1. Announcing a Webcast on Aging. It should be noted that the National Academy of Elder Law Attorneys (NAELA) will host its first ever NAELA public webcast called “Aging in America: How to Plan for It”. Free registration is available at http://www.naela.org/. 2. VA Accreditation for Attorneys- Dull but Important Information. The Department of Veterans Affairs has released its new rules and regulations outlining how the new accreditation forms for attorneys are to be filed for those attorneys who prepare and prosecute claims for VA benefits on behalf of clients. Veterans can obtain free VA benefits assistance through the completion of an application from accredited veteran service organizations. Only accredited agents and attorneys may receive fees from veterans making claims or appeals provided in connection with representation. However, no organization or individual, including lawyers, can charge for the preparation, presentation and prosecution of a claim. 3. More on Reverse Mortgages- Law Changes. Recent federal law changes that go into effect October 1, 2008 increase the borrowing level on reverse mortgages. The national limit on the amount that a homeowner can borrow is $417,000. The limit can be increased to $625,000 in areas with high housing costs.The actual amount that a homeowner can borrow however is always independent on the age of the borrower, interest rates at the time, location, and the home’s value. At the present time, the current range for loan limits for reverse mortgages is approximately $200,000-$360,000. Also, under the new law, fees will be capped at 2% of the first $200,000 borrowed and 1% on the balance, with a maximum of fees of $6,000 in total. The law also prohibits lenders from requiring borrowers to purchase an annuity or other products as a pre-condition for getting the reverse mortgage. 4. Nursing Home Risks. The NY Times recently reported that more than 90% of nursing homes were cited for violations of federal health and safety standards. The article indicated that for-profit nursing homes are more likely to have problems than other types of nursing homes. Only 17% of nursing homes had deficiencies that caused actual harm or immediate jeopardy to patients. Problems reported included infected bedsores, medication mix-up, poor nutrition, and neglect of patients. 5. Scams, Again. The LA Times recently reported that the convicted mastermind of an investment scam that wiped out approximately $190,000,000 of retirees’ savings was sentenced to spend the rest of his life in prison. During the trial, the prosecutors described the scheme in which seniors were invited to slick free lunch seminars at restaurants and hotels. At those meetings the seniors were given a chance to buy what was referred to as conservative “secured” notes with “guaranteed” returns. Be careful out there! 6. Virtual Doctor Visits May be Coming. Newsday recently reported that tele-health is a means of using technology to monitor persons more frequently in their homes and keep them in their homes longer. This consists of a “virtual” visit that can do almost everything a home visit can do, except touch the patient. The way it works is that after discharge from a hospital stay, the client (who may live alone or with a caregiver) will get a home patient statement that includes a video monitor, high resolution camera, blood pressure machine, stethoscope, pulse oximeter, and digital scale. 7. Medicare Advantage- Some Clinics Will Not Accept the Plan Timber J newspapers indicates that on January 1, 2009, Northern Minnesota healthcare providers will stop accepting some Medicare advantage insurance plans. This will affect a lot of seniors who must switch to another Medicare advantage option, or return to traditional Medicare to retain coverage for health services. Clinics had complained that collecting payments from the plans had been difficult. 8. Be Alert for Cognitive Decline- It Usually Does NOT Happen OvernightWe recently had a client bring their parent to the office in order to engage in some long term care planning. When the son brought his mother to his office and I began asking the mother some questions about what types of services she would like to have us perform for her, the mother sat there with a blank stare and was unresponsive. I asked the son how long she had been like this. The son replied that she had been like this only recently. That is, he said that she started to decline about a year ago. I informed the son that I would be unable to help the mother prepare long term care documentation, such as wills and trusts, because she lacked the cognitive capacity to create these documents. I said that I could help him with obtaining guardianship if he could obtain a report from his mother’s doctor that confirmed my suspicions that she lacked the requisite mental capacity to do any estate planning or long term care planning. The moral of the story is- be on the look out for decline in those around you. Sometimes when we are close to our loved ones and around them all the time, we tend to accept and often ignore declines in their mental capabilities. Stay alert for this. If a senior declines to the point where mental capacity is gone, options for protecting the senior and the senior’s assets for the senior’s future usage and the potential beneficiaries of his or her estate may be lost. Don’t be in denial, be realistic about what is happening to your loved one. Keep your eyes and ears alert for slippage in their abilities and then seek peace of mind by consulting with your elder care professionals. 9. Elder Care Planning A recent Wall Street Journal describes creating an estate plan that is especially built for special needs persons. Likewise, in the area of long term care, we need to create estate plans that are built for the long term care of most of our senior clients. Most of our seniors want to ensure that their assets last as long as possible for them and also provide some of their assets to pass to their loved ones through inheritance. In order to accomplish all of the above, long term care planning is required. It is preferable to do this early on in the elder care journey rather than in a crisis mode. Again, we can protect more assets andprovide better continuity in your care with pre-planning than relying solely on last minute crisis planning. P.S. Please contact our office for more information. You can reach us at (847) 563-4887. We would be happy to assist you with all matters pertaining to your VA benefits planning, estate planning, Medicaid planning needs, and long term care and nursing home needs. P.S.S. On May 15, 2008, I conducted a workshop regarding VA benefits in Stone Park, Illinois. The response was strong. If you would like to make reservations for future VA workshops, please contact our office at (847)292-1220. Also, don’t miss our other workshop: “5 Step Plan – How to Get Medicaid Coverage for your Nursing Home Care… Without Selling your Home or Leaving your Family Without a Dime” set for the following dates. Please contact our office at (847) 563-4887 to register.

October 29, 2008 at 4:00 pm

November 5, 2008 at 4:00 pm

November 19, 2008 at 6:30 pm

Call (847) 292 1220 to make a reservation in our training room. •- You don’t want to miss this workshop!

