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Does Medicaid Cover Self-Measured Blood Pressure?

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According to the American Heart Association, high blood pressure contributes to many significant health conditions, including heart attack, heart failure, stroke, and kidney failure. In the United States, 121.5 million adults suffer from high blood pressure, also known as hypertension.

While half of these individuals have improved their conditions, others have uncontrolled blood pressure, which can harm their health. Self-monitoring one’s blood pressure can help control this condition. Depending on your state, Medicaid may cover part of the cost.

What Is Self-Measured Blood Pressure (SMBP)?

Medical care is an important part of blood pressure management. Yet, you can also help your doctor treat you by monitoring and recording your symptoms at home. This is called self-measured blood pressure (SMBP). When combined with a doctor’s support, SMBP might improve your health.

You can use a manual blood pressure cuff or an automated blood pressure device to monitor your BP. With at-home measurements, you can record your blood pressure levels over time. Your doctor can use this information to help treat you.

The Benefits of Monitoring Blood Pressure at Home

Some evidence suggests that SMBP with clinical support may be more effective than medical care alone.

  • When you measure your blood pressure at home, you can assess your condition regularly. You do not have to wait for a medical professional to evaluate your BP. If your blood pressure becomes dangerously high, you can inform your doctor and seek emergency treatment.
  • By keeping track of the fluctuations in your blood pressure at home, you can give your doctor detailed information to help with your treatment. For instance, your doctor can use the information to decide what kind of medication and dosage to prescribe.
  • Sometimes, blood pressure levels change depending on the situation. SMBP can identify forms of hypertension that present differently. At-home measurements can reveal white-coat hypertension (when a patient’s BP is high at the doctor’s office, but at a healthy level at home) and masked hypertension (when BP readings appear normal in a doctor’s office but are high in other settings, such as at home or work).

Why Might Medicaid Beneficiaries Need Coverage for SMPB?

Per Medicaid.gov, one-third of all Medicaid beneficiaries have high blood pressure. With uncontrolled hypertension disproportionally affecting low-income, nonpregnant adults on Medicaid, SMBP coverage and reimbursement through Medicaid can be beneficial for many.

Does Medicaid Cover Home Blood Pressure Monitoring?

Medicaid covers SMBP in certain states. Yet not all states have coverage. Continue reading for more information.

What Does SMBP Medicaid Coverage Include?

Depending on your state, Medicaid’s coverage for self-measured blood pressure could include the following:

  • Provider reimbursement for medical support
  • BP measurement devices for you to use at home (manual blood pressure cuffs or automated blood pressure devices)

In most states with SMBP coverage, Medicaid takes care of medical care as well as devices. Other states cover just one or the other. The American Medical Association outlines what Medicaid provides in each state.

Which States Cover Medical Support and BP Measurement Devices?

The following states provide coverage to some extent for both medical support and devices:

  • Arizona
  • Colorado
  • Delaware
  • Hawaii
  • Idaho
  • Indiana
  • Michigan
  • Nebraska
  • New Jersey
  • New Mexico
  • North Carolina
  • North Dakota
  • Ohio
  • Oregon
  • Texas
  • Virginia
  • Wisconsin
  • Wyoming

These states only cover durable medical equipment (manual blood pressure cuffs or automated blood pressure devices):

  • Alaska
  • Arkansas
  • California
  • Connecticut
  • D.C.
  • Illinois
  • Iowa
  • Kansas (only covers manual blood pressure cuff)
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Minnesota
  • Mississippi
  • Missouri
  • Nevada
  • New Hampshire
  • New York
  • Utah
  • Vermont
  • Washington

The following states reimburse providers for supporting patients with SMBP. However, Medicaid does not pay for at-home devices.

  • Georgia
  • Kentucky
  • Montana
  • Rhode Island

Speak With an Attorney

If you have high blood pressure, self-measurement might help. Consult with an attorney to learn more about whether you could be eligible for Medicaid coverage in your state.

What Is Respite Care? Can It Help With Caregiver Burnout?

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It is easy to burn out when you are responsible for providing full-time care to an aging or disabled loved one. In some cases, caregiver burnout can result in resentment toward the individual they care for, despite their love for them.

