How to Become an Organ Donor

If you want to become an organ donor, you need to communicate your wishes.
If you want to become an organ donor, you need to communicate your wishes.

If you want to become an organ donor, you should communicate those wishes to the people who will carry them out.

Organ donation is one of the most regulated aspects of the healthcare industry, and the legalities of being an organ donor have very unique considerations. Essentially, organ donation is the physical transfer of the body parts of a person (the donor) to another person through surgical means. Organ donation can occur during the donor’s lifetime or at the organ donor’s death. Here we’re focusing primarily on the transfer of organs at the time of the organ donor’s death.

Although the need for organ donations is exceptionally high worldwide, the supply is often low. The lack of clearly communicated and documented consent by a potential organ donor is one of the most common challenges to organ donation. Despite an individual’s desire to donate organs, a failure to follow the right protocol can render the individual’s decision unenforceable.

What You Can Donate

Scientific advancements now allow for a single donor to donate organs to up to seventy-five donees. Organ donors can provide their kidneys, liver, heart, lungs, and pancreas. Donors can also donate tissue such as bone, skin, tendons, corneas, bone marrow, and stem cells. There are even instances where hands and feet have been successfully transferred. However, for many of these organs, the transfer must be initiated within twenty-four hours. Additionally, each potential donor must be evaluated on a singular basis with respect to the particular organ at issue.

Alternatively, some donors are interested in donating their entire body to scientific research. If you are interested in this route, you must be careful to avoid organ donation opportunities because scientific research requires complete bodies. In such instances, identifying the scientific institute you are interested in donating to and working with that institute directly is the best method. As you work with them, be careful to document your specific intent to donate your remains to science.

Making Your Wishes Known

There are a number of ways to make your wishes regarding organ donation known and increase the likelihood that they will be enforced. The most effective approach is a comprehensive one. This involves registration as a donor, legal planning, and communication of your wishes. The first and most important step is registering as an organ donor, which you can do in two ways: (1) find your state’s unique registry on www.organdonor.org and register online or (2) register at your local department of motor vehicles. In the latter scenario, your license will likely state that you are an organ donor.

The next step you can take is ensuring your wishes are recorded in your estate planning documents. An advance healthcare directive and living will are key documents that can include your end-of-life wishes. Finally, to ensure that your wishes are known, communicate them to your friends and family. These are the people who will end up intimately involved with your end-of-life decisions. Carefully select your healthcare agent and clearly communicate to that agent your desire to donate your organs.

It is important to note that the steps described above should not be taken in isolation. This is particularly true regarding your estate plan and communication of your wishes to friends and family. If there are conflicts between your plan and what family members think your wishes are, some states give greater weight to the documents memorializing your wishes. Your estate plan should contain your wishes, as well as information on any donor registrations you have made. Your documented wishes should then be expressed to those closest to you and who will carry out your wishes after you pass away.

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Estate Planning with a Business

Estate planning with a business addresses owner succession, protecting assets and the smooth operation of the business.

Estate planning with a business is different. If you have children, ownership shares in a business, or even in more than one business, a desire to protect your family and business if you became disabled, or charitable giving goals, then you need an estate plan attuned to those needs. The recent article “Estate planning for business owners and executives” from The Wealth Advisor explains why business owners, parents and executives need estate plans.

An estate plan is more than a way to distribute wealth. It can also:

  • Establish a Power of Attorney, if you can’t make decisions due to an illness or injury.
  • Identify a guardianship plan for minor children, naming a caregiver of your choice.
  • Coordinating beneficiary designations with your estate plan. This includes retirement plans, life insurance, annuities and some jointly owned property.
  • Create trusts for beneficiaries to afford them asset or divorce protection.
  • Identify professional management for assets in those trusts if appropriate.
  • Minimize taxes and maximize privacy through the use of planning techniques.
  • Create a structure for your philanthropic goals.