The “3 Phase” Lawyers

Legal Counsel Assisting You in the 3 Phases of Your Life:

– Maturing Years – Will, Trust, Taxes, and Asset Protection

– Senior Years – Long Term Care, Medicaid, and Nursing Home Protection

– Post Death Years – Estate, Probate, and Trust Administration

“Educate to Motivate”

Anthony B. Ferraro Attorney-CPA The Law Offices of Anthony B. Ferraro, LLC Columbia Centre I 5600 N River Road, Suite 764 Rosemont, IL 60018 PH(847)292-1220 abferrarolaw@abferrarolaw.com abferrarolaw.com Note: Pursuant to federal regulations imposed on practitioners who render tax advice (“Circular 230”), we are required to advise you that any tax advice contained herein is not intended or written to be used for the purpose of avoiding tax penalties that may be imposed by the Internal Revenue Service. This document is for discussion purposes only and is not intended to be, nor should it be, considered as legal advice. You should never attempt Medicaid planning, Estate planning, Probate, or Estate and Trust Administration without the advice of competent legal counsel.

I. When You Are In A Nursing Home, Who Pays? Estate Recovery Law More Aggressive Than Ever: Your mother is in a nursing home and has qualified for Medicaid. She has been able to keep her home because it is an exempt asset so long as she is living and “intends to return home.” But what happens to the house after she dies? What if it was your spouse on Medicaid and the state has paid over $70,000 in benefits? Will they attempt to recover benefits upon your spouse’s death? After a Medicaid recipient dies, the state has the right to recover any assets remaining in order to reimburse itself for Medicaid benefits paid out. This policy is called estate recovery. But while this policy may make sense, families are never happy to learn that the state may put a lien on your/your parent’s home after your spouse/parent dies. As budgets become tighter, states will begin to try to pursue assets from many different sources in order to make up for Medicaid benefits that the state has paid. In Illinois at one time the Department of Health Care and Family Services was authorized to claim against the estate of a deceased recipient and at one time also authorized a claim against the estate of the deceased recipient spouse. This claim against the deceased recipient spouse’s estate was declared invalid by the Illinois Supreme Court decision in Hines v. Department of Public Aid. Therefore for purposes of claims, the State of Illinois claims all of the real and personal property and other assets included within the deceased person’s estate, as that term is used in the probate act. Thus at the present time in Illinois, the claim can only be made against the deceased person’s probate estate and not for example, other assets such as his trust estate. However, frequently a transfer between spouses takes place and therefore the transfer of incoming assets from a nursing home resident to the resident’s community spouse are reviewed very carefully. In addition, the states are now placing liens on the Medicaid recipient’s home. This is a way for the state to secure a debt against the Medicaid recipient’s property,meaning that the property can not be sold or transferred until the lien is satisfied. Fortunately, the state will not place a lien on the home if the Medicaid recipient’s spouse, minor child, or disabled child is still living in the home. Nor will the state place a lien on the home if the Medicaid recipient’s doctor thinks he or she may be able to go home. There are still, in certain circumstances, perfectly legal ways of avoiding estate recovery. For example, if mom is the Medicaid recipient, and she has a child with a qualifying disability, she may be able to give her home to that child penalty free and avoid estate recovery at her death. Medicaid estate recovery rules are complicated and vary state-to-state. You should consult an Elder Law Attorney who practices in the area of Medicaid before planning with the intent of qualifying for Medicaid with the hopes of avoiding estate recovery. II. Our Firm Solves Nursing Home Residents’ No. 1 Complaint: What is the No. 1 complaint of today’s families who have a loved one in a nursing home? According to our clients, it is that there is no resource that truly addresses how family can pay the cost on of nursing home care. But now our Firm has helped reduce the hassles associated with qualifying for assistance to pay the cost of long-term care. In talking with our clients, it became very clear to me that they were searching for a way to find the right nursing home, get good care there, and pay for it without going broke. The problem was that everything was happening at a time in their life when events seemed to be a blur… and no one was stepping up to help seniors and their families deal with these issues. Knowledge taken from experts, doctors, and an elder law attorney empowers individuals and families to calmly face the situation. P.S. Please contact our office for more information. You can reach us at (847) 563-4887. We would be happy to assist you with all matters pertaining to your VA benefits planning, estate planning, Medicaid planning needs, and long term care and nursing home needs. P.S.S. On May 15, 2008, I conducted a workshop regarding VA benefits in Stone Park, Illinois. The response was strong. If you would like to make reservations for future VA workshops, please contact our office at (847) 563-4887. Also, don’t miss our other workshop: “5 Step Plan – How to Get Medicaid Coverage for your Nursing Home Care… Without Selling your Home or Leaving your Family Without a Dime” set for the following dates. Please contact our office at (847) 563-4887 to register.

November 19, 2008 at 6:30 pm

December 10, 2008 at 4:00 pm

December 17, 2008 at 6:30 pm

Call (847) 292 1220 to make a reservation in our training room. •- You don’t want to miss this workshop!

The “3 Phase” Lawyers

Legal Counsel Assisting You in the 3 Phases of Your Life:

– Maturing Years – Will, Trust, Taxes, and Asset Protection

– Senior Years – Long Term Care, Medicaid, and Nursing Home Protection

– Post Death Years – Estate, Probate, and Trust Administration

“Educate to Motivate”

Anthony B. Ferraro Attorney-CPA The Law Offices of Anthony B. Ferraro, LLC The Estate & Trust, Elder and Asset Protection Law Firm Columbia Centre I 5600 N River Road, Suite 764 Rosemont, IL 60018 PH(847)292-1220 abferrarolaw@abferrarolaw.com https://abferrarolaw.com/ Note: Pursuant to federal regulations imposed on practitioners who render tax advice (“Circular 230”), we are required to advise you that any tax advice contained herein is not intended or written to be used for the purpose of avoiding tax penalties that may be imposed by the Internal Revenue Service. This document is for discussion purposes only and is not intended to be, nor should it be, considered as legal advice. You should never attempt Medicaid planning, Estate planning, Probate, or Estate and Trust Administration without the advice of competent legal counsel.

