Author Topic: Making a Will or Trust With Minor Children + Medical Needs  (Read 674 times)

la Condessa

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Making a Will or Trust With Minor Children + Medical Needs
« on: December 16, 2023, 11:56:43 AM »
My husband and I are planning on doing a will or maybe a trust, and I was wondering what we should put in particular into it about medical care.  We will soon have six kids.  My 9-year-old son has cancer.  He will most likely survive, but he will need medical monitoring and possibly physical therapy forever, and he will probably need repeated bouts of intensive cancer treatments with breaks in between into early adulthood.  His type of cancer generally becomes much less aggressive around the mid- to late-twenties, so if he makes it to around 29 or 30, his medical needs should lighten up significantly then. 

We want the kids to go to my sister and brother-in-law, with my parents’ assistance, if something were to happen to us.  All our assets go towards first, providing for the kids, second, their educations, and third, (if anything is left at that point) divided equally among them.

We have double insurance for son9, both private and state, and it has done well at mostly covering his medical care.  I do have some concerns about when he ages out of being allowed on a parent/guardian’s insurance at age 26, maybe just coming out of school or maybe not done yet, and maybe still in the midst of this long fight against cancer.

My sister and bil’s family have very high deductible insurance through his work that they basically never use because they never meet the deductible.  If they were our kids’ guardians and our kids’ qualification for state insurance were based on their income, ds would not qualify.  Unless CA has an exemption from income requirements for diagnosis that would allow him to have it, or if the qualifications are different for kids you become the guardian of than kids you are the parent of?

My parents’ insurance might be better, so making them the guardians might be better in that way, but while they are very young for their age, they are in their later sixties and will hopefully retire before too much longer. 

What special considerations would you make in a will for a kid’s medical condition?  Maybe we should delay distributing the remainder after education costs to the kids until ds is older, beyond the window of when his cancer is likely to cause problems, so it would be there for medical needs first?  That might put my oldest into her mid-thirties before it was finally distributed.  Not that I am sure that there will be a remainder.  We don’t have a ton of assets, raising and educating six kids is expensive, and raising a kid with cancer is more expensive.  I hope that with the life insurance it would be enough that it wouldn’t be a financial burden on the guardians, but I could certainly imagine the money running out before everyone’s higher education is covered, depending on how soon a tragedy occurred and how expensive medical care runs in the ensuing years. 

My parents would absolutely help in every way, financial and childcare and medical appointments.  My husband’s parents intend to give him an inheritance someday that would go to our kids if something happened to him.  I don’t think they would help with the regular needs of our kids growing up, but the kids could later pay off student loans and medical bills with that inheritance money if what we left for them didn’t go far enough.

Any thoughts on how to best structure this?

Sibley

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Re: Making a Will or Trust With Minor Children + Medical Needs
« Reply #1 on: December 16, 2023, 06:03:10 PM »
You need a lawyer, and one experienced in setting up this sort of thing. This is a complicated situation and if the will/trust were to be used, messing it up could have serious consequences. This is NOT a DIY thing.

Some things to think about:
-setting up unequal inheritances can cause serious problems with future relationships. Now, your son didn't choose to have cancer but that doesn't lessen the potential impact it can have on the rest of the family. If his medical costs exhaust potential education funds for his siblings, that will have a real consequence.
-You've got 6 kids. If something happened to you, are you sure your sister could take them all? That's a huge ask, and even if she's willing that doesn't mean she actually could. Also, just because your will states you want the kids to your sister the court may decide otherwise. No idea how often it happens, but it is a possibility.
-You're relying on your parents. By definition, they are older than you are, and are getting older every day. Just because they're willing to help doesn't mean they'd be able to help.
-Principles and values are going to be more helpful in navigating the shifting landscape of life than specific rules. This however may not be appropriate to write out in a legal document, so maybe you need to write a separate document detailing out those values and thought processes. Ask the lawyer.
-You're making assumptions about potential medical insurance that you shouldn't make. BIL's insurance is x now. That could change next year. Or never. State insurance might drop the kids, or it might not. You need some more facts about the state insurance at a minimum.

la Condessa

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Re: Making a Will or Trust With Minor Children + Medical Needs
« Reply #2 on: December 16, 2023, 08:08:16 PM »
You need a lawyer, and one experienced in setting up this sort of thing. This is a complicated situation and if the will/trust were to be used, messing it up could have serious consequences. This is NOT a DIY thing.

