MARYLAND UPDATE

It is the goal of EAGLE PUBLISHING COMPANY to keep our publications fresh and up to date. To do so we will print changes in the law and corrections to the book that come to our attention after the book has gone to print. The following are updates to:
A Will is not Enough in Maryland and
Guiding Those Left Behind in Maryland

Update to: Both Books

ORDER OF PRIORITY FOR ALLOWING AN ANATOMICAL GIFT, IF THE DECEDENT DID NOT EXPRESS HIS PERMISSION
1st spouse 2nd adult son or daughter
3rd either parent 4th adult brother or sister
5th the Guardian of the decedent at time of death
6th a friend or other relative, provided he signs an Affidavit
 (a sworn, written statement), stating that he had regular contact with the decedent, and was familiar with the decedent’s activities, health and personal beliefs.
7th any other person or agency authorized to dispose
of the body (Est. & Trusts 4-503).
 
 ORDER OF PRIORITY FOR APPOINTING A PERSONAL REPRESENTATIVE
Est. & Trusts 5-104 was revised in 2005.
The order of priority is as follows:
1st the Personal Representative named in a Will
2nd If the Will gives someone authority to name a Personal Representative,
       then whoever is named by that person
3rd the surviving spouse. If no Will, then the surviving spouse and children
4th the residuary beneficiaries of the decedent’s Will
5th the children who are beneficiaries under the decedent’s Will
6th the grandchildren who are entitled to inherit the decedent’s Estate
7th the decedent’s parents who are entitle to inherit the decedent’s Estate
8th brothers and sisters who are entitled to inherit the decedent’s Estate
9th other relations
10th the largest creditor who applies for administratin
11th anyone else who applies for administration
12th any other person.

Update to: A Will Is Not Enough In Maryland 1st and 2nd Ed.

CHAPTER 9: MEDICARE UPDATE
The 2006 figures for a stay in a skilled nursing facility (i.e., a nursing home) under the Original Medicare Plan are as follows:
You pay nothing for the first 20 days of skilled nursing care and $119 for days 21-100; i.e., you pay up to $9,520 for the next 80 days of a stay in a skilled nursing facility.
You are responsible for all costs thereafter.

The 2007 Medicare value for a stay in a skilled nursing facility for days 21 through 100 is $124 per day.

In 2008, those on the original Medicare plan will pay:

$128 per day for days 21-100 in a skilled nursing facility for each benefit period. This is $4 higher than the 2007 value.

CHAPTER 10: MEDICAID UPDATE -   

CHANGES MADE IN 2007

The 2007 values set by the federal government are as follows:

The maximum Community Spouse Resource Allowance is $101,640.

The Minimum Community Spouse Resource Allowance is $20,328.

Community Spouse Excess Shelter Allowance is $495.

Community Spouse Maximum Monthly Maintenance Needs Allowance is $2,541.

Community Spouse Minimum Monthly Maintenance Needs Allowance is $1650.

The 2007 private pay rate to determine the penalty period for uncompensated transfers is $5938.

The private pay rate for calculating the period of ineligibility: $4300.

 As of Feb, 2007, the Maryland legislature has not ruled on the home equity exclusion   so it remains at $500,000 .

MARYLAND ESTATE TAXES
The Maryland legislature has "uncoupled" their Estate Tax law from the federal Estate Tax law.  As of 2004, there is no federal Estate Tax unless the decedent's Estate exceed $1,500,000, however there is a Maryland Estate Tax for residents who die in 2004 and thereafter and whose Estate exceed $1,000,000. (Tax-Gen. 7-309).

CHANGES MADE BY CONGRESS IN 2006
Congress passed the following changes to the Medicaid law:
FIVE YEAR LOOK BACK
The Look-back period is extended from three years to five years.

PENALTY PERIOD STARTS WHEN YOU APPLY
Under the prior Medicaid law the Penalty Period started from the day the transfer was made. Under the new law the Penalty Period begins on the day the Applicant applies for Medicaid, meaning that the Penalty clock doesn’t start ticking till the Applicant actually applies. For example, if a person makes an uncompensated transfer during the five year period before he applies for Medicaid, the Penalty Period will begin as of the day he applies for Medicaid.