1. Can Long Term Care Insurance Act as a Wealth Building Strategy? While long term care insurance has been policy of choice for middle income persons to transfer the risk of long term convalescent care to the insurance company, it is being suggested by some professionals that some ultra high net worth individuals are also looking to long term care policies as a means of wealth replacement. Many are purchasing policies that have a return of premium rider. The return benefit however is directed to either the children or a trust. This allows the return of premium to be included outside of their taxable estate. There are issues associated with income tax and gift tax that have to be dealt with, but this may be another wealth preservation strategy that will be expanded upon in the future. 2. Long Term Care Financing Was an Issue in This Year’s Election. According to Market Watch 84% of baby boomers say that the presidential candidates’ position on long term care issues and funding was an important issue in the November elections. 3. How Much Did We Lose? According the center for retirement research, the stock market as measured by the Wilshire 5000 declined 42% between its peek on Oct 9, 2007 and Oct 9, 2008. During that period of time the value of equities and pension and household portfolios fell by 7.4 trillion. 4. Medicaid Recovery Again With regard to Medicaid recovery as indicated in a recent Elder Law Update, it is important to know that most estate recovery units in state Medicaid agencies will tell you that in order to understand estate recovery you need to read both the federal and the state provisions side by side to make sense of the estate recovery laws. 5. 4 Ways to Survive the Costs of a Long Term Nursing Home Stay: 1. Find the right nursing home. You can do this by looking at the internet or call our office for a guide that provides a number of available nursing homes and assisted living facilities. 2. Be careful before you sign any admission contracts. These contracts can be tricky and you want to get advice before you sign. 3. You need to review current Powers of Attorney Wills & Trusts to make sure that the documents don’t work against your goals in placing someone in a Medicaid funded nursing home. 4. Check into the availability of any insurance coverage that you might have to help pay the cost of care. If your savings put you in the range where long term care insurance makes sense, be careful in the purchase of long term care insurance. You’ve got to understand the risks and costs. One way to minimize risk of paying into long term care but not ever needing the benefit is to buy policies where the premium is affordable. If the premium becomes unaffordable then the risk that you run is that all the premiums that you paid into the policy will be lost because you could end up dropping the policy and losing all that you’ve paid into it. Some insurers let you have a return of premium rider that will allow you to recoup the premiums in these cases, but that can increase the cost of your premium by 50%. Also, be aware that when the time comes to use the policy you might not qualify for the benefits unless you meet the needs specified in the policy for assistance with the activities with daily living. Finally, check the insurer’s financial health. You should go with an insurer that receives top financial ratings from at least 2 insurance rating companies such as AM Best, Moody’s, Standard & Poor’s or Weiss. 5.  Assisted Living: Mixed Results The New York Times reports that assisted living facilities have promoted themselves with the notion that they can do what most of what nursing homes can do. This often turns in to be a fallacy. Assisted living facilities are very good at various stages of our lives, however assisted living facilities may not have or be able to afford the type of staff to measure and manage issues related to health on site. Therefore, while our office is a big proponent of assisted living facilities, make sure you understand that they are not skilled care nursing facilities. 6. Watch Those Powers of Attorney A recent Pennsylvania case appeals court ruled that even though an agent under Power of Attorney that contained gifting language the agent did not have the power to make unlimited gifts or change retirement beneficiaries. If that type of power is desired in a Power of Attorney that it needs to be set forth in more specific language. The court felt that the language authorizing the agent to make gifts is insufficient to vest in an agent the authorization to make unlimited gifts. P.S. Also, don’t miss our free workshop: “5 Step Plan – How to Get Medicaid Coverage for your Nursing Home Care… Without Selling your Home or Leaving your Family Without a Dime” set for the following dates. Please contact our office at (847) 563-4887 to register. November 19, 2008 at 6:30 pm December 10, 2008 at 4:00 pm December 17, 2008 at 6:30 pm Call (847) 292 1220 to make a reservation in our training room. •- You don’t want to miss this workshop!

The “3 Phase” Lawyers

Legal Counsel Assisting You in the 3 Phases of Your Life:

– Maturing Years – Will, Trust, Taxes, and Asset Protection

– Senior Years – Long Term Care, Medicaid, and Nursing Home Protection

– Post Death Years – Estate, Probate, and Trust Administration

“Educate to Motivate”

Anthony B. Ferraro Attorney-CPA The Law Offices of Anthony B. Ferraro, LLC The Estate & Trust, Elder and Asset Protection Law Firm Columbia Centre I 5600 N River Road, Suite 764 Rosemont, IL 60018 PH(847)292-1220 abferrarolaw@abferrarolaw.com https://abferrarolaw.com/ Note: Pursuant to federal regulations imposed on practitioners who render tax advice (“Circular 230”), we are required to advise you that any tax advice contained herein is not intended or written to be used for the purpose of avoiding tax penalties that may be imposed by the Internal Revenue Service. This document is for discussion purposes only and is not intended to be, nor should it be, considered as legal advice. You should never attempt Medicaid planning, Estate planning, Probate, or Estate and Trust Administration without the advice of competent legal counsel.

