Moschella & Winston, LLP Your Legal Advisor for Life

Boston Elder Law Attorney

Attorney Alex Moschella describes his passion and commitment to elder and disability law, which spans more than 30 years — including teaching elder law at Boston’ Suffolk Law School (his alma mater). Alex enjoys helping people who are vulnerable — helping them to overcome adversity and overwhelmig difficulties navigating government agencies, and to hold on to their hard earned savings.

Please get to know Alex by watching the video below.

See more videos by our Massachusetts estate planning attorneys.

You can reach Alex at (617) 776-3300.

Boston Elder Law Attorney Alex Moschella describes the urgent and complex situation of getting a loved one into a nursing home

Attorney Alex Moschella describes how his firm provides “Crisis Medicaid Planning” for couples or single persons when long-term care in a nursing home is urgently needed. These are “crisis cases,” since decisions must be made immediately as to placement and determining the source of funds to pay for nursing home care — that in the greater Boston area easily averages over ten thousand dollars a month.

The firm regularly assists families facing the crushing blow of dealing with disabling conditions such as advanced Alzheimer Disease, Multiple Sclerosis, Parkinsons, or complex medical conditions. The nursing homes will not accept their loved one if  the method of payment is not determined at the outset.  (more…)

The May/June episode of Legally Speaking with Michelle Mulvena. This episode discusses news affecting seniors with Ward 3 Alderman/Vice President of the Board of Alderman Tom Taylor, and Aldermnan-At-Large William White.

By Michelle Mulvena, Esq.

A life estate is a type of ownership interest in real estate.  Most commonly the life estate is conferred by deed but may also be conferred in a will or trust.  The typical scenario pertains to a parent who wants to “give the house to the kids” but retain control over the property. The parent transfers the real estate by deed to the children reserving a life estate for him or herself. The parent is known as the “life tenant,” and the children have what is known as a “remainder interest.”

The life estate avoids probate because the real estate goes directly to the children upon the death of the life tenant.  The life estate can also protect the home from Medicaid after the five year look back period imposed by Medicaid.  The life tenant is entitled to any rental income, continues to pay all expenses of the real estate including real estate taxes, homeowners insurance, repairs and the capital gains tax exclusion.  The life estate will qualify for a step up in basis upon the death of the life tenant.

There are some pitfalls.  A life estate is a transfer of the remainder interest to the children.  Thus according to Uncle Sam, it is a gift.  You will need to file a gift tax return for the value of the remainder interest.  Also, if the home is sold during the life of the life tenant, then the children may have to pay capital gains tax.

While the life estate is a simple and often used planning tool, as always, it is best to consult with an estate planning lawyer to ensure that the life estate is right for you.

Michelle Mulvena is an attorney at Moschella & Winston, LLP, a law firm specializing in legal planning and protection for individuals and families for over 30 years. She is also host of the Somerville Cable TV show, “Legally Speaking with Michelle Mulvena.” Please contact her at mm@moschellawinston.com or (617) 776-3300.

The January/Februay episode of Legally Speaking with Michelle Mulvena. This episode discusses elderly identity theft. More about Michelle Mulvena.

By Michelle M. Mulvena, Esq.

This is the final segment in a three-part series that discusses the Medicare open enrollment period for Medicare Parts A, B, C and D. Be sure to check out Part I and Part II in the series.

As you know, the Medicare annual open enrollment period began on November 15, 2010 and runs through December 31, 2010. This is the only opportunity you will have to make changes to your Medicare plans for 2011 so it is essential to take advantage of this time frame.

The health care reform act has changed Medicare coverage. Thus it is particularly important to do your homework for your 2011 Medicare coverage.

The changes include:

1. Starting in 2011, Medicare participants will be able to receive preventive services like mammograms and colonoscopies for free.
2. The prescription drug coverage gap known as the “donut hole” will decrease until it is eliminated in 2020. This year, eligible participants who hit the donut hole received a $250 rebate check. Next year, participants will receive a 50 percent discount on the brand name prescription drugs they purchase when they hit the donut hole.
3. Free annual wellness check ups starting in 2011.

