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Creative Financial Approaches to Long Term Care Services

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Long term care insurance was sold aggressively in the 1980s, 90s and thereafter to offset the costs of seniors needing to live in a nursing home, assisted living or needing at home health care. Now, however, the business of long term care insurance has dramatically changed. What was once over 100 insurers providing LTC policy for sale has shrunk to a pool of less than twenty insurers who continue to sell the health care product. The big financial problem was that the majority of insurers had badly underestimated the longevity of these long term care policy holders and how many claims would be filed during their lifetime. The model became unsustainable from a business perspective.

As reported by the Wall Street Journal ( the industry is now in financial turmoil and has turned to the old adage of privatize the gains and socialize the losses; the translation being that millions of people age sixty-five or older with long term care policies are facing steep rate increases. It is not uncommon for a policy holder to face a fifty percent increase in their premium while some of the worst cases are upwards of ninety percent. Because the industry itself used such poor benchmarks and miscalculated projections, policy holders are seemingly left with two choices: Pay the money or leave your coverage after paying into it for years, and sometimes decades.

What if you want a different choice? Everyone would agree that being priced gouged for premiums as you age is inherently unconscionable but if the policy is discontinued what then will happen to the peace of mind long term care brings? What was once the safety net of senior aging care (without becoming a burden to family members) is rapidly disappearing.

CNBC has recently reported about this very issue and suggests getting financially creative for long term care. ( There is a surprising source that you can tap in order to maintain protection for yourself but it requires planning, professional help and time. Do not delay.

The financially creative premise is to become asset poor, impoverished, and qualify for Medicaid which pays for nursing home care and services. This does not mean the legacy you built during your lifetime will not go to your selected inheritors. On the contrary the assets you own must move out of your name to qualify for Medicaid. The assets will then shift to your designated beneficiary since to qualify you as an individual cannot have over $2,000 in assets.

To begin you will need to retain the services of a qualified elder law attorney, who may also bring in an accountant and a financial advisor. Ideally, you will be able to wait five years before needing long term care and the help of Medicaid. If there are assets transferred during the “five year lookback” it may be subject to penalties or make the applicant ineligible for some period of time requiring them to pay out of pocket.

Now with time on your side it becomes critical to select the right vehicle for transfer. These can be annuities but more often tend to be irrevocable trusts. The assets in the irrevocable trust are no longer under the control of the older person and can provide protection from certain creditors. The vehicle chosen for transfer of assets is very important not only for the older individual but the recipient as well. In the case of an outright gift of appreciated assets (i.e. stocks or real property) there would be no stepped up cost basis which could lead to crushing capital gains taxes when it is time to sell. An elder law attorney with input from your accountant and financial planner can help you choose the right transfer of wealth plan.

Elder law attorneys are closely watching changes in Medicaid,, as Congress is often proposing legislation to change the program.. Be certain your elder law attorney is up to speed on the current requirements, as the eligibility requirements can change very quickly in each state, and sometimes each county.

Though you may never have thought you would find yourself creatively trying to qualify for Medicaid while protecting assets, the current long term care premium prices preclude a large portion of seniors from being able to pay the cost of the policy. Genworth Financial reports the national median cost of a private nursing home room to be $97,455 a year. It doesn’t take long to be wiped out at that cost without long term care. Medicaid may be your solution and time is of the essence for planning.

Contact our office today and schedule an appointment to discuss how we can help you with your planning.


Greg McIntyre

Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street

Shelby, NC 28150


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IDENTITY THEFT! It is a reality we live with today. Seniors are especially susceptible.

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IDENTITY THEFT! It is a reality we live with today. Seniors are especially susceptible. In this Elder Law Report, Greg & Hayden call an identity theft provider and ask questions. We plan to bring our clients a discount to these services.

Success!!! Great Education Breakfast this morning…

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Great group to of folks today and great discussion and conversations about the 2018 tax laws and other important issues. Call our office to sign up for next month’s topic. 704-259-7040.