I. Do a Nursing Home-Medicaid Pre-Plan–Don’t Wait for a Health Crisis. After a nursing home resident dies, the state has the right to recover any assets remaining in order to reimburse itself for Medicaid benefits paid out. Not just confusing for the families – the states Attorneys for the various States, themselves, find it challenging to interpret Estate Recovery laws. As most attorneys for the Estate Recovery Units in the US will tell you – in order to understand Estate Recovery, you need to read both the federal provisions AND the state provision side by side to make sense of the ER laws. In addition to the states recovery monies after a Medicaid recipient has died, the states are now placing liens on the Medicaid recipient’s home (lien imposition is different then enforcement). What our office would like you to take from this discussion is that you have the opportunity to do effective pre-planning to avoid liens and other Medicaid spend down penalties. Many clients, however, wait until there is a health care crisis and then the only strategies to protect their assets, their monies and their home are crisis strategies. Crisis strategies do not allow us to protect as much of your money as comprehensive pre-planning strategies. Therefore, the moral of the story is since you have the time to engage in adequate pre-planning now, please do so. II. Elder Mediation Resolves Family Conflicts: A recent article of “Planning for Elder Care” indicates that they have seen an increase in requests from care giver children for help in solving disputes with siblings with regard to care giving issues for parents. A practitioner experienced in elder mediation is a perfect choice for solving disagreements due to issues with the elderly. Mediation is a non-adversarial approach to solving disputes. Mediation is a process of bring two or more disputing parties together and having them mutually negotiate a solution to their disagreement. The mediator is not a judge and does not render decisions but is there to make sure that the combination flows freely between the disputing parties. Elder mediators are trained in the art of negotiating resolutions between elderly parents and family members. III. Seniors Beware: Part D Costs Will Raise 30 – 60 % in 2009. A recent article issued by “Justice Newsflash” that the US Medicare Part D, medication benefit program will cost seniors 31% to 60% more for drugs next year. Some insurers are even sharply increasing medication co-payments. IV. IRS Announces 2009 Tax Changes. For 2009 personal exemptions and standard deductions will rise and tax brackets will widen because of inflation adjustments the IRS announced. Absent further legislation, personal dependency exemptions will go up to $3,650. The new standard deduction is $11,400 for married couples filing a joint return and $5,700 for married individuals filing separately. V. Internet Can Stimulate Aging Brains. A recent article from “McKnights Long Term News” indicates that researchers at UCLA have discovered that there may be a benefit for web active seniors. It indicates that web activity might stimulate brain function and improve cognitive ability. Scientists believe that the constant mental stimulation is a good guard against dementia cognitive decline. But for the first time researchers are counting on web surfing alongside more traditional mental stimulus such as puzzles and word games. VI. Rules Double Maximum Loan on Reverse Mortgage Payouts. Older homeowners who need cash may be able to get more assistance through changes implemented several weeks ago in the Federal Reverse Mortgage Program. Home values of up to $417,000 will be used nation wide as a basis for establishing the size of loan availability for reverse mortgages, which is more then double the $200,160 that has been used across much of the country. Be careful however with reverse mortgage loans, they are a great method of obtaining cash flow but do nothing for protecting assets. VII. Four Tips for reducing Holiday Stress for Alzheimer’s givers. According to Kansas Elder law attorney William G Hammond, “The holiday season is the most stressful time of year for anyone caring for loved ones with Alzheimer’s. That’s because there are so many demands on caregivers’ time during this busy season that it becomes difficult, if not possible to go at it alone”.Here are a few tips that can give holiday caregivers some help in avoiding stress or at least reducing it. Tips are as follow: 1. Learn “acceptance behavior“, an Alzheimer’s caregivers’ technique, designed to remove the stress from care giver and patient. 2. Caregivers need to take care of themselves first. They need plenty of rest to have the strength to go about their care giving chores. If you can’t get rest with your loved one there consider respite care or calling in a friend or family member to give you a break. 3. Be sure all of the appropriate planning documents are in place so you are not dealing with an emergency situation on your own during the busy holiday season. 4. Look in to any available benefits that are offered publicly. The general public is often surprised to find there are at home benefits available and that there are ways to cut the cost of nursing home care if they talk to someone skilled and knowledgeable in the area. Remember that this doesn’t have to be the most stressful time of the year. Holidays can be a wonderful time to reconnect with your friends and family. That’s doubly true if you have a loved one who has Alzheimer’s. Knowledge taken from experts, doctors and elder law attorneys empowers individuals and families to calmly face the situation. For a free consultation please call our offices at 847-563-4887. P.S. Also, don’t miss our workshop: “5 Step Plan – How to Get Medicaid Coverage for your Nursing Home Care… Without Selling your Home or Leaving your Family Without a Dime” set for the following dates. Please contact our office at (847) 563-4887 to register. December 10, 2008 at 4:00 pm December 17, 2008 at 6:30 pm January 13, 2009 at 4:00pm Call (847) 292 1220 to make a reservation in our training room. – You don’t want to miss this workshop!

The “3 Phase” Lawyers

Legal Counsel Assisting You in the 3 Phases of Your Life:

– Maturing Years – Will, Trust, Taxes, and Asset Protection

– Senior Years – Long Term Care, Medicaid, and Nursing Home Protection

– Post Death Years – Estate, Probate, and Trust Administration

“Educate to Motivate”

Anthony B. Ferraro Attorney-CPA The Law Offices of Anthony B. Ferraro, LLC The Estate & Trust, Elder and Asset Protection Law Firm Columbia Centre I 5600 N River Road, Suite 764 Rosemont, IL 60018 PH(847)292-1220 abferrarolaw@abferrarolaw.com https://abferrarolaw.com/ Note: Pursuant to federal regulations imposed on practitioners who render tax advice (“Circular 230”), we are required to advise you that any tax advice contained herein is not intended or written to be used for the purpose of avoiding tax penalties that may be imposed by the Internal Revenue Service. This document is for discussion purposes only and is not intended to be, nor should it be, considered as legal advice. You should never attempt Medicaid planning, Estate planning, Probate, or Estate and Trust Administration without the advice of competent legal counsel.

Preparing for a Productive 2009

Dear Colleague: In 2009 we want to help our advisors grow their businesses. In anticipation of our planning for what we believe will be a very productive 2009 (not withstanding the current recession), please accept our firm’s invitation to you and your colleagues for: 1. Our lunch time telephonic conference call workshops (for advisors only) updating you on the most important issues facing both our clientele and your clientele in 2009 regarding long term care planning and asset protection planning. 2. Our in-service (or in-house) workshops for you and your colleagues or clients regarding long term care and asset protection planning for both the wealthy and the elderly (two of the fastest growing populations). 3. And, of course, continuation of our well received public workshop series entitled “How to Get Medicaid Coverage for Your Nursing Home Care…Without Selling Your Home or Leaving Your Family Without a Dime.” Whether in a tight economy or a booming economy, long term care planning andasset protection planning are essential for clientele and new prospects that need your advice and services in these fundamental areas of planning. Look for our invitations right after the first of the year. Upcoming topics will include: 1. Disability and Long Term Care Planning for Nursing Home Bound Seniors and Elderly 2. Special Needs Planning for the Disabled 3. Asset Protection of your Children’s Inheritance From Divorce and Creditors 4. Medicaid Asset Protection Planning for the Nursing Home Bound Senior From our firm to yours we wish you the best of health and happiness during the holidays and look forward to a very productive and exciting 2009. ABF

