until the last month of the public health emergency,” said Eric Carlson, a directing attorney with Justice in Aging, a non-profit legal advocacy group. “There’s no particular benefit to cutting it close.”

Reference: CNN (March 30, 2021) “Nursing home residents have a little more time to spend stimulus checks before losing Medicaid”

Court Victory for Adults Caring for Parents at Home

A New Jersey Appellate Division recently reaffirmed the state’s regulation that allows older adults to transfer their homes to adult caregiver children without Medicaid penalty, reports an article titled “Major Victory for Adults Who Provide Home Care for Parents” from The National Law Review. The regulation permits the home to be transferred with no Medicaid penalty, when the adult child has provided care to the parent for a period of two years. This allows the parents to remain at home under the care of their children, delaying the need to enter a long-term care facility.

New Jersey Medicaid has tried to narrow this rule for many years, claiming that the regulation only applies to caregivers who did not work outside of the home. This decision, along with other cases, recognizes that caregivers qualify if they meet the requirements of the regulation, regardless of whether they work outside of the home.

The court held that the language of the regulations requires only that:

  • The adult child must live with the parent for two years, prior to the parent moving into a nursing facility.
  • The child provided special care that allowed the parent to live at home when the parent would otherwise need to move out of their own home and into a nursing care facility.
  • The care provided by the adult child was more than personal support activities and was essential for the health and safety of the parent.

In the past, qualifying to transfer a home to an adult caregiver child was met by a huge obstacle: the caregiver was required to either provide all care to the parents or pay for any care from their own pockets. This argument has now been firmly rejected in the decision A.M. v. Monmouth County Board of Social Services.

The court held that there was nothing in the regulation requiring the child to be the only provider of care, and the question of who paid for additional care was completely irrelevant legally.

It is now clear that as long as the child personally provides essential care without which the parent would need to live in a nursing facility, then the fact that additional caregivers may be needed does not preclude the ability to transfer the home to the adult child.

The decision is a huge shift, and one that elder law estate planning attorneys have fought over for years, as there have been increasingly stricter interpretation of the rule by New Jersey Medicaid.

While Medicaid is a federal program, each state has the legal right to set its own eligibility requirements. This New Jersey Appellate Court decision is expected to have an influence over other states’ decisions in similar circumstances. Since every state is different, adult children should speak with an elder law estate planning attorney about how the law of their parent’s state of residence would apply if they were facing this situation.

Reference: The National Law Review (March 22, 2021) “Major Victory for Adults Who Provide Home Care for Parents”

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What Is Plan for Social Security Recipients, Who Haven’t Received Stimulus Money?

Democratic leaders on the House Ways and Means Committee are calling for the IRS and Social Security Administration to step up their efforts to get the funds to recipients of Social Security who have not received their stimulus money.

Congressional Democrats, including Representative Richard Neal of Massachusetts, who serves as chair of the House Ways and Means Committee, sent a letter to the IRS and Social Security Administration on Monday calling for “immediate attention to this urgent matter.”

Other committee leaders who signed the letter include Representatives John Larson, D-Conn.; Bill Pascrell Jr., D-N.J.; and Danny Davis, D-Ill.

CNBC’s recent article “Lawmakers call for prompt payment of $1,400 stimulus checks to Social Security beneficiaries” reports that delays have been reported in sending $1,400 stimulus checks to Social Security, Supplemental Security Income, Railroad Retirement Board and Veterans Affairs beneficiaries who don’t typically file tax returns.

“The American Rescue Plan was intended to provide much-needed economic stimulus and assistance to people across the country — immediately — and we are counting on your agencies to ensure that beneficiaries are not left behind in the seamless delivery of those payments,” the lawmakers wrote.

“Some of our most vulnerable seniors and persons with disabilities, including veterans who served our country with honor, are unable to pay for basic necessities while they wait for their overdue payments,” the lawmakers said.

The IRS has not given a timeline for those payments, according to the letter.

To date, the IRS has sent out about 90 million of the third stimulus checks, which amount to up to $1,400 per person, provided people meet certain income thresholds and other qualifications.

A second batch of those $1,400 checks is due to arrive via direct deposit as soon as Wednesday, while more payments have also been sent by mail as a paper check or prepaid debit card.

Reference: CNBC (March 23, 2021) “Lawmakers call for prompt payment of $1,400 stimulus checks to Social Security beneficiaries”

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