Over the years, in having seen many individuals with Alzheimer’s and dementia, a general rule of thumb has developed.
While an individual may have not gotten substantially worse for a period of time, a triggering event, such as getting sick, someone close passing away or a fall, speeds up the effects of the disease.
If you have a loved one or family member with Alzheimer’s, this upcoming flu season could be one of those triggering events.
The Centers for Disease Control and Prevention (CDC) recently warned that a severe flu season is possible this year.
Most of the circulating virus is the H3N2 strain of influenza A and has mutated to other forms that are less affected by current flu vaccinations. Hospitalizations and deaths could be higher because of this.
If this happens to your family member, and nursing home care is needed, it is vital that you have the necessary documents handy to apply for Medi-Cal to help pay the monthly nursing home costs of $7,000 or more.
But, as with many government programs, the amount of paperwork to fill out can be overwhelming. Perhaps one of the most difficult tasks for the family is the gathering of the necessary information that the state requires for the approval of benefits. The following list should help you to be prepared if such an event should occur.
Information for both husband and wife are required, not just for the applicant. Copies are fine.
- Social Security card
- Medicare card
- Health insurance card
- Valid California senior ID card or driver’s license. If none is available, then a recent utility bill in the applicant’s name.
- Birth certificate. If none is available, then a voter registration card.
- Resident alien card or naturalization certificate.
- Current facility information such as name, address, and phone number.
- Most recent health insurance bill showing name of insured, premium amount, frequency of payment. If applicant belongs to the Gardeners Association Blue Cross plan, make a copy of bill prior to submitting with payment.
- Payment stubs or statements showing gross pension, Social Security, or other income.
- “Your New Benefit Amount” from Social Security that comes in December showing next year’s monthly benefit. This statement typically arrives in December.
- Previous four months’ bank statements, including closed accounts. All pages must be provided even if the page is blank.
- Previous four months’ brokerage, mutual funds or other investment account statements.
- Life insurance and annuity policy and most recent statement showing face amount and cash value.
- Burial trust policy paperwork, including contract.
- Vehicle registration.
- Deed for burial plot.
- Deed and tax bills for all real estate.
- Living trust including, Schedule A.
- Proof of redress.
Keep copies in a place where they can be easily accessed in time of crisis. Also, keep the Durable Power of Attorney for Asset Management and Advanced Health Care Directive handy.
It doesn’t have to be fancy. Use a big cardboard box and throw everything in there. At least you’ll know everything is in one place.
One of the most frustrating tasks is showing the trail of money when an account such as a certificate of deposit has been closed. When the Medi-Cal application is submitted, the state pulls up all of the past three years’ 1099s.
If a 1099 shows up for an account that has not been accounted for in the application, the state wants to know if the account is still open or closed.
If it is closed, they want a closing statement showing a zero balance. They then want to know what happened to the money and you must show proof of the disposition of the funds through deposit receipts and bank statements.
Also frustrating is that Medi-Cal wants to see all of the pages of your bank statements. For instance, let’s say that there are four pages in the statement. However, the last page is either blank or has all of the garbage language.
Well, most normal people would throw away that last page to save space in their files.
Bad move. They want this page. So, the moral of the story is “save everything.”
Dealing with banks such as Chase, Bank of America, Wells Fargo, Union Bank, and California Bank and Trust on behalf of a person that is legally incapacitated can be time-consuming and frustrating even if you have an attorney-drafted Durable Power of Attorney for Asset Management.
It is the policy of the banks that unless a Power of Attorney card is on file, then the person taking care of the finances for the incapacitated person will not have access to the account.
A very easy solution that doesn’t cost anything except your time is to have the bank account owner and person that is going to handle the finances get a Limited Power of Attorney card filled out for each bank where there is an account. Both have to go to the branch.
This way it is on file and the attorney in fact can start handling the finances right away. This is a great way for parents to make sure that their kids can take over without them actually being an owner of the account. Should the kid get sued or divorced, the parents’ funds are safe.
This does not apply to credit unions. They will accept the attorney-drafted Power of Attorney.
Another issue that has come up recently is due to the Patriot Act. Let’s say that you are widowed and have a brokerage account titled in the name of your living trust with one of the major firms. You have a checking account in your name only.
When you close your brokerage account, the firm will give you a check made payable to your living trust.
Did you know that you cannot deposit that check in your checking account? It would have to be deposited in a checking account that was titled in the name of your living trust. “Like into like.”
But what would happen if you had severe Alzheimer’s, are in a long-term care facility, couldn’t walk and didn’t have a valid, in force California senior ID? Your family would be stuck because you have to have a valid ID, be able to get to the bank, and be mentally competent to open a checking account titled in the name of your living trust.
This is a very common problem that we see. There are very straightforward ways to avoid this problem. The accounts should be titled in the widower’s name only with a beneficiary named.
Banks refer to this as a Pay on Death (POD) account and securities firms refer to this as a Transfer on Death (TOD) account.
Titling the accounts as TOD or POD means that if the account is closed while the account holder is still living, the check is issued in the individual’s name only and can then be deposited in the individually titled checking account with no problem.
But if the person were to die, the proceeds of the account would go to the beneficiary on the account bypassing probate.
If you do these very simple things to get organized for the upcoming flu season and 2015, should nursing home care be needed, your stress will be reduced significantly.
Karl Kim, CFP, CLTC is California’s premier retirement planning specialist. He is the author of “Don’t Go Broke Paying the Nursing Home: How Californians Can Protect Their Home, Cash and Retirement Accounts.” His office is located in La Mirada. He can be reached at (714) 994-0599 or at www.ReverseRetirementPlanning.com. He has submitted over 1,000 Medi-Cal applications over the past 20 years with a 99.9% success rate. This is meant to be an educational article. Do not make any decisions solely on the information in this article. Consult your tax advisor, financial advisor or attorney before taking any action. We are not responsible for any inaccuracies or misinformation.