An estate plan ensures that fiduciaries are identified to oversee and distribute assets as you want. Estate planning with a business especially focuses on managing ownership assets, which requires more sophisticated planning. Ideally, you have a management and ownership succession plan for your business, and both should be well-documented and integrated with your overall estate plan.   See here for a deeper dive into business succession planning.  https://www.galliganmanning.com/business-succession-planning-in-your-estate-plan/

Some business owners choose to separate their Power of Attorney documents, so one person or more who know their business well, as well as the POA holder or co-POA, are able to make decisions about the business, while family members are appointed POA for non-business decisions.

Depending on how your business is structured, the post-death transfer of the business may need to be a part of your estate planning with a business. A current buy-sell agreement may be needed, especially if there are more than two owners of the business.

An estate plan, like a succession plan, is not a set-it-and-forget it document. Regular reviews will ensure that any changes are documented, from the size of your overall estate to the people you choose to make key decisions.

Reference: The Wealth Advisor (July 28, 2020) “Estate planning for business owners and executives”

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Medicare Basics: What to Know

Many clients who are retiring or suffering job loss face key decisions about their healthcare. These Medicare basics will help make those decisions.

Medicare is a commonly misunderstood government benefit.  With so many baby-boomers retiring and especially with the impact of COVID-19 on the economy, many clients are faced with important decisions on their healthcare.  For that reason, I wanted to cover some Medicare basics to help readers understand these issues.

If you’re 65 or older and lose your job, you can keep your employer-based health insurance under a federal law known as COBRA. However, it also could be more expensive. In addition, COBRA coverage isn’t qualifying insurance in place of Medicare, and if you miss some deadlines for enrolling in Medicare without having the right coverage, you could pay life-lasting penalties, explains CNBC’s recent article entitled “What to know about getting Medicare if you are 65 or older and lost your job.”

Another critical Medicare basic is that Medicare isn’t free. However, if you find yourself currently with no employer-based insurance, it may be your best option. There are also ways to lower your costs, if your income has dropped a lot.

Provided that you have at least a 10-year work history, you’ll have no premiums to pay for Medicare Part A, which covers hospital stays, skilled nursing, hospice and certain home health services. If you don’t satisfy the eligibility requirements for it being premium-free, you could pay up to $458 per month for coverage. Either way, Part A’s deductible is $1,408 per benefit period, with some caps on benefits.

Part B covers outpatient care and medical supplies. It has a standard monthly premium of $144.60 in 2020, but higher earners pay more. There is also a $198 deductible in 2020. Once you meet the deductible, you’ll typically pay 20% of covered services. You are allowed eight months to sign up for Part B, once you lose workplace coverage.

You can get a standalone plan to have with original Medicare, or you can get an Advantage Plan (Part C). These plans are offered by private insurance companies and typically include prescription drug coverage. If you select this, your Parts A and B benefits will be delivered via the insurer offering the plan (which may or may not have a premium).

A Part D drug plan covers prescriptions. The average cost for this coverage in 2020 is roughly $42 a month, but high earners pay extra for their premiums. The maximum deductible for Part D is $435 in 2020.

If you already have Part A and are enrolling in Part B because of a job loss, there is a form that you and your ex-employer should complete to avoid late-enrollment penalties, by making certain that you had qualifying coverage during the period of time you were eligible for Part B but weren’t enrolled.

Another important issue of Medicare basics is what Medicare excludes from cover.  Consider how you’ll pay for items like dental work, routine vision, or hearing care. It also excludes long term care, cosmetic procedures and overseas medical care.  Clients often mistaken the skilled nursing facility rehab component of Medicare with long term care insurance, so see here for more detail on that.  https://www.galliganmanning.com/long-term-care-whats-it-all-about/ 

Seniors frequently use original Medicare and a supplemental policy (“Medigap”) to help cover out-of-pocket costs, such as deductibles and coinsurance. Medigap policies are standardized, regardless of which insurance company sells them and your location. However, the premiums can differ from insurer to insurer and among locations. Therefore, it is critical that you know the differences you may see when evaluating your options. Look at a carrier’s premium rating system, its claims history and its customer service ratings.

If you go with an Advantage Plan, dental and vision coverage may be included. Note that these plans have their own copays, deductibles and out-of-pocket maximums.

Reference: CNBC (June 26, 2020) “What to know about getting Medicare if you are 65 or older and lost your job”

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