Lessen the Tax Burden of your Estate with a Properly Drafted Will

If you plan properly and have your plan reviewed periodically, you may lower or eliminate the tax burden on your estate and leave more to your beneficiaries.

Last Will & TestamentBefore you make a will, you should also know how estate and income taxes affect you and your assets. The federal and New York tax laws change often as a result of various tax reform acts. So you may not be up-to- date with these complex and frequently changing laws.

Also, you may be unaware that you can choose which of your beneficiaries pay the estate taxes. If you do not choose how your estate taxes will be allocated, the tax burden will be allocated among your beneficiaries according to statutory rules that may not be in accordance with your wishes. An attorney can help you draft a will and create an estate plan that addresses these issues. If you plan properly and have your plan reviewed periodically by an attorney, you may be able to reduce or eliminate the tax burden on your estate and leave more to your beneficiaries. You may and should discuss the question of a fee with your attorney in advance. The cost of drawing a will depends on the amount of time your attorney spends on the matter, the complexity of your assets, and your dispositive wishes. In small estates, when a will contains no complicated provisions and need not address any unusual problems, the fees may be very modest. Remember, the advice of an expert may prove invaluable. Making a will is one of the wisest and potentially most important investments of your life. This information, which is based on New York law, is intended to inform, not to advise. No one should attempt to interpret or apply any law without the aid of an attorney. This is particularly true of trusts and estates law. You should consult an attorney before making decisions in this area. For questions or help preparing your Will call me at 212-268-8200 for a free consultation.

Does Medicare cover Home Health care?

If you qualify, Medicare will cover your home health care. You are entitled to Medicare coverage of your home health care if you meet the following requirements:

  • You are confined to your home (meaning that leaving it to receive services would be a “considerable and taxing effort”).
  • Your doctor has ordered home health services for you.
  • At least some elements of the services you receive are “skilled” (intermittent skilled nursing care, physical therapy or speech therapy).

If you need an element of “skilled” care, then you will also be entitled to Medicare coverage of social services, part-time or intermittent home health aide services, and necessary medical supplies and durable medical equipment. You can receive up to 35 hours of services a week, although few beneficiaries actually get this level of service. You are entitled to the same level of services whether you are a member of an HMO or are enrolled in traditional fee-for-service Medicare.

Medicare recipients do not have to pay anything for these services except 20 percent of the cost of medical supplies and equipment, which is covered by some Medigap policies.

While under the law there’s no limit on the length of time you will be covered, in practice coverage is limited. While the government insists that it has not changed the criteria for who is eligible for home care services, home health agencies have inevitably cut back on services they provide in order to make their own budgets balance. All this means that Medicare recipients must advocate for the services they need. Medicare home health benefits can mean the difference between you or a family member continuing to stay at home, or your health deteriorating until hospital care or nursing home placement become necessary.

If you have to appeal a termination of service, the good news is that most people who appeal Medicare home health benefits win their cases. At the first level of review, 39 percent are successful, and on appeal to an administrative law judge, 81 percent are successful. The bad news is that you have to pay privately for the care in order to have an appealable issue. This is because the issue on appeal is not the termination of a service, but the denial of Medicare payment for the service. As a result, many beneficiaries simply try to make do without the care or hire help on their own without the training and supervision provided by home health agencies.

Most Medicare beneficiaries are not informed of their appeal rights when given notice that their home health care benefits will be terminated. If your benefits or those of a family member are reduced or terminated, you should take the following steps:

  1. Ask your home health agency to explain the cutback and write down its answer. Ask the agency to give you written notice of the cutback or termination of service.
  2. Ask your physician to call the agency to urge it not to cut back the services and to provide a letter verifying the level of care you need. This can be essential to whether you ultimately receive the benefits you deserve.
  3. Consult your attorney or a Medicare assistance agency in your state to determine whether you likely would be successful on appeal.
  4. If you decide to appeal, do so immediately, and arrange with the home health agency to pay privately for the services pending the result of the appeal.

