Medicaid and Medicare Open Enrollment: Remember Medicare is Not Medicaid

Medicaid and Medicare Open Enrollment: Remember Medicare is Not Medicaid

Do you get mixed up between Medicaid and Medicare? During Medicare’s Open Enrollment Period, it is important to remember that Medicare is not Medicaid.  Let us highlight four differences to keep in mind.

1. Qualifications. Medicare covers adults aged 65 and older and individuals younger than 65 with a qualifying disability. Medicaid, on the other hand, is generally available to individuals of all ages based upon qualifying low-income. Another important difference in coverage is that Medicare only provides coverage for individuals, it does not offer family plans. Medicaid, however, can provide coverage for qualifying families.

2. State v. Federal. Medicare coverage plans are more uniform because it is run through the federal government. Medicaid benefits can vary state to state because it is a state run program governed by federal guidelines.

3. Cost. Medicare recipients pay premiums, deductibles, and some out of pocket costs depending on their plan. Medicaid recipients do not pay for coverage, although they may have small co-pays in some states for certain services.

4. Coverage. Medicare is meant for acute health issues and does not cover long-term inpatient care or nursing home care. Medicaid can assist qualifying individuals with long-term care while also providing coverage for routine medical care. Unfortunately, there are many times when families are forced to navigate the muddy waters between where Medicare stops and Medicaid begins when dealing with an elderly relative’s acute health issue that has turned into a long-term care problem. For example, consider the scenario of an elderly relative suffering a fall and breaking her hip. Now this relative needs surgery to repair the hip and then requires long-term care because she will not recover from the surgery successfully enough to be able to ever live independently again.  If this elderly relative is on Medicare, her Medicare plan will cover the surgery and perhaps some of her rehabilitation, but she will need Medicaid coverage to cover her long-term care. Oftentimes, obtaining this coverage can be difficult and confusing. This is just one of the many examples of why it is beneficial to have a comprehensive plan in place to address the possibility of requiring long-term care. 

For help understanding Medicaid and Medicare benefits as well as planning for long term care coverage, please feel free to reach out to our office with any questions or concerns you may have.

Can Mom Get All of Dad’s Income? Yes! How to do It.

Can Mom Get All of Dad’s Income? Yes! How to do It.

THE BACKGROUND STORY

A few times every year, I visit with an adult child and their mother at my office. They explain that “Dad” is in a nursing home, and isn’t able to come home. They realize that the safest place for him is in a nursing home. But Mom can’t afford the $8,500.00+ monthly cost of nursing home care, and she thinks that they have too much money to get medicaid. Mom also mistakenly thinks all of Dad’s income would go to the nursing home. Needless to say, she’s scared.

Like so many others, the family believed one of many Medicaid Myths. First of all, they don’t have too much money to qualify for Florida Medicaid. Mom is allowed to have $128,640, and she has less than that. Sure, Dad’s income is too high for Florida Medicaid’s Income limit of $2,349.00, but there’s a workaround called a Qualified Income Trust.

WILL MOM GET ALL OF DAD’S INCOME?

It’s true that much of Dad’s income will go to the nursing home, at first. However, there are affordable legal steps that will help Mom get ALL of Dad’s income. With our help, Mom will likely not worry about paying bills or choosing between groceries and medications. And the best news, she can sleep comfortably knowing that her husband is safe and that she’s financially secure.

LET’S BAKE THE CAKE

Here’s how we do it. We go to Court and prove that Mom can’t live on the meager amount of Dad’s Income that Medicaid allows. We prove that Dad wants his income to go to Mom instead of the Nursing Home. Dad even has a separate lawyer to represent his interests.

As long as the numbers align (and we don’t file until they do), the Judge will grant Mom’s request that all of Dad’s income go to Mom. And Medicaid has to honor the court order. We then inform Medicaid about the Court’s decision and Viola! Mom gets the rest of Dad’s Income.

If you’d like to meet with us to discuss this subject, call 386-256-1443, text us @ 386-855-8976, or visit our contact page to send us a message. We’d love to help you.

How to Understand if You or a Loved One are Having Aging Issues

How to Understand if You or a Loved One are Having Aging Issues

Collectively, Americans are getting older.  As a result, experts predict a significant shift in demographics in the next fifteen years. They say by 2035, the number of people in the United States age 65 and older will greatly outnumber the number of people here age 18 and under. They also say by 2030, all Baby Boomers will be at least 65. In other words, 1 out of every 5 Americans will be eligible to retire in ten years.