The “3 Phase” Lawyers

Legal Counsel Assisting You in the 3 Phases of Your Life:

•- Maturing Years

•- Senior Years

•- Post Death Years

“Educate to Motivate”

Anthony B. Ferraro Attorney-CPA The Law Offices of Anthony B. Ferraro, LLC The Estate & Trust, Elder and Asset Protection Law Firm Columbia Centre I 5600 N River Road, Suite 764 Rosemont, IL 60018 PH(847)292-1220 abferrarolaw@abferrarolaw.com https://abferrarolaw.com/ Note: Pursuant to federal regulations imposed on practitioners who render tax advice (“Circular 230”), we are required to advise you that any tax advice contained herein is not intended or written to be used for the purpose of avoiding tax penalties that may be imposed by the Internal Revenue Service. This document is for discussion purposes only and is not intended to be, nor should it be, considered as legal advice. You should never attempt Medicaid planning, Estate planning, Probate, or Estate and Trust Administration without the advice of competent legal counsel.

Dear Clients and Colleagues: This Elder Law Update is to invite you to our bi-monthly workshop regarding Long Term Care and Medicaid Planning. This workshop has been a huge success and is free to you and your friends and family. Please call immediately to sign up as the workshops fill up quickly. Please see the invitation below. Bring a friend or family member. IMPORTANT UPCOMING WORKSHOP REVEALS: “How To Get Medicaid Coverage For Your Nursing Home Care… Without Selling Your Home Or Leaving Your Family Without A Dime” How to pay the cost of nursing home care is one of the greatest fears families face today. It=s a shame when you scrimp and save for years, only to find out that your life savings is at risk if your health fails. But with nursing home costs running $6,500 per month or more in our area, it=s easy to see how your entire life=s savings could be gone in a matter of months if you or your loved one needs nursing home care. Then, to make matters worse, Congress passed a harsh new law recently…and this law changes the landscape of asset protection. It used to be that you could wait until you needed nursing home care before you took steps to protect your assets. That is no longer true. Smart families are now discovering that there are still steps to take to protect their assets, but they need to Act now. A new Free informational workshop is being offered by Anthony B. Ferraro, Attorney-CPA, of The Law Offices of Anthony B. Ferraro, LLC, in Rosemont, on January 13, 2009. Here is some of what you will discover at this meeting: • How to protect your assets from nursing home costs – you may be able to save more than you would expect…even if your loved one is already in a nursing home. • One of the most important legal documents you need – and the three things it should contain. • Why traditional estate planning may not work…And the life-care planning steps you should be taking instead. • How to avoid being disqualified for Medicaid coverage by properly structuring gifts. • How to help ensure your estate provides an inheritance for your heirs…and supports your nursing-home-bound spouse. • How to qualify for “hidden” veterans benefits to help you stay at home. Your attendance at this new workshop is Free, but seating is limited. To reserve your spot, call 847-563-4887. This workshop has been extremely popular and we expect it to fill up quickly. If there is no space available by the time you call, we will put you on the waiting list and notify you when we hold the next workshop.**Special Bonus** Attendees will receive a FREE copy of our “Easy Guide Outline of Issues for Medicaid Planning and Asset Protection for Long Term Nursing Home Care”. (Limit one Outline per household). To make your reservation, call The Law Offices of Anthony B. Ferraro, LLC at 847-563-4887.Call now. These workshops fill up quickly! Please call for additional dates and times. ***Advisors please call us for the upcoming lunch teleconference regarding the 5 Mistakes that Financial Professionals Are Making about Estate and Long Term Care Plans…and What You Can Do to Avoid Them. ***Advisors if you would like a sample email to use to send to your clients regarding our workshops please contact our office and we will send one to you.

The “3 Phase” Lawyers

Legal Counsel Assisting You in the 3 Phases of Your Life:

– Maturing Years – Will, Trust, Taxes, and Asset Protection

– Senior Years – Long Term Care, Medicaid, and Nursing Home Protection

– Post Death Years – Estate, Probate, and Trust Administration

“Educate to Motivate”

Anthony B. Ferraro Attorney-CPA The Law Offices of Anthony B. Ferraro, LLC The Estate & Trust, Elder and Asset Protection Law Firm Columbia Centre I 5600 N River Road, Suite 764 Rosemont, IL 60018 PH(847)292-1220 abferrarolaw@abferrarolaw.com https://abferrarolaw.com/ Note: Pursuant to federal regulations imposed on practitioners who render tax advice (“Circular 230”), we are required to advise you that any tax advice contained herein is not intended or written to be used for the purpose of avoiding tax penalties that may be imposed by the Internal Revenue Service. This document is for discussion purposes only and is not intended to be, nor should it be, considered as legal advice. You should never attempt Medicaid planning, Estate planning, Probate, or Estate and Trust Administration without the advice of competent legal counsel.

What are people calling our office about in order to get solutions and peace of mind?

