them thank you all for coming out today i really appreciate it i've never ben here at the belmont senior center before and i'm really impressed what a beautiful place that you all have to come so thing thank you for coming out today and i'd like to talk to you today about how you can protect your home and your savings from the high cost of long term care insurance so this something a lot of people are worried about and by coming here today getting information you need you'll have the knowledge hopefully to allay your fears and know what you can do now if there's anything you want to do it at least have more information about it so today my goals are to try to explain the different ways that people pay for long term care and and discuss the steps for you to take so you can protect your assets and i'm sure you're going to have a lot of questions for me but if possible i'd like to try to hold the questions until that and unless it's something you think is really important  just let me know ok so let's just start so the first question is what is long term care and long term care is really the services that you might lead if adult ever are unable to fully take care of yourself so some people get long term care in their home maybe they have a home health aide come in or a companion or a nurse's aide some people assisted living facility and some people mean need more care than they can get at home or in an assisted living facility and so they the nursing home care so so that's what we're going to talk about today  how to pay for that so there's a lot of mess and bad advice out there about long term care and a lot of reasons why people procrastinate and so i think they just think oh i  i won't need a nursing home or i'll move there with my kids or my my spouse will take care of me but unfortunately in life sometimes things happen and as much as your children may love you or your spouse may love you it might just be more than you could reasonably expect them to handle so it's important to have a plan and know know what you will do if you're in that situation as a people think oh i have insurance i have health insurance i will pay for it but really health insurance just provides very limited coverage so it's important to know you can't really count on that and i think people desire want to think about it ok so just a few facts about long term care odds are that half of us will need some long term care during our life so it's really something that we shouldn't just expect won't happen to us because could happen to us and then also i think a lot of people are surprised to hear how expensive it nursing home care is that it's in this area it's about twelve thousand dollars a month and that's really unfortunate because you think well for twelve thousand dollars a month i could be living on a cruise around the world who set of being in a nursing home but  but unfortunately that's that's the case and and the average length of the nursing home stay is about two and a half years so that can cost about three hundred sixty thousand dollars and that's why this planning and advance can really help you and that's that's sort of the key to making sure that you don't get stuck with a bill for a nursing home that could wipe out your your life savings you worked really hard to protect your assets that's a nursing home that's not assisted living assisted living really ranges and costs from i'd say about four to six thousand a month  hampshire probably is a little cheaper i mean i don't know i'm in massachusetts but i think to think the further that you get outside of boston the a little bit cheaper gets but i mean in the boston area unfortunately that's the that's the statistics and i just i just checked it before i came because i wanted to make sure that it was that it was right so i mean just it's very high so you might think well why would it why would i even need long term care but there are things that happen in life that we don't expect or anticipate even among the healthiest people if you could if you got sick or if you got diagnosed with dementia or alzheimer's or if you have a stroke if you fall or sickness usually what happens is you you go to the hospital and from that event at the hospital they'll say it's not really safe for you to go home unless you have more care and at that point it's it would be really helpful if you had done some planning and finance if you didn't do planning in advance are still probably ways we can help you but y ok so the question is can the hospital force she you to do something well not maybe not i mean that the house but but they don't want to release people from the hospital that are in danger or if they release so sometimes hospitals will even go to court and have a guardian appointed for you know to say it's not safe for this person to go home and they think they can go home but if they go home they won't they won't live there there's something really wrong if they go home so that there are some situations where hospitals will will do that or if you have a power of attorney and a health care proxy in place that could come into play too but i can talk about that with well we're kind of getting into a lot of specific details here and then i just want to sort of stay on the tropic topic but yes i think you could you could leave the hospital you know i guess against medical advice but they can also take legal actions to protect you and that might include a guardianship so you have to be i think th e well if you can afford to pay the hospital right well you know i think that's a question maybe i'd rather sort of discuss later because i just want if i don't stick to the topic  twenty five slides were never going to we're never going to get where we need to go but i'd be happy to talk to you at the end if you'd like you have an illness or a sickness like dementia or alzheimer's where you're not really going to make progress