As a result, there is heightened public awareness about age-related issues. Being properly informed can help you recognize when you or a loved one may need help. It will also allow you to address age-related relevant concerns such as a potential need for long-term care.

With a bit of luck, you and your loved ones will be happy and healthy well into your older years. With time, however, you may succumb to some of the common effects of aging or you may already be experiencing them. These can include, but are not limited to, physical ailments such as:

  •     Diminishing eyesight

Hearing loss

  •     Brittle bones
  •     Loss of strength
  •     Limited mobility

as well as cognitive impairment, such as:

  •     Memory loss and personality changes not related to Alzheimer’s Disease
  •     Memory loss and personality changes related to Alzheimer’s Disease and similar conditions

 Other issues impacting Older Americans include grief, especially following the loss of a spouse, social isolation following retirement, and loneliness. These issues can exacerbate chronic and underlying health conditions. They can also cause anxiety, depression, and even over-reliance on alcohol or medication. They can also make you more susceptible to criminal activity, such as fraud and other forms of financial exploitation.

We know that this blog may highlight concerns you are having for yourself or for a loved one.  Remember, it is never too soon to start asking questions and get the support you need in your local community. Long-term care challenges are not easy but we can work together to develop a plan for what is ahead. We routinely work with seniors and their loved ones, and encourage you to schedule a meeting to discuss these, as well as other, important issues.

Ways to Find the Right Nursing Home for You and Your Loved Ones

Ways to Find the Right Nursing Home for You and Your Loved Ones

For most of us, the idea of moving to a nursing home can be a difficult subject to discuss. Whether you are a Florida senior who needs to consider moving out of the home or an adult child looking to help your aging parent, you may be confused as to where to start. Where do you find the information you need? How do you know how to choose the right facility for you? How will you be able to afford it?

We deal with each of these questions on a daily basis when we work with our clients and their loved ones. We know the challenges you face and want to be able to help you navigate these issues. 

As you complete your research on finding the right nursing home for you or a loved one, you need to have the right tools to review and compare the places you are considering. Medicare does have a resource for you. Medicare has created the Nursing Home Compare Tool. According to Medicare, when using this tool, you may find “detailed information about every Medicare nursing home in the country.” You can perform a search using city, state, and zip code features.

Recently, The Center for Medicare and Medicaid Services (CMS) has made an effort to give consumers even more critical information. We have been watching these chances that were announced to be put into play this year. CMS reported that updates were coming “to Nursing Home Compare and the Five-Star Quality Rating System to strengthen this tool for consumers to compare quality between nursing homes.”

How does this work? According to The Center for Medicare and Medicaid Services:

“Nursing Home Compare has a quality rating system that gives each nursing home a rating between 1 and 5 stars. Nursing homes with 5 stars are considered to have above average quality and nursing homes with 1 star are considered to have quality below average. There is one Overall 5-star rating for each nursing home, and a separate rating for each of the following three factors:

Health Inspections: Inspections include the findings on compliance to Medicare and Medicaid health and safety requirements from onsite surveys conducted by state survey agencies at nursing homes.

Staffing Levels: The staffing levels are the numbers of nurses available to care for patients in a nursing home at any given time.

Quality Measures: The quality of resident care measures are based on resident assessment and Medicare claims data.”

Further, on October 7, 2019, CMS announced more enhancements where “CMS will display a consumer alert icon next to nursing homes that have been cited for incidents of abuse, neglect, or exploitation.  According to CMS, this critical move toward improved transparency is yet another way the Agency is delivering on its five-part approach to ensuring safety and quality in nursing homes.”

We know this article may raise more questions than it answers. We also know the challenges you face when searching for nursing home care for yourself or a loved one. We encourage you not to wait to reach out to us and schedule a meeting to find answers to your questions.

5 Ways to Help Protect Your Loved Ones from Elder Abuse

5 Ways to Help Protect Your Loved Ones from Elder Abuse

On June 15, citizens worldwide will commemorate World Elder Abuse Awareness Day to help bring awareness to the millions of older adults subject to elder abuse, neglect, and exploitation each year. According to the Department of Health and Human Services, 2.1 million older Americans are mistreated annually, and that’s just the beginning. For every case of elder abuse reported, as many as five more remain unreported.

 

How do we protect our Florida loved ones from becoming the next unsuspecting victim of elder abuse? We want to share with you some simple steps that you can take to help protect your loved ones from harm.