Some things to think about:
-setting up unequal inheritances can cause serious problems with future relationships. Now, your son didn't choose to have cancer but that doesn't lessen the potential impact it can have on the rest of the family. If his medical costs exhaust potential education funds for his siblings, that will have a real consequence.
-You've got 6 kids. If something happened to you, are you sure your sister could take them all? That's a huge ask, and even if she's willing that doesn't mean she actually could. Also, just because your will states you want the kids to your sister the court may decide otherwise. No idea how often it happens, but it is a possibility.
-You're relying on your parents. By definition, they are older than you are, and are getting older every day. Just because they're willing to help doesn't mean they'd be able to help.
-Principles and values are going to be more helpful in navigating the shifting landscape of life than specific rules. This however may not be appropriate to write out in a legal document, so maybe you need to write a separate document detailing out those values and thought processes. Ask the lawyer.
-You're making assumptions about potential medical insurance that you shouldn't make. BIL's insurance is x now. That could change next year. Or never. State insurance might drop the kids, or it might not. You need some more facts about the state insurance at a minimum.

-We already have to deal with the effects of unequal use of financial resources.  Raising a kid with cancer definitely affects how much we are able to put away for the kids’ futures each month.  Unpleasant as it might be, a parent’s responsibility to keep a child alive is more important than a parent’s desire to give their kids a leg up in life.  We certainly want to divide what we have to give towards our kids’ higher educations equally among them, but medical needs have to come first.
-My husband is an attorney.  He has done a number of wills for clients before, but never dealt with a situation with minor heirs with uneven needs.  He hasn’t done a trust before, so if we decide that is what we need, we may need to hire a different attorney.
-My sister and brother-in-law are some of our best friends, and have five kids of their own, who are mostly older than our kids (my oldest daughter and my youngest nephew are 14 and almost exactly the same age, their other kids are 16, 17, and young adults).  We have a similar arrangement in their will for us + my parents to care for their kids if something were to happen to them.  They are great parents with a very large house who are quite well off.  My bil is a successful dermatologist.  They could and would provide for our kids themselves, if needed, but of course we would prefer to leave enough so that would not be necessary if at all possible, so that their excess means go to their own kids someday rather than be spent on raising ours.
-My parents being older is definitively a consideration in why we’re thinking we’d probably make my sis and bil the guardians with their help, and not the other way around, even though my sister also has minor kids and it would be a very full house.  Even though my parents are currently very physically able, we don’t know how long that will last.
-I can see that specific rules would be burdensome on future guardians.  We have a lot of faith in the principles and values of my sister and bil.  We are pretty in alignment when it comes to parenting values.  I do think we might need to outline our preferences with son9’s long term care, like no radiation in his spine before he’s reached his adult growth unless doctor says it’s the last recourse, while making it clear that we trust them to make final decisions. 
-The medical insurance is such a big factor in trying to estimate whether we are leaving enough to provide for them, and it’s so variable.  I need to find out more about the state insurance in sis & bil’s state, but that’s only one piece of trying to estimate this cost.

Sibley

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Re: Making a Will or Trust With Minor Children + Medical Needs
« Reply #3 on: December 16, 2023, 08:49:56 PM »
Rock and hard place, I get it. Just be aware of the relationship consequences, because awareness means you can try to mitigate.

Great that your husband is an attorney. Still not a (complete) DIY thing. There is a reason why doctors aren't allowed to treat family members, and that reason applies here. Neither of you can 100% think dispassionately about this. 95% isn't 100%, and your kids need 100%. You need that independent viewpoint, and since your husband is a lawyer that means he should have an easier time finding someone who has the proper experience. Your husband can probably do a good chunk of the work, but planning and review is where you want someone independent. Better to poke holes in the plan now than have your kids find out the hard way.

And obviously, don't forget to update the plan as time goes on. What makes sense now may not make sense in 5 years and won't make sense in 20 years. But hopefully these documents will never be needed.

While you're on the estate planning track - bug all the grandparents to make sure they've done their planning.

Hope there's medical advancements which help your son, and good results from treatments.

Just_Me

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Re: Making a Will or Trust With Minor Children + Medical Needs
« Reply #4 on: December 16, 2023, 09:27:19 PM »
This is an incredibly challenging situation and kudos for trying to do the best for your kids. Just a couple of thoughts about the whole situation.

- Don't forget about social security payments upon death of a parent if there is credit

- Go talk to 3 estate attorneys. You are committed to ensuring the best medical care for DS9 while you are alive, and you are 100% committed to making that determination outlive you. You can't do that without their help.

- Sister and BIL may not take this as serious as you do. Talk to them about it. Several times. While unlikely, it is a plausible scenario they would have to manage. They need to provide input to you on how to develop the estate plan.

- don't forget about Medicaid if there are insurance gaps. In CO, I have called several times about eligibility scenarios and they have been able to provide answers.

Best of luck.
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la Condessa

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Re: Making a Will or Trust With Minor Children + Medical Needs
« Reply #5 on: December 18, 2023, 03:02:20 PM »
Thank you both for your input. 

Lots of research to do.

 

Wow, a phone plan for fifteen bucks!