they're not going to pay for one hundred days for you and they're going to say ok well now you have to pay privately for your care so so that's important to know you can't just count on your your insurance necessarily or medicare ok and then you might think well long term care insurers out they'll pay for it for me well if you have a long term care insurance then they should pay for part of it for you or whatever your contractor agreement says with the long term care insurance company but most of us don't have long term care insurance and i think you would know if you had it because it's very expensive and you probably would be paying a lot each month and you would know it's not something you think oh i think i have  it you would know home so so if you do have long term care insurance chances are according to your policy they will pay for portion of it oh yeah the hospital can discharge you to a rehab so i agree with you but i'll be happy to talk to you after ok so then mass health and medicaid so let me just explain medicaid and mass health are the same thing ok so this gets a little confusing for because there's medicare which is completely different and there's medicaid and mass health and i like to call it mass health but occasionally i'll call it medicaid too so hopefully i'm not confusing you too much but this is a program administered by the state of massachusetts where they will pay the help pay for nursing home care and for some home care and for some assisted living for people that meet certain medical and financial requirements so usually i don't worry about the medical requirements i'm never actually met anybody who needed long term care that didn't meet the medical requirements are pretty pretty broad but the financial requirements are are a lot more strict so and there are actually two different sets of rules for our mass health for people that need mass hell so they can stay in their house or so they can stay in an assisted living versus people that need mass health because they need a nursing home so there's two different sets of rules and that gets a little confusing for people but  general the rules for somebody that needs mass health to stay at home or in the community are a lot more generous so there are there are some excellent programs that will provide you with some home care it's not enough is not twenty four hour seven days a week home care but if you have a family that's involved and helping you it and you just need maybe an additional twenty hours a week or some help that that's a great option to look into because most people don't want to leave their homes so if you need just some care to stay home that might help you and there is a program called the frail elder waiver program and in order to find out if you meet the medical requirements for that program you call spring well as anybody in her spring well ok so spring rolls really great ok yes spring wells really wonderful ok well i spring well is intended to help you figure out to help you make sure that your needs are met and if you if you have some needs at home even now even though you might be living at home and coming the senior center you maybe you save i could even use some help right now mean if you call spring well they can come out and evaluate you and tell you if you would qualify for some help but there is a great program called the frail elder waiver program and your income has to be under two thousand one hundred ninety nine dollars a month but if your income is over that limit we still you still could get some help it gets a little bit more confusing at that point so you might need to consult with an elder law attorney to help you figure out what to do if your incomes over that amount but you shouldn't think oh i'm over that i guess there's nothing that could be done there still might be something we could do an asset limit is two thousand dollars and the might think well that doesn't mean we're never worked for me but this is a very important concept understand for mass health for people living in the community that have a  spouse they could they could transfer their assets to the spouse and still qualify for the mass health in the community so there's no problem with transferring assets to a spouse so that the spouse that needs more help can get the help that they need and they're only going to look at the income and the assets of the person that needs the help  and if you don't have a spouse i would say you should still check with an elder law attorney because the transfer of asset rules for mass health for people in the community are much much more generous than the transfer of asset rules for somebody needing nursing home care so this is i guess that's kind of a confusing thing to understand yet we're going to talk about that there for if you need nursing home care and you give away any money within five years of needing that nursing home care you're not going to quote you're going to have trouble qualify for medicaid but that's for nursing home care if you need home care in your house and you gave away some money within the past five years it's not the same rule but it's very important to know about that five year rule very important because it's big can prevent you from qualifying for mass health to pay for the nursing home so you have to be so careful about giving anybody money any time within five years of needing a nursing home which is the hard part is who knows when they're within five years of needing a nursing home we don't have crystal balls in life we don't know what's going to happen so well we can talk about that ok so ok so now we're going to talk about so i just talked about the financial requirements if you need mass health to help you stay at home but now i'm going to talk about the financial requirements or if you need mass health because your you need nursing home care so so the asset limit for a single