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ALEXA HELPING SENIORS? That’s exactly what we explore in this Elder Law Report. Amazing some of the ways this little device can help with reminders, locking the house and turning on and off the lights (among many other things).


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GAME SHOW EPISODE: Learn about Estate Planning, Elder Law and the firm in today’s game show episode of the MEL Feud. So much fun today!

Three Questions “The Elder Law Guy” gets asked the most:

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1. If I Don’t Have Debt, Should I Still Worry?

Does not having debt protect you?

A lady and her husband were shrewd, with little or no debt. They lived right, had rental houses, paid everything in cash with no mortgages.

Question: Did they have to worry?

If you or your husband have a long-term care event costing $75 to $100,000 per year, will that dent your finances?

Are the rental houses, bank account, savings going to be okay?


At that rate of spend-down, it’ll be hard maintaining your lifestyle.

So what can you do? Separate the liability with the rental houses and your personal income.

That way if the renter sues, it wouldn’t come back against your personal assets.

Separate your business liability. Maybe set-up an LLC and put all rental houses in it.

Separate it so your house, car, savings can’t be attacked.

How many layers of protection can you add? It’s up to you. The more layers, the more exhaustive to another plaintiff’s attorney to get at your nest egg and assets.

Another consideration is using an Irrevocable Asset Protection Trust to protect assets from a healthcare crisis requiring long-term care?

2. What If My Attorney-In-Fact Predeceases Me?

If the attorney-in-fact under a Power of Attorney passes away before you, then it ceases to have any power… unless you have appointed within the document second or third backup agents to serve as your attorney-in-fact. Think about it. If a player fouls out of the game you always want players on the bench to take their place.

3. I Already Have A Will…

People think they’re protected with a Will.

A will is great but can be a dangerous place to pass property.

If we’re passing your home through your will and open it to a probate estate in court, you must go to the courthouse, pay to open the estate, publish it in the paper, and wait 90 days (at least). That’s when liens such as Medicaid liens which may have paid for long-term care during your lifetime attach and force the sale of that property to pay that lien.

For information about other ways to easily avoid probate with real property (land/homes) and liquid assets (money/investments) contact:

Greg McIntyre

Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street

Shelby, NC 28150


Hometown Heroes – Veterans Interview Video Links:

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Below are links to the videos of the interviews I conducted over the last several years that found their way into the Hometown Heroes book. I always enjoy putting a face and voice to a name and thought you may as well. Enjoy!

Click on the link below to view the video interview.

Story 1- Jim Hardin –

Story 2-  J.C.Horne –

Story 3- Roland Stewart –

Story 4- JD & Virginia Thomas –

Story 5- Earl Mace –

Story 6- Dr Frank Sincox –

Story 7- The Schenk Brothers –

Story 8- Michael Carpenter & Barry Carpenter –

Story 9- David Rose –

Story 10- Bob Cabiness –

Story 11- Gene Ramsay –

Story 12- Ray Kale –

Story 13-  Bill Hardin & Larry Gamble –

Story 14- Roger Wuerst –

Story 15- Tom Haines –

Story 16- Evan Thompson –

Story 17- Ludy Wilkie –

Story 18- Jim Quinlan –

Story 19- Martha Bridges –

Story 20- Martin Mongiello –

Story 21- Arthur Gordon –

Story 22- Dr Rit Varriale –

Story 23- Greg McIntyre –


Alzheimer’s 101 – Understanding the Basics

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What is Alzheimer’s Disease?

Alzheimer’s disease is defined as an irreversible, progressive mental deterioration that can occur in middle or old age. It is the most common form of dementia.


What causes Alzheimer’s Disease?

