The Latest Republican Efforts to Repeal and Replace Obamacare
Several months ago I wrote about the first attempt to repeal and replace Obamacare since the 2016 elections, which failed. The latest attempt, revived by New Jersey Congressman Tom MacArthur, passed thru the House of Representatives. The Senate, in secret meetings that have stirred more controversy, put out its own version which has yet to be voted on. The Congressional Budget Office has estimated that more than 20 million people will lose health care coverage if Obamacare is repealed and the Senate version is adopted. The Senate bill includes cuts in Medicaid funding. Remember that part of Obamacare includes an option for states to expand their Medicaid programs with additional federal funds to support that expansion. New Jersey took full advantage of Medicaid expansion. The question I am repeatedly asked is, “what does this mean for Medicaid?” – meaning the Medicaid programs that cover long term care. It is still too early to tell with any certainty what Congress and President Trump will actually get passed into law – since compromises along the way can dramatically change things. We can, however, look at what is currently on the table. The Senate version of health care reform changes Medicaid to
Assisted Living Medicaid is Still Not Retroactive (Part 2)
Last week I was telling you about an important difference between assisted living Medicaid and nursing home Medicaid. I explained this to my client but she heard – or thought she heard – something different from the facility. I had said that ALF Medicaid is not retroactive, meaning if I apply for Medicaid in June and am financially eligible for June but Medicaid doesn’t approve the application till December I won’t get Medicaid to start paying until December. The 5 month gap is something I or my family must pay at the facility’s private pay rate. My client called me a few weeks later to tell me that the facility said there is “gap coverage” for this period. That didn’t sound right to me so I called the facility. Sure enough there was a misunderstanding. The facility representative was talking about something entirely different. Let me explain. A few years ago New Jersey Medicaid went to managed care. After Medicaid is approved it can take a few months until managed care kicks in – until the MCO starts paying. During that “gap” period the State will cover the cost. As is common with Medicaid, how everything works is so
Assisting Living Medicaid is Still Not Retroactive (Part 1)
There are some very important differences in the Medicaid regulations and coverage for nursing home vs. ALF Medicaid. ALF Medicaid is a community based “waiver” program. It is not part of the basic Medicaid coverage that all states must agree to provide when they accept federal funds. Rather, this is additional coverage that they can choose to offer or not. So, what do I mean when I say that ALF Medicaid is not retroactive but nursing home Medicaid is? Let’s say I apply for Medicaid on June 15 and I want Medicaid to start paying for my care on June 1. I must meet all the eligibility requirements as of May 31 in order to be eligible for coverage on June 1. However, it may take 6 months or longer for the State to review my application and approve it. If my application is not approved until December and I am in a nursing home applying for “nursing home Medicaid” then the approval will be retroactive to June 1. I can even seek coverage back another 3 months to March, again, if I have met all financial and other eligibility requirements as of February 28. On the other hand,
Sobering Story About Lack of POA
June is a month for celebrations. Whether it’s friends or family it seems there is always a prom, high school or college graduation or wedding to celebrate every year. It’s the good stuff in life. While I certainly don’t want to ruin the party, this week I do want to share a call we received last week. Monica called concerning her son, Jay who is 22 years old. Two weeks before he his college graduation he was in a serious car accident. After being hospitalized for a few weeks he is now moving to a long term care facility. Monica explained that he sustained a brain injury and doctors have told her he has a long road to recovery. She called us because Jay does not have a financial or medical power of attorney. Monica and her husband are running into problems making decisions on his behalf - both financial and medical - and right now Jay is not yet competent to execute any documents on his own behalf. Guardianship for Jay is the only option. I have written in this blog a number of times about why you want to avoid a guardianship. (See 10-14-12 post.) It is
Anatomy of a Scam
As far as scams go, it is not one that will cause anyone to lose their life savings. Maybe calling it a scam is not entirely accurate. At the very least the letter Joan received was misleading and confusing. As part of an asset protection plan we placed Joan’s home into a trust. We prepared a deed which Joan signed and we recorded it with the Register of Deeds in the county where the home is located. Once we received the deed back we sent it to Joan. A few months later Joan received a letter from the “Local Records Office”, in connection with the “recently recorded deed” to her home, which of course was the one we recorded. The letter stated that for a $100 fee they would send her “a copy of the only document that identifies Joan as the property owner” as well as a “complete property profile”. The letter does not explain what this profile is exactly. Joan called us confused as to whether she needs what this company is offering. She does not. I have received similar calls from clients for years. These services have been around for quite a while. They are required
Dad Gets Knocked Off of Medicaid (Part 2)
Last week I was telling you about John’s dad who was about to be knocked off of Medicaid. His mom had recently died. Her will stated that should Dad survive Mom her estate would pass to him. Included in the estate was the marital home which she was able to keep as an exempt asset when he applied for Medicaid. That’s because she continued to make it her home. The company John hired to file the Medicaid application advised them to remove Dad’s name from the deed. So why was he now about to lose Medicaid? Because he was about to receive the home under her will. Since he is in a nursing home and not living in the marital home it is now a countable asset for him. The State of New Jersey gave him 2 very unappealing options. Option 1 is to sell the home and turn over all the proceeds to the state and remain on Medicaid. If, however, Dad dies and it turns out that the amount in Medicaid benefits he received is less than the money John turned over, there will be no refund. The state gets