person that needs nursing home care is only two thousand dollars and they they don't count your house as long as your house isn't worth more than eight hundred twenty eight thousand dollars they don't have your house but they're going to put a lien on your house so i'm going to talk about a lien a little bit later but a lien means they won't count your house and they'll give you  you the help you need to pay for the nursing home but if you go to sell your house or at the end of your life they want to get paid back from your house for the money that they paid for your care so that's basically what they want to le so the asset limit for a married couple right now is one hundred twenty one thousand two hundred twenty dollars and they don't include your house they don't include your car you can have a small life insurance policy you can have a prepaid funeral and burial a single person and it's two thousand dollars plus your house so our so these rules are really pretty strict and if you said oh well i don't have to worry about that i'm i'm within that range pull that that's great then you don't have to worry about it so much and if you say wait a minute i'm over that range well then it's important to pay attention to what i'm going to say as we're going to talk about some ideas and some tips and some things that you can keep in mind because just because you're over that range doesn't mean that you're out of luck it just means you have to be a little bit more careful about planning in advance or knowing that if you're ever in that situation that you need to get some help so we're going to talk about things that you can do so one thing i i mentioned a little bit earlier but i want to just talk about again is that the five year lookback period is really important so when you if you apply for mass health to pay for nursing home care they're going to they're going to ask  statements and they're going to they're going to have you fill out a question on the application that says did you give away any money within the past five years or did you transfer your the title of your real estate within the past five years so there if you did they want to know about th ok well i deal with this a lot because i help people apply for mass health and and lots of people don't have the information we need because they'll ask for a lot of information and this is actually a really good question you're asking so they can ask for bank statements for up to five years so i think it's a good idea to keep them but if you don't if you don't have them don't worry because i can go to the bank and get them or you can go to the bank and get them as the bank will give them to and my experience i've never had a bank that was unable to give me a bank statement and so but it's important because they do ask for a lot of verifications about your financial accounts so it's good to just know know where that is  they're going to so if you gave away money within five years they want to know about it and it can present of the person that you gave the money to can give it back to you then it's ok that's fine as long as they give the money back to you there's no problem but if they can't give the money back to you then there's a big problem and you won't qualify for mass health when you need it so this so mostly the all the planning that i'm about to talk about is really let's try to do this planning when we think we have five years where we're we're fairly healthy we don't want to this planning if you just found out that you have to go in the nursing home next month it's not going to help us out ok ok so we just got a question and said what happens if you have a joint account with somebody who's not your spouse and and their on your bank account well they're going to assume that that is your money if it's a bank account ok if it's a bank account they're going to assume it belongs to you unless you can show them because this comes up a lot my practice sometimes people say oh my my brother has my name you know for just for convenience sake sometimes people are on another person's account but you would have to prove that that money didn't belong to you that it was somebody else's so if you have a joint account was somebody they're going to assume it belongs if there's somebody applying for medicaid mass health and they have a joint account mass health is going to say oh that that money belongs to the person applying from for mass health unless unless somebody can show us otherwise that is what we're going to assume now if it's a bank account it gets the rules going to little bit different actually for investment accounts but for a bank account that's the assumption it belongs to the person applying for myself and less you can show otherwise other question is here is they don't throw the records away no the bank i've never had a trouble with the bad don't worry about that of all the things you have to worry about all don't worry about whether the bank will be able to give you your bank statements if you need them because they all the technology today they have about you so so well don't worry about that but the most important point i'm trying to make is that if you when you say you're going to give somebody money for some reason you have a grandchild in there you just want to be nice and buy them a car will be careful because you never know if what's going to happen in the next five years and that that could ok here's a question what if somebody gives you a present well then it belongs to you and it's considered an asset available to you so people should you know if for any reason you think you might need nursing home care within five years and people are giving you of money or lots of presents you might say well i don't know i don't know if i should accept this is a really great question because i think this is what people think a lot they think i can g up to ten thousand dollars a