Alzheimer’s disease is caused by a generalized deterioration of the brain. The disease is caused by a combination of factors, including genetic, lifestyle, and environmental factors. There are a variety of factors that put people at risk for Alzheimer’s disease. Age and genetics are risk factors. As people age or if there is a family history of Alzheimer’s, there is a greater risk of the onset of Alzheimer’s disease. People with Down Syndrome or mild cognitive impairment have a greater chance of having Alzheimer’s as they age. If a person has experienced past head trauma, this puts them at risk for Alzheimer’s.


The risk of Alzheimer’s is also related to lifestyle and heart health. Those with poor heart health and an unhealthy lifestyle put themselves at greater risk for the disease.


Finally, women are more likely to be diagnosed with Alzheimer’s than men. Some causes and risk factors of Alzheimer’s disease are impossible to change or control, but lifestyle and heart health are things that can be controlled.

What are the symptoms of Alzheimer’s Disease?

Alzheimer’s disease, in general, destroys memory and thinking skills. In the late stages, a person with Alzheimer’s is unable to carry out even the simplest tasks. A person who is experiencing the onset of Alzheimer’s will experience mild symptoms, which may include increasing forgetfulness or mild confusion. As the disease progresses, the memory loss increases, especially recent memories. The progressive nature of the disease causes memory to continue to deteriorate throughout the rest of the person’s life. The ability to think and reason are impaired until even performing familiar tasks can become impossible.


A person with Alzheimer’s disease often experiences changes in behavior. They may do things out of their character for them prior to the disease. Common changes in behavior include aggressive behavior, agitation and irritability. Alzheimer’s disease symptoms can include depression, mood swings, and difficulty sleeping. The deterioration of the brain causes a person to change in ways that are difficult and trying for all involved.


How is Alzheimer’s Disease diagnosed?

Alzheimer’s disease is complicated and getting to a diagnosis is a long process. If a person or their family suspects the onset of Alzheimer’s disease, it is important to understand that there will be many steps and visits with doctors to determine if in fact it is Alzheimer’s. There is no single test. The first step for the doctor will be to get a comprehensive medical history. The doctor can use this history to determine if the patient has risk factors for Alzheimer’s disease. The next step is to complete testing on mental status and mood of the patient. Beyond this there will be physical and neurological examinations. If the doctor suspects Alzheimer’s, the tests will continue with blood tests and brain imaging. The goal is to rule out other causes to be sure that Alzheimer’s disease is the correct diagnosis.


What treatment options are available?

Alzheimer’s disease has no cure. Treatment options are meant to delay or slow the progression of the disease. Medication is one treatment option. The medicines are used to treat the cognitive symptoms. As the disease progresses, symptoms continue to worsen. Medication is unable to stop the damage that Alzheimer’s disease causes to brain cells, it can help stabilize the patient or slow the progression for some time.


Behavioral symptoms can be treated with some medication as well, but there are other ways to address these symptoms. The first thing is to know and be aware of triggers. By knowing triggers, there are a variety of coping strategies that can be used. Some of these include avoiding confrontation, making sure the Alzheimer’s patient gets adequate rest, monitoring comfort, and creating a calm environment. Many are now looking at herbal remedies, dietary supplements, and “medical” foods as possible treatments to enhance memory. There is no conclusive evidence that these things work.


Alzheimer’s disease is complicated. The causes and symptoms vary from one person to the next as does the progression of the disease. Being educated about the disease and care options is the key to helping a loved one with Alzheimer’s disease. Doctors, therapists, and elder law attorneys can guide families through the difficult process of caring for a loved one with Alzheimer’s.


If you have any questions about something you have read or would like additional information, please feel free to contact us.

Greg McIntyre

Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street

Shelby, NC 28150


3 Points About the New 2018 Tax Law Seniors Should Know:

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 Is Social Security Taxable?

Combined Income is not taxable under $25,000. As a general rule, Social Security income is taxable! 15% of your social security benefit is a tax free benefit under the tax rules. However, you could pay a maximum of 85% on your Social Security income depending on your total combined income. Combined Income is your Adjusted Gross Income plus your non-taxable interest plus one-half of your Social Security income that year.