The fact is, we all need a break sometimes. That is why respite care exists. If you are a caregiver who needs to take time for yourself, read more to learn about respite care.

What Does Respite Mean?

Taking respite means having a temporary period of rest. For primary caregivers, this typically refers to securing short-term care for your loved one – even several weeks or months – so that you can recharge amid the very real burdens of caregiving.

In finding respite, you also might make time to practice self-care, from going to the gym to connecting with friends. Do not forget to find ways to maintain your sense of self while you are in the midst of giving so much of your time and attention to someone else.

Caregivers Want Information About Respite Care

In a 2022 survey of caregivers, Caregiving in America found that most were unaware that respite care was available. Many caregivers need more education about their options for respite care and how to build a network of support to share the load of providing financial and emotional support to an ailing loved one.

Here are some of the study’s findings:

  • Fifty-nine percent of respondents reported that they were the primary emotional support system for a sick or impaired loved one.
  • Twenty-two percent of respondents said they worked more than 40 hours per week as the primary caregiver to a disabled family member.
  • Forty-eight percent of respondents disclosed they needed emotional support for themselves.
  • Forty-four percent of respondents shared that they wanted information about where to find respite care.

Caregivers need information about maintaining their own health while supporting a family member. It is essential to prioritize yourself when caring for an aging or disabled relative.

Preventing Caregiver Fatigue

The challenges of taking care of an ailing loved one can be extremely stressful. More than that, the strain of serving as a caregiver – often unpaid – can make a real and lasting impact on your own health if not kept in check.

Symptoms of burnout among caregivers may include the following:

  • Losing sleep and extreme fatigue
  • Feeling hopeless
  • Having a quick temper
  • Lack of interest in your favorite activities

If you or someone you know has taken on the responsibilities of caregiving, be aware of the signs of burnout and actively seek support. Respite care is among your potential options.

What Is Respite Care?

Respite care gives caretakers a chance to relax and take a break from the responsibility of providing full-time care to loved ones who are aging or disabled. Respite programs offer short-term replacement care. These providers will step in for a short period to take on the responsibility of caring for your loved one.

The types of care you can expect them to take on may include the following:

  • Bathing and dressing
  • Cooking and cleaning
  • Helping your loved one eat, drink, and take their medication
  • Getting into and out of bed
  • Assistance with the restroom
  • Spending quality time with your loved one
  • Helping with exercise and personal care

How Much Does Respite Care Services Cost?

The cost of respite care varies depending on how long you use the service. You can schedule respite care for several days, weeks, months, or longer.

Who Pays for Respite Care?

Private insurance will typically not cover respite care, unfortunately. If your loved one is covered by Medicare or Medicaid, you may be able to secure five consecutive days of respite care. Your loved one must be receiving hospice care benefits for Medicare to cover respite care.

Finding Respite Care

Several organizations provide respite care. If your family member is covered by Medicaid, you can speak to a Medicaid planner in your state to determine what programs may be available. As mentioned above, Medicare covers respite care under its hospice benefit.

If your loved one is not covered by Medicare or Medicaid, don’t worry; there are private organizations that provide this service. These organizations include:

In addition, connect with your attorney to talk through your options.

Becoming a Family Caregiver for an Ailing Loved One

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Taking on the responsibility of providing full-time care for an aging or disabled loved one can be a rewarding experience. Being a primary caregiver helps you rest assured that your loved one is receiving compassionate care from someone who will go above and beyond to ensure they are comfortable and looked after.

Despite your good intentions to create a comfortable environment for your loved one, full-time caregiving is a significant time commitment. There is also a financial reality that the caregiver must face. Fortunately, family members who want to serve as caregivers may have options to help cover the expense.

What Is a Caregiver, and What Do They Do?

Professional caregivers work intimately with seniors to meet their needs as they age. As individuals get older, their needs change and they may need more help going about their day.

Examples of the kinds of help caregivers provide include:

  • Bathing and grooming
  • Help with toileting
  • Medical appointments and medication compliance
  • Transportation
  • Companionship
  • Cooking, cleaning, and grocery shopping
  • Care for animals
  • Laundry
  • Coordinate benefit care/speak to insurance companies on the senior’s behalf, if authorized

Family Caregivers: Know the Downsides

Having a family member serve in the role of caregiver can make for a better experience for your loved one and, in some ways, give you peace of mind as well. However, there are some downsides to be aware of if you are considering becoming a family caregiver.