Medicare has typically cut off payment for home care services when the patient failed to improve, which is illegal.  Under the settlement of a lawsuit lodged in 2011, Medicare will no longer use this as a reason to discontinue or deny services, meaning that Medicare beneficiaries who need skilled care to maintain their current level of functioning or to avoid further deterioration should get continued coverage.

Regards, Brian

What are the advantages of a PrePlan — pre-paying funeral expenses?

  • There are many advantages. Both financial and practical. On the financial side, New York State allows an individual applying for Medicaid or Supplemental Security Income (SSI) to set aside funds in an irrevocable account for their funeral and burial expenses. These funds are considered an excludable asset, meaning they are not counted as a resource when determining eligibility. A Medicaid/SSI applicant also has the option of setting funds aside to pay the funeral/burial expenses of certain family members. Any account established for the benefit of a family member must, under New York State law, also be irrevocable, as any and all funds in such account would be an excludable asset as well.
  • On the practical side, a PrePlan makes it easier on your family members or loved ones. With everything planned and prepaid there is less stress and burden on others and better decisions can be made at a much less emotional time. Eliminating financial and logistic decisions also allows for less anxiety at a time when fond memories, sharing and grieving are important.
  • How to Choose a funeral home: Get recommendations from family, friends and neighbors, or even contact the New York State Funeral Directors Association at       1-866-644-PLAN for a list of member funeral homes in your community.                 For my clients and readers in the NYC area I recommend the GREENWICH VILLAGE FUNERAL HOME and the BETH ABRAHAM MEMORIAL CHAPEL both at              199 Bleecker Street. They offer a wide array of services and provide professional, caring, and compassionate service. Funeral Directors Peter DeLuca and Jennifer Greenberg are very knowledgeable about Pre-Planning. If you mention my name, they’ll offer you a free, no pressure consultation. I highly recommend doing that. I always advise my friends and clients…“be informed and then you can make a sound decision.” As a special accommodation, they will also provide a guaranteed price for my clients. All funeral home service charges, livery and merchandise items will be price guaranteed to the time of death per the terms of the New York PrePlan contract.  This can possibly save you thousands of dollars as well.                         Call Peter DeLuca or Jennifer Greenberg at 212-674-8055 or 212-614-2300.  Links:
  • http://www.greenwichvillagefuneralhome.com  Pre Plan funeral
  • http://www.bethabrahammemorialchapel.com    Beth Abraham Funeral Home                                                                     If you have any questions about how a PrePlan fits into your Estate Planning or Medicaid Planning needs, feel free to email me or call.                                       Regards, Brian                                                                                                                braphan@raphanlaw.com  212-268-8200

The Law Offices of Brian A. Raphan, P.C.
7 Penn Plaza, 7th Ave/31st, New York, NY 10001 http://www.RaphanLaw.com

Are hospitals liable if a patient develops a bed sore?

Bedsores are often a sign of neglect and can be the result of hospital malpractice, nurse malpractice or nursing home negligence. It is simply not acceptable that they should happen while a person is at a facility in the care of professionals. Sadly, bedsores are the underlying cause of death for several thousand Americans each year. They are not the fault of the patient. The patient is a victim. Medical negligence by a hospital, doctor, nurse, aide or medical technician is unacceptable and may cause pain, suffering or death to the patient.

Video: Bed Sores

Bedsores can develop quickly, progress rapidly and are often difficult to heal. Caring for them can cost into the tens of thousand of dollars. Often, due to the lower staffing in nursing homes, patients are forced to wait longer for care, such as simply being turned in a bed, or the changing of soiled linens and clothes. If an elder cannot change themselves then they are forced to sit or lay in their own urine until a caregiver arrives. While the elderly wait, their skin is being weakened by the moisture making them susceptible to bedsores. Health experts agree that bedsores do not have to occur. Preventive measures are your legal right and can maintain the skin’s integrity and health with proper blood flow. It is the duty of a nursing home or hospital to follow proper procedures to prevent them.

Click here for information on treatment.

If you want further information on this subject, feel free to email or call me. All conversations are confidential.



braphan@RaphanLaw.com  212-268-8200