Home Ownership for People With Special Needs

People with special needs often require housing that accommodates their lifestyle. In many cases, group living facilities are called for, with the group environment providing stability and support. But in other cases, a person with special needs needs a very specific type of housing, designed particularly for her. Or, it may simply make sense for a person with special needs to have a place of her own. The rental market is clearly not equipped to provide the specific accommodations many individuals with special needs require. Fortunately, there are many ways to provide private housing for a person with special needs without compromising the majority of her means-based government benefits.

The first step when thinking about purchasing a home for a person with special needs is to decide whether the home should be held in trust or given to the resident to own in her own name. Since many people with special needs are perfectly capable of managing their own property, both Supplemental Security Income (SSI) and Medicaid regulations permit beneficiaries to own their own home without it counting as an asset for purposes of qualifying for or maintaining benefits (although there may be specific limits on the value of the home a beneficiary owns, which vary by state). Home ownership also allows increased access to credit, binds a person with special needs with their community, and provides a deep sense of self-worth.

But home ownership comes with many responsibilities, and frequently families choose to place a home into a special needs trust (SNT) instead of giving it to a person with special needs. Putting the home in a trust protects the home from a trust beneficiary’s creditors, who may be able to go after the equity in the home if it were owned by the beneficiary outright. Placing the home in trust also allows for flexibility if the home needs to be sold quickly, since the proceeds are retained by the trust. If a homeowner with special needs sells his own home, he would have to quickly purchase a new one for the same price or transfer the proceeds into a different kind of special needs trust (called a “first-party trust,” with a government payback provision) in order to maintain access to government benefits. Finally, some people with special needs, especially those suffering from mental illnesses that make it hard for them manage property or make them especially likely to be taken advantage of, should simply not own property in their own name.

Once the decision is made about who owns the home, the next step is determining how the home should be purchased. This decision depends on the finances of those buying the home and the government benefits being received by the resident. When a home is purchased outright (either by a trust or by a beneficiary’s family, who then gives the home to the resident), SSI rules dictate that the purchase counts as in-kind support and maintenance for the month of purchase only. Under the complicated restrictions, this means that an SSI beneficiary could lose up to about $244 (in 2013) of her benefit for one month. If the beneficiary’s monthly SSI award is reduced to zero by this reduction, she could lose her benefits, and accompanying health care, for the month of the gift. She could then regain eligibility at the conclusion of the month.

On the other hand, if the home is purchased through some combination of a down payment and a mortgage being paid by the trust or by family members, then the resident’s SSI award will be reduced by approximately $244 during each month that someone other than the beneficiary pays the mortgage. However, it does not matter if the mortgage payment is very large — the beneficiary still loses approximately $244 monthly. While this amount usually pales in comparison to the benefits of living in a home of one’s own, should a beneficiary receive an SSI award that is less than $244 a month before the purchase of the home, he will lose his SSI benefit because his award is reduced to zero by the in-kind mortgage payment. Because the mortgage payments will presumably be ongoing, this loss of SSI and health care benefits could be permanent, unlike the one-time loss of benefits if the home is purchased outright. Since other sources of income can also affect an SSI award, it is extremely important that families work with a qualified special needs planner to make sure that they are not going to compromise important benefits by purchasing the home.

After the home is purchased, maintenance becomes key. Under SSI regulations, payment of many household expenses for a beneficiary counts against her SSI benefit. This applies even if a trust owns the home the beneficiary is living in. For example, if the trust pays for the home’s water or electric bill, the SSA will deduct the same (up to?) $244 from a beneficiary’s award. So if a trust owns the home outright and manages to avoid paying a mortgage, the beneficiary can still incur a penalty should the trust pay for the upkeep of the home, and the same concerns regarding benefits apply. There is one important exception to these restrictions – a trust can pay for home improvements without penalty because these are not typical household expenses expected to be provided by a beneficiary.

The rules governing home ownership may seem complex, but the rewards are many and well worth exploring with a qualified special needs planner.

Medical Identity Theft

Not only do you need to protect your identity from identity theft for your finances, now you need to consider protecting your medical identity.  A thief may use your name or health insurance numbers to see a doctor, get prescription drugs, file claims with your insurance provider, or get other care. If the thief’s health information is mixed with yours, your treatment, insurance and payment records, and credit report may be affected.