Your own health, both physical and emotional, can be negatively affected when taking on the burden of caring for a family member. Be sure to engage in self-care, maintain a healthy diet, and watch out for signs of stress and burnout. When you do need a break, consider looking into respite care.

If your loved one has specific medical issues that will require the attention and expertise of a professional health care provider, you may want to reassess whether you should take on the role of family caregiver.

Taking care of a loved one who is getting older or who is disabled will likely require a great deal of your time, too. You may find yourself not performing as well at work or having a longer commute as you fulfill the needs of your ailing loved one. Not to mention that your own immediate family may be missing out on valuable time with you while you are caregiving elsewhere.

In turn, this could mean you will have less time to hold down a full-time job. In fact, a 2020 AARP survey showed that about 20 percent of family caregivers reported experiencing a high level of financial stress. Nearly 30 percent of them stopped saving altogether as a result of providing care for their loved one.

In these challenging economic times, you must be able to support yourself while ensuring the best care for your aging family member.

Can Family Members Get Paid for Their Work as a Caregiver?

Fortunately, certain programs are available to help family members care for ailing relatives. You may need to do a bit of research to find the right option for your circumstances.

  • Medicaid Self-Directed Care

For individuals on Medicaid, the Medicaid Self-Directed Care Program is one option that gives them the authority to manage their services. In certain states, this program offers recipients the ability to use the resources allocated for home care to pay a family member to help them with their daily needs. The Medicaid Self-Directed Care Program lets seniors have more autonomy over their care.

Note that such programs vary by state, however, and not all states will have an option like this. Each state may also use different criteria to define who qualifies as a “family” caregiver. Find your local Area Agency on Aging to learn more about the possibilities, or call your local Medicaid agency.

Note that, generally, Medicare will not cover the costs of caregiving by a family member.

  • Veteran’s Benefits

If your loved one is a military veteran, there are special benefits available to cover their home care, including the Veteran’s Directed Home and Community Based Services program. This program gives veterans a flexible spending budget that the veteran can use to pay a family member to act as their caregiver.

  • National Family Caregiver Support Program

Note that this program does not pay caregivers directly. Rather, it helps fund several different types of services for family caregivers, from training in caregiving to respite care. Learn more about this program.

  • Long-Term Care Insurance

If you are thinking ahead to who will care for you as you age, you may consider long-term care insurance when creating an estate plan. Certain long-term care insurance policies allow the policyholder to pay family members to work as caregivers. However, that is not true for every policy. Some policies do not allow policyholders to pay family members to work as caregivers if they live in the policyholder’s home.

Before taking out this type of insurance policy, you should speak to your attorney to ensure you are properly advised.

Aging Care: 6 Tips for Caring for Elderly Parents

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Many adult children wonder what their aging parents may need and how can they can help provide it for them.

You may constantly worry about your parents or other older loved ones, especially if you live far away from them. You can, however, take some simple steps to ensure your parents are safe as they age.

Tip No. 1: Recognize the Risks Older Adults Face

Knowing the risks seniors face can help you begin an action plan for your parents. It may be difficult for some older adults to complete tasks they could do before with ease, particularly if they live alone. Examples of those tasks can include:

  • Taking medication correctly and on time
  • Remembering things, keeping up conversation, or multitasking
  • Getting help in a medical emergency, such as a fall
  • Eating healthfully
  • Moving safely around their home

Being aware of these common concerns can be an important first step in doing everything you can to protect your parents as they age.

Tip No. 2: Ensure Medication Compliance

If your parents have health conditions that require them to take medication regularly, you should take time to make sure they are adhering to their prescription instructions. It may be a good idea to routinely review the medications your parents take, the name of the medications, and any potential side effects.

You may consider creating a medication schedule that you can both follow, so that you (or a home care provider) can check in and confirm your loved one is remembering to take medications when necessary.

Tip No. 3: Prepare for Cognitive Decline

Alzheimer’s disease and other forms of dementia affect more than 5 million adults aged 65 and older, according to the Centers for Disease Control and Prevention (CDC). Keep your parents safe by understanding their current cognitive abilities and any risks they may face for future decline.

