Elder Law and Estate Planning: An Interview with Chris Petillo Part 2

{3:48 minutes to read} In Part 2 of our conversation with Chris Petillo, Certified Elder Law Attorney (CELA) and Certified Public Accountant (CPA) with the law firm of Feldman, Kramer & Monaco, P.C, we concentrate on Medicaid and a little-known way to boost your retirement funds using your health savings account:

Michael Fliegelman: Speaking of Medicaid, a lot of people feel that Medicaid is a means-tested program, so they are ineligible for Medicaid, but I’m not sure that’s always the case.

Chris Petillo:

Yes. Medicaid is never anyone’s first choice, but actual care costs can be shocking. Most people are afraid to spend more than their fixed income.

The cost of care in downstate New York is so expensive that most people can’t sustain the hit for an extended time. Most people are unprepared to absorb the blow to their nest egg.

The best-case scenario is when clients meet us while they’re younger. Ideally, we are meeting them much younger, so that they can go and speak with a professional like you to learn more about long-term care insurance. If they buy it earlier, the premium is lower, and the 20% NYS income tax credit is beneficial during working/wage earning years.

Getting home care that’s paid for by Medicaid is not as unattainable, because you have the ability to transfer assets, is that correct? Does it have to go to a child, or to a trust?

There are different rules for nursing home care as opposed to home care. It starts with meeting with your elder law attorney to see what options are realistic.

As I said, ideally we’re not meeting with that client for the first time at a time of crisis. If the client waits for the care need to call, there is still planning that can be done, but with fewer options available.

That’s the key in planning, being proactive rather than reactive. Recently I was at a meeting where we were discussing the utilization of health savings accounts, not in the traditional sense of using the money for unreimbursed medical expenses, but actually taking those savings accounts and letting that money accumulate toward the cost of health care during retirement.

Absolutely. Any extra tool in the toolbox is a welcome tool.

What we see the parents and the kids struggle with, even well-intentioned kids, is if Mom and Dad don’t have something like a health savings account, or long term care insurance, they’re forced to decide between raiding the intended “inheritance” versus waiting to see if Mom and Dad can get by another month. Failure to plan puts everyone in a bad spot.

Conversely, when there is a health savings account or a pot of long term care insurance dollars, there’s no question as to what the money is supposed to be used for. You’re not pitting kids against their parents by asking them to make a decision against their personal financial interest. The person with insurance is more likely to spend and get care than the person who has to dip into principal.

That’s great, Chris. Thank you for taking the time today to speak with us. If anyone has questions, they can reach me at Michael@swanwealth.com and if you have any specific questions for Chris, we’ll get those questions to him as well.

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