Crisis Medicaid Planning Upheld in Zahner Case

Protecting assets from the rising cost of long term nursing care has become a very important concern for aging Pennsylvania residents.  Immediate annuities are among the tools the elder law attorneys at Unruh, Turner, Burke & Frees use to help both single and married nursing home residents qualify for Medicaid coverage while either:

1.  protecting the standard of living of the healthy spouse at home; OR

2.  helping preserve assets for the families of unmarried or widowed nursing home residents.

First, many spouses of nursing home residents face a dramatic reduction in income when the nursing home spouse qualifies for Medicaid.  Purchasing an immediate annuity can convert assets into an income stream for the healthy spouse while avoiding a penalty for transferring assets.

Second, an institutionalized individual can buy an annuity that will provide income to pay the nursing home while waiting out a Medicaid ineligibility period caused by a gift made within the previous five years.  Often, these latter annuities are of short duration, usually only as long as the penalty period.

Read my earlier article on the “Reverse Half A Loaf” crisis Medicaid planning for a more full understanding of the short term annuity strategy at work.

Immediate annuities can help Medicaid applicants in two basic ways:

THE ZAHNER CASE:

Some states, including Pennsylvania, have maintained that short-term annuities, usually two years or less, are still subject to a transfer penalty.  This should change now that the Third Circuit Court of Appeals has ruled that Medicaid officials must accept applicants’ short-term annuities, and that these types of annuities cannot be counted as resources and be made subject to penalty.  Zahner v. Secretary Pennsylvania Dept. of Human Services (3rd Cir., Nos. 14-1328, 14-1406, Sept. 2, 2015).  This was a huge win for the Elder Law community and for anyone who finds themselves in need of Medicaid asset protection planning.

In reaching its decision, the court combined three separate Pennsylvania cases.  In one, Donna Claypoole and her husband transferred more than $100,000 to family members.  When Ms. Claypoole was admitted to a nursing home and applied for Medicaid, the transfers resulted in a period of Medicaid ineligibility.  In part to pay for her nursing home care during the period of Medicaid ineligibility, Ms. Claypoole paid $84,874 for an immediate annuity that would give her an income of $6,100 a month for 14 months.  She was 86 years old at the time of the purchase, with a life expectancy of more than six more years.  Another Medicaid applicant, Connie Sanner, also transferred assets and then bought a 12-month annuity to pay for her nursing home care during the period of ineligibility.  In both cases, Pennsylvania’s Medicaid officials determined that the annuity’s term was less than the purchaser’s life expectancy and was therefore a “resource” that required a new period of Medicaid ineligibility. (The original plaintiff in the case, Anabel Zahner, is deceased and no longer a party.)

The Medicaid applicants filed a case in federal court, arguing that the annuities met the requirements of federal Medicaid law and should not have been considered asset transfers.  The U.S. district court ruled that the short-term annuities are countable assets subject to asset transfer rules, holding that the term of the annuity must “bear a reasonable relatedness to the beneficiary’s life-expectancy.”

U.S. Court of Appeals for the Third Circuit has now overturned this decision.  The court found nothing in federal Medicaid law to suggest that an annuity cannot be shorter than a person’s actuarial life expectancy.  The only requirement, the court said, is that the annuity not be longer than the beneficiary’s life expectancy, to prevent people from purchasing overly long annuities as a way to leave money to heirs. The court further held that an annuitant’s motive in purchasing an annuity should not determine whether it is viewed as a resource.  Although the Third Circuit is only one of 13 federal appeals courts, the court noted that its opinion is “precedential” federal law for Medicaid-complaint annuities.

FURTHER ZAHNER COURT FINDINGS:

1) The Court found that there is no minimum term required for a Medicaid compliant annuity. In addition, the fees charged for the purchase of an annuity do not have an impact on the definition of an annuity; and the annuitant’s motive in purchasing the annuity is not determinative.

2) The term of the annuity complies with Medicaid rules if it is for any period that does not exceed the life expectancy of the annuitant as defined by Social Security life expectancy tables;

3) The Court also dismissed the trust-like device argument, finding that commercial annuities cannot be defined as trusts.

While the decision provides more certainty, immediate annuities must still meet a number of stringent requirements to be accepted as legitimate by Medicaid authorities.  .

To read the court’s decision, click here.

For assistance developing a comprehensive nursing home asset protection plan in Pennsylvania, please contact Douglas L. Kaune, Esquire at (610) 933-8069 or email him at dkaune@utbf.com. Doug’s entire practice is focused on elder law, Medicaid application, estate planning, trust planning, estate administration and protection of clients’ assets from nursing home spending and estate and inheritance taxation. Unruh, Turner, Burke & Frees, P.C. is a full service law firm which has three convenient office locations in Phoenixville, West Chester and Paoli, Pennsylvania. The firm primarily services clients in Chester, Montgomery, Delaware, Philadelphia, Bucks and Berks Counties, but can represent clients throughout Pennsylvania.