Consider setting up a routine for your parents’ day-to-day lives. This might include social engagement and spending time with you and other family members, which may become even more crucial if their cognitive health has deteriorated.

Tip No. 4: Equip Aging Parents for Medical Emergencies

Older adults that live alone are vulnerable to falls and other medical emergencies. If you live out of state, you may have concerns about your parents being able to act quickly in ensuring they get emergency medical attention when they need it.

To help your parents respond to emergencies, consider using a medical alert system. With a medical alert system, your parents will have emergency assistance at the push of a button. Many different companies offer this type of service. An online search can help you narrow it down.

Tip No. 5: Plan for Meals

Seniors, especially those that live with memory issues, may not eat regularly. Without adequate nutrition, older adults may fall ill, or any current condition may worsen. Many seniors across the United States are food insecure. Fortunately, there are certain Medicare Advantage grocery benefit programs as well as other free or inexpensive meal delivery services, such as Meals on Wheels, that deliver nutritious meals to seniors.

Tip No. 6: Prevent Household Injury

Household injury is a major risk for seniors, especially those who live alone. You should do a sweep of your parent’s home and remove all potential hazards, including unsecured electrical cords, household products and chemicals, or loose rugs. Fix broken handrails on staircases, install grab bars in bathtubs, and ensure there is adequate lighting in their home. Taking each of these steps, and any others you see fit, can help avoid a preventable injury.

What Does the Term “Decedent” Mean?

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“Decedent” is a legal term that refers to a person who has died with unsatisfied legal obligations.

At the end of their life, a decedent has some legal duties that must be fulfilled through a representative. For example, decedents remain obligated to satisfy certain debts incurred during their life and file their last income tax return.

What Is the Difference Between a Decedent and a Deceased Person?

A deceased person is someone who has died. While the word “decedent” also refers to a person who has passed away, it denotes a legal status as well. Essentially, all decedents are deceased people, but not all deceased people are decedents.

The word “decedent” is mostly used for estate planning purposes. For example, you may see this term in a last will and testament, or in estate closure documents related to closing a deceased person’s bank account and filing their final income taxes.

In addition to finalizing an estate, if a person was a party in an active civil lawsuit before they died, the word “decedent” will be added to the party’s name in court documents to signify that a representative is continuing with the case.

How Are Their Legal Obligations Fulfilled After Death?

Decedents have legal obligations after their death. Since they cannot perform these duties, the person they appointed before their death must meet any obligations. These legal responsibilities must be handled according to state law if the deceased person did not name a representative before they died.

Duties that someone has after they die that must be completed by their representative include the following:

  • Notify banks, credit card companies, and other creditors about the death of the individual. Also, government agencies must be notified, including Medicaid, Medicare, and the Social Security Administration.
  • File the decedent’s last will and testament with the probate court. The representative will also be responsible for representing the decedent’s estate in court.
  • Pay any of their outstanding and payable debt.
  • File income taxes.
  • Open a bank account for the estate. The representative will pay bills, debts, and taxes from the new account.
  • Distribute the estate’s assets to the heirs named in the decedent’s last will and testament, or ensure that the heirs at law receive the appropriate property if assets are passed down via intestate succession.

What Is Included in Their Estate?

A decedent’s estate includes all the property they owned when they died. Examples of property included in their estate may include:

  • Cash
  • Property (i.e., their home)
  • Jewelry
  • Vehicles
  • Stocks
  • Bonds
  • Land

Their estate must go through the probate process before the estate is closed. Some property may be included in the estate but is not subject to probate, including life insurance.

What Is a Decedent Trust?

Also called an A-B trust, this type of trust is created between a married couple and dissolves when the first spouse dies. Its goal is to reduce the amount of estate taxes.

If you would like guidance on estate planning for yourself or for administering an estate following the death of a loved one, be sure to consult with your attorney.

Step-Up in Basis and Why It Matters in Estate Planning

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Recent news stories may have made you aware of the “step-up in basis” and the current administration’s desire to eliminate or adjust it.

If you are considering engaging in estate planning or you may be inheriting assets, it is important to understand what the step-up in basis is and how it may affect you.

