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Estate Planning & Palliative Care

wife checking on elder husband on palliative care

While not everyone chooses to address end-of-life questions in their estate planning, it is generally recommended to do so. This is particularly true of people who think they may need palliative care, which can be cost-prohibitive if not planned for correctly. There are many different things that your estate should plan for, but palliative care should be at the top of the list, because too many insurers will not cover it, and without careful planning, you can be left in a frightening financial position.

Non-Curative Care Is Often Optional

Palliative care is defined as medical care that tries to improve a patient’s quality of life without necessarily being curative in nature. For example, giving a patient with terminal cancer access to pain medication like Fentanyl can be seen as palliative care – it will not play any role in curing the patient’s cancer, but it will ease their passing and improve their quality of life until the end. However, many insurers do not cover palliative care services, because they are often seen as optional – after all they are not curing the illness, so in the black-and-white world of insurance, these treatments are often seen as unnecessary.

It can sometimes be difficult to define exactly what constitutes palliative care versus curative care. The average person might think a stay in hospice would qualify, but it is generally classified as its own separate entity. For example, Medicare covers hospice care in many situations, but only if the patient has been given less than 6 months to live, and signs off on not receiving other, more potentially curative care. Regardless, if you wind up in a position where you need palliative care, it is crucial that you have the right estate plan in place or you will not be able to afford coverage.

Medicaid Planning Can Help

There are four ways in which an older person can pay for long-term medical care, or any mixture thereof: Medicare, Medicaid, veteran’s benefits (if appropriate), and private insurance. Medicaid is the most used program of the four, though it is need-based, with strict asset limits (though no income cap currently exists). Essentially, if a person lacks means to pay for long-term healthcare, they can apply to Medicaid to have the costs of their care paid for. That said, many choose to plan with an estate planning attorney so that they can legally protect as many of their assets as possible while still qualifying for the program.

There are several ways in which a person can legally and ethically convert their assets into a non-countable or exempt form. However, it is a good idea to have legal representation on your side, so you do not make missteps that can result in a financial penalty. For example, it is sometimes acceptable to gift assets or cash to friends and family so as to lower your asset amount – but Medicaid has what is known as a “lookback” period. The lookback period starts on the day one applies for Medicaid, and goes back five years – any gifts within that period are scrutinized to ensure that an applicant is not simply giving assets away so they meet the Medicaid threshold.

Contact A Naples Estate Planning Attorney

If you have questions, concerns or just want to set up a complimentary consultation to discuss your personal legal issues in a confidential setting, contact James R. Nici, the Managing Partner of Nici Law Firm, a Naples estate planning attorney with almost 30 years of legal experience.  This may be the first step toward ensuring all is how you want it to be going forward. Contact our offices today via our website, or on the telephone at 239-449-6150, to schedule your complimentary consultation.


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