1. Long Term Care Planning. Long Term Care Planning is the process of solving your problems with strategies for funding of in-home care and long term nursing home care. This is done without losing your home and leaving your family without a dime. Long Term Care Planning is vital for those who cannot qualify for or afford any or enough long term care insurance. The greatest fear of most of our clients is the high cost of long term convalescent care. On average in Illinois: $6000-$8000 per month, per person. Do your Long Term Care Planning. Let’s outline your options. 2. Dying in Pain. Through discussions with health care professionals, it is becoming clear that many people’s Powers of Attorney for Health Care may require change. Specifically, people are authorizing their agents under health care powers of attorney to withdraw nutrition and hydration so that they can pass on peacefully and not prolong life at the end of their days. However, is it wise to remove hydration in all cases? In many cases, painful deaths from cancer can be avoided with morphine drip and other drugs administered through an IV. Thus, do not automatically reject nutrition and hydration in your Long Term Care Planning simply because you “don=t want to suffer hopelessly like Terry Schiavo@. Please consider whether retaining hydration for purposes of pain relief is needed in your Power of Attorney for Health Care. Don=t send mixed signals to health care providers who are authorized by law to provide for comfort care and alleviation of pain. Review your end of life wishes with legal counsel. 3. Asset Protection Planning for Your Children’s Benefit. With the economy in turmoil and stock prices reeling, it is hard to find a silver lining in these events. However, as the Wall Street Journal noted in a recent article, these troubled times offer some of the best opportunities in years to transfer wealth to younger generations. Therefore, instead of leaving assets to children directly, it may be more prudent to leave assets in a spendthrift trust. So while the children do inherit the assets, it is through the vehicle of an Asset Protection Trust. This type of discretionary trust protects the assets, at the time of inheritance, from the children=s divorcing spouses, creditors, predators, lawsuits, and bankruptcies. But you choose who remains in control. Such a trust itself may be the biggest gift you can give to your children. •4. Estate Tax Planning. President Obama=s proposed estate tax changes are likely to set the federal estate tax exemption at $3.5 million. The proposal would also potentially include changes as to how the estate tax exemption would be treated for married couples. With fiscal pressure ever present, Obama could instead let the Bush 2001 tax cuts lapse thus, allowing the federal estate tax exemption to reduce down to $1,000,000 as in 2001. Enable your estate documents to automatically adjust to changes that are looming. P.S. Also, don’t miss our workshop: “The Elder Care Journey – How to Get Benefits Coverage for your Nursing Home Care…Without Selling your Home or Leaving your Family Without a Dime” set for the following dates. Please contact our office at (847) 563-4887 to register.

February 18, 2009 at 6:30 pm

March 5, 2009 at 4:00 pm

March 19, 2009 at 6:30pm

Call (847) 292 1220 to make a reservation in our training room. •- You don’t want to miss this workshop! Long Term Care Planning Attorneys The “3 Phase” Lawyers Legal Counsel Assisting You in the 3 Phases of Your Life: – Maturing Years – Will, Trust, Taxes, and Asset Protection – Senior Years – Long Term Care and Nursing Home Protection – Post Death Years – Estate, Probate, and Trust Administration

“Educate to Motivate”

Anthony B. Ferraro Attorney-CPA The Law Offices of Anthony B. Ferraro, LLC The Estate & Trust, Elder and Asset Protection Law Firm Columbia Centre I 5600 N. River Road, Suite 764 Rosemont, IL 60018 PH (847) 563-4887 FAX (847) 292-1221 Website: https://abferrarolaw.com/ Email: abferrarolaw@abferrarolaw.com Any tax advice contained in this communication was not intended to be used, and cannot be used, by you (or any other taxpayer) to avoid penalties under the Internal Revenue Code. The Illinois rules of Professional Conduct require attorneys to identify unsolicited communications to prospective clients as Advertising Material. If the context requires, please consider this letter and the enclosed literature to be Advertising Materials. This document is for discussion purposes only and is not intended to be, nor should it be, considered as legal advice. You should never attempt Medicaid planning, Estate Planning, Probate or Trust Administration without the advice of competent legal counsel.

Caring for A Veteran at Home

VA Benefits May Cover the Cost

As we discussed in a previous Elder Law Update, the Veteran’s Administration provides a wonderful pension benefit for those individuals who served at least one day during a period of wartime and are not disabled due to non-service connected reasons (aging related issues, Alzheimer’s, Parkinson’s, multiple sclerosis, and/or other physical disabilities). This pension, referred to as “Aid and Attendance Allowance”, will pay not only for the long term care provided in a nursing home or assisted living facility, but will also pay for care provided to the veteran in their own home. So, for those veterans and widows (widowers) who are eligible, these benefits will allow family members to be paid for the care they are providing a loved one, so long as certain criteria are being met. The “Aid and Attendance” (A and A) benefit is available to a veteran who is disabled and requires the aid of another person to perform the personal functions required in everyday living. A veteran can show they are eligible if they have a substantial need for assistance with the activities of daily living. Such activities include bathing, dressing, meal preparation, etc. A veteran would also qualify for this pension if they can show they need the attendance of another person in order to avoid the hazards of his other daily environment. The need for assistance does not have to be permanent. A family member can provide in-home care for a veteran who is applying for aid and attendance. In order to meet the disability criteria, the care services provided by an unlicensed relative must be prescribed by a health care professional (ex., doctor, RN, LPN or licensed physical therapist) and the professional must consult with the unlicensed relative caregiver at least once a month (in person or by telephone) to monitor the regimen. In addition, there must be a valid care contract in place and the caregiver must be receiving no more than fair market value for services he or she is providing. Simplified Example: Harry Smith is a 67 year old veteran and, due to his health needs, his doctor has stated he needs assistance with bathing, meal preparation, medication administration and other activities of daily living in order to remain at home. He and his daughter, Jane agrees that she will spend 5 hours a day with Harry, 7 days a week. The fair market value for her services is $12 per hour, and they enter into a contract reflecting those terms. Harry’s income is $1,800/ month, his medications are $200/month and he is paying his daughter $1,680/month. Rather than deplete his saving of $45,000, he applies for a service pension through the VA. The VA considers the $200/month for medications and the $1,680/month he is paying to his caregiver daughter unreimbursed medical expenses and “subtracts” the amount from his income. In other words, when calculating his pension, the VA considers his income to benegative $80. He applies for benefits and is eligible for $1,520/month to help cover the cost of his prescriptions and care contract! If you or someone you know is a Veteran receiving care in their home, please encourage them to file a claim for this benefit. It would be prudent to seek the guidance of an experienced elder law attorney who is familiar with veteran’s benefits. An attorney skilled in elder law can provide a veteran and the veteran’s family with pre-filing consultations to determine the appropriate steps that must be taken and to help determine if it would be right to apply for this VA benefit. P.S. Also, don’t miss our workshop: “The Elder Care Journey – How to Get Benefits Coverage for your Nursing Home Care…Without Selling your Home or Leaving your Family Without a Dime” set for the following dates. Please contact our office at (847) 563-4887 to register.

March 19, 2009 at 6:30 PM

April 8, 2009 at 4:00 PM

April 23, 2009 at 6:30 PM

Call (847) 292 1220 to make a reservation in our training room. •- You don’t want to miss this workshop!