What Is the Step-Up In Basis?

The step-up basis is a provision in federal tax law. It determines how assets are valued for calculating capital gains taxes when a person passes away, leaves these assets to heirs, and those assets are sold.

So, for example, imagine a person passes away and leaves their home to their children through their will.

When the children inherit the property, the home’s cost basis changes. (“Cost basis” is the amount for which an item is originally purchased.) The home’s cost basis is adjusted – or “stepped up” – from what it was valued at when the parent originally purchased the home to its fair market value on the date the parent died.

In this case, suppose the original cost of the home 30 years ago was $100,000, and the “stepped up” basis in 2022 (date of death) is $300,000.

If the children then sell the home for $500,000, the resulting capital gains liability is calculated by subtracting the stepped-up basis from the sale price. This determines the children’s taxable gain ($500,000 – $300,000 = $200,000 gain). The effect is that the capital gain between the original purchase of the home and the children’s receipt of it is eliminated.

In other words, without the step-up in basis, the children who inherited the property would have had a considerably higher taxable gain after the sale ($500,000 – $100,000 = $400,000 gain). As a result, they would then have potentially had to pay more in capital gains tax.

Why Bequeath Assets Through a Will or Estate Plan?

Passing assets, such as the home in the example above, to your loved ones through your will or estate plan means those who inherit are often subject to much lower capital gains tax than if the assets were outright transferred or given to your loved ones during your life.

This is because assets transferred or gifted before death are subject to the purchaser’s cost. Capital gains tax is then calculated based on the differential between the original cost basis and the sale price (after considering any depreciation or other capital gains exclusions that may apply).

What Assets Step Up In Basis Upon a Person’s Death?

The step-up in basis can apply to many kinds of assets, including:

  • real estate
  • personal property
  • brokerage accounts
  • stocks
  • bonds
  • bank accounts
  • businesses
  • art
  • antiques
  • collectibles
  • and much more

Gifting or bequeath these types of assets through your will or estate rather than giving them away during your life can make a big difference for your heirs.

In addition, under federal law, all community and marital property gets a new basis when the first spouse dies. Their death brings the property up to the fair market value at that time. So, a surviving spouse could sell these assets and take advantage of this adjusted basis. And, subject to certain exceptions, the qualifying property of the surviving spouse can also receive a second step-up in basis at their death.

When Does the Stepped-Up Basis Not Apply?

While some assets qualify for a stepped-up basis, some can lose the ability to receive an adjusted basis.

For example, a surviving spouse cannot benefit from a second step-up in basis for assets that had been placed into an irrevocable trust before the first spouse’s death.

The stepped-up basis also does not apply to the following types of assets:

  • IRAs
  • employer-sponsored retirement plans
  • 401(k)s
  • pensions
  • tax-deferred annuities
  • gifts made before death
  • and some other assets

When Are Capital Gains Taxes Assessed?

Capital gains are taxed when an asset is sold (for a profit).

In the above example, if the house is sold three years after the parent’s death for $700,000 (which would mean it increased in value by an additional $400,000 during this time), then capital gains tax is potentially due on $700,000 (sale price in 2025) – $300,000 (stepped-up basis at date of death) = $400,000 of gains.

It is assessed and payable for the tax year in which the post-death sale occurred, and liability effectively shifts to the heirs who benefit.

Why Do Some Believe the Step-Up in Basis Should Be Eliminated?

Many believe the stepped-up basis creates an inequitable tax loophole that allows people with significant assets to shelter these assets from capital gains tax if they dispose of them through their estate.

For example, in the scenario above, if the home was initially purchased for $100,000 and sold by the heirs of the purchaser for $1,000,000 shortly after the purchaser’s death, $900,000 of capital gains would effectively never be taxed.

Meanwhile, someone who sell their assets during their lifetime will likely not get equal tax benefits (even considering the $250,000 personal residence capital gains exclusion) and may face a hefty capital gains tax bill.

On the other side of this argument are those who posit that not having a stepped-up basis can lead to double taxation. From their viewpoint, heirs or an estate would face capital gains tax as well as potentially significant estate tax.