year as a gift and it's not a problem but that's not true because that's a cheap and that's an old assessed gift tax rule ok it's  and for most people the gift tax rule right now so this is like an ira rest rule of federal rule about giving away money that says and actually the rule right now is you can give away fourteen thousand a year per person without having to file a gift tax return but for most people this really wouldn't even if you gave away so you gave twenty five thousand to your grandson well you're obligated by the ira i asked you're supposed to file a gift tax return but you probably aren't going to old i r s any money because the only people that would old iras any money for giving giving away giving money away are people that have given away more than five million dollars in their life so for most of the clients that come in my office i've actually never met anybody who has given away one million dollars i say that's not the rule you need to worry about how you don't need to worry about this fourteen thousand dollar less rule the rule that you need to worry about is the rule of mass hell with the rich says that if you give away money within five years of applying for mass  we're going to impose a penalty period which means you won't be able to qualify for mass health to pay for your nursing home for some time based upon the money you gave away so it's not ok to give away ten thousand a year that's in the eyes of met and the eyes of mass health that's not ok the question here is there's a big concern about a joint account where somebody on there that's not your spouse and what happens if they're taking money out and you're taking money out well what the thing that you would really need to show mass h that's not all my money that's partly their money they're taking out their money i'm taking out my money but it would check a lot of verifying of that so i can talk to him a little bit more about it later because i deal with a lot of clients with joint accounts so just i can give you a little face at the end here ok so some ways to protect your assets in advance is to purchase long term care insurance but but one problem with that is it's super expensive and lots of people can't afford to pay for it and you shouldn't feel badly if you can't because if you can't afford to pay for a long term care insurance there are probably other things we can do to protect to protect your assets maybe it only covers two hundred dollars a day when the nursing home cost four hundred dollars a day so there's lots of it's not it's not perfect but one way that you can go one way one benefit of long term care insurance is that if you have if you have a long term care insurance policy and you live in massachusetts and that policy needs certain very specific minimum requirements and you needn't you need mass health but the long term you have the long term care insurance policy there is protection of your home to say well even if you need mass health it but you had that long term care insurance policy we're not going to go after your house when you die there's not going to be not going to be a state recovery but that's a very specific situation for people who had the perfect long term care insurance policy so it's one way if you if you want to protect your house and really that's one of the number one questions people say to me i'm so worried i don't want my house to go into a nursing home and the nursing home is never going to just like take anybody's house that's not what's going to happen but if you need mass health they're going to put the lien on your house and what the leaning is as it's kind of like an iou if you sell your house you die tend to pay back mass health for the money that they paid for your care so most people don't want that lien they don't want to have to they don't want to think they're going to have to pay that lien so we're going to talk about another way and i think that this is the best way to protect your house but it really only applies to certain people this is called a life estate deed and what it is if it if you think that you are going to stay in your house for as long as you can hopefully for the rest of your life then i think the life estate theatre's a really great option for you and what it does is you say you have to change the title of your deed so this is something usually you go to a lawyer to help you with because anytime you're dealing with a deed it's sort of a tricky area and you want to make sure you have somebody who knows what they're doing so i'm not recommending you do this yourself i i would say this something you need help with but you're you're saying in this deed for as long as i live this is my house and when i die i wanted to go to my children or i want to go to whoever and there's a lot of protection for you in the in the life estate because if you set this up five years before you need a nursing home care then the nursing home will never be able to recover from a lien against your house if you keep that house until your death even if you need ma help to pay for your nursing home care if you set it up five years before you needed the care your house will be protected and there will never be able to cut recover from a lean and so it's in is the really fairly easy way to protect people's most valuable asset and i also think it's a very safe way because nobody can kick you out of your house it's still your house and the only the only downside of that is if you decide to sell it whoever you name is that remainder person they're going to have to sign the deed with you it's not but nobody can sell the house out from underneath you either because you have to sign t it because i always i'm looking out for my clients and thinking i want them to be safe i don't want them to do anything that's too risky because especially with your house that's where you live you can't  can't can't take too many