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Monthly Archives

July 2014

What To Do When Your Child Turns 26 While On Your Health Insurance Plan

By Medicare

Q.  My adult daughter and I are covered through my husband’s employer. Our daughter turns 26 this summer, but I thought we couldn’t sign up under the Obamacare Health Insurance Marketplace until open enrollment later this year. What is she supposed to do between her summer birthday and the Obamacare open enrollment in November?

A.   Now that your daughter is turning 26, she will eventually need to get her own plan.  The Affordable Care Act allows her to stay on her parents’ plan only until she is 26.   Here are a few things to do and/or consider:

1. Check with your husband’s employer to find out exactly when your daughter will lose her coverage.  It may be on her birthday this summer or it may be at the end of the plan year.

2. If your daughter wants to stay on your husband’s plan as long as possible, she may be able to extend it for up to 18 months under the federal law known as COBRA. Just know that she would be responsible for paying the entire cost of her premium, which could be expensive.

3  If her own job does not provide health insurance coverage, your daughter can apply for an individual plan using the federal health insurance marketplace.  Because Florida refused to enact its own state insurance marketplace, citizens of Florida have to use the federal site at healthcare.gov.  It doesn’t matter that she’s applying prior to the November “open enrollment period”.  Because she’s losing her coverage under your plan, she’ll be eligible for a special enrollment period.   Note that she may be eligible for premium tax credits to make coverage more affordable if her income is between 100 and 400 percent of the federal poverty level (as of July 2014 the range is $11,490 and $45,960 for a single individual).

If you are an employer or a family looking to apply for health insurance coverage under the Affordable Care Act and have questions about the tax incentives available, call Bach & Jacobs and make an appointment with Board Certified Tax Lawyer Fred Jacobs by calling (941) 906-1231.

July 29, 2014
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How Does Your State Rank Regarding Long Term Care?

By Long-Term Care

A:  A new study from AARP indicates long term care varies dramatically in cost and quality depending on where a person lives in the United State.  You can find the ‘scorecard’ that ranks all the states based on 26 different variables here: http://www.longtermscorecard.org/ Unfortunately, Florida ranks in the bottom 25% based on the study’s criteria.

All the more reason to have a Board Certified Elder Lawyer advise you about your options.  You can listen to a recent NPR story about the study here: http://www.npr.org/blogs/health/2014/06/19/323356217/how-your-state-rates-in-terms-of-long-term-care.

To make an appointment with Board Certified Elder Lawyer Babette B. Bach, contact Bach & Jacobs today.

July 25, 2014
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What Happens If An Employer Discontinues Retiree’s Health Insurance Plan?

By Elder Law, Health, Medicare

Kaiser Health News recently answered readers’ questions about the Affordable Care Act and the federal Marketplace exchange, which has caused a lot of confusion for folks.  Here’s an excerpt From: http://www.kaiserhealthnews.org/Stories/2014/May/20/Andrews-IYH.aspx?p=1
Q:   I will be retiring this year from my company, before age 65. My company is dropping retiree health care in January, stating that retirees younger than 65 can elect coverage through the exchanges. Will the company be required to offer COBRA starting in January? I fear that coverage will be expensive through the exchanges since we will not be eligible for any subsidies due to my husband’s $200,000 income. He’s self-employed and covered under my company’s health plan.
A:  In general, if an employer discontinues its retiree plan, it’s not required to offer retirees the opportunity to extend their coverage for up to 18 months under the federal law known as COBRA, according to a Treasury Department official. The cancellation of your retiree plan will create a special enrollment opportunity for you to sign up for a plan on the health insurance exchanges. You won’t need the special sign-up period; however, since January is midway through the annual open enrollment period that runs from Nov. 15 through Feb. 15 when people can change plans anyway.
As you note, you won’t be eligible for subsidized coverage on the exchange because your husband’s income exceeds 400 percent of the federal poverty level ($62,920 for a couple next year). But it’s worth checking out plans on the marketplace anyway, says Laurel Lucia, a policy analyst at the Center for Labor Research and Education at the University of California, Berkeley. Depending on your health needs, a marketplace plan might be a better fit. “The typical job-based plan resembles a gold or platinum marketplace plan, but on the marketplace they’d have the option of buying silver and bronze level plans as well,” she says. Many individuals find the costs of Marketplace plans are much more affordable than COBRA plan rates.

July 23, 2014
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AHCA Issuing New Increased Penalty Divisor for Medicaid

By Government Benefits, Medicaid Planning

The State of Florida Agency for Health Care Administration (AHCA) confirmed an expected increase in the 2014 average private pay daily rate for nursing home care.  The new number is $262.14, an increase from $250.42 last year.  This means the estimate of the new penalty divisor for Medicaid is expected to be about $7,995.00. It will take DCF several months to process the rule change implementing the new penalty divisor.  You can read a draft copy of the AHCA study here: http://origin.library.constantcontact.com/download/get/file/1110588872530-130/2014+Private+Pay+Rate+as+determined+by+AHCA.pdf

 

July 8, 2014
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Florida Increases Medicaid Personal Needs Allowance

By Government Benefits, Medicaid Planning

The State of Florida has enacted a new law that will increase the Personal Needs Allowance for Medicaid recipients from $35.00 to $105.00, the first increase in the history of the Medicaid Institutional Care Program in the state.  The increase will become effective on July 1, 2014. The increase is in line item #239 in the General Appropriations Act (HB 5001), which was not among the line items vetoed by the Governor.  $14,189,102 from the General Revenue Fund and $21,246,910 from the Medical Care Trust Fund are provided to increase the PNA for residents in institutional settings.

July 1, 2014
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