Many Medicare plans change or are eliminated every year. But this year there are an exceptional number of plans that will be discontinued. Even those with plans that are continuing should be carefully evaluated to ensure they cover the medications you need and that you can afford the premiums, deductibles and co-pays.

Resources for Medicare Beneficiaries

1. Visit www.medicare.gov. Personalized comparisons of costs and coverage plans available in your area. Multilingual Open Enrollment information and counseling is available.
2. Call 1-800-MEDICARE (1-800-633-4227) for around-the-clock assistance to find out more about coverage options. TTY users should call 1-877-486-2048.
3. Review the 2011 Medicare & You handbook. It is also accessible at www.medicare.gov and has been mailed to the homes of people with Medicare benefits.
4. Contact your local Elder Service Plan (ESP) for free one-on-one assistance. In the Somerville/Cambridge area your local Elder Service Plan is Somerville-Cambridge Elder Services, 61 Medford Street, Somerville, MA 02143-3429, 617-628-2601.
5. Get one-on-one counseling assistance from the local State Health Insurance Assistance Program (SHIP). Local SHIP contact information can be found:

• At http://www.medicare.gov/contacts/organization-search-criteria.asp
• On the back of the 2011 Medicare & You handbook or;
• By calling Medicare at 1-800-MEDICARE (1-800-633-4227; TTY, 1-877-486-2048)
• Through a listing of national stand-alone prescription drug plans and state specific fact sheets can be found at: http://www.cms.hhs.gov/center/openenrollment.asp

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Michelle Mulvena is an attorney at Moschella & Winston, a law firm specializing in legal planning and protection for individuals and families for over 30 years. She is also host of the Somerville Cable TV show, “Legally Speaking with Michelle Mulvena.” Please contact her at mm@moschellawinston.com or (617) 776-3300.

By Michelle M. Mulvena, Esq.

This is the second posting in a three part series that discusses the Medicare open enrollment period for Medicare Parts A, B, C and D. Check out the first part here.

As you know, the Medicare annual open enrollment period began on November 15, 2010 and runs through December 31, 2010. This is the only opportunity you will have to make changes to your Medicare plans for 2011 so it is essential to take advantage of this time frame.

Medicare benefits are split into four parts:

1. Part A covers hospitalization and other in-patient care.
2. Part B covers services and treatment such as doctor visits.
3. Part C is known as the Medicare Advantage plan, which includes Part A and Part B as well as extra benefits.
4. Part D is the prescription drug plan.

Beneficiaries choose either original Medicare (A and B) or the advantage plan, and can then elect to add Part D. If the beneficiary needs services not covered by these plans, they can select a Medigap plan.

Participants of Part C, Medicare Advantage, get government-provided Medicare through a private insurance company, in the form of a health maintenance organization or a preferred provider organization. It usually includes the elements of Part A and Part B hospitalization, medical care and a prescription drug plan, and often comes with extras, such as covered annual physicals.

Medicare Advantage includes specialized care for people who need a large amount of health care services. In addition participants are covered for emergency or urgent care services when traveling outside of their plan coverage area.

For Medicare Advantage participants it is especially important to pick the right plan during the open enrollment period. Unlike previous years, people enrolled in Medicare Advantage plans can no longer switch to other Medicare Advantage plans during January, February and March. However, after January 1, 2011, participants can still leave their Advantage plan and go back to original Medicare.

Right now there is a lot of information circulating out there about the open enrollment period. Buyer beware of Medicare scams and take precautions to protect your Medicare number as diligently as you would protect your social security number. Identity theft and fraud targeting seniors is in full force this time of year. Make sure you are receiving information from trusted sites such as Medicare.gov or from your local Senior Center or Elder Service Plan.

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Michelle Mulvena is an attorney at Moschella & Winston, a law firm specializing in legal planning and protection for individuals and families for over 30 years. She is also host of the Somerville Cable TV show, “Legally Speaking with Michelle Mulvena.” Please contact her at mm@moschellawinston.com or (617) 776-3300.

The November/December episode of Legally Speaking with Michelle Mulvena. This episode discusses the Medicare open enrollment process with Corinne Loftchie of Somerville/Cambridge Elder Services.