Individuals with combined income of $25,000 to $34,000 will pay up to 50% income tax on every dollar of Social Security income over the $25,000 threshold. Individuals with combined income of more than $34,000 will pay up to 85% income tax on every dollar of Social Security income over the $34,000 threshold.*

There are strategies to avoid paying taxes going into retirement which include Roth IRAs and having the Social Security Administration withhold taxes from every check or pay quarterly.

What are the Rules on Gifting and Estate Tax?

The tax exempt gift limit during an individuals lifetime is now $5.6M. The tax exempt estate and gift tax is the same $5.6M per individual. However, the lifetime and estate taxes work together. For example. If you give away $1M during your lifetime then at death you may only pass $4.6 as tax exempt.

Do I have to report gifts?

The reportable gifting limit per person per year went from $14k in 2017 to $15k in 2018. You must report a gift to a person over $15k to the IRS. This is presumably so that the IRS can track your gifting to subtract each gift over $15k from the total allowable lifetime and death tax amount of $5.6M.

This has been a summary of just a few of the tax law changes going into 2018 that I wanted to pen from my presentation and discussion at our March Monthly Client Breakfast. If you have any questions, please contact me at: 704-259-7040.

* Average SS Income for 2017 was $1,400 per month or $16,800 per year.

* Always consult a tax professional.

Greg McIntyre

Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street

Shelby, NC 28150


Senior Adults and Identity Theft – How to Protect Against It

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Image result for senior identity theftSenior adults can be more susceptible to identity theft than others. Identity theft is a crime that is on the rise. It involves a criminal stealing personal identifying information to create a new identity or to steal money from the victim. Senior adults are targeted for a few reasons. One reason is that they often have more money saved after a lifetime of working than younger people. Another factor is that personal information for elderly adults often passes through more hands, especially those in hospitals and nursing homes.  Senior adults can be more trusting of people and often do not pick up on warning signs. Finally, aging adults are far less likely to report identity theft crimes. They fear that their independence might be taken away by their loved ones. It is important for senior adults and their caregivers to know how to protect themselves against identity theft.



The rapid growth of technology has given identity thieves many new outlets for preying on seniors. Many thieves use email to present themselves as a reputable group or company. In the emails, they request personal information. Seniors give their information and the thief has what they need to steal from them. Identity thieves also use phone calls to gain personal information from elderly adults. They may pose as representatives from companies or the government, and ask for personal information. Unsuspecting seniors, then give them personal information. Social media is another place that identity thieves comb to find the personal information of senior adults. To protect their identity, seniors should never give any personal information through unsecured sources, such as email or over the phone. Seniors should avoid sharing personal information on social media. Even information like the exact date of birth can allow identity thieves to obtain information to steal from an unsuspecting adult.


Image result for identity theftPaperwork

Papers, including mail, are an excellent way for thieves to get personal information. Keep tabs on all important documents and store them safely in a file cabinet that locks or a safe. If a senior adult is in the hospital or travelling, it is important to stop mail delivery or arrange for daily pick up. Monitoring credit and bank accounts on a regular basis also helps to protect the identity of senior adults. Shred old paperwork, mail, and receipts instead of just throwing them away and be careful when throwing away receipts in places like hotels.



The starting point for for seniors to be protected from identity theft is to be informed. Seniors and their loved ones should educate themselves and their loved ones on common scams that identity thieves use. Another way to protect identity is through a monitoring service. For a small fee, companies can monitor online accounts and  a person’s social security number to help prevent identity theft.


There are also a variety of legal planning tools to help protect seniors and their loved ones from identity theft.  The way assets are titled can play a large part in whether those assets can be stolen. Planning with trusts can also provide a layer of protection against identity theft and fraud.  A thorough legal plan combined with knowledge and awareness is the best defense.


If you have any questions or would like additional information, please feel free to contact us.

Greg McIntyre

Elder Law Attorney
McIntyre Elder Law
123 W. Marion Street

Shelby, NC 28150


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