If you have a family member who is suffering from some form of dementia, you know how financially difficult providing quality care can be. According to a study published this month in the New England Journal of Medicine, the financial burden on the nation as a whole is staggering, with the costs now exceeding those of both heart disease and cancer. [Read more…]
Medicaid Patients Risk Eviction
Some residents of assisted living facilities who are covered by Medicaid are at risk of being evicted if they leave the facility for a period of time – even if they leave merely for a temporary hospitalization.
This is a significant problem that seniors should be aware of when they are planning for long-term care.
In general, Medicaid will pay nursing homes to hold a room for a Medicaid recipient who is temporarily absent due to a hospitalization. This entitles the resident to return to the first-available room.
However, most states don’t make similar “room-hold” payments to assisted living facilities. And there is no law requiring assisted living facilities to give priority to returning residents.
As a result, even if an assisted living resident leaves for only a short hospital stay, the facility could refuse to accept the resident once he or she is ready to return. The resident might end up having to find a nursing home instead.
Although the federal government has authorized state Medicaid programs to make “room-hold” payments to assisted living facilities, only a handful of states (including Georgia, Illinois, Montana, and Washington) have adopted such programs so far.
Should you have any questions about your Medicaid planning to avoid eviction, contact Attorney Kristina Vickstrom at 508-757-3800.
[photo credit: MyFutureDotCom]
Five Things to Discuss With Your Spouse to Develop a Retirement Plan
You may have a vision for your retirement plan, but does your spouse share that vision?
A recent study by Fidelity Investments shows that many couples are not in accord about their retirement plan. For example, one-third of couples approaching retirement disagree about or don’t know where they are going to live after they retire, and 62 percent don’t agree on their expected retirement ages.
Here are some important things to discuss with your spouse as you get ready retire and develop a retirement plan:
1. When to stop working. Many factors go into a decision about when to retire, including job enjoyment and financial needs. But you’ll also want to include in your retirement plan how to maximize your Social Security benefits. There are a number of different strategies for when each spouse should file for various types of benefits, and couples who do it wrong can leave a lot of money on the table.
2. Finances. Both spouses need to understand their financial situation to develop a retirement plan. The survey found that very often, one spouse is much less involved in planning retirement finances than the other, and might not be ready to manage financial affairs should the need arise.
3. Lifestyle. Do you want to travel? Volunteer? Or relax on a beach somewhere? It’s important to have a conversation about your hopes and dreams for retirement. You can start by creating individual wish lists and then comparing them when developing your retirement plan.
4. Health care. Make sure you and your spouse have adequate health care coverage, either from Medicare or an employer-based plan. You’ll also need to understand the rules regarding Medicare coverage and when to sign up for it.
5. Long-term care. Unfortunately, one or both spouses will likely need some type of long-term care at some point. There are things you can do to make it easier on yourself if the need arises. Talk to your elder law attorney about putting a plan together – doing it early will save lots of headaches and expense later.
Hopefully your respective visions for your post-career life are similar. When you’ve taken these steps, it’s now time to put your dream plans in motion. To ensure that your long-term care plans for retirement are met, it’s vital that you speak with a qualified elder law and estate planning attorney so your wishes are always met.
Contact us when you are ready to make your retirement plan a reality.
Settlement Over the Medicare Improvement Standard Will Improve Coverage for Some
If you, or a loved one, depend on Medicare for ongoing care of a chronic or degenerative disease, you may be familiar with the Medicare Improvement Standard.
Medicare is health national insurance for people over age 65, the disabled, or those with end stage renal disease. For decades, the Medicare Improvement Standard meant that coverage for physical, occupational and speech therapy and some inpatient skilled nursing was denied by contractors processing claims for many people who had reached a plateau in their treatment, that is to say, for those who were not improving.
Medicare is supposed to pay for reasonable treatment as long as a doctor has prescribed it. For in-home care, a doctor must have certified that you are, in fact, homebound and have prescribed treatment that only a skilled practitioner can provide. This “skilled practitioner rule” keeps Medicare from paying for assistance with everyday activities like bathing and dressing.
Consider the case of Glenda, she is 76 and rendered disabled by diabetes. She is both blind and has suffered amputation of a leg and several toes. She was the lead plaintiff in the case that led to the settlement, and under the Medicare Improvement Standard, had been denied coverage of the skilled care she needed due to the fact that her condition was chronic and did not improve. This unofficial policy has been frustrating to many. It is often painfully obvious that those suffering chronic or degenerative diseases will not and cannot improve. But, the kind of skilled care covered by the Medicare Improvement Standard settlement can stabilize or slow the progression of such diseases. These patients can now prevent painful and costly complications.
The Medicare Improvement Standard settlement requires the Centers for Medicare and Medicaid Services to clarify to their contractors that home and nursing home therapy and nursing services for Medicare beneficiaries are not dependent “on the presence or absence of a beneficiary’s potential for improvement from the therapy (and nursing care), but rather on the beneficiary’s need for skilled care.” This language also pertains to outpatient therapy services. This clarified policy is know as the “maintenance coverage standard.”
The Center for Medicare Advocacy, co-counsel for the Plaintiffs, stresses that the new standard applies now, and that Medicare patients denied coverage under the old “medicare improvement standard” should advocate for themselves and appeal those denials.
It is important to remember that this Medicare Improvement Standard settlement does not affect the need for long-term care planning. Without careful planning you may still have to pay for years in a nursing home when you can no longer handle basic tasks of daily living and staying in your home is no longer practical.
If you, or a loved one, would like more information about long-term care planning contact us. Proficient in Estate Planning, Elder Law and Long-Term Care/Medicaid (MassHealth) Planning, Attorney Kristina Vickstrom can help you understand your rights and any remedies that may be available to you.
When it Could be OK to Give Assets Away When Planning for Long Term Care (Nursing Home)
Not long ago, I posted a blog on gift transfers and their affect on qualification for MassHealth (Medicaid) for an institutionalized individual. Generally, transferring assets to dispose of property so that you qualify for MassHealth will not actually help you qualify because the state imposes a five-year “look-back” period, in which those assets are counted and used to assess eligibility for MassHealth. Fortunately, there are some exceptions to the general rule. [Read more…]