This would likely only affect those with a good amount of wealth, given the current federal estate and gift tax exclusion, which will rise from $12.06 million in 2022 to $12.92 million in 2023. Most people will not fall into this category. Because of this, the tax revenue that the government could raise by eliminating the step-up-basis could arguably outweigh the double taxation issue.

However, this could all change after 2025, when the federal exclusion is set to be cut by approximately half. This will potentially affect a much larger group of people. The argument may not be so strong under those circumstances.

Navigate Estate Planning With a Qualified Attorney

Planning to avoid capital gains taxes is a complex endeavor that a person should only undertake with the assistance of a qualified professional. Every person’s situation is different, and there is no one-size-fits-all solution.

While saving money on capital gains may seem attractive, there may be situations where leaving assets to heirs upon your death may not be the best plan or may create more significant tax issues. In addition, it may not be the best strategy if, for example, you need to engage in Medicaid planning.

Contact your attorney for answers to questions about capital gains taxes and whether you or your loved one may benefit from a step-up in basis.

No Will? You’re Putting Your Kids at Risk

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Many people delay the conversation or thoughts of having to prepare a will. Confronting the possibility of one’s death is not easy. However, as the recent death of Anne Heche shows us, not having a will can place a significant burden on your children and cause undesirable complications. Even if difficult, planning ahead may be a better solution than the alternative.

What Happened With Actress Anne Heche?

Anne Heche’s case is a good example of why a person may want to consider creating a will sooner rather than later. Heche was divorced with two children from different relationships when she passed away. Her eldest son is 20 years old, but her younger son is still a minor.

Although they are assumed to be her sole heirs, only her oldest son is of age to administer her estate. He has filed a petition for a guardian ad litem to be put in place to protect his younger brother’s interests. The guardian ad litem may be a financial burden to Heche’s estate, and the costs of securing this professional will potentially reduce the assets available to her sons.

Even though her eldest son is dealing with his mother’s estate, this is undoubtedly very difficult for a person to go through at such a young age. Heche’s eldest son likely will not be able to do this all on his own and will need the services of a probate attorney — likely further increasing the costs of administering her estate and depleting how much is left for her children.

It has also been reported that an inventory and appraisal of her estate is needed to determine its worth and what assets she had. This process requires further professional involvement and fees that her estate must pay. In addition, it is possible that the father of her youngest son may seek to intervene in the estate’s administration to ensure he is treated fairly. Litigation costs could rack up quickly if there is any disagreement related to this.

Preparing a will and other estate planning documents can make legal proceedings significantly less complex and expensive and keep your situation as private as possible. It can also make it easier for your loved ones to know exactly what you want to happen to your assets and possessions.

Who Inherits When You Die Without a Will?

Many people do not realize that if you pass away without a will, your local state laws on intestacy will determine who qualifies as your heirs and inherits your property.

For example, in many states, if a person passes away unmarried but with children, the children will inherit everything. But what if the person had a long-term partner or was engaged to be married? They may have wanted their significant other to inherit some of their assets, but a “default” state law may lead to a different result. Or, what if you have no living children, siblings, parents, or spouse? Your property may go to the government instead of friends, grandchildren, nieces, or nephews. Having a will prevents these scenarios from happening.

Choose a Guardian for Your Children

Another benefit parents should consider is their ability to choose a guardian for their children in advance.

This matters, for example, when the other parent is not living or cannot be located. If a person does not set forth their wishes ahead of time, multiple parties may step up after a person’s death and argue over who should care for any minor children.

A court may be tasked with making this decision, and it may not be what you would have wanted. This can be expensive, traumatic for all involved, and a long process. Courts will generally try to appoint the individual a person has selected if your wishes are in a will or other planning document.

The Bottom Line

The bottom line is that having estate planning documents in place makes your wishes more likely to be honored and less likely that a court will decide what happens. This is also true where you may be incapacitated and unable to voice your wishes. While Anne Heche’s situation is not unusual, it is avoidable.

For information on preparing a will or other estate planning documents, contact your attorney.

What Is the Difference Between a Springing and Non-Springing Power of Attorney?

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A power of attorney is a document that grants various powers and responsibilities to a trusted third party or “agent” who can act on your behalf. This document usually only allows an agent to make non-medical decisions on your behalf. A power of attorney can be a valuable planning tool that lets you decide in advance who will manage your affairs should you become unable to do so. It can also be a way to avoid expensive guardianship or conservatorship proceedings if you become disabled or incapacitated.