HOMESTEAD WITH EQUITY OF $500,000 OR MORE
 If the equity in the Applicant’s home (current market value less mortgages and liens) is equal to $500,000 or more, he will not be eligible to receive Medicaid benefits. States are given the option of increasing this value to $750,000 or more.

 These changes need to be adopted by the states, so it may take several months before these laws are put into effect.

Check with an Elder Law attorney to determine the status of the Medicaid law in Maryland.

Updates to: Guiding Those Left Behind in Maryland

CHAPTER 1: VA Pamphlet 051-000-00228-8 FEDERAL BENEFITS FOR VETERANS AND DEPENDENTS now costs $7, however you can download it without charge: http://www.va.gov.

CHAPTER 1: The telephone number for the Arlington National Cemetery is (703) 607-8585. 

Chapter 2: The number for information about COBRA has been changed to (866) 444-3272

CHAPTER 3: The Web site for the FAA is http://www.faa.gov.
The telephone number to call is (866) 835-5322.

GIFT TAX EXEMPTION: As of 2002, there will be an annual cost of living adjustment to the Gift Tax Exemption of $10,000 per person, per year. As of 2002, you can gift up to $11,000 per person, per year, without notifying IRS of the gift.

Page 48 MEDICARE AND YOU (Publication No. CMS-10050) is now published by the Centers for Medicare and Medicaid Services. You can get the publication from the Medicare Web site or by writing to: U.S. Dept. of Health and Human Services
Centers for Medicare and Medicaid Services
7500 Security Blvd.
Baltimore, MD 21244-1850

CHAPTER 4 MEDICARE UP-DATE
There are many new changes in the Medicare system.

MEDICAL BILLS COVERED BY INSURANCE
If the decedent had health insurance you may receive an invoice stamped "THIS IS NOT A BILL." This means the health care provider has submitted the bill to the decedent’s health insurance company and expects to be paid by them. If the decedent was receiving Medicare, you will receive a Medicare Summary Notice listing all of the services or supplies that were billed to Medicare for the prior 30 days. In some areas of the country, you can get a copy of the decedent’s Medicare Summary Notice from the Internet: http://www.medicare.gov

HOW TO CHECK MEDICARE BILLING
The structure of Medicare has been changed giving people in some parts of the country, the option of staying with the Original Medicare Plan or choosing one of the Medicare + Choice Plans. Coverage differs depending on which plan is chosen. If the decedent was covered by Medicare, you need to determine whether he was covered under the Original Medicare Plan, or whether he chose a Medicare + Choice Plan. The publication Medicare and You explains coverage under the different options. See Chapter 2 to obtain a copy of the booklet.

An important billing question is whether the health care provider agreed to accept Medicare assignment, meaning that they agreed to accept the Medicare-approved amount. If so, the patient is responsible for the coinsurance (usually 20% of the approved amount) and any deductible amount. Doctors and health care providers who do not accept assignment, are limited in the amount they can charge for a Medicare covered service. The highest they can charge is 15% over the Medicare-approved amount. This Limiting Charge applies only to certain services and does not apply to supplies and equipment.
If all of this appears confusing, it is.

To check the decedent’s Medicare billing, you first need to determine whether he was in the Original Medicare Plan or in one of the Medicare + Choice Plans. The Medicare and You booklet explains what is covered under the Original Medicare Plan. You will need a copy of the contract for the Medicare + Choice Plans to determine what is covered under that plan.  If the decedent was in the Original Medicare Plan, you need to determine whether the health care provider accepted assignment; and if not whether the Limiting Charge applies to the services provided. Finally if assignment is accepted or the Limiting Charge applies, you need to determine the Medicare-approved amount.

NOTE: A doctor or supplier can give the patient an Advance Beneficiary Notice that says Medicare probably will not pay for a service. If the decedent received such notice and signed an agreement saying he wants the service and agrees to pay for it, then if he received the service, his estate is now liable to pay that debt.

COST OF NURSING CARE IN ORIGINAL MEDICARE PLAN
Medicare pays for the first 20 days of nursing care.
For days 21 to 100, the patient pays up to $109.50/day.
Medicare does not pay for nursing care beyond 100 days.