The Importance of a Good Medicare Supplemental Policy (Part 2)
Last week I was telling you about a call I received from Mary. Her husband, John had a heart attack which led to other medical complications. Long story short he had been in the hospital for 4 months and was now close to exhausting his Medicare coverage under Part A, exposing them to hospital bills in the tens of thousands of dollars or more. How is that possible? Let’s look at how Medicare Part A coverage works. Medicare will cover up to 90 days of hospitalization for a single benefit period. There is a deductible of $1316 for days 1 thru 60. Days 61 thru 90 carry a coinsurance charge of $329/day. For the first 90 days of John’s hospital stay the out of pocket cost to Mary and John was $11,186. If a hospital stay lasts more than 90 days, there are an additional 60 days of coverage under a lifetime reserve. As the term “lifetime” suggests, this is a onetime 60 day term. John is in danger of running thru all his lifetime days. These additional 60 days of coverage also come with a coinsurance charge of $658 per day. That totals $39,480 out of pocket. Mary
The Importance of Having a Medicare Supplement (Part 1)
Since a large majority of our clients are over the age of 65 or disabled and receiving Social Security, those clients also receive Medicare benefits. Medicare does not cover long term care so as elder law attorneys we don’t spend much time addressing Medicare questions and problems. However, I do get questions from clients who are turning 65 about what to choose when it comes to sufficient coverage. There are gaps in Medicare coverage so a comprehensive supplemental or “Medigap” policy is important to fill those gaps. We refer these questions to knowledgeable insurance professionals who focus on the Medicare supplement market and are very adept at finding the right policy for clients. A call I received not too long ago highlights the importance of these supplemental policies. Mary called because her husband John, age 75, was in the hospital. He had a heart attack which led to further complications caused by diabetes. The result is that he has been in the hospital for an extended period of time. Mary told me that he has been hospitalized for 4 months now and is within 30 days of using up his Medicare lifetime reserve days. Mary and John have more
What to Do When You Have No One to Help (Part 2)
Last week I presented to you the hypothetical, but very common case, of Jane who is in the hospital and has acute and chronic health issues. She has no family or she is estranged from her family. The immediate problem is that she has no designated person to act on her behalf as agent under her power of attorney or as health care representative under her health care directive. Her current mental and physical state is such that she can’t make the many decisions large and small that the hospital staff – doctors, nurses and social workers – need her to make with regard to her treatment and discharge plan. So to whom can she turn? Before I answer that question let’s talk about what kinds of decisions will need to be made? If Jane is in the midst of a serious medical crisis, doctors and nurses will administer whatever treatment is necessary to stabilize Jane if she is in immediate danger. The need for a decision maker doesn’t stop there, however. If Jane is elderly and has chronic health issues tough questions remain concerning her discharge plan. Can she go home alone or will she need supervised care?
What to Do When You Have No One to Help
I have written often about the need for everyone to have a support system in place in the event of a crisis. Think about whom you would turn to if you needed help. For most people it would be family, a spouse, child, grandchild, sibling, niece or nephew. But, what if you have no one? What would happen in that case? What kind of crisis am I talking about and what might it look like? Usually the issues come to a head because of a medical crisis. Let’s look at Jane Doe, who is admitted to the hospital because of an acute medical condition or injury. If Jane is 70 years of age or older she very well could have a mental impairment. It could be a direct result of an illness such as dementia or Alzheimer’s disease. It could be a result of trauma from a fall or a side effect of the combination of medications she is taking or has stopped taking. It could be that Jane is mentally competent but a physical ailment prevents her from attending to her needs. Whatever the reason, Jane is now in the hospital and needs care. As anyone who has
New Medicaid and VA Figures for 2017 #2017Medicaidnumbers
It’s time to update the numbers for many of the government programs that affect our clients’ lives and that we work with so often. I am talking about cost of living adjustments for the new year. For 2017, the Social Security Administration announced that Social Security recipients will receive a small .3% increase, after receiving no increase last year. Because Medicaid and the VA Aid and Attendance program adjustments are tied to the same percentage increase, this means that those benefits will also increase by .3%. So here are the numbers you need to know for 2017. The Medicaid income cap will go up slightly to $2206 per month. This number is the limit on income per month needed to qualify for most Medicaid programs. For Medicaid recipients whose income exceeds this limit a Qualified Income Trust (commonly known as a Miller Trust) must be used to achieve and maintain eligibility. The Community Spouse Resource Allowance (CSRA) will increase to $120,900. That is the maximum amount a healthy spouse may keep in countable assets (provided the married couple have at least that amount times 2 at the time the “snapshot of assets” is taken). The minimum CSRA is $24,180, meaning
Important Change to Special Needs Trust Law
In 1993 Congress enacted a law commonly referred to as OBRA 1993. The law contained major changes to the Medicaid laws. Included in the law was a provision permitting the creation of a special needs trust for disabled individuals under the age of 65, into which could be placed the disabled individuals own assets so he/she could preserve Medicaid eligibility. This type of trust is known as a “d(4)(A) trust, a reference to the section of the law which created it. It is also referred to as a 1st party special needs trust because the assets place into the trust are the disabled individuals own assets. These trusts have particular importance to disabled individuals who have received inheritances from family members or others that were not placed into what are known as 3rd party special needs trusts. They are also helpful to disabled individuals who have received personal injury settlements. In both instances, the SNT allows them to use the funds in the trust to improve their quality of life without sacrificing government assistance which pays for basic living , medical and/or long term care expenses. A quirk in the law, however, existed for 23 years. OBRA 1993 provides