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Government Benefits

Statewide Medicaid Managed Care (SMMC) – Managed Medical Assistance Program

By Asset Protection Planning, Government Benefits, Long-Term Care, Medicaid Planning

Statewide Medicaid Managed Care (SMMC) is the program where most Medicaid recipients receive their Medicaid services.

There are two different parts that make up the SMMC program:

  • The Managed Medical Assistance (MMA) Program
  • The Long-term Care (LTC) Program

Medicaid recipients who qualify and become enrolled in MMA will receive all health care services (other than long-term care) from a managed care plan. Medicaid recipients who qualify and become enrolled in LTC will receive long-term care services from a Long-term Care managed care plan.

What does the Statewide Medicaid Managed Care program provide?

Medicaid members receive their health care services through a managed care plan. MMA plans cover services such as prescriptions, doctors’ visits and hospital stays.

All MMA plans offer the following health care services:

  • Advanced Registered Nurse Practitioner
  • Ambulatory Surgical Center Services
  • Assistive Care Services
  • Behavioral Health Services
  • Birth Center and Licensed Midwife Services
  • Chiropractic Services
  • Dental Services
  • Child Health Check Up
  • Immunizations
  • Emergency Services
  • Emergency Behavioral Health Services
  • Family Planning Services and Supplies
  • Healthy Start Services
  • Hearing Services
  • Home Health Services and Nursing Care
  • Hospice Services
  • Hospital Services
  • Laboratory and Imaging Services
  • Medical Supplies, Equipment, Prostheses and Orthoses
  • Optometric and Vision Services
  • Therapy Services
  • Physician Assistant Services
  • Physician Services
  • Podiatric Services
  • Prescribed Drug Services
  • Renal Dialysis Services
  • Clinic Services
  • Transportation Services

Medicaid applicants will receive a letter once you are approved for Medicaid informing them of the MMA plan the state has enrolled them with. Applicants are allowed to switch to an alternate plan in the first 120 days.

If you have specific questions regarding your Medicaid eligibility, the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

June 23, 2020
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Statewide Medicaid Managed Care (SMMC) – Long-term Care Program

By Asset Protection Planning, Government Benefits, Long-Term Care, Medicaid Planning

In 2011, the Florida Legislature created a new program called the Statewide Medicaid Managed Care (SMMC) program.

There are two different programs that make up the Statewide Medicaid Managed Care:

  • The Long-term Care (LTC) Managed Care Program
  • The Managed Medical Assistance (MMA) Program

Medicaid recipients who qualify and become enrolled in the Statewide Medicaid Managed Care – Long-term Care program will receive long-term care services from a long-term care managed care plan. Medicaid recipients who qualify and become enrolled in the Statewide Medicaid Managed Care – Managed Medical Assistance program will receive all health care services other than long-term care from a managed care plan.

What does the Statewide Medicaid Managed Care program do?

Medicaid recipients will receive their long-term care services from a managed care plan. These managed care plans will cover long-term care services only and do not cover medications, doctor’s visits or other healthcare related services.

All long-term care managed care plans offer the following services:

  • Adult Companion
  • Adult Day Care (Adult Day Health Care)
  • Assistive Care Services
  • Assisted Living Facility Services
  • Attendant Care
  • Behavior Management
  • Caregiver Training
  • Case Management
  • Home Accessibility Adaptation
  • Home Delivered Meals
  • Homemaker
  • Hospice
  • Intermittent and Skilled Nursing
  • Medical Equipment & Supplies
  • Medication Administration
  • Medication Management
  • Nursing Facility Care
  • Nutritional Assessment and Risk Reduction
  • Occupational Therapy
  • Personal Care
  • Personal Emergency Response System
  • Physical Therapy
  • Respiratory Therapy
  • Respite Care
  • Speech Therapy
  • Transportation

The state will send Medicaid recipients a letter notifying them as to whether or not they are required to enroll in Florida’s Statewide Medicaid Managed Care – Long-term Care program and provide a list of plans for their specific region.

