In helping clients prepare for their future, estate planning and elder law attorneys use many acronyms. Understanding some of the common medical and legal terms in this field can give you added confidence in your approach to planning for your own future or that of your loved ones.
1. CSRA (Community Spouse Resource Allowance) — When one spouse goes on Medicaid and enters a nursing home and the other remains at home, federal spousal impoverishment rules provide that the spouse remaining in the community can retain a certain amount of the couple’s resources. (Note: In Illinois, this allowance has been frozen at the same amount since 2012. Public Act 102-1037, signed into law this past summer, will incrementally increase the amount of resources a community spouse is allowed to retain as their CSRA, until the year 2034, when it will be fully realigned with the then current federal maximum allowance.)
2. CCRCs (Continuing Care Retirement Communities) — Older adults who want to stay in one place as their care needs progress can reside in continuing care retirement communities, which provide different levels of care as their medical and care needs change. Residents can start out living independently and then receive assisted living or nursing home care when required.
3. CMS (Centers for Medicare & Medicaid Service) — CMS is the federal agency that regulates Medicare, Medicaid, and Children’s Health Insurance Programs, as well as the Federally Facilitated Marketplace, an online health insurance marketplace.
4. DPA (Durable Power of Attorney) — Using a DPA, you can appoint a trusted individual to manage your health care decisions or financial decisions in the event that you cannot make choices for yourself. A health care agent can make decisions about what kind of care you receive, whereas a financial agent can help manage your finances and pay your bills. Having a durable power of attorney in place can help you avoid needing a guardian in the future if you become incapacitated.
5. GAL (Guardian ad Litem) — When the court has concerns about a person’s ability to handle their personal or financial affairs, it can appoint a guardian ad litem to advocate for the individual’s best interests.
6. IRA (Individual Retirement Account) — Individual Retirement Accounts are accounts that allow individuals to save money for retirement on a tax-free or tax-deferred basis. Traditional IRAs use tax-deductible income and are tax-deferred, whereas Roth IRAs use post-tax income and are not taxed upon withdrawal.
7. MMNA or CSMMNA (Monthly Maintenance Needs Allowance / Community Spouse Monthly Maintenance Needs Allowance) — When one spouse goes on Medicaid and enters a nursing home and the other remains at home, federal spousal impoverishment rules provide that the spouse remaining in the community can retain a certain amount of the couple’s income.
The Minimum Monthly Maintenance Needs Allowance is the minimum amount of the couple’s income the spouse who remains at home must receive. When the healthy spouse’s income falls below the minimum, the spouse receiving Medicaid can give a portion of their income to the community spouse. (Note: In Illinois, this allowance has been frozen at the same amount since 2012. Public Act 102-1037, signed into law this past summer, will finally give the citizens of Illinois a much needed raise. On January 1, 2023, Illinois will realign the CSMMNA with the federal maximum allowance. The new federal maximum allowance, and now Illinois CSMMNA for 2023 will be $3,715.50.)
8. POLST (Practitioner's Order for Life Sustaining Treatment - previously known, in Illinois, as a Do Not Resuscitate Order "DNR" order) — Among other decision, a POLST allows individuals to choose not to have physicians prolong their lives with CPR or cardiopulmonary resuscitation. The person as well as their physician must sign the order. A POLST differs from Health Care Powers of Attorney and from Living Wills. POLSTs are specific to CPR, whereas a Health Care Power of Attorney provides one's health care decisions to be made by an agent and living wills allow individuals to state whether or not they want general medical care to prolong their lives.
9. SNF (Skilled Nursing Facility) — Individuals with acute illnesses and injuries can recover in skilled nursing facilities, which are short-term rehabilitation centers. Skilled nursing facilities provide skilled nursing that meets residents’ unique needs and are distinct from nursing homes, which provide long-term care.
10. SSA (The United States Social Security Administration) — The Social Security Administration regulates Social Security retirement, survivor, and disability insurance benefits programs. It is the agency responsible for allocating the Supplemental Security Income program for individuals with disabilities and assigning Social Security numbers.