classnotes pt 2
classnotes pt 2 LEGL 326
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This 7 page Class Notes was uploaded by Diona Spencer on Thursday July 9, 2015. The Class Notes belongs to LEGL 326 at Towson University taught by Michael Seganish in . Since its upload, it has received 101 views. For similar materials see Elder Law in Law and Legal Studies at Towson University.
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Date Created: 07/09/15
Healthcare decision making 0 1900 o No required guidelines Shorter life span Lack of technology to keep someone alive Religious implication 1960 197039s 0 Living will declaration applies only if terminal Allows someone who is in imminent risk of death to declare that you should use no heroic methods to keep someone alive Would apply to someone who is in a coma or in a persistent vegetative state stroke heart attackto withhold life extending procedures 0 1976 0 Advanced healthcare directive Incorporates living will and instructions in other instances 0 199039s 0 Even without advanced health care directive or a living will the court can decide to terminate treatment life A courts substituted judgement for the disabled person 0 File suit introduce evidence as to what the person would have wanted Court can make a decision in the best interest of the person Death with Dignity Assisted suicide terminal 2 MD s Bill introduced in 2015 in MD legislature Healthcare decision making 0 1914 informed consent patient must know risks before they make a decision 0 1976 quilan case as long as a person is competent then they can decide how much effort to use to keep them alive Kinds of decisions how much effort do vou want to keep vou alive 0 Persistent vegetative state do not have higher cerebral function Brainstem death cannot function on your own at liner body will die 0 Terminal illness Assisted suicide 0 Oregon rst state to pass law in 1994 Suicide not a crime 0 Assistance o 70 of all medical expenseoccurs in the last few years of your life 0 Nursing home skilled nursing could run 100000 0 Advanced health care directiveDagent can make certain decision 0 Persistent vegetative state no upper cerebral functioning o Brainstem death only way kept alive is arti cially Must the US ration healthcare determines how much care you getlj can impact your ability to stay alive 0 Ex Dialysis machinelj for kidneys 23 days for week machine removes impurities kidneys cannot 0 Britain yes very few machines 1 yr wait to get dialysis Insurance 0 Types 0 Long term care 0 Life 0 Property 0 Automobile 0 Liability 0 Devil in the details mystery of insurance do not know if policy covers it unitl you get the chech from insurance company 0 3 D39s of insurance 0 Deny 0 Delay payment 0 Defend payment 0 Basis of insurance is a small periodic payment premium to avoid having to pay a large amount later 0 In order to set premium based on statistics law of large numbers otherwise it would be gambling and you would not know if your insurance company would remain in existence 0 Some companies selfinsure so large that premium would be so high set aside amount per year Pensionshealth care 0 Law of large 5 must be actuality based statistically sound 0 State of MD retiree bene ts only 60 funded If you stop paying premiums your insurance coverage ends you do not build up any cash value paying for protection 0 This may not be true with some life insurance 0 Term life insurance premium goes up follows the mortality curve If you stop paying life insurance ends 0 Whole life pay more difference builds up cash surrender value Cashitin Buy paid up insurance 0 Cannot cancel if health gets worse 0 Guaranteed insurability to buy additional insurance o If it is whole life you can get low interest loans against the cash surrender value of the policy Waiver of premiums if become disabled term or whole life Other uses for life insurance 0 Have policy to cover burial expenses debts 0 Get a policy to cover inheritance taxes or to buyout a partner or shareholder quotkey person insurancequot Inheritance tax Federal estate tax 500000 and state estate tax 1000000 Tax federa as high as 55 Estate will pass for tax free to a spouse unlimited marital deduction Lower estate tax gifts like 14000 per person Law of trusts quotcredit shelter trustquot If you sell property before death it may involve capital gains 0 If single you are exempt up to 250000 from capital gains if married except up to 500000 0 When heir gets property by inheritance you get the value for you as the market value at date of death 450000 get the property39s quotstepped up basisquot Long term Care Insurance Pay for nursing home or care in your home if you are disabled 0 Details after initial period 30180 days Level premiumater the age which you take out the policy the higher the premiums 0 Take out at 50 it39s going to be lower than if you take it out at 62 pay starting at 75 years old There is no cash value which is built up When you stop paying premium before you draw it no coverage Provisions 0 How many years does it pay 25 years 0 How