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Traditional estate planning is focused on estate tax planning and on what happens after you die. Elder law planning is focused first on what happens while you are still alive, helping you to plan for future incapacity and long term care needs, as well as providing for your loved ones upon your death. Elder law attorneys must have comprehensive knowledge of Medicaid, Medicare, Social Security, probate, real estate, and tax law, much of which is constantly subject to change. But we also must be excellent listeners and educators and social workers as we help our clients navigate the complex challenges of aging. Elder law attorneys bring to the table their extensive networks of professionals in the financial and health care worlds to help us guide our elder and disabled clients to the best solutions to address their many needs. The short answer is that the practices of nearly all elder law attorneys include estate planning, but the practices of nearly all estate planning attorneys do not include elder law. There are over 50,000 currently practicing attorneys in the Commonwealth; only a little more than 500 of us in the entire state concentrate our practices in elder law!
The classic lawyer answer is: “It depends.” If your documents were prepared less than 3-5 years ago by an attorney concentrating in elder law and there have been absolutely no changes in your family, health, or financial situation, then you are probably in good shape. But if, like most people we see, your documents are old, the drafting attorney was a traditional estate planner or general practitioner, and/or your situation has changed in some way since you signed the documents, it is time for you to schedule an appointment with an elder law attorney to view your existing plan. So often, we review the existing documents of clients who believed they were all set and discover that the documents do not in fact cover all of the bases needed in order to plan for the client’s long term care needs. It is so much better (and less traumatic and costly) for us to be able to identify problems and revise an existing plan when things are calm, than to identify problems when you are in the throes of a medical or financial crisis. A few hours spent being proactive can give you peace of mind knowing that you are prepared for any crisis that may come your way.
A large part of our practice is counseling caregivers about all of the many options for care, facilitating access to care, and accessing government benefit programs to help pay for care. We will review any existing estate planning documents that your loved one has in place, and will help you understand your responsibilities and powers and how the plan works (or doesn’t work). We will recommend changes to the plan if necessary. We will review past and present finances to determine how financial resources can be maximized, with an eye to enabling your loved one to remain as independent as possible for as long as possible. We will help your loved one become eligible for financial assistance to cover the often devastating costs of long term care services. We will bring in to our planning team the expertise of professionals in the health care and financial worlds as needed to ensure that your loved one gets the best possible care. We will be your loved one’s advocate and advisor so you are free to focus on caregiving. And, we will make sure that you are connected with resources to help you take care of yourself as well.
While we appreciate and respect your wish to pay no more than necessary, this is one area where being “penny wise” can end up being “pound foolish.” Losing out on even one month of nursing home coverage because you didn’t do the application just right and MassHealth denies your application can cost you $10,000 or more in private payments to the nursing home. The MassHealth system is complex and convoluted and MassHealth’s ever-changing positions on all kinds of issues is sometimes mystifying even to those of us who do this work for a living. Applying for Community or Long Term MassHealth can be a cumbersome process. The MassHealth caseworkers and the nursing home representatives are not lawyers and by law are not allowed to give you legal advice about how to preserve and protect your home, your other assets, and your family members. As attorneys, we are your legal advocates in this protracted process, using estate and long term care planning strategies to protect not only the patient but also the spouse (and children) remaining at home.
Based on our knowledge of the breadth of Medicaid law as elder law attorneys, we can help a patient navigate the MassHealth system and become eligible for benefits at the soonest possible date, can help to preserve assets and ensure that funds will be available for a community spouse, can prepare and facilitate the approval of a MassHealth application, can handle any appeal necessary to obtain benefits, and can counsel about strategies to protect any remaining assets from “estate recovery” down the line. We are proud to be able to say that our clients have never been denied benefits due to a failure to provide required verifications, and all of our clients’ applications have been approved either by the caseworker or on appeal.
We completely understand that you may be under a huge amount of stress and that you are worried about many things, especially if you are caring for a loved one with a serious illness. We also appreciate that some lawyers appear very formal and intimidating. We definitely are not. We want you to be comfortable and we strive to offer a relaxed and compassionate experience for our clients in a warm and welcoming environment. We pride ourselves in speaking plain English rather than “lawyer-ese”, and in helping you to “get” complex and challenging concepts. The son of one of our clients recently exclaimed at an initial consult: “I just learned more from you in 20 minutes than we did from our former attorney after three meetings!”