If you have specific questions regarding your Medicaid eligibility, the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

June 22, 2020
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How to Get on the Florida Medicaid Waiver Wait List

By Asset Protection Planning, Elder Law, Government Benefits, Long-Term Care, Medicaid Planning

In Florida, the Medicaid program that helps pay for long-term care in an assisted living facility or at home is called the Long-Term Care Diversion Waiver. There is a waitlist for this program. In order to get on the waitlist, you will need to do the following:

  1. Call your local Area Agency on Aging and request a “screening for home and community-based services.” Each county in Florida is assigned to an Area Agency on Aging. Your local agency can be found here.

The representative will collect some preliminary information and will schedule a time for the phone screening with the individual requiring assistance, primary caregiver ,or closest family member.

  1. Complete the screening interview. The interview usually lasts about 30 to 40 minutes. The interview covers basic demographic information for the applicant, as well as information regarding the applicant’s income and assets. The interviewer will also ask about the applicant’s needs for care, including the applicant’s ability to perform Activities of Daily Living. It is important to be honest and provide the interviewer with all health and care issues no matter the extent of the issue.
  2. Following the interview, you should receive a prioritization decision. This letter indicates the applicant’s priority score, which determines their place on the waitlist. The higher the score, the higher the priority the applicant receives on the waitlist.
  3. At this point, you do not actually need to submit a Medicaid application, so you do not need to be technically asset or income qualified for Medicaid. However, it is important to have a plan in place to become income and asset qualified for Medicaid, so that you are ready to apply when the applicant receives a spot off the waitlist. If the applicants’ condition deteriorates while on the waitlist, you can request a re-assessment to move higher up on the waitlist.
  4. Once you receive notification that the applicant has received a spot off the waitlist, you will be provided with a deadline to submit the Medicaid application.

If you have specific questions regarding preserving your Medicaid eligibility, the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

June 19, 2020
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Beware of Coronavirus Related Scams in Florida

By Elder Law, Long-Term Care

The IRS is warning taxpayers to be on the lookout for scams related the Coronavirus, or COVID-19, which can lead to tax-related fraud and identity theft. The IRS and its Criminal Investigation Division have seen a new wave of phishing schemes against taxpayers.  Senior citizens are among the most vulnerable to these scams and should be especially careful during this time.

In its press release, the IRS reminded taxpayers that the IRS is never going to call you asking to verify or provide your financial information so you can get an economic impact payment or refund faster.  Taxpayers should watch out for emails, text messages, websites, and social media attempts that appear to be from the IRS and request money or personal information. If you receive an email that appears to be coming from the IRS, do not open it or click on attachments or links. You should go to the IRS official website, www.IRS.gov for the most up-to-date information.

The IRS also provides the following items to keep in mind, in order to protect yourself and your loved ones:

  • Scammers may emphasize the words “stimulus check” or “stimulus payment.” The official term is economic impact payment.
  • Scammers may ask the taxpayer to sign over the economic impact payment check to them.
  • Scammers may ask by phone, email, text, or social media for verification of personal and/or banking information, saying that the information is needed to receive or speed up their economic impact payment.
  • Scammers may suggest that they can get a tax refund or economic impact payment faster by working on the taxpayer’s behalf. This scam could be conducted by social media or even in person.
  • Scammers may mail the taxpayer a bogus check, perhaps in an odd amount, then tell the taxpayer to call a number or verify information online in order to cash it.

 

Taxpayers who receive unsolicited emails, text messages, or social media attempts to gather information that appear to be from the IRS should forward it to [email protected].

Fred Jacobs is a Florida Board Certified Tax Lawyer and Sean Byrne is an elder law litigator.  Contact Fred or Sean at Bach, Jacobs & Byrne, P.A. if you or a senior you know has been the target of elder exploitation or needs assistance with tax matters. Call (941) 906-1231 to schedule an appointment.

June 9, 2020
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Can a Florida Nursing Home or Assisted Living Facility Take My Stimulus Check?