 

1. Be proactive. Even if your loved one is in good health, being prepared in the event of an emergency will provide you both with some comfort. Encourage your loved one to establish an agent through his or her Durable Power of Attorney, designate a health care surrogate, and create a living will or a trust before an emergency occurs or his or her mental capacity diminishes. Work with your loved one and his or her attorney now to plan for any long-term care decisions that may need to be made in the future. These crucial legal decisions can help protect your loved one’s assets and simplify any future legal needs.

 

2. Stay informed.  Make a point to visit your loved one often. By keeping in regular contact, you will recognize changes in behavior and have an opportunity to step in and take over affairs if necessary. Be involved, ask direct questions, and pay attention. Asking simple questions – for example, did you make this transaction? Or how did you get that bruise? – may reveal underlying issues and provide your loved one with a reliable outlet to express his or her concerns.

 

3. Know the signs. Elder care abuse typically begins with isolation. It’s crucial to have access to your loved one at any time of day or night. Not being allowed to meet with your loved one alone, unexplained signs of injury, or your loved one being taken to multiple medical facilities for treatment may signal that abuse is occurring. Keep in mind that abuse is not always physical. Neglect, emotional abuse, and financial exploitation are all forms of elder care abuse.

 

4. Check-in regularly, even from afar. If you live in a different state from your aging parent, you may not be immediately available to address any sudden changes in his or her health or daily needs. Many long-distance caregivers seek help from geriatric case managers and elder care law attorneys to oversee the day-to-day financial, medical, and long-term care concerns of their loved ones. Establishing a local support system is crucial. In addition to your elder care attorney,  recruit the help of local neighbors, family, and friends to check in on your loved one every day or two. If the time comes that a caring neighbor isn’t enough, you may wish to consider long-term care options to ensure your loved one is receiving more assistance than can reasonably be provided at home and we can guide you through this process.

 

5. Know when to take further action. Remember, at all times we are a resource for you. Further, if you suspect your loved one is in immediate danger, don’t hesitate to call 911 or report the suspected abuse. If you don’t believe the danger is immediate but suspect abuse is occurring, voice your concerns to adult protective services, the state ombudsman, or involve the local police department. When it comes to protecting your loved one, no measure is too extreme.

 

Does this article raise more questions than it answers for you? We know how to plan for the elder care law needs of you and your Florida loved ones. Do not hesitate to contact our office to schedule a meeting about your planning needs.

How Do We Protect Seniors During National Elder Law Month?

How Do We Protect Seniors During National Elder Law Month?

Each month, many of us worry how to best ensure that our older parents who live alone in Florida are safe. This starts with making sure that our senior loved one has the Florida estate and long-term care planning he or she needs to protect him or herself now, and well into the future.

 

While for many of us it is enough to have basic estate planning in place, this is not the case for Older Americans living in Florida. “Older Americans” are the generation of individuals who are over 60 years of age. These seniors especially need to prepare for a time when they may need long-term care assistance outside the home.The cost of long-term care continues to rise and Florida seniors are at risk of losing all of their assets if they do not plan ahead for long-term care.

 

The rising cost of long-term care is just one type of protection that Florida seniors need. Today, the scams that target Older Americans continue to be on the rise. Each month, there are new scams that emerge that specifically target elders. Let us help you protect yourself and the seniors you love by sharing several of the most common scams with you.

 

1. Medicare scams. No matter what month of the year it is, Medicare scammers continue to target Older Americans. These scammers have a variety of ways to interact with their intended senior victims. Discussions of copayments, coverage, and medication, are just the beginning. They reach out to seniors in numerous ways including through the mail and phone scams. As a senior, be wary of any call or piece of mail you receive claiming to be from Medicare.

 

2. Hurricane insurance companies. Insurance scams are especially on the rise in Florida. In the wake of recent hurricanes, seniors not only need to watch out for false construction repair companies but also for companies trying to sell them fraudulent insurance policies. Although hurricane insurance can have a significant value for you and your senior loved ones, before providing any financial information to a policy that you believe would help you, do your research. Investigate to make sure that the company is a real company and is not attempting to scam you.

 

3. Jury Duty Scams. Recently, more and more jury duty scams are on the rise. This type of scam focuses on telling seniors that they have to call in and report for mandatory jury duty. This phone number, may try to extort money from the senior or obtain access to private information. This scam may also track the senior’s phone number and collect any data that he or she may give. Be extremely suspicious of any piece of mail that you receive and call your local courthouse before responding or taking any action.

 

Do not wait to take action to protect your aging parents from threats like these listed in this article. Seniors need more protection. Do not wait to contact us and let our form protect you and the Older Americans you love most.