Long Term Care Planning Attorneys

The “3 Phase” Lawyers

Legal Counsel Assisting You in the 3 Phases of Your Life: – Maturing Years – Will, Trust, Taxes, and Asset Protection – Senior Years – Long Term Care and Nursing Home Protection – Post Death Years – Estate, Probate, and Trust Administration

“Educate to Motivate”

Anthony B. Ferraro Attorney-CPA The Law Offices of Anthony B. Ferraro, LLC The Estate & Trust, Elder and Asset Protection Law Firm Columbia Centre I 5600 N. River Road, Suite 764 Rosemont, IL 60018 PH (847) 563-4887 FAX (847) 292-1221 Website: https://abferrarolaw.com/ Email: abferrarolaw@abferrarolaw.com Any tax advice contained in this communication was not intended to be used, and cannot be used, by you (or any other taxpayer) to avoid penalties under the Internal Revenue Code. The Illinois rules of Professional Conduct require attorneys to identify unsolicited communications to prospective clients as Advertising Material. If the context requires, please consider this letter and the enclosed literature to be Advertising Materials. This document is for discussion purposes only and is not intended to be, nor should it be, considered as legal advice. You should never attempt Medicaid planning, Estate Planning, Probate or Trust Administration without the advice of competent legal counsel.

The Basics of Medicaid and Long Term Care Planning or…”What the Nursing Home Says You Can and Cannot Keep” In order to understand Medicaid qualifications for Long Term Care, you first need to know how Medicaid treats your assets. Basically, Medicaid breaks your assets down into two separate categories. The first are those assets which are exempt and the second are those assets which are non-exempt or countable. Exempt assets are those which Medicaid will not take into account (at least for the time being). While the laws in Illinois differ in some respect, generally the following assets are exempt:

• The Home, (so long as the equity is not greater than $500,000.) The home must be the principal place of residence. The nursing home resident may be required to show some “intent to return home,” even if this never actually takes place.

• Household and personal belonging, such as furniture, appliances, jewelry and clothing.

• One vehicle, there may be some limitation on value

• Prepaid funeral plans and burial plots.

• Cash value of life insurance policies, as long as the face value of all policies added together does not exceed $1,500. If it does exceed $1,500 in total face amount, then the cash value in these policies is countable. Also, term life insurance is exempt.

• Cash (e.g. a small checking or savings account) not to exceed $2,000 in Illinois.

These are basically the assets which Medicaid will ignore, at least for now. Keep in mind, however, that the estate recovery unit may come back to recoup payments made to a Medicaid recipient after the death of the recipient and the recipient’s spouse if they are married. Most other assets which are not exempt (i.e. the ones not listed earlier) are countable. This includes checking accounts, savings accounts, certificates of deposit, money market accounts, stocks, mutual funds, bonds, IRAs, pensions, second cars and so on. While there are some minor exceptions to these rules for the most part, all money and property, as well as any item that can be valued and turned into cash is a countable asset, unless it is one of those listed earlier as exempt. While the Medicaid rules themselves are complicated and somewhat tricky, for a single person it’s safe to say that you will qualify for Medicaid so long as you have only exempt assets plus a small amount of cash, (i.e. $2,000 in Illinois). For a married couple the community spouse (i.e. the one not needing nursing home care) can receive the “Community Spouse Asset Allowance” (CSAA) which is the amount of non-exempt assets the “resident spouse” is permitted to transfer to the “community spouse” without affecting the resident spouse’s eligibility. The current CSAA is $109,560. Of course, this does not mean there are not things which can be done to protect assets beyond these levels. Instead, this issue of the Elder Law Update is designed to review the basics in a way which a caseworker from the Department of Human Services in Illinois would do so. P.S. Also, don’t miss our workshop: “The Elder Care Journey – How to Get Benefits Coverage for your Nursing Home Care…Without Selling your Home or Leaving your Family Without a Dime” set for the following dates. Please contact our office at (847) 563-4887 to register.

April 8, 2009 at 4:00 PM

April 23, 2009 at 6:30 PM

May 7, 2009 at 4:00 PM

Call (847) 292 1220 to make a reservation in our training room. •- You don’t want to miss this workshop!

Long Term Care Planning Attorneys

The “3 Phase” Lawyers

Legal Counsel Assisting You in the 3 Phases of Your Life: – Maturing Years – Will, Trust, Taxes, and Asset Protection – Senior Years – Long Term Care and Nursing Home Protection – Post Death Years – Estate, Probate, and Trust Administration

“Educate to Motivate”

Anthony B. Ferraro Attorney-CPA The Law Offices of Anthony B. Ferraro, LLC The Estate & Trust, Elder and Asset Protection Law Firm Columbia Centre I 5600 N. River Road, Suite 764 Rosemont, IL 60018 PH (847) 563-4887 FAX (847) 292-1221 Website: https://abferrarolaw.com/ Email: abferrarolaw@abferrarolaw.com Any tax advice contained in this communication was not intended to be used, and cannot be used, by you (or any other taxpayer) to avoid penalties under the Internal Revenue Code. The Illinois rules of Professional Conduct require attorneys to identify unsolicited communications to prospective clients as Advertising Material. If the context requires, please consider this letter and the enclosed literature to be Advertising Materials. This document is for discussion purposes only and is not intended to be, nor should it be, considered as legal advice. You should never attempt Medicaid planning, Estate Planning, Probate or Trust Administration without the advice of competent legal counsel.

Think You Don’t Need Long Term Care Planning?

Think Again!!