By Elder Law, Government Benefits, Long-Term Care

The recently enacted federal Coronavirus Aid, Relief, and Economic Security (CARES) Act provided for a direct payment of up to $1,200.00 to most taxpayers, including many residing in nursing homes and assisted living facilities. Unfortunately, the Federal Trade Commission has received several reports of nursing home and assisted living facilities requiring their residents who are on Medicaid to sign over the stimulus funds to the facility. There have been reports of facilities claiming that because the resident is on Medicaid, the facility gets to keep their stimulus payment. This claim is not true.

According to the CARES Act, the stimulus payments are a tax credit. Under the Internal Revenue Code, tax credits do not affect eligibility for federal benefits programs, like Medicaid, and they are not counted as a resource that an individual must use to pay for those benefits.

Because most nursing homes and assisted living facilities are currently closed off to the public due to COVID-19, it can be more difficult to monitor your loved one’s finances. If you are managing a facility resident’s financial affairs (such as an agent under power of attorney) or your loved one lives in a nursing home or assisted living facility and you are not sure what happened to their stimulus payment, talk to the facility’s management.

If you find out that a Florida nursing home or assisted living facility has taken your loved one’s stimulus payment, you should report it to the Florida attorney general’s office immediately and file a complaint with the Federal Trade Commission.

If you have specific questions regarding your stimulus payment and preserving your Medicaid eligibility, the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

June 8, 2020
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How much of my income should be deposited into the Qualified Income Trust?

By Asset Protection Planning, Medicaid Planning

The Trustee must deposit the amount of the Medicaid recipient’s income that exceeds the income cap into Qualified Income Trust (QIT) each and every month.  In 2020, the gross monthly income cap is $2,349.00. So, for example, if the Medicaid recipient’s gross monthly income was $4,000.00, the Trustee would need to deposit a minimum of $1,651.00 into the QIT each month.  If the Medicaid recipient’s gross monthly income was $4,500.00, the Trustee would need to deposit a minimum of $2,151.00 into the QIT each month.  In order to account for any discrepancies or fluctuations that may arise in monthly income, we always advise our clients to deposit more than the minimum amount each month.

Properly managing and funding a QIT is very important for maintaining Medicaid Eligibility.  If you have specific questions regarding funding a Qualified Income Trust account or your duties as the Trustee of a Qualified Income Trust, the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

May 29, 2020
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Opening the Qualified Income Trust Bank Account

By Asset Protection Planning, Elder Law, Medicaid Planning

Opening the Qualified Income Trust Bank Account

Once a Qualified Income Trust (QIT) has been prepared and signed, the Trustee must establish and maintain a separate bank account in the name of the QIT. The account can be established at any banking institution. Prior to going the bank to open the account, it is a good idea to call your bank and make an appointment. It helps to explain the situation before you arrive for the appointment, so that the bank representative will know what your purpose is and will be better equipped to help you.  When you call to make the appointment, explain that you, as Trustee of a Trust, will be setting up a checking account and making a deposit. Explain that it is not a trust account, but just a regular checking account that happens to be in the name of a trust.  Make sure that the bank can offer you a checking account that is non-interest bearing, and that you do not need to keep any minimum amount in the account at any given time.

The QIT account should be titled in the name of the Trust, for example, “Jane Doe Qualified Income Trust Dated __________, 2020” or “John Smith, Trustee of the Jane Doe Qualified Income Trust Dated ________, 2020.” A QIT is a “grantor trust”, which means that for tax reporting purposes, the trust’s finances are the same as the Settlor’s finances. Therefore, the bank should use the Social Security Number of the Settlor (the Medicaid recipient).

Make sure you bring the original Trust Agreement and your Driver’s License or other government issued photo identification with you to the bank to open the checking account. The bank can make a copy of the Trust, but you should not relinquish possession of the original Trust.

If you have specific questions regarding setting up a Qualified Income Trust account or your duties as the Trustee of a Qualified Income Trust, the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

May 26, 2020
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My Dead Relative Received a Stimulus Check. How Do I Return It?

By Elder Law, Government Benefits, Probate, Tax Law

According to the IRS, stimulus payment made to someone who died before receiving it should be returned to the government. If the payment was made to a single filer, the entire payment should be returned. If the payment was made to joint filers, and one spouse had not died before the receipt of the payment, only the portion of the payment made on account of the decedent should be returned. This amount will be $1,200.00, unless the joint adjusted gross income exceeded $150,000.00.