When you call our office, you will first speak with our legal assistant who will ask you some background questions about your situation, family, and finances and then book an initial consultation appointment approximately two weeks out from the time you call. Of course, if you or a loved one are in the midst of a medical or financial crisis and need immediate help, we will do our best to get you in ASAP so we can get to work right away on addressing the crisis. If necessary, one of our attorneys will follow up that discussion with a short complimentary telephone consultation to explore the scope of your issues more fully. We will then send you an introductory letter and an intake form which we ask you to complete and return before your appointment. To prepare for our meeting, we carefully review your form before you come in.
Sometimes we can tell from the information you share during the intake interview that your legal needs are outside of our areas of expertise. Since we have a large network of attorney colleagues, we will do our best to get you connected to other legal professionals who can better address your issues.
First, be assured that any information you provide on the form and in any of our discussions is held in the strictest of confidence. The intake form gives us an introduction about who is who in your family, what assets you own (and don’t own), how you own them, and an estimated total value. Exact dollar amounts are not necessary at this stage; ballpark estimates are fine. All of this information allows us to prepare for our initial meeting and to focus our discussion on the planning strategies that will best address your particular situation. And, by providing this information ahead of time, we can use our meeting time to get right down to a substantive discussion rather than taking part of our time together to collect phone numbers and zip codes, or talking about things that are not applicable to you and your family.
You should plan for our Initial Consultation to last approximately one and a half hours. Because each of us has done “homework” to prepare for the meeting, we are able to hit the ground running and our meeting is a substantive work session. During our meeting, we will discuss in depth your family, health and finances. We will listen carefully to your concerns and the goals you are seeking to achieve. We will explain complex concepts using plain talk and clear examples, and will help you truly understand the legal strategies that will best help you achieve the quality of life and care that you desire for yourself and your loved ones. In most cases, by the end of our meeting, we are able to recommend a comprehensive plan that addresses your unique circumstances and goals. If we are unable to decide together on a specific course of action because we need more in-depth examination of multiple strategies, we will follow up the initial meeting with a comprehensive planning letter and then have a second meeting for follow up discussions and decisions. We will take as much time as needed for you to be comfortable with your planning choices.
We provide nearly all of our Elder Law and Estate Planning services on an all-inclusive “flat fee” basis, with the actual fee charged to each client determined by the scope and nature of the work to be done rather than by time. There are no hidden fees, and no hourly charges. We do not want you ever to hesitate to ask questions or to feel any pressure to sign your planning documents because you are worried about being charged for a phone call or email or extra meeting. By paying one fee – and only one fee – we can both focus on results rather than bills.
If you retain us to represent you on an Elder Law or Estate Planning matter, our initial consultation will be just the first of several meetings and there is no separate charge. In recognition of the depth and scope of our initial consultation, and the time and expertise we have invested in preparing for and conducting the meeting, if there is no work to be done beyond the initial consultation, or if you are not yet ready to move forward with a plan, the fee for our consultation time will be $400 ($500 if you have an existing trust), payable at the conclusion of the session. If you retain us within forty five days of our initial meeting, we will credit the consultation fee against your total fee for services. As incentive for you to act on what you have learned, we typically waive the consultation fee if you have recently attended one of our educational programs but then decide not to proceed with planning.
Where appropriate, we offer reduced fees to our clients who have very limited income or assets.
Because cases involving the courts are not completely under our control, we do handle Estate & Trust Administration, Guardianship / Conservatorship, and Creditors’ Rights cases, including the initial consultation, on an hourly basis plus costs, usually charged against a retainer which we will agree upon during our initial consultation. Our current hourly rate is $315 for our attorneys, and $100 for our legal assistant.
Every case is different, and our advice is always customized based on the special family, health, and financial circumstances presented by each client. Because there is no “one size fits all,” we cannot quote fees on the phone. We are not trying to be coy, but feel that we are doing both you and us a disservice by trying to guess what work you might need before we have fully analyzed your needs.