If you see signs of medical identity theft, order copies of your records and check for mistakes. You have the right to see your records and have mistakes corrected.

Detecting Medical Identity Theft

Read your medical and insurance statements regularly and completely. They can show warning signs of identity theft. Read the Explanation of Benefits (EOB) statement or Medicare Summary Notice that your health plan sends after treatment. Check the name of the provider, the date of service, and the service provided. Do the claims paid match the care you received? If you see a mistake, contact your health plan and report the problem.

Other signs of medical identity theft include:

a bill for medical services you didn’t receive

a call from a debt collector about a medical debt you don’t owe

medical collection notices on your credit report that you don’t recognize

a notice from your health plan saying you reached your benefit limit

a denial of insurance because your medical records show a condition you don’t have.

Correcting Mistakes in Your Medical Records

If you know a thief used your medical information, get copies of your records. Federal law gives you the right to know what’s in your medical files. Check them for errors. Contact each doctor, clinic, hospital, pharmacy, laboratory, health plan, and location where a thief may have used your information. For example, if a thief got a prescription in your name, ask for records from the health care provider who wrote the prescription and the pharmacy that filled it.

You may need to pay for copies of your records. If you know when the thief used your information, ask for records from just that time. Keep copies of your postal and email correspondence, and a record of your phone calls, conversations and activities with your health plan and medical providers.

A provider might refuse to give you copies of your medical or billing records because it thinks that would violate the identity thief’s privacy rights. The fact is, you have the right to know what’s in your file. If a provider denies your request for your records, you have a right to appeal. Contact the person the provider lists in its Notice of Privacy Practices, the patient representative, or the ombudsman. Explain the situation and ask for your file. If the provider refuses to provide your records within 30 days of your written request, you may complain to the U.S. Department of Health and Human Services’ Office for Civil Rights.

 Protecting Your Medical Information

Your medical and insurance information are valuable to identity thieves.

Be wary if someone offers you “free” health services or products, but requires you to provide your health plan ID number. Medical identity thieves may pretend to work for an insurance company, doctors’ offices, clinic, or pharmacy to try to trick you into revealing sensitive information.

Don’t share medical or insurance information by phone or email unless you initiated the contact and know who you’re dealing with.

Keep paper and electronic copies of your medical and health insurance records in a safe place. Shred outdated health insurance forms, prescription and physician statements, and the labels from prescription bottles before you throw them out.

Before you provide sensitive personal information to a website that asks for your Social Security number, insurance account numbers, or details about your health, find out why it’s needed, how it will be kept safe, whether it will be shared, and with whom. Read the Privacy Policy on the website.

If you decide to share your information online, look for a lock icon on the browser’s status bar or a URL that begins “https:” the “s” is for secure.

To read more about protecting yourself from Medical Identity theft and what to do if you find out that you Medical identity has been stolen go to the Federal Trade Commission Website.

* The information contained in this Blog is intended for general information and educational purposes only and does not constitute legal advice or an opinion of counsel.

American College of Obstetricians (ACOG) Recommends Screening Women For Elder Abuse

Elder abuse is a prevalent issue and needs to be screened for in women aged 60 years and older during preventive health care visits, according to a Committee Opinion published in the July issue of Obstetrics & Gynecology. The ACOG Committee on Health Care for Underserved Women reviewed published literature and recommendations regarding the prevalence and identification of abuse in women, particularly in older women.

The following are included in ACOG’s recommendations: screen all patients older than 60 years for signs and symptoms of elder abuse, starting with open-ended questions and progressing to more specific questions; advocate for a safe environment for all aging women; follow individual state guidelines for reporting elder abuse to Adult Protection Services; provide education regarding elder abuse to patients, family, caregivers, and health care providers; and encourage research on elder abuse and mistreatment. “Screening, education, and policy change are the best interventions for the prevention of elder abuse,” the authors write. “Early identification and prompt referral should be part of the preventive health care visit for women aged 60 years and older.”

Source/more: Health Day Physician’s Briefing

* The information contained in this Blog is intended for general information and educational purposes only and does not constitute legal advice or an opinion of counsel.