chances with that so i would recommend i think the life of a city is great it's a real deed there's no trust involved in it and also the added benefit to elizabeth your house avoids probate so i think it's really in the in the deed because if you see these deeds it looks a little it almost looks like you gave your house to somebody but then right in the deed it says i reserve it i reserve a life interest to live in the house to collect the rents from the house until i die so so it's it's right in there right in  the well usually for mass health we only do it for the house you're living in if you have another house because for mass health if you have multiple houses it would it is probably not going to serve the purpose that we want because it's the mass health allows you to have a certain amount of assets plus your primary residence so we only usually do this on the primary residence because they'll let you keep your primary residence if you say you have a house in florida to our condo in florida well they're going to look at the value of that that the tax assessor value of that real estate so usually if you had multiple houses i say advanced planning is really important because we probably want to do something with that other house to put it to put it into a different kind of trust but for your primary residence this is the safest possible way to for you to have mass health protection on your house and still live there and it's the safest thing you can do but i'm also saying you it's the have you think you want to live there for the rest of your life so lots of people i meet with they say oh no we're not we're going to be moving to a condo we're not going to live here for the rest of our life so that then i would say oh if you know you're moving we've been i don't think you would do this then there's another type of with that and so for the most part they're still ok and they're still going through but i know as an elder law attorney and the other elder law journeys are work with this shaky ground so i'd say we just recommend it but very carefully if we recommend it and the laws do change so this might be something that would be good for us for a second home that ok so this is a trust where you're saying i give up all rights to the principal and i only reserve the right income so what that means is that you're saying if i sell the house for five hundred thousand i'm not going to get the five hundred thousand it's going to stay in the trust and i'm only going to get the income that that five hundred thousand produces which right now if you put it in the bank it's probably really pathetic so but but then whoever the trustee is they could actually use that trust money to go and buy another piece of real estate x a you are living in a big house and you want to move to a condo where they can use that money in that you're bocce ball income only trust to buy you a condo so there's more flexibility which is was a reason why it's a good it's good for people who think they might want to move but the reason why it's also not so great is because it's sort of under attack right now so tell me they don't want to they want to move well then the life estate isn't really a great thing for them so then this this was the has another choice that era vocal income only trust s ok so so the income that you earn on this trust how does that affect you well the income is considered available to you and for mass health for nursing home care there's no income limit although there does become a point where if you're incomes around six thousand a month it causes a lot of problems so but yes but there's no income limit necessarily for mass tell and the spouse if say your spouse needs mass health your spouse they're not really looking at your spouse's income your spouse can have unlimited in their income and they're not looking at that what happens if you go into a nursing home and you apply for mass health and you have a spouse and even if you don't have  say a husband and a wife ok let's say a husband or wife and husband needs the nursing home what they're going to do is they're going to the husband's going to have to contribute his income toward the cost of the nursing home care so if he had two thousand dollars a month in income he'd get certain deductions for health insurance and you're allowed to keep seventy two dollars and eighty cents a month  and that's it that's it so that the rest of your income has to go to contribute toward the cost of your nursing home care so sorry i think i'm getting off on a tangent a little here just trying to get back on my power point but so this era vocal income only trust is a little bit more flexible way to protect a home but it also has a lot of drawbacks you're giving up a lot of control over that house you're really putting  faith in a trustee you're losing the ability to say hey i want to sell my house and travel around the world a few times with that money you wouldn't be able to do it so it's it's an option but it's something that we really have to think about oh ok so lots of times i meet with people who say i'm going to have my mom move in with me to my house and i'm going to build a addition and in laws hartman on the back and she's going to live with me and i think if anybody has that idea and it's a good idea it's a great idea it's a nice idea to have to be there with your family but it's really important to say we should meet with an elder law attorney before we do this because we need to make sure that the whole thing is down in a written agreement to say who's going to pay for the renovation on the house and to make sure that mass health isn't going to look at that as some kind of gift that you made because it really should be looked at as a gift oh yeah i'm sorry i skipped down to the second one you're right ok so but but i think either way parents moving in with kids kids moving in with parents there's