By Michelle M. Mulvena, Esq.

Earlier this year I posted a blog describing the status of the federal estate tax law for 2010.  I fully anticipated that by now I would be updating you as to the new estate tax law, but alas that is not to be.  Congress has yet to take any action on the matter.  As of this posting, the current federal estate tax law will ride off into the sunset on December 31, 2010.  It will be replaced with a $1 million exemption level with a tax rate of 55% – yes, that’s 55%!

There is considerable debate as to whether Congress will take any action before the end of the year as we enter a lame duck session after the November elections. I suspect that Congress will not change the estate tax law before the end of the year. In fact, I’m going to wager a guess that the law may not even change in 2011 or if it does, it will be well into 2011.  Could Congress change the law late in 2011 and make it retroactive to January 1, 2011?  Sure and that will make things very interesting.

So for now prepare yourselves for the worst-case scenario because if the federal law does not change many estates will be impacted.  The person owning a multifamily in Somerville and a decent size investment portfolio needs to be concerned.  The person who owns a home in Winchester and a vacation home on the Cape needs to be concerned.  Have your estate plans reviewed now to try to minimize the risk.

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Michelle Mulvena is an attorney at Moschella & Winston, a law firm specializing in legal planning and protection for individuals and families for over 30 years. She is also host of the Somerville Cable TV show, “Legally Speaking with Michelle Mulvena.” Please contact her at mm@moschellawinston.com or (617) 776-3300.

A few months ago there was an article in the AARP Bulletin that discussed a growing trend of nursing home residents regaining their independence and transferring back into the community. This trend is gaining momentum partly because more state and federal programs are designed to help them do it.  According to the National Center for Assisted Living, spending for home and community-based care rose 81.5% between 2001 and 2007, while Medicaid spending for nursing home care rose only 9.8%.  There is a federal program that encourages states to use Medicaid funds to transition nursing home residents to independence.  This program received a five-year, $2 billion extension in the health care reform bill.

Nursing home residents who are receiving Medicaid can usually transition that assistance to help in the home.  The transition from nursing home to independence is not an easy road and many factors must be considered before the transition can occur.  You should inquire with your local elder service plan, such as Mystic Valley Elder Services or Somerville-Cambridge Elder Services, or your local Council on Aging to see whether they can offer any assistance with the transition.  The transition may require getting new identification cards, setting up bank accounts and finding suitable living arrangements, as well as care in the home.

The most important consideration is whether the senior can receive the level of care and services needed to move into the community.

Consider the following when determining whether a senior should return to the community:

• Do you want to live independently?

A senior must be motivated to overcome the obstacles to independent living.

• Can you physically and safely live on your own?

Mobility is a key element of independence.

• Can you afford to live outside of a nursing home?

Various funding options may be available in addition to Social Security and pension income.

• Is in-home care available?

Community based Medicaid programs may provide considerable assistance.

• Can you find appropriate housing?

Issues such as access, safety features, security, kitchen or dining facilities should be considered and vary with health and mobility.

• Does the home have everything that you need?

You will need items such as emergency contacts, a telephone, kitchen equipment, and personal care items.

• Does your community have necessary medical services?

It is critical to identify this in advance, and if possible, contact providers in the community to ensure that services are available.

• Do you have the skills needed to live at home independently?

This may include everything from preparing meals, shopping and paying bills, to showering or bathing.

• Do you have transportation available?

Many communities have transportation programs for seniors.

• Do you have social support?

Senior day care, activities in senior housing, Council on Aging programs, religious programs, and visits from family can prevent isolation if returning to the community.

Transitioning from a nursing home to the community may be a viable option for some seniors.  The key is to assess the current situation and potential options, research available support, anticipate unexpected circumstances, and plan well in advance of a move.

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Michelle Mulvena is an attorney at Moschella & Winston, a law firm specializing in legal planning and protection for individuals and families for over 30 years. She is also host of the Somerville Cable TV show, “Legally Speaking with Michelle Mulvena.” Please contact her at mm@moschellawinston.com or (617) 776-3300.