much does it pay 30000 40000 per year 0 In ation rider on policy 0 After initial period 30180 Understand who pavs what Regulation DDprescription coverage Medical medical assistance Medicare A 0 Health insurance 0 Acute care in hospital patient rst 0 Applies to person over age of 65 years old Medicare B 65 yrs 0 Covers doctors bill covers 80 so patient must cover 20 or get a Medicare supplement policy 0 Skilled nursing in a nursing home 0 Cannot have more than 2500 in assets D spending down assets social security long term care how long will it take to reach 2500 Livino Accommodations Independent 0 Own home long term care insurance pays for o Spent housing ADL39s 0 Combined living facilities Combination of independent assisted living and nursing home congregate own apartment but if you need more care you can move to assisted living or nursing home 0 What costs are 0 Edenwald across from the mall Put dollar amount each year you live there you have to ammonites this down payment 7 years 0 down 0 Erickson model Oakcrest Buy own apartment when leave sell apartment and get back 0 Pickensgill No down payment monthly fee apartments monthly rental Assisted Living 0 A B level 0 Some help for ADL39s 0 Government does not pay for assisted living facility 68000 month 0 Long term care insurance pays for it 0 6080 cost of nursing home 0 Own home 0 30000 per year for 23 years 0 Income social security private investments pension Nursing home 0 Cognitive problems alzheimers stroke 0 Need high level of care for ADL39s 0 Evaluate the individual delmanua l does this in MD level of care needed need skilled nursing care 0 May qualify for medical assistance will pay for the nursing home needs based program assets need to be less than 2500spend down to reach this level Social Security 0 Maximum 30000 per year o 62 eary 656667 depending on date of birth 0 Individual investments very little 300000 may not be 300000 is it s in a tax sheltered account have not paid taxes on it 0 Individual retirement account keough 401k 0 SEP simpli ed employer pension Reverse Mortgage Normal if you buy 100000 0 Loan mortgage put down 80000 20000 in equityD make payments to bank 30 yrs to repay 80000 and own house free and clear 0 Home equity line 2nCI mortgage take out against your property 0 Repaid any other normal mortgage Homo equity conversion mechanism HECM reverse mortgage 0 Requirements 62 years old Do no thave to repay it as long as you or your spouse continue to live in the house After 6 months of neither living in the house it comes due Maximuml 600000 Qualify for 350000 you can receive it in lump sum on annuity annual payment Pay interest and charges on the loan When it comes due soldD get whatever equity still left in the property after withdrawals interest charges 3 legged stool Pension 0 De ned bene t pension know how much you will receive after retirement 0 De ned contribution pension only know how much has been paid in State of MD TIACREF insurance company contribute 7 14 of salary employee contribute per year employer match what you put in 0 Lower have wo paying tax on it COLA Cost of living adjustmentkeeps purchasing power the same Pensions 0 De ned bene t yrs of servicepercent receive55yry salary lf pension becomes insolvent under employment retirement income security act of 1974 o Pension bene t guaranty corporation pays max bene t 55840 0 Plans 0 Pension amount when die balance goes back into pension fund 0 One pension present value on pension if do not draw this out balance is paid estate 0 Joint and survivor Spouse will receive the same amount for her life payments end at death of survivor De ned Contribution 0 Know how much you put in but not how much income you annually receive 0 What do you do with it to generate income Bank savings account less than 1 interest Certi cated of deposits with bank 1 0 Plans pretax contribution 401 k Keoughlj self employed IRA individual retirement account 0 PoliceFire o Retire 50 saary after 20 years c FCA o 62 paid by employers o 62 paid by employee 0 Ages 0 65 Take a lump sum distribution directly to you Take 401 kljrollover to IRA no tax due 0 Invest in stocks 0 Invest in bonds have face value 6 problems interest rate 0 If less than 59 12 Take out tax deferred money pay income tax pay 10 penalty 0 If 70 12 Mandatory minimum distribution 50 penalty if you don39t take out Annuity from insurance company give dollar amount tells you how much income this will buy Income 0 In addition to individual retirement account there are other means to lower income tax and have money grow tax deferred 401 k keough plans 0 Employee can put in plan employer can match this 0 Grow up tax deferred Once you decide to draw money out 0 De ned bene t pension already knew how much going to be paid per year 0 Decide how you want to be paid Annuity annual payment from insurance company give money tell you how much they will pay annually to you ROTH IRA 0 Put in after tax dollars No tax deduction when create 0 When draw it after 59 12 it is tax free
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