probably some things we can do there if you want to compensate your child for that because what if you have if you really needed a lot of help and your daughter had to leave her job so she could stay home and take care of you if you don't have some sort of written agreement about what's going to happen and you just start paying your daughter mass health is going to say oh what was this checks to your daughter these are gifts because you didn't have a written agreement so my advice to anybody is just if you're thinking about any situation like that say it couldn't hurt to sit with an elder law attorney for an hour or two and make sure you have a plan and an agreement in place for the young woman right otherwise it will be considered yes i'll add that to myself ok and but there's actually a well i'm going to talk about this again in a in a little bit but i'll mention it now there's actually a really great benefit if your kids want to move in with you there's something called a caretaker child exception which applies to the transfer of asset rule within five years so if you have a child that lives with you and provides care to you that kept you out of the nursing home you c transfer your house to that child the day before you move into the nursing home or even the day after you move in the nursing home and as long as you can show mass health they lived with me for two years and they provided care to me that otherwise i would have need a nursing home care that is not going to be a problem that's not going to be considered a gift that subject to that five year look back so that's called the caretaker child exception i'm in a mentioned that again in a in a minute but but the things that i was saying what you shouldn't do and these are things maybe or some sometimes are bad advice out there so i don't want anybody taking better by saying this is all bad advice i don't think you should just give the house to anybody outrage to say oh i'm worried about this i think i have five years i'm just going to put the house in in my daughter's name and then that way i don't have to worry about it well i'm sure you have a wonderful daughter and she would never want anything bad to happen but if she ever got divorced or sued or went into bankruptcy the next thing you know you might not have a house to live in so i as an as an elder law attorney i just i'm always thinking about you and thinking don't do that and also there's some  negative tax consequences from doing that too because if you sell the house they're going to be subject to capital gains taxes that they otherwise could have avoided so please don't do  protected we i have a trust it's fine it's it well i really need to see your trust and i look at it and the first thing i see revokable trust well no sorry you might not have understood i understand why you wouldn't understand you would realize that this trust wasn't going to help you if you needed to apply for mass health because you're not a lawyer but this revokable trust isn't isn't helping you for this reason ok maybe it was helping avoid probate or do something else but it wasn't helping you avoid the cost of nursing home care so if you have a trust or any documents that you don't really know what they do well right now i'm talking about if you apply for ma big problem with houses and revokable trust they'll make you take the house out of the revokable trust and put it back in your name and then they'll put a lien on your house and when you die or you try to sell the house will say oh we paid two hundred thousand dollars for your care you got to sell your house and gets the money  irrevocable trust it really depends on the terms of that trust there's there's terms that trusts are so many different kinds of your local trust that even if you haven't you're a vocal trust and you don't know it's a good idea to have a lawyer look at  eight i think it's fine maybe not because things have changed a lot i mean they just couldn't hurt to make sure you know what what that why you have it and what it does oh i'm sorry you have a question  so we're talking about how you can protect your home and so just a few minutes ago i talked about well how can you protect your home now if you think i'm healthy enough i think i've got five years that's no problem so i talked about that but now i'm going to talk about what happens if you're your husband goes into the nursing home tomorrow well what do you do that well the first thing you do is you call an elder law turning to make sure that you do the right thing but you want to you're going to need to change the title of your house because if you're the houses in the name of the husband and the wife and the husband is in the nursing home if anything happens to the wife that she didn't expect the husband's going to own the house and that house will have a lien on it and in the end it will medicaid will want to get paid back from the liens so the first thing we do is  say we need to put this house in the name of the healthy spouse the one that's still at home and then we also need to make sure we change their will because of that they have a well maybe they say i don't have a well that's ok but we need to make sure they have a will that doesn't doesn't just leave everything back to the sick cousin in the nursing home so those are two steps that we would take if you came and this is a crisis planning and actually i should say you if you if you knew if you said i am i know that my spouse is really sick and if something happened to me before my spouse my spouse would have to go to a nursing home well  probably a good idea for us to look at your will and make sure that you're not going to leave everything to a spouse that you know would have to go to a nursing home if you want to live because them work we have planning opportunities now but we won't have that many planning opportunities that ok so let's see so i talked