The way a power of attorney is formalized varies from state to state. Some states have particular requirements and wording that must be in a power of attorney for it to be valid and accepted. You may have heard of the terms “springing” and “non-springing” power of attorney and wonder what they mean.

Springing Power of Attorney

A springing power of attorney is a document executed now, but that does not take effect unless the principal becomes incapacitated or a particular event occurs. This type of power of attorney is contingent on something specific happening before it comes into force. If the event or incapacity never occurs, an agent will not be empowered to act on behalf of the principal.

Many people want a springing power of attorney because they feel more comfortable knowing their agent can only exercise powers if a triggering event occurs. This can alleviate any concern that the agent may try to misuse a power of attorney.

A springing power of attorney is not always easy to use. Depending on your jurisdiction, it may be necessary to have a medical professional such as a doctor certify that a triggering condition has occurred.

Let’s say you become medically incapacitated. Where required, the professional will likely have to complete an affidavit attesting to your condition or that certain events occurred. Often, a medical professional will not be comfortable signing an affidavit or may require their own attorney to advise them on how to proceed. This can cause delays that can frustrate an agent’s ability to act, especially in time-sensitive situations.

Additionally, financial institutions may be reluctant to accept this type of power of attorney because it is difficult for them to judge whether you truly are incapacitated or if a triggering event has in fact occurred. A certain amount of caution on the part of financial institutions is understandable: When someone steps forward claiming to represent the account holder, the financial institution wants to verify that the individual indeed has the authority to act for the principal.

Non-Springing Power of Attorney

With a non-springing power of attorney, the agent has the powers granted in the document the moment it is signed by you and the agent(s) you designate. So, even if you are capable of signing for yourself or handling certain transactions, your agent could still sign for you without your involvement.

How Some States Approach Powers of Attorney

Many states have taken steps to address some of these problems. New York, for example, implemented a statutory form in 2021 that, if filled out and executed correctly, financial and other institutions will be more likely to accept. In particular, it has a provision where the agent agrees to reimburse the third party for any claims that may arise against the third party because of reliance on a power of attorney.

To help limit the potential for abuse by an agent, New York’s form also allows a power of attorney to be narrowly tailored to a specific purpose.

The laws of each state will vary when it comes to powers of attorney. For guidance on a springing or non-springing power of attorney, consult your attorney.

What Is a Life Estate?

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The phrase “life estate” often comes up in discussions of estate and Medicaid planning, but what exactly does it mean? A life estate is a form of joint ownership that allows one person to remain in a house until his or her death, when it passes to the other owner. Life estates can be used to avoid probate and to give a house to children without giving up the ability to live in it. They also can play an important role in Medicaid planning.

In a life estate, two or more people each have an ownership interest in a property, but for different periods of time. The person holding the life estate — the life tenant — possesses the property during his or her life. The other owner — the remainderman — has a current ownership interest but cannot take possession until the death of the life estate holder. The life tenant has full control of the property during his or her lifetime and has the legal responsibility to maintain the property as well as the right to use it, rent it out, and make improvements to it.

When the life tenant dies, the house will not go through probate, since at the life tenant’s death the ownership will pass automatically to the holders of the remainder interest. Because the property is not included in the life tenant’s probate estate, it can avoid Medicaid estate recovery in states that have not expanded the definition of estate recovery to include non-probate assets. Even if the state does place a lien on the property to recoup Medicaid costs, the lien will be for the value of the life estate, not the full value of the property.

Although the property will not be included in the probate estate, it will be included in the taxable estate. Depending on the size of the estate and the state’s estate tax threshold, the property may be subject to estate taxation.

The life tenant cannot sell or mortgage the property without the agreement of the remaindermen. If the property is sold, the proceeds are divided up between the life tenant and the remaindermen. The shares are determined based on the life tenant’s age at the time — the older the life tenant, the smaller his or her share and the larger the share of the remaindermen.