If the payment was a paper check and you have not cashed it:

  1. Write “Void” in the endorsement section on the back of the check.
  2. Mail the voided Treasure check to the appropriate IRS location, based on your state of residence. This information can be found at https://www.irs.gov/coronavirus/economic-impact-payment-information-center#more. If you live in Florida, the check should be mailed to:

         Austin Internal Revenue Service

3651 S. Interregional Hwy

Austin, TX 78741

  1. Do not staple, bend, or paperclip the check.
  2. Include a note stating the reason for returning the check.

If the payment was a direct deposit, or if the payment was a paper check and you have cashed it:

  1. Submit a personal check, money order, etc., payable to “U.S. Treasury,” immediately to the appropriate IRS location, based on your state of residence. This information can be found at https://www.irs.gov/coronavirus/economic-impact-payment-information-center#more. If you live in Florida, the check should be mailed to:

         Austin Internal Revenue Service

3651 S. Interregional Hwy

Austin, TX 78741

  1. Write “2020EIP” and the deceased recipient’s social security number on the memo line of the check.
  2. Include a brief explanation of the reason for returning the payment.

Fred Jacobs is a Florida Board Certified Tax Lawyer.  Contact Fred at Bach, Jacobs & Byrne, P.A. to discuss tax planning for you and your family. Call (941) 906-1231 to schedule an appointment.

May 20, 2020
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My Dead Relative Received a Stimulus Check. Can I keep it?

By Government Benefits, Probate

There have been a number of glitches in sending stimulus payments to Americans under the recently enacted CARES Act, including sending stimulus payments, which are intended to ease the financial stress caused by the Coronavirus, to dead people. Initially, this issue left many unanswered questions for the relatives of the deceased. What should I do with the money? Do I get to keep it? Should it be deposited into an estate account? Should I send it back? However, now, the IRS has issued specific guidance on what to do if you receive a stimulus check for a deceased person.

According to the recently released guidance, the IRS says that a stimulus payment made to someone who died before receiving  should be returned to the government. If the payment was made to a single filer, the entire payment should be returned. If the payment was made to joint filers, and one spouse had not died before the receipt of the payment, only the portion of the payment made on account of the decedent should be returned. This amount will be $1,200.00, unless the joint adjusted gross income exceeded $150,000.00.

Fred Jacobs is a Florida Board Certified Tax Lawyer.  Contact Fred at Bach, Jacobs & Byrne, P.A. to discuss tax planning for you and your family. Call (941) 906-1231 to schedule an appointment.

May 19, 2020
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How Do I Replace My Medicare Card?

By Asset Protection Planning, Elder Law, Long-Term Care, Medicaid Planning

If your Medicare card has been lost, stolen, or damaged, you have three options to replace it:

  • Call the National Security Hotline at 800-772-1213
    • You will need to provide your:
      • Name as it appears on your most recent Social Security card;
      • Social Security number; and
      • Date of birth.
    • Hours of Operation: Monday-Friday 7:00 a.m.- 7:00 p.m.
  • Apply for a new card online
    • Go to https://secure.ssa.gov/RIL/SiView.do
    • If you don’t already have an account, you can create one online. Go to Sign in or Create an Account.
    • Once you are logged in to your account, select the “Replacement Documents” tab. Then select “Mail my replacement Medicare Card.”
    • Your Medicare card will arrive in the mail in about 30 days at the address on file with Social Security.
    • You can only create an account using your own personal information and for your own exclusive use. You cannot create an account for another person or using another. person’s information or identity, even if you have that person’s written permission.
  • Go to your local Social Security office
    • You can find your local Social Security office and their hours by entering your zip code at https://secure.ssa.gov/ICON/main.jsp
    • Make sure to bring a government issued photo ID, and your Social Security number.

If you have specific questions regarding asset protection planning and Medicaid eligibility, the experienced elder law attorneys of Bach, Jacobs & Byrne, P.A. are here to assist you. Call us at (941)906-1231 to set up a consultation.

May 15, 2020
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