also about the caretaker child and just so that's if you have a child that lives with you in your house it even works for like a two family house and i've had i've been able to to have that caretaker child exception help me out with like a two family house or three family house if your child lives there with you and takes care of you then you should be able to protect the house by doing that if i had a few brothers and sisters that live together in a house and owned it together and as long as they live as long as this is gone on for more than a year i believe that the one sibling went into the nursing home the other siblings should be able to transfer the house to the other one that that's come up in my practice a few times they have to live in the  over two thousand dollars and a house and i need nursing home care what's going to happen well unfortunately i think there's like for the single person we don't have all that many options we have a couple options but they're not that great so there's there's something called a pool trust and and there are actually two agencies that run these in massachusetts and for a single person that's about to go in a nursing home this is such a great way for them to spend down their money so say they had one hundred thousand dollars but there they can't qualify for medicaid unless they only have two thousand well and once they go on medicaid they're only going to be allowed to keep seventy two dollars and eighty cents a month from their income that's it so this pool trust is a way for you to put your money in this trust it's as managed by their two nonprofit groups and massachusetts that run them you give your money to the trust there's a case manager assigned and they can use that money in the trust to pay for things that mass health won't pay for you so things like if there's if you have if you want if you need a companion if you want special food that they don't have at the nursing home if you need if you need like special services or you say you love magazines or you love to get your hair done every week or you that's seventy two dollars and eighty cents a month so they pay for these things if you like cable you you know you have expensive tastes spoiled trust money is there to pay for things that mass health wouldn't pay couldn't pay for otherwise and i think it's really important for somebody who's a single that doesn't have like children or a you know close family because for them sometimes it's really nice to have a companion who can come into the nursing home and and take you out for a walk on a nice day and this is a way to pay for that that otherwise you wouldn't be able to get so so it's just important for single people to know that they have some planning options too and you can always prepay your funeral and your  but i'm sorry as was said by personal items so any personal items you need and then there's a special rule that says if you're if you're going and if you're in a nursing home and you need to spend on your money and you give your money to a disabled person that's ok and that's not subject to the look back period of this five years if the person is disabled as defined by social security so if they g s s so if say you had to say oh i have a grandchild who is disabled and instead of spending all my money here at the nursing home i'd rather put it into a special trust for that two and i can get information later but there's the plan in massachusetts and there's another one called the guardian trust these are the two i know about there i mean there could possibly be more but i only know about two and they have websites and but i also want to just make sure one thing that these all these things i'm talking about now these are last minute planning things so we don't want to do any of that now like don't leave here and say i think i'll get myself a pool trust  that unless you are in the nursing hall and you need mass health and you say ok oh my options aren't really very good here either i spend all my money on the nursing home or set up a pool just ok so for a married couple if if one of the spouses needs nursing homes care so say your husband or wife and your husband needs nursing home care well in most cases as long as you meet with an  the steps you need the spouse we should be able to protect all of your assets for that spouse that's still a home so even though earlier i said the asset limited is one hundred twenty one thousand two hundred twenty dollars plus your house as long as you don't have a whole lot of money like over a million dollars usually i can say don't worry we're going to take six steps and we're going to protect the money so that the wife at home gets to keep everything so you probably think how do you do the have well usually involves the purchase of this immediate annuity and this is another thing where i just would say don't go out and buying immediately nobody right now immediate annuity is like a really bad investment for anybody who isn't in this very specific situation who otherwise would just spend all their money in a nursing home it's not an investment but in and of way immediate annuity works is it says i'm over to ask that limit by two hundred thousand dollars so the immediate annuity you and you give two hundred thousand dollars to a financial company there are different like new york life there are all these financial companies that sell this product and they give you all your money back within usually it's like a five year term it can't be longer than your life expectancy so depending upon your age but i like a five year term because what happens is you say i give you two hundred thousand and they say ok we're going to pay  because you gave us two thousand of those fit those numbers are not right but just to give you an idea you can you get all your money back but the way that mass healthy is that is you turn your money from asset income and