1. Alzheimer’s Projections. Recently during a Senate Special Committee on Aging hearing, a couple of prominent politicians noted that there is no single effort that would do more to lower the cost of entitlement than preventing the onset of Alzheimer’s disease. They noted that Alzheimer’s will cost Medicare and Medicaid a projected $19 trillion between the years 2010 and 2050. It was noted that a five year delay of onset would save approximately $8.5 trillion over that same period. It was further noted that the human pain and financial burden of Alzheimer’s is so great and the potential breakthroughs in science are so encouraging, that a Manhattan type project approach to Alzheimer’s is justified. 2. More Coming. A respected report says that 5.3 million people in the U.S. have Alzheimer’s. An estimated 5.3 million Americans have Alzheimer’s and each patient on average costs Medicare three times more than patients without the disease. 3. Kin Using Elders’ Funds in Downturn. Recent studies show that family members are often inappropriately using an elder’s funds in economic down turn. It has been noted recently by some long term care ombudsman that children don’t have the legal authority to make some decisions for parents. Worse yet, some of the decisions that are made by children on behalf of their parents are purely economically motivated. One case was noted where a nursing home resident was blocked from receiving antibiotics because her daughter cited a “do not resuscitate” clause in her mother’s Living Will. The suspicion is that the daughter was trying to hasten her inheritance. Seniors are advised to be cautious because sometimes the power of attorney given to a family member can give an unscrupulous person license to exploit. This is not a reason not to have a power of attorney but rather should signal that caution and counseling are required in providing such power. 4. Impact of Long Term Care. A recent report indicates that nearly two-thirds of U.S. households are at risk of being unable to maintain their standards of living due to long term care costs. 5. Avoid a Crisis…Talk to Mom & Dad. It is recommended that children sit down and have a heart to heart talk with mom and dad as their capabilities for maintaining independence in their household begin to dwindle. Joint accounts are dangerous. Adding a loved one to a bank account can affect Medicaid planning, as well as expose your account to the loved one’s creditors. When a person applies for Medicaid for long term care coverage, the state looks at the applicant’s assets to see if the applicant qualifies for assistance. If your name is on a joint account and you enter a nursing home, the state will assume the assets in the account belong to you unless you can prove that you did not contribute to the account. Furthermore, if you are a joint owner of a bank account and you or the other owner transfers assets out of the account, this can be considered an improper transfer of assets for Medicaid purposes. Another problem with joint accounts is that the account can become vulnerable to the joint account owner’s creditors. Finally, be sure you can trust your joint account holder because he or she will have full access to the account. In our opinion, there are better ways to conduct estate planning and planning for disability. The power of attorney is a better approach and will provide your agent access under power of attorney to your finances in case of your disability. If you are trying to avoid probate, a trust may be better than a joint tenancy account as well. You need to discuss these issues with an elder law attorney. 6. Ways To Pay For Long Term Care. Remember the possibilities of covering the cost of long term care. The most common ways are:

1. 1. Paying out of pocket
   2. Carrying long term care insurance
   3. Qualifying for Medicaid by obtaining legal guidance and a legal spend down of your assets. Strict compliance with state laws is necessary.
   4. Lastly, getting a reverse mortgage.

Note: for Veterans who qualify for nursing home care in a Vet Nursing Home, the closest facility of which we are aware is in Manteno, Illinois. 7. Is It Time to Update Estate Plans? Because of the uncertainty regarding estate plans and laws that may shift treatment, formula clauses in Wills and Trusts can become problematic. The current Federal Estate Tax exemption amount of $3,500,000 creates this situation, but there are a number of solutions to this problem. One is to put the full exemption amount into a family trust while making sure that your spouse is a major beneficiary of that trust and can receive distributions liberally and for broad purposes. 8. Watch Your CDs. Not all Certificates of Deposit are the same. Recently, the SEC accused a former Texas financier of fraud. The allegations are that the scheme revolved, in large part, around the sale of suspicious high yielding CDs. The CDs were not insured by the FDIC, resulting in a lot of people being unable to protect their life savings. Some CDs are covered by the FDIC, which currently offers insurance of up to $250,000 per person, per bank. Additional coverage can be obtained depending on how you hold the CD. 9. What you Need to Know About Estate Planning. You need to have a Will and maybe a Trust. You also need either a standard, enhanced, or comprehensive Power of Attorney for Property for Long Term Care Planning. You need to have Living Wills and advanced medical directives to avoid a situation like Terry Schiavo. Special Needs Trusts are often essential when there are family members who are physically or mentally challenged. The estate tax right now is as favorable as it has been in a long while. Each U.S. citizen is entitled to up to $3.5 million of assets before they have to pay estate tax. For a couple, that adds up to $7 million,if planned properly. Please remember that the federal exemption amount under current law is scheduled to go back to $1 million in 2011. 10. Housing Bubble Impacts Elderly. Because of the recent housing slump, many elderly are not obtaining the needed support and care which they would be afforded by moving into retirement communities or assisted living facilities. Many are effectively stranded in their own homes. Without the ability to sell their houses or condominiums, many cannot afford to buy into retirement homes that require substantial down payments just to move in. So they are taking themselves off of waiting lists and staying at home. The inability to sell their home or condo is isolating a lot of the elderly. At present count, there are 4.2 million unsold homes in the United States, but it is unknown how many of those are occupied by people 65 years or older. P.S. Also, don’t miss our workshop: “The Elder Care Journey – How to Get Benefits Coverage for your Nursing Home Care…Without Selling your Home or Leaving your Family Without a Dime” set for the following dates. Please contact our office at (847) 563-4887 to register.

April 23, 2009 at 6:30 PM

May 7, 2009 at 4:00 PM

May 18, 2009 at 6:30 PM

Call (847) 292 1220 to make a reservation in our training room. – You don’t want to miss this workshop! Long Term Care Planning Attorneys The “3 Phase” Lawyers Legal Counsel Assisting You in the 3 Phases of Your Life: – Maturing Years – Will, Trust, Taxes, and Asset Protection – Senior Years – Long Term Care and Nursing Home Protection – Post Death Years – Estate, Probate, and Trust Administration

“Educate to Motivate”

Anthony B. Ferraro Attorney-CPA The Law Offices of Anthony B. Ferraro, LLC The Estate & Trust, Elder and Asset Protection Law Firm Columbia Centre I 5600 N. River Road, Suite 764 Rosemont, IL 60018 PH (847) 563-4887 FAX (847) 292-1221 Website: https://abferrarolaw.com/ Email: abferraro@abferrarolaw.com Any tax advice contained in this communication was not intended to be used, and cannot be used, by you (or any other taxpayer) to avoid penalties under the Internal Revenue Code. This document is for discussion purposes only and is not intended to be, nor should it be, considered as legal advice. You should never attempt Medicaid planning, Estate Planning, Probate or Trust Administration without the advice of competent legal counsel.