Be aware that transferring your property and retaining a life estate can trigger a Medicaid ineligibility period if you apply for Medicaid within five years of the transfer. Purchasing a life estate should not result in a transfer penalty if you buy a life estate in someone else’s home, pay an appropriate amount for the property and live in the house for more than a year.

For example, an elderly man who can no longer live in his home might sell the home and use the proceeds to buy a home for himself and his son and daughter-in-law, with the father holding a life estate and the younger couple as the remaindermen. Alternatively, the father could purchase a life estate interest in the children’s existing home. Assuming the father lives in the home for more than a year and he paid a fair amount for the life estate, the purchase of the life estate should not be a disqualifying transfer for Medicaid. Just be aware that there may be some local variations on how this is applied, so check with your attorney.

To find out if a life estate is the right plan for you, contact your attorney.

Do Frequent Flier Miles Expire When You Do?

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Accumulated frequent flier miles can be valuable assets, but what happens to those miles after someone dies? Can a spouse or other heirs inherit them, or do the miles simply evaporate like a contrail?

Whether they can be inherited depends on the airline, and in most cases, airlines will point out in their terms and conditions that frequent flier miles are not, in fact, your property. Regardless, even if the airline’s official policy is “no,” with a little perseverance, there is always the chance that the answer could be “yes.”

Here’s a look at several major airlines’ current mileage transfer rules:

Alaska Airlines’ Memorial Miles

Alaska Airlines, according to travel website and blog The Points Guy, may require only a copy of a death certificate to transfer your deceased loved one’s miles to you – without a fee. Call 1-800-654-5669 to reach Alaska Airlines customer service.

Transferring Miles With American Airlines

While current AAdvantage members do have the ability to move their miles to another member’s account (with the payment of fees and certain limitations), American Airlines will not generally allow for accrued mileage credit to be “transferable by the member upon death.” That said, the airline’s regulations do seem to offer such transfers in certain cases: “American Airlines, in its sole discretion, may credit accrued mileage to persons specifically identified in … wills upon receipt of documentation satisfactory to American Airlines and upon payment of any applicable fees.”

If your deceased loved one was an AAdvantage member, it may be worth a visit to American Airlines’ Buy, Gift, and Transfer Miles webpage to learn more.

JetBlue’s Points Pooling

In 2018, JetBlue launched the Points Pooling program to its TrueBlue loyalty members. Two to seven TrueBlue members, regardless of whether they are family, can join a “pool” and each contribute their points to it. Any member of your pool can leave their unused points for the remaining members of their pool to redeem. In theory, this would allow you to inherit the points of a loved one who passes away.

United Airlines: MileagePlus

For United Airlines customers who are part of the MileagePlus Program, it may be possible to transfer accumulated United Airlines miles upon the death of an individual.

Similar to American, the following is outlined on the airline’s website: “In the event of the death … of a Member, United may, in its sole discretion, credit all or a portion of such Member’s accrued mileage to authorized persons upon receipt of documentation satisfactory to United and payment of applicable fees.”

Call United’s customer service line at 1-800-421-4655 for guidance on the airline’s Transfer Miles Program.

Delta SkyMiles

Looking to transfer miles from a deceased Delta SkyMiles member into your name?

If you have the login details for their account, you may be able to make the transfer online via Delta’s website. Consider opening your own SkyMiles account first to simplify the process. Note that Delta charges 1¢ for each mile transferred, plus a $30 processing fee. Taxes may also apply. Miles can be transferred in 1,000-mile increments, and the maximum that can be transferred from one SkyMiles account to another is 150,000 miles per year.

Even if you have only the name of the individual and their SkyMiles number, you may still consider calling Delta’s SkyMiles customer service number at 800-323-2323 to ask for help.

Southwest Airlines

The account of a Southwest Airlines’ Rapid Rewards member who dies will become inactive and the points will be unavailable, according to the airline. In fact, its site explicitly states: “Points may not be transferred to a Member’s estate or as part of a settlement, inheritance, or will.”

Plan Ahead for Your Own Loved Ones

If you are part of an airline loyalty program and have accumulated a substantial number of miles, you may want to give your loved ones the details they need to access your frequent flier accounts so that they can log in directly in the event of your death.

Or, ask your estate planning attorney about how to go about adding into your will your wishes for passing those miles along to someone, should your preferred airline allow it.

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