this thousand home is allowed to have their income in they're allowed to keep it so but the way that the mass health out process works if you're a married couple once you get through this this medicaid application and surreal process and they really scrutinize you i think of it like a race as soon as you cross that finish line and you show them that you had under the ass at the one hundred twenty one thousand to twenty and your house and you are under the countable asset limit soon as you cross the finish line if you win though if your spouse wins the lottery that doesn't matter they're only looking now at the one that need that needs the mass health that like say it's the husband in the nursing home and they want to make sure their assets don't go over two thousand but the souses out of the picture at that point once they've been approved so if you're just getting this money back for the if you can have an immediate annuity and eventually that two hundred thousand dollars just comes back to you it's ok there's no real there's no revisit to the spouse only to the only to the mass help health recipient only will the only assets they can look at after the death of the recipient are assets that were in the recipients name so but so i mean these are just some of the things that we that that elder law attorney will recommend but it gets pretty complicated so i don't think it's really a doing yourself thing it's just for you to know if you're going to sleep at night thinking oh my gosh what if i i need a nursing home will for married couples you know it's just so so for single people the news is a lot worse really it's you have two thousand dollars and your house but they're going to put a lien on your house and so for single people like i talked about earlier and i go over it again to you know the unfortunately that's why the advance planning is so important because even though i say all the married couple don't worry if  the last minute you need help i should be able to help you out we still want to do the advance planning because eventually they'll only be one of you alive and if that last one of life needs the nursing home care well that's where we can spend a whole lot of money and i i won't have that many options except like this pool trusts and a few other things so so i mean the takeaway should be plan in advance if you're worried about this and i mean some people might say oh that you know what i'm not even worried about this i have five million dollars and i'm not going to hurt him but if you're thinking ok well i have you know i worked really hard we have a house and we have a few hundred thousand dollars well then that's the kind of person that's probably the planning is bet advanced planning is best for them so here's some the other miss that i don't want you to believe and you already brought one up when you said i can give away ten thousand dollars a year without of her being a problem and the problem is that's a problem for mass health and so you kind of worrying about something you almost don't know there's a whole lot of questions and i'm in no rush to go anywhere so i can talk i can you talk to people if you have a question we have oh yeah right well you know there's all different lawyers out there and they all charge in different ways i can tell you that's not what i charge and that's not what but that's what some people charge and i some people charge a flat fee some people know it's so hard for me to say because as a lawyer the way that we try to do it is how much time is it going to take us and sometimes with these cases they could want for nine months they're really long cases so you might say well twelve thousand dollars is really high but if you're going to work with somebody for nine months and it needed could potentially get up to that but that would be a pretty that would be kind of start to finish everything getting somebody on mass health but that's just a certain kind of kind of case it's hard to say ok here's a really good question as an annuity an option for advanced planning and i say no i don't like and no worries i whenever i see annuities i think i think first seniors there just really i think sometimes these financial advisors are thinking about their own commissions they're not thinking about you and the problem with those annuities is that if you need to get out of them and sometimes you do there are these huge penalty fees and so i know i mentioned the new or the here in my opinion that is a crisis situation only you are in the nursing home and i was only doing that because i have to i right well what my favorite thing is the life state and that that that because i i think most people the biggest asset they have is their house and that's the most important asset to them and that's a really easy thing to protect but that's if you own your house and if you want to stay there so i realize that not everybody if you say well what about my money i have a lot of money in a solid just invested in for a one qasem well you know that gets a lot harder because the only way to really deal with your money is either through one of these irrevocably and come only trust and i know i wouldn't really put a four a one k and something like that and they're sort of under attack right now or just give away your money and for me i'm really cautious about saying give it away give it away if you gave it away you just have to realize is the person i'm giving it away to i think rock solid super trustworthy because well they give it back me and that's really hard to say because if they get divorced sued then crapsey there goes your money and if you ever get if you ever said well keep you know i'll give it to you but i might need it back you just have to be so careful at that i mean i don't want anybody to walk away and say oh she said just give away all my money no no no just be be so careful of that's what you're thinking