Legal – Medicaid Long-Term Care Benefits

Legal – Medicaid Long-Term Care Benefits

‘Tis Better to Give than Receive, but … It’s the giving season. Whichever holiday you celebrate, most enjoy showing their affection by giving gifts to loved ones. For larger families, these gifts can amount to a lot of money each year.

And that’s wonderful, but if you might need to apply for Medicaid long-term care benefits, you need to be careful. Giving away money or property can jeopardize your eligibility. Here’s why you need to speak with an experienced elder care/elder law attorney about gifting.

If you give assets away to someone other than your spouse within five years before applying for long-term Medicaid, you might be ineligible for benefits. Medicaid pays for some or all your care at home, in an Assisted Living Community, or in a Nursing Home.

The length of time you’ll be ineligible depends upon how much you give away. Even small gifts affect eligibility. The 2017 IRS rules allow gifts up to $14,000 a year, but Medicaid rules allow the government to deny benefits anyway.

And there is no exception for gifts to charities. So, gifts for holidays, weddings, birthdays, and graduations could all cause ineligibility. If you buy something for a friend or relative, this could also result in a denial.

If you face this problem, you can overcome it, but you’ll need help. To overcome a denial, you’ll have to prove by “clear and convincing evidence” that the purpose of the gift had nothing to do with becoming eligible for Medicaid. “Clear and Convincing” is almost the same as “Beyond a Reasonable Doubt.”

So, before giving away assets or property, check with your elder law attorney to ensure that it won’t affect your Medicaid eligibility. Contact us today with any questions you may have.

Two Under-Used VA Pension Benefits That Can Help Pay for Long-Term Care Needs

Two Under-Used VA Pension Benefits That Can Help Pay for Long-Term Care Needs

We know that Florida seniors often find themselves in a difficult situation. As their health care and living expenses increase, their ability to work and generate income decreases. It is an unsettling scenario, but one that the Veterans Administration may be able to help with for those eligible for VA pensions.

A VA pension is a tax-free monetary benefit paid to low-income wartime vets who are either age 65 or older, disabled, living in nursing homes, receiving Social Security Disability Insurance or Supplemental Security Income. An additional, and under-used, type of pension benefit that all impacted veterans should be aware of is called Aid and Attendance. This is available for veterans and the surviving spouses of veterans whose unreimbursed medical expenses exceed their monthly income. The purpose is to provide financial assistance for those who need help performing activities of daily living.

If you are not sure if you or your loved one qualifies, consider contacting an accredited VA attorney to help determine your eligibility or for information about how to access the VA Pension with the Aid and Attendance benefit. Remember, veterans whose income is above the limit for a VA pension also may qualify if they have large medical expenses that are not reimbursable. Your VA accredited attorney can discuss with you options to become eligible or how to find the long-term care support you need.

Aid and Attendance support is available for vets who served at least 90 days, with at least one day during wartime. It is not reserved for those with service-related disabilities. Veterans, and their surviving spouses, are eligible if they meet the above criteria and if they need aid from another person to help them perform basic living activities, such as:

  • Assistance with personal care needs, like bathing, dressing and using the bathroom.
  • Living in a nursing home.
  • Are mentally or physically incapacitated.
  • If they are bedridden.
  • Suffer from extremely poor eyesight.

A second long-term care benefit tied to the VA Pension program is known as the Housebound Allowance. This underused pension feature offers an additional monthly monetary benefit for veterans who are significantly restricted to their homes because of a permanent disability. Eligibility rules may require a written statement from a doctor describing a qualifying vet’s needs and limitations and you will want to discuss this with your VA accredited attorney as well.

Finally, Aid and Attendance and Housebound Allowance benefits are paid on top of monthly pension payments. This means that they increase the overall pension amount, making people who are not normally eligible for a basic VA pension due to excessive income potentially eligible for these long-term care items.

We know this article may raise more questions than it answers for you. We encourage you to ask us your questions this Veterans Day or, at any time, schedule a consultation with attorney Scott Selis to get the elder care support you need.

Can I Receive Dental and Vision Coverage through Medicare

Can I Receive Dental and Vision Coverage through Medicare

Original Medicare coverage, also known as Medicare Parts A and B, is reserved for what’s considered “medically necessary” health care. In other words, care that’s required to diagnose or treat an illness or condition. What this means is that, unfortunately, dental and vision care does not fall into Medicare’s medically necessary framework.

So are seniors just out of luck? Not at all!

There are two main ways to obtain important dental and vision coverage. One is through Medicare Advantage, or Part C. Another is through supplemental coverage.

Medicare Advantage is an alternative to Original Medicare, with approved coverage plans being administered through private insurance companies. While these plans must offer the same basic hospital and medical services coverage as Parts A and B, they can also offer more options on top, such as prescription drug coverage, and dental and vision benefits.

Keep in mind that Advantage plans’ costs and coverage features may depend on where you live and what plan you choose. They may also require a monthly premium.

Medicare supplemental insurance, sometimes called Medigap, is another avenue to secure dental and vision coverage. It helps pay for items Original Medicare does not cover. This can include deductibles, copays and coinsurance for doctors’ visits, hospital stays, and other medical services. It is also issued by private insurance companies.

While Medigap itself may not provide dental and vision coverage, certain insurers can offer their Medicare supplemental insurance customers additional options for dental and vision care, or discount programs to help save money on dental and vision costs. Supplemental insurance plans can also depend on where you live, although unlike Medicare Advantage, coverage is standardized by the federal government.

One of the best ways to explore supplemental insurance offerings in your area is to log on to Medicare “Medigap Policy Search” webpage and type in your zip code. The site provides plan details from insurance companies.

The online Medicare “Plan Finder” tool is also a great way to search for the right Medicare supplemental insurance plan. It also offers search assistance for Medicare Advantage plans.

For most people, and especially for senior citizens, dental and vision coverage is just too important not to have. Exploring Medicare Advantage and Medicare supplement insurance options can help you get the services you want and need. Do you not wait to find the answers you need during this Medicare Open Enrollment Period, which will end on December 7th of this year.

We know that this article may raise more questions than it answers for you. Do not wait to contact our